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YOU HAVE A CHOICE! Dr S Andaz MD, FACS, