CANCER B.

Carcinogens
• Cancer is a class of diseases characterized by out-of- • Carcinogens are a class of substances that are directly
control cell growth, with the capacity of invading the responsible for damaging DNA, promoting, or aiding
neighboring parts of the affected area spreading to other cancer. Tobacco, asbestos, arsenic, radiation such as
organs. There are over 100 different types of cancer, and gamma and x-rays, the sun, and compounds in car exhaust
each is classified by the type of cell that is initially affected. fumes are all examples of carcinogens.
• Cancer harms the body when damaged cells divide C. Genes - the family type
uncontrollably to form lumps or masses of tissue called • Cancer can be the result of a genetic predisposition that is
tumors (except in the case of leukemia where cancer inherited from family members. It is possible to be born
prohibits normal blood function by abnormal cell division with certain genetic mutations or a fault in a gene that
in the blood stream). Tumors can grow and interfere with makes one statistically more likely to develop cancer later
the digestive, nervous, and circulatory systems, and they in life.
can release hormones that alter body function. Tumors that D. As we age, there is an increase in the number of possible
stay in one spot and demonstrate limited growth are cancer-causing mutations in our DNA.
generally considered to be benign. E. Several viruses have also been linked to cancer such as: human
• More dangerous, or malignant, tumors form when two papillomavirus, hepatitis B and C and Epstein-Barr virus,
things occur: Human immunodeficiency virus (HIV) - and anything else
• A cancerous cell manages to move throughout the body that suppresses or weakens the immune system - inhibits the
using the blood or lymph systems, destroying healthy tissue body's ability to fight infections and increases the chance of
in a process called invasion. developing cancer.
• That cell manages to divide and grow, making new blood
vessels to feed itself in a process called angiogenesis. How is cancer classified?
• When a tumor successfully spreads to other parts of the There are five broad groups that are used to classify cancer.
body and grows, invading and destroying other healthy 1. Carcinomas are characterized by cells that cover internal
tissues, it is said to have metastasized. This process itself is and external parts of the body such as lung, breast, and
called metastasis, and the result is a serious condition that colon cancer.
is very difficult to treat. 2. Sarcomas are characterized by cells that are located in
• How cancer spreads – scientists reported in Nature bone, cartilage, fat, connective tissue, muscle, and other
Communications (October 2012 issue) that they have supportive tissues.
discovered an important clue as to why cancer cells spread. 3. Lymphomas are cancers that begin in the lymph nodes and
It has something to do with their adhesion (stickiness) immune system tissues.
properties. 4. Leukemias are cancers that begin in the bone marrow and
• In 2007, cancer claimed the lives of about 7.6 million often accumulate in the bloodstream.
people in the world 5. Adenomas are cancers that arise in the thyroid, the
• WHO reports that cancer is the second leading cause of pituitary gland, the adrenal gland, and other glandular
death worldwide, accounting in 2008 to 7.6 million deaths tissues.
(around 13% of all deaths). Lung, stomach, liver, colon,
and breast cancer cause the most cancer deaths each year. Characteristic of malignant neoplasms
• Malignant cells are more agile than non-malignant 1. Malignant neoplasms are rather poorly separated from
ones - scientists from the Physical Sciences-Oncology normal tissues. From the periphery, where growth is active,
Centers, USA, reported in the journal Scientific infiltrating processes extend out to impinge on and destroy
Reports (April 2013 issue) that malignant cells are much the surrounding tissue.
“nimbler” than non-malignant ones. Malignant cells can 2. They metastasize.
pass more easily through smaller gaps, as well as applying 3. They tend to recur when removed surgically because the
a much greater force on their environment compared to tumor cells have widely infiltrated the surrounding tissues
other cells. and the borders are poorly outlined.
4. They cause extensive destruction of tissues
What causes cancer? 5. They produce such effects in the body such as anemia,
• Cancer is ultimately the result of cells that uncontrollably weakness, loss of weight, tumor and cachexia.
grow and do not die. Normal cells in the body follow an 6. They have little resemblances to the normal cells of the
orderly path of growth, division, and death. Programmed parent tissue. The arrangement of the cells in the malignant
cell death is called apoptosis, and when this process breaks tumor does not conform to that of any normal adult tissue.
down, cancer begins to form. Unlike regular cells, cancer 7. They kill, regardless of location, unless properly and
cells do not experience programmatic death and instead vigorously treated
continue to grow and divide. This leads to a mass of
abnormal cells that grows out of control. Danger signs of cancer
A. Genes – the DNA type 1. Any sore that does not heal.
• Cells can experience uncontrolled growth if there are 2. A lump or thickening in the breast or elsewhere.
damages or mutations to DNA, and therefore, damage to 3. Unusual bleeding or discharge from the body orifice
the genes involved in cell division. 4. Any change in a wart or mole.
• Four key types of gene are responsible for the cell division 5. Persistent indigestion or difficulty in swallowing
process: 6. Persistent hoarseness or cough
1. Oncogenes tell cells when to divide, 7. Any change in the normal bowel habits
2. Tumor suppressor genes tell cells when not to
divide How is cancer diagnosed and staged?
3. Suicide genes control apoptosis and tell the cell • Imaging techniques such as X-rays, CT scans, MRI
to kill itself if something goes wrong, and scans, PET scans, and ultrasound scans are used
4. DNA-repair genes instruct a cell to repair regularly in order to detect where a tumor is located and
damaged DNA. what organs may be affected by it. Doctors may also
 conduct an endoscopy, which is a procedure that uses a leukemia and lymphoma cases can be treated with the
thin tube with a camera and light at one end, to look for hormone cortisone.
abnormalities inside the body. 6. The goal of gene therapy is to replace damaged genes with
• Biopsy – the only absolute way to diagnose cancer. ones that work to address a root cause of cancer: damage
• Physicians will analyze your body's sugars, fats, proteins, to DNA. For example, researchers are trying to replace the
and DNA at the molecular level. For example, cancerous damaged gene that signals cells to stop dividing (the p53
prostate cells release a higher level of a chemical called gene) with a copy of a working gene. Other gene-based
PSA (prostate-specific antigen) into the bloodstream that therapies focus on further damaging cancer cell DNA to the
can be detected by a blood test. point where the cell commits suicide.

How is cancer treated? How can cancer be prevented?

• Cancer treatment depends on the type of cancer, the stage • Cancers that are closely linked to certain behaviors are the
of the cancer (how much it has spread), age, health status, easiest to prevent. For example, choosing not to smoke
and additional personal characteristics. tobacco or drink alcohol significantly lower the risk of
• There is no single treatment for cancer, and patients often several types of cancer - most notably lung, throat, mouth,
receive a combination of therapies and palliative care. and liver cancer. Even if you are a current tobacco user,
• Treatments usually fall into one of the following quitting can still greatly reduce your chances of getting
categories: surgery, radiation, chemotherapy, cancer.
immunotherapy, hormone therapy, or gene therapy. • Skin cancer can be prevented by staying in the shade,
1. Surgery protecting yourself with a hat and shirt when in the sun,
• Innovations continue to be developed to aid the and using sunscreen. Diet is also an important part of
surgical process, such as the iknife that "sniffs" out cancer prevention since what we eat has been linked to the
cancer. Currently, when a tumor is removed, surgeons disease. Physicians recommend diets that are low in fat
also take out a “margin” of healthy tissue to make sure and rich in fresh fruits and vegetables and whole grains.
no malignant cells are left behind. This usually means • Certain vaccinations have been associated with the
keeping the patients under general anesthetic for an prevention of some cancers. For example, many women
extra 30 minutes while tissue samples are tested in the receive a vaccination for the human papilloma virus
lab for “clear margins”. If there are no clear margins, because of the virus's relationship with cervical cancer.
the surgeon has to go back in and remove more tissue Hepatitis B vaccines prevent the hepatitis B virus, which
(if possible). Scientists from Imperial College London can cause liver cancer.
say the iknife may remove the need for sending • Some cancer prevention is based on systematic screening in
samples to the lab. order to detect small irregularities or tumors as early as
2. Radiation treatment, also known as radiotherapy, possible even if there are no clear symptoms present.
destroys cancer by focusing high-energy rays on the cancer Breast self-examination, mammograms, testicular self-
cells. This causes damage to the molecules that make up the examination, and Pap smears are common screening
cancer cells and leads them to commit suicide. methods for various cancers.
Radiotherapy utilizes high-energy gamma-rays that are • Researchers from Northwestern University Feinberg School
emitted from metals such as radium or high-energy x-rays of Medicine in Chicago reported in the
that are created in a special machine. journal Circulation that the 7 steps recommended for
3. Chemotherapy utilizes chemicals that interfere with the protection against heart disease can also reduce the risk of
cell division process - damaging proteins or DNA - so that developing cancer. They include being physically active,
cancer cells will commit suicide. These treatments target eating a healthy diet, controlling cholesterol, managing
any rapidly dividing cells (not necessarily just cancer cells), blood pressure, reducing blood sugar, and not smoking.
but normal cells usually can recover from any chemical-
induced damage while cancer cells cannot. DIABETES
• Chemotherapy treatment occurs in cycles so the body Fast facts on Diabetes
has time to heal between doses. Common side effects • Diabetes is a long-term condition that causes high blood
of chemotherapy: sugar levels.
 Hair loss • In 2013, it was estimated that over 382 million people
 Nausea throughout the world had diabetes (Williams textbook of
 Fatigue endocrinology).
 Vomiting
4. Immunotherapy aims to get the body's immune system to TYPES OF DIABETES
fight the tumor. Local immunotherapy injects a treatment 1) Type 1 Diabetes
into an affected area, for example, to cause inflammation • The body does not produce insulin. Some people may refer
that causes a tumor to shrink. Systemic immunotherapy to this type as insulin-dependent diabetes, juvenile
treats the whole body by administering an agent such as the diabetes, or early-onset diabetes. People usually develop
protein interferon alpha that can shrink tumors type 1 diabetes before their 40th year, often in early
• Immunotherapy can also be considered non-specific if adulthood or teenage years.
it improves cancer-fighting abilities by stimulating the • Approximately 10% of all diabetes cases are type 1.
entire immune system, and it can be considered • Patients with type 1 diabetes will need to take insulin
targeted if the treatment specifically tells the immune injections for the rest of their life. They must also ensure
system to destroy cancer cells. proper blood-glucose levels by carrying out regular blood
5. Hormone therapy is designed to alter hormone production tests and following a special diet.
in the body so that cancer cells stop growing or are killed 2) Type 2 Diabetes (adult-onset or noninsulin-dependent
completely. Breast cancer hormone therapies often focus on diabetes)
reducing estrogen levels (a common drug for this is • The body does not produce enough insulin for proper
tamoxifen) and prostate cancer hormone therapies often function, or the cells in the body do not react to insulin
focus on reducing testosterone levels. In addition, some (insulin resistance).
 • Approximately 90% of all cases of diabetes worldwide will take water from your blood in order to dilute the
are of this type. glucose - which in turn fills up your bladder.
• Being overweight, physically inactive and eating the wrong • Disproportionate thirst
food contribute to our risk of developing type 2 • Intense hunger
diabetes. Drinking just one can of (non-diet) soda per • Weight gain
day can raise our risk of developing type 2 diabetes by • Unusual weight loss. This is more common among people
22%. with Diabetes Type 1. Muscle tissue and fat will be broken
• The risk of developing type 2 diabetes is also greater as we down for energy. As Type 1 is of a more sudden onset and
get older. Those with a close relative who had/had type 2 Type 2 is much more gradual, weight loss is more
diabetes, people of Middle Eastern, African, or South noticeable with Type 1.
Asian descent also have a higher risk of developing the • Increased fatigue
disease. • Irritability
• Men whose testosterone levels are low have been found to • Blurred vision. This can be caused by tissue being pulled
have a higher risk of developing type 2 diabetes. from your eye lenses. This affects your eyes' ability to
Researchers from the University of Edinburgh, Scotland, focus. With proper treatment this can be treated. There are
say that low testosterone levels are linked to insulin severe cases where blindness or prolonged vision problems
resistance. can occur.
3) Gestational Diabetes • Cuts and bruises don't heal properly or quickly
• This type affects females during pregnancy. Some • More skin and/or yeast infections. When there is more
women have very high levels of glucose in their blood, and sugar in your body, its ability to recover from infections is
their bodies are unable to produce enough insulin to affected.
transport all of the glucose into their cells, resulting in • Itchy skin
progressively rising levels of glucose. • Gums are red and/or swollen - Gums pull away from
• The majority of gestational diabetes patients can control teeth. If your gums are tender, red and/or swollen this
their diabetes with exercise and diet. Between 10% to 20% could be a sign of diabetes. Your teeth could become loose
of them will need to take some kind of blood-glucose- as the gums pull away from them.
controlling medications. Undiagnosed or uncontrolled • Frequent gum disease/infection
gestational diabetes can raise the risk of complications • Sexual dysfunction among men. If you are over 50 and
during childbirth. The baby may be bigger than he/she experience frequent or constant sexual dysfunction (erectile
should be. dysfunction), it could be a symptom of diabetes.
• Numbness or tingling, especially in your feet and hands

How To Determine Whether You Have Diabetes, Prediabetes or

Neither
• Doctors can determine whether a patient has a normal
metabolism, prediabetes or diabetes in one of three
different ways - there are three possible tests:
1. The A1C test
o at least 6.5% means diabetes
o between 5.7% and 5.99% means prediabetes
o less than 5.7% means normal
2. The FPG (fasting plasma glucose) test
o at least 126 mg/dl means diabetes
o between 100 mg/dl and 125.99 mg/dl means
prediabetes
o less than 100 mg/dl means normal
3. The OGTT (oral glucose tolerance test) 
o at least 200 mg/dl means diabetes
o between 140 and 199.9 mg/dl means prediabetes
o less than 140 mg/dl means normal
Diabetes is a Metabolism Disorder
• Diabetes (diabetes mellitus) is classed as a metabolism
disorder. Most of what we eat is broken down into Controlling Diabetes
glucose. Glucose is a form of sugar in the blood - it is the • Treatment is effective and important.
principal source of fuel for our bodies. • All types of diabetes are treatable. Diabetes type 1 lasts a
lifetime, there is no known cure. Type 2 usually lasts a
What Is Prediabetes? lifetime, however, some people have managed to get rid of
• The vast majority of patients with type 2 diabetes initially their symptoms without medication, through a combination
had prediabetes. Their blood glucose levels were higher of exercise, diet and body weight control.
than normal, but not high enough to merit a diabetes • Patients with type 1 are treated with regular insulin
diagnosis. The cells in the body are becoming resistant to injections, as well as a special diet and exercise.
insulin. • Patients with Type 2 diabetes are usually treated with
tablets, exercise and a special diet, but sometimes insulin
Most Common Diabetes symptoms injections are also required.
• Frequent urination. When there is too much glucose • If diabetes is not adequately controlled the patient has a
(sugar) in your blood you will urinate more often. If your significantly higher risk of developing complications.
insulin is ineffective, or not there at all, your kidneys
cannot filter the glucose back into the blood. The kidneys Complications Linked to Badly Controlled Diabetes
 • Eye complications – glaucoma, cataracts, diabetic disease because their immune system destroyed the insulin-
retinopathy, and some others. producing beta cells. A diet high in calories, which can
• Foot complications – neuropathy, ulcers, and sometimes make people overweight/obese, raises the risk of
gangrene which may require that the foot be amputated developing type 2 diabetes, especially if there is a history of
• Skin complications – people with diabetes are more this disease in the family.
susceptible to skin infections and skin disorders • I know when my blood sugar levels are high or low.
• Heart problems – such as ischemic heart disease, when the Very high or low blood sugar levels may cause some
blood supply to the heart muscle is diminished symptoms, such as weakness, fatigue and extreme thirst.
• Hypertension – common in people with diabetes, which However, levels need to be fluctuating a lot for symptoms
can raise the risk of kidney disease, eye problems, heart to be felt.
attack and stroke • Diabetes diets are different from other people. The diet
• Mental health – uncontrolled diabetes raises the risk of doctors and specialized nutritionists recommend diabetic
suffering from depression, anxiety and some other mental patients to become healthy ones; healthy for everybody,
disorders including people without the disease. Meals should contain
• Hearing loss – diabetes patients have a higher risk of plenty of vegetables, fruit, whole grains, and they should be
developing hearing problems low in salt and sugar, and saturated or trans-fat.
• Gum disease – there is a much higher prevalence of gum • High blood sugar levels are fine for some, while for
disease among diabetes patients others they are a sign of diabetes. High blood-sugar
• Gastroparesis – the muscles of the stomach stop working levels are never normal for anybody. Some illnesses,
properly mental stress and steroids can cause temporary hikes in
• Ketoacidosis – a combination of ketosis and acidosis; blood sugar levels in people without diabetes. Anybody
accumulation of ketone bodies and acidity in the blood. with higher-than-normal blood sugar levels or sugar in their
• Neuropathy – diabetic neuropathy is a type of nerve urine should be checked for diabetes by a health care
damage which can lead to several different problems. professional.
• HHNS (Hyperosmolar Hyperglycemic Nonketotic • Diabetics cannot eat bread, potatoes, or pasta. People
Syndrome) – blood glucose levels shoot up too high, and with diabetes can eat starchy foods. However, they must
there are no ketones present in the blood or urine. It is an keep an eye on the size of the portions. Whole grain starchy
emergency condition. foods are better, as is the case for people without diabetes.
• Nephropathy – uncontrolled blood pressure can lead to • One person can transmit diabetes to another person.
kidney disease NOT TRUE. A parent may pass on, through their genes to
• PAD (peripheral arterial disease) – symptoms may their offspring, a higher susceptibility to developing the
include pain in the leg, tingling and sometimes problems disease.
walking properly • Only older people develop type 2 diabetes. Things are
• Stroke – If blood pressure, cholesterol levels, and blood changing. A growing number of children and teenagers are
glucose levels are not controlled, the risk of stroke developing type 2 diabetes. Experts say that this is linked to
increases significantly the explosion in childhood obesity rates, poor diet, and
• Erectile dysfunction – male impotence. physical inactivity.
• Infections – people with badly controlled diabetes are • I have to go on insulin, this must mean my diabetes is
much more susceptible to infections severe. People take insulin when diet alone or diet with oral
• Healing of wounds – cuts and lesions take much longer to or non-insulin injectable diabetes drugs do not provide
heal good-enough diabetes control, that's all. Insulin helps
diabetes control. It does not usually have anything to do
Some Facts and Myths Regarding Diabetes with the severity of the disease.
• People with diabetes should not exercise. NOT TRUE!! • If you have diabetes, you cannot eat chocolates or
Exercise is important for people with diabetes, as it is for sweets. People with diabetes can eat chocolates and sweets
everybody else. Exercise helps manage body weight, if they combine them with exercise or eat them as part of a
improves cardiovascular health, improves mood, helps healthy meal.
blood sugar control, and relieves stress. Patients should • Diabetic patients are more susceptible to colds and
discuss exercise with their doctor first. illnesses in general. A person with diabetes with good
• Fat people always develop type 2 diabetes eventually. diabetes control is no more likely to become ill with a cold
This is not true. Being overweight or obese raises the risk or something else than other people. However, when a
of becoming diabetic. They are risk factors, but do not diabetic catches a cold, their diabetes becomes harder to
mean that an obese person will definitely become diabetic. control, so they have higher risk of complications.
Many people with type 2 diabetes were never overweight. • People can often have diabetes and be completely unaware.
The majority of overweight people do not develop type 2 The main reason for this is that the symptoms, when seen
diabetes. on their own, seem harmless. However, the earlier diabetes
• Diabetes is a nuisance, but not serious. Two-thirds of is diagnosed the greater the chances are that serious
diabetes patients die prematurely from stroke or heart complications, which can result from having diabetes, can
disease. The life expectancy of a person with diabetes is be avoided.
from five to ten years shorter than other peoples. Diabetes
is a serious disease. CARDIOVASCULAR DISEASES
• Children can outgrow diabetes. This is not true. Nearly • Leading cause of death in US accounting for nearly half of
all children with diabetes have type 1; insulin-producing all deaths
beta cells in the pancreas have been destroyed. These never • The collective term for various forms of diseases of the
come back. Children with type 1 diabetes will need to take heart and blood vessels
insulin for the rest of their lives unless a cure is found one
day. Risk factors for cardiovascular disease
• Don't eat too much sugar, you will become diabetic. This MAJOR RISK FACTORS THAT CAN BE CHANGED
is not true. A person with diabetes type 1 developed the 1. Tobacco Use
 • about 1 in 5 deaths (chest pain) and heart attacks. The good news is that
• People who smoke a pack of cigarettes a day have you can do something about heart disease.
twice the risk of heart attack; smoking 2 or more • Atherosclerosis, occurs when the normal lining of
packs a day triples the risk the arteries deteriorates, the walls of arteries
• Women who smoke heavily and use oral thicken, and deposits of fat and plaque buildup,
contraceptives are up to 32 times more likely to have a causing narrowing (or even blockage) of the
heart attack and 20 times to have a stroke arteries.
2. High blood pressure • Atherosclerosis is a type of arteriosclerosis
3. High Levels of cholesterol (thickening and hardening of the arteries). As we
• LDL – blood fat that transports cholesterol from age, some hardening of the arteries can occur
the liver to organs and tissues; excess is deposited on naturally. When a person has atherosclerosis, the inner
artery walls, where it can eventually block the flow of walls of the arteries become narrower due to a
blood to the heart and brain buildup of plaque. Plaque results from deposits of
• HDL – blood fat that helps transport cholesterol fat, cholesterol, and other substances. Blood clots
out of the arteries and thus protects against heart form, thus blocking the blood flow. This can lead
diseases to heart attacks and strokes. Risk factors for
4. Physical Inactivity atherosclerosis include:
• The more physical activity you engage in, the more – High blood cholesterol
cardiovascular benefit you derive. – Smoking
5. Obesity – High blood pressure
• The risk of death from CVD is 2-3X higher in obese – Diabetes
people (BMI ≥30) than it is in lean people (BMI 18.5- – Obesity
24.9) and for every 5-unit increment of BMI, a – Not physically active
person’s risk of death from Coronary heart disease 2. Angina
increases by 30% • Angina is a pain or discomfort in the chest that
• Abdominal obesity happens when some part of the heart does not
6. Diabetes receive enough blood. It often feels like a pressing or
• Having diabetes doubles the risk of CVD for men squeezing pain, generally in the chest under the
and triples the risk for women breastbone, but sometimes in the shoulders, arms,
• People with prediabetes also face a significant neck, jaw, or back. The most common trigger for
increased risk of CVD angina is physical exertion. Other triggers include:
– Emotional stress
Contributing Risk factors that can be changed – Extreme cold or heat
1. High Triglycerides Levels – Alcohol
2. Psychological and Social Factors – Smoking
A. Stress • Angina seldom causes permanent damage to the heart,
B. Chronic hostility and anger unlike a heart attack. A heart attack happens when the
C. Suppressing psychological distress blood flow to a part of the heart is suddenly and
D. Depression and anxiety permanently cut off.
E. Social isolation 3. Stroke
F. Low economic status • Lack of blood flow to the brain from a blood clot, or
3. Alcohol and drugs bleeding in the brain from a broken blood vessel,
causes a stroke. Without a good blood supply, brain
MAJOR RISK FACTORS THAT CAN’T BE CHANGED cells cannot get enough oxygen and begin to die. You
1. Heredity can also have what is sometimes called a "mini-
2. Aging stroke," or transient ischemic attack (TIA), where
3. Being Male no damage is done to the brain. Even though they do
4. Ethnicity no damage, TIAs are serious and can put you at
greater risk of having a full stroke. Risk factors
Cardiovascular disease includes a number of conditions for stroke include:
affecting the structures or function of the heart. They can  Uncontrolled high blood pressure
include:  Smoking
• Coronary artery disease (narrowing of the  Diabetes
arteries) 4. High Blood Pressure
• Heart attack • There are ways to measure blood pressure and
• Abnormal heart rhythms or arrythmias several medications to lower it if it is too high.
• Heart failure A blood pressure reading measures the force of
• Heart valve disease blood pumped from the heart against the walls of your
• Congenital heart disease blood vessels. It is recorded as two numbers: a top
• Heart muscle disease (cardiomyopathy) number of systolic pressure (the pressure of blood in
• Pericardial disease the vessels as the heart beats), and a bottom number of
• Aorta disease and Marfan syndrome diastolic pressure (the pressure of the blood between
• Vascular disease (blood vessel disease) heartbeats, when the heart rests).
5. Heart Attack
1. Coronary Artery Disease • Most heart attacks are the result of coronary heart
• Coronary artery disease (CAD) is atherosclerosis, disease, a condition that clogs coronary arteries
or hardening, of the arteries that provide vital with fatty, calcified plaques. In the early 1980s,
oxygen and nutrients to the heart. . It causes angina researchers confirmed that the immediate cause of
nearly all heart attacks is not the obstructive plaque
 itself. Instead, it's the sudden formation of a blood and shortness of breath.  The swelling and shortness
clot on top of plaque that cuts off blood flow in an of breath are the primary symptoms of heart failure.
already narrowed blood vessel.  • Heart failure is a major health problem in the U.S.,
• The step-by-step process that leads to heart attack is affecting nearly 5 million Americans. About 550,000
not fully understood. Major risk factors, though, are people are diagnosed with heart failure each year. It is
well-known, and some can be controlled. Of these, the the leading cause of hospitalization in people older
main ones are high blood pressure, high than 65.
cholesterol, obesity, smoking, diabetes and a • Congestive heart failure is a term often used to
sedentary lifestyle. Stress may also raise the risk, and describe heart failure. Congestion, or the buildup of
exertion and excitement can act as triggers for an fluid, is only one symptom of heart failure and does
attack. Another important risk factor is family history. not occur in all people who have heart failure. There
A family history of heart disease can increase the risk are two main categories of heart failure: systolic and
in both men and women at earlier ages. diastolic. Within each category of heart failure, the
• Men over the age of 50 with a family history of heart symptoms vary from person to person.
disease are predisposed to heart attack. High levels
of estrogen are thought to protect premenopausal HEART VALVE PROBLEMS
women fairly well, but the risk of heart attack • Your heart valves lie at the exit of each of your four heart
increases significantly after menopause. chambers and maintain one-way blood-flow through your
heart.
Heart Attack Treatment • Examples of heart valve problems include mitral valve
• A heart attack is a medical emergency. It must be prolapse, aortic stenosis, and mitral valve insufficiency.
quickly addressed by conventional medicine. At this
point, alternative medicine cannot compete with 1. Mitral valve prolapse
standard drug therapy and surgical • One or both valve leaflets protrude into the left atrium.
treatments. Alternative medicine may at other times, MVP syndrome is the term used when the anatomic
though, make valuable contributions to heart attack prolapse is accompanied by signs and symptoms unrelated
prevention and recovery. to the valvular abnormality
2. Aortic insufficiency
Conventional Response to a Heart Attack • Blood flows back into the left ventricle during diastole,
• Heart attack victims are usually hospitalized in special causing fluid overload in the ventricle, which dilates and
coronary care units (CCU) for at least 36 hours. hypertrophies. The excess volume causes fluid overload
Standard drug therapy includes:  in the left atrium and finally, the pulmonary system. Left
 A painkiller such as morphine  ventricular failure and pulmonary edema eventually
 Vasodilators such as nitroglycerine to expand results.
blood vessels 3. Mitral stenosis
 Beta-adrenergic blocker drugs to calm the • Narrowing of the valve by valvular abnormalities,
heart  fibrosis or calcification obstructs blood flow from the
 Aspirin to reduce clotting activity left atrium to the left ventricle. Consequently, left atrial
volume and pressure rise and the chambers dilate
Heart Attack Diagnosis • Results from rheumatic fever
• A cardiologist, or heart specialist, relies on various • Most common in females
tests to diagnose a heart attack. These tests can also 4. Aortic stenosis
identify sites of blockage as well as tissue damage. • Increased left ventricular pressure tries to overcome the
• Monitoring the heart's electrical activity together resistance of the narrowed valvular opening. The added
with blood tests provides data for an initial assessment workload increases the demand for oxygen, and diminished
of the patient's condition. Images of the heart and cardiac output causes poor coronary artery perfusion,
coronary arteries done with angiograms and ischemia of the left ventricle and the left ventricular
radioisotope scans locate specific areas of damage failure.
and blockage. Ultrasound tests called 5. Pulmonary insufficiency
echocardiograms evaluate the heart's function. With • Blood ejected into the pulmonary artery during systole
such data, the doctor can decide on proper treatment as flows back into the right ventricle during diastole, causing
well as anticipate potential complications. fluid overload in the ventricle, ventricular hypertrophy
and finally ventricular failure
Abnormal Heart Rhythms 6. Pulmonic stenosis
• The heart is an amazing organ. It beats in a steady, • Obstructed right ventricular outflow causes right
even rhythm, about 60 to 100 times each minute (that's ventricular hypertrophy, eventually resulting in right
about 100,000 times each day!). But, sometimes your ventricular failure
heart gets out of rhythm. An irregular or abnormal 7. Tricuspid Insufficiency
heartbeat is called an arrhythmia. An arrhythmia • Blood flows back into the right atrium during systole,
(also called a dysrhythmia) can involve a change in decreasing blood flow to the lungs and left side of the
the rhythm, producing an uneven heartbeat, or a heart.
change in the rate, causing a very slow or very fast • Cardiac output also lessens
heartbeat. • Fluid overload in the right side of the heart eventually
lead to right ventricular failure
6. Heart Failure 8. Tricuspid stenosis
• The term "heart failure" can be frightening. It means • Obstructed blood flow from the right atrium to the
the heart does not pump as well as it should. This then right ventricle causes the right atrium to dilate and
leads to salt and water retention, causing swelling hypertrophy
 • This leads to right ventricular failure and increases – Rheumatic fever due to untreated streptococcal
pressure in the vena cava throat infection, damaging the heart muscles
and heart valves (rheumatic heart disease )
Cardiomyopathy, Dilated
• Resulting from extensive damage myocardial muscle fibers, You can do a lot to lower your odds of getting heart disease. Taking
it interferes with myocardial metabolism and grossly dilates action will improve your health -- and, possibly, save your life. Get
all chambers of the heart going on these 8 ways to get on track.
• This gives the heart a globular appearance 1. Quit smoking. If you smoke, you are more than twice as
• Leads to intractable heart failure, arrhythmias, and likely to have a heart attack as nonsmokers, and you’re
emboli much more likely to die if you do have a heart attack.
• Can be due to viruses, endocrine and electrolyte 2. Improve cholesterol levels. You're more likely to get heart
disorders, and nutritional deficiencies disease if you have:
 Total cholesterol level over 200
Cardiomyopathy, Hypertrophic  HDL ("good") cholesterol level under 40
• Characterized by disproportionate, asymmetric  LDL ("bad") cholesterol level over 160
thickening of the interventricular septum in relation to  Cholesterol isn't the only thing that matters. Your
the free wall of the left ventricle. doctor will consider the big picture, including all your
• Cardiac output may be low, normal or high depending on potential risks. To help lower cholesterol levels, eat a
whether stenosis is obstructive or nonobstructive diet low in cholesterol and saturated fat.
• May be inherited or idiopathic 3. Control high blood pressure. More than 50 million people
in the U.S. have hypertension, or high blood pressure,
Cardiomyopathy, Restrictive making it the most common heart disease risk factor.
• Characterized by restrictive ventricular filling and Exercise and healthy eating help. Some people may need
endocardial fibrosis and thickening. medicine to control their blood pressure, too.
• If severe, it’s irreversible 4. Get active. People who don't exercise are more likely to get
• Unknown cause heart disease, and die from it, than people who are active.
Check with your doctor before starting a new
Pericarditis exercise program, especially if you aren't active now. She
• Inflammation of the pericardium, the fibroserous sac can tell you what you can do.
that envelops, supports and protects the heart. 5. Follow a heart-healthy diet. Eat foods that are low in fat
• Can be acute or chronic and cholesterol. Just about everyone should eat more fruits,
• Common causes are: vegetables, whole grains, beans, nuts, legumes, and other
– Bacterial, fungal, viral or parasitic infection plant-based foods. The fiber is good for your cholesterol,
– Neoplasms and you'll get vitamins the natural way, from foods.
– High dose radiation to the chest • You can still eat fish (especially salmon or tuna, which
– Uremia are high in good-for-you omega-3 fatty acids),
– Hypersensitivity or autoimmune disease such poultry, and meat, but make it lean and keep
as rheumatic fever, LE and rheumatoid the portions modest. Also limit salt and sugar. Most
arthritis people get too much of both.
– Postcardiac injury such as MI, trauma, or 6. Get to a healthy weight. Losing extra weight is good for
surgery your heart. It can also help you lower high blood pressure
– Drugs such as hydralazine or procainamide and manage diabetes.
– Idiopathic factors 7. Control diabetes. Diabetes makes heart disease more
likely. Many people who have diabetes don't know it. Get
Marfan Syndrome tested and get treated.
• Rare inherited, degenerative generalized disease of the 8. Manage stress and anger. Everyone has stress, and it's
connective tissue that causes ocular, skeletal and normal to get angry now and then. When stress and anger
cardiovascular anomalies flare up, especially if it happens a lot, that's a problem.
Managing your stress and handling your anger in healthy
Vasculitis ways puts you back in charge.
• A broad spectrum of disorders, vasculitis is characterized
by inflammation and necrosis of blood vessels • Although the average blood pressure reading for adults is
• The clinical effects depend on the vessels involved and 120/80, a slightly higher or lower reading (for either number)
reflect tissue ischemia caused by blood flow obstruction may not be a problem. High blood pressure is diagnosed when
• Can occur at any age the reading consistently exceeds 140/90. High blood pressure is
• Maybe a primary disorder or secondary to other disorders often called a "silent" killer because it usually has no signs or
such as LE and rheumatoid arthritis symptoms. High blood pressure can cause heart failure and can
also lead to:
Congenital Heart Disease  Stroke
• Hypertrophic cardiomyopathy (HCM)  Kidney failure
– Inherited condition that causes the heart muscle  Other health problems
to become hypertrophic, primarily in the septum, • Talk to your healthcare provider and get your blood pressure
which is the area between the two ventricles monitored regularly. If you have high blood pressure, diet,
– With high risk of sudden death exercise, and medicine can help you in lowering it.
– Should not be engaged in competitive sports o Systolic heart failure happens when the heart's ability
to pump blood decreases. The heart cannot push enough
Other forms of heart disease blood into the circulatory system, which causes the blood
• Rheumatic Heart Disease coming into the heart from the lungs to back up and leak
fluid into the lungs (called pulmonary congestion).
 Diastolic heart failure occurs when the heart has 3. Develop an action plan – hold
trouble relaxing or resting. The heart muscle becomes meetings/include timeline
stiff and cannot fill with blood, causing lung congestion 4. Mobilize to action
and other areas of fluid buildup (most often in the feet, 5. Implement
ankles, and legs). Talk with your healthcare provider right 6. Evaluate
away if you have any of the signs of heart failure. There are • Task we need to consider to mobilize to action
drugs that can treat heart failure. Having a healthy diet and – Identify potential supporters by going door to
getting regular exercise can lower your risk for heart door
failure. – Build a base of support in the community
– Determine constituents and likely allies
COMMUNITY ORGANIZING – Contact constituents and meet with key
Community Organizing members
• a participatory, systematic and sustained process of – Make presentations
building people’s organizations by enhancing the – Identify elected officials who you think will be
capabilities and resources of the people for the resolution of supportive
their issues and concerns. – Solicit advice of supportive politicians for
• Heather Booth, founder of the Midwest Academy and more potential contacts
legendary community organizer, expressed the – Ask people to get involved – give them specific
fundamentals in this formula: tasks
OOO = Organizers Organize Organizations. • Once your group has identified its policy goals your
• Community organizing is a long-term approach where the responsibility as the organizer is to keep the momentum
people affected by an issue are supported in identifying of the group moving forward. To do this you should:
problems and taking action to achieve solutions – Break large jobs into small tasks
- Tactics and strategies – Get and keep your team members engaged,
- Helps to bring out many voices to add informed, involved, and in the spotlight
collective power and strength to an issue – Be responsive and reliable
- Key part of an overall strategy – Keep group focused and on track
- Help community residents develop the skills – Don’t let opponents get your group off
necessary to address their own issues message or task
• At the heart of community organizing are inclusion,
ownership, relationship building and leadership Health education
development • Process by whereby knowledge, attitude and practice of
• Individual vs. Collective action people are changed
 community organizing looks at collective solutions • Means of improving the health of the people
 many traditional agency responses look at • The sequence of steps in health education includes
individual solutions creating awareness, motivation and decision-making
action to practice health services
Benefits of community organization – Information
1. It contributes to the establishment of an environment – Communication
with different community resources – education
2. It stimulates the various groups to examine their
program to determine how well they are meeting their
problems Principles of health education
3. People are given the chance to study their problems, 1. Health education considers the health status of the
offer solutions and give a chance to plan for an action people
4. As a result of this working together, a strong unity and 2. Health education is learning
coherence is developed 3. Health education involves motivation, experience and
5. Community organization sets up action pattern to solve change in conduct and thinking
problems 4. Should be recognized as a basic function of all health
workers
Basic methods and steps in community organization process: 5. Takes place in the home, in the school and the
1. Fact finding community
2. Determination of needs 6. Is a cooperative effort
3. Program formation 7. Meets the needs, interests and problems of the people
4. Education and interpretation affected
8. Is achieved by doing
Qualities of a good organizer 9. Is a slow continuous process
• Imaginative 10. Makes use of supplementary aids and devices
• Sense of humor 11. Utilizes community resources
• A vision of a better world 12. Is a creative process
• An organized personality 13. Helps people attain health through their own effort
• Strong ego/ sense of oneself 14. Makes careful evaluation of the planning, organization
• A free, open mind and political relativity and implementation of all health education programs
• Ability to create the new out of the old and activities

Principles of Organizing Health education teaching methods and strategies

• Six stages of effective community organizing: • Interviewing
1. Assess the community – know the community • Counseling
2. Create an action team – Invite people • Lecture-discussion
 • Open forum Determination of needs, (3) Program formation, (4) Education
• Workshop and interpretation – 1, 2, 3, and 4
• Case study 22. Benefits of community organization: - It contributes to the
• Role play establishment of an environment with different community
• Symposium resources
• Group work- buzz sessions 23. Community organization contributes to the establishment of an
• Community assembly environment with difference community resources. – TRUE
• Nominal group technique 24. Community organizing aims to empower those people who are
• Laboratory training voiceless and powerless. – TRUE
• Use of IEC (information, education and 25. Community organizing is a ______ approach where the people
communication) materials as leaflets, brochure, affected by an issue are supported in identifying problems and
comics handouts, flyers taking action to achieve solutions. – Long Term
• Use of publication 26. In community organization, only organizers are given the chance
• Use of audio-visual aids, bulletin boards, billboards, to study the community problems, offer solutions and give a
posters chance to plan for an action. – FALSE
• Use of IEC support as fans, umbrellas, etc. 27. Is a participatory, systematic, and sustained process of building
people’s organizations by enhancing the capabilities and
resources of the people for the resolution of their issues and
QUIZ concern: - Community Organizing
1. Angina can be triggered MOST commonly by – Physical 28. The following are principles of health education, EXCEPT: -
Exertion Use of audio-visual aids, bulletin boards, billboards, posters
2. What do you call the process in which a tumor spreads to other 29. TRUE about principles of health education: - Health education
parts of the body and grows, invading and destroying other considers the health status of the people
healthy tissues? – Metastasis 30. Which of the following is the first step in health education? –
3. It is part of conventional medicine that is used to calm the heart Creating awareness
during heart attack – Beta-adrenergic blocker drugs
4. All of the following are TRUE for Diabetes, EXCEPT – Type 1
diabetes is the most common form of diabetes
5. All of the following are characteristics of malignant neoplasm,
EXCEPT – They are well separated from normal tissues
6. All of the following are tests to determine the existence of
diabetes, EXCEPT – FPJ
7. Diabetes is a nuisance, but no serious. Also, children will not
outgrow diabetes – First statement is FALSE, second
statement is TRUE
8. Cells that did not undergo apoptosis will develop into cancer. -
TRUE
9. All of the following are TRUE for Cardiovascular Disease,
EXCEPT – Aortic stenosis is where the blood flow to the
heart muscle is suddenly blocked
10. All of the following are TRUE for Vasculitis, EXCEPT: - It is a
broad spectrum of disorders that affects arteries, veins and
capillaries and affects only the older adults.
11. Majority of the cases of diabetes are – Type 2
12. Mandy developed a complication of diabetes wherein his body
starts breaking down fat at a rate that is much too fast. The
complication of diabetes is known as: - Ketoacidosis
13. A patient was diagnosed to have a tumor on her breast. The
tumor already spread to the lymph nodes. What type of tumor is
MOST LIKELY being described? – Malignant tumor
14. It is a narrowing of the tricuspid valve opening that slows blood
flow from the right atrium to the right ventricle – Tricuspid
stenosis
15. Which of the following is described to be a pain or discomfort in
the chest that happens when some part of the heart does not
receive enough blood? – Angina
16. Cancer is a class of diseases characterized by out-of-control
growth. It also has the capacity to invade and spread to other
organs of the body. – All statement is TRUE
17. All of the following are major modifiable risk factors of
cardiovascular disease, EXCEPT – Race
18. When the result of fasting plasma glucose test is 132 mg/dl,
what does it indicates? – with Diabetes
19. All of the following are tumor causing cancers, EXCEPT: -
Leukemia
20. According to WHO (2008), the following are most common
type of cancer that causes death each year, EXCEPT: - Prostate
21. All of the following are basic methods and steps in community
organization process, EXCEPT: (1) Fact finding, (2)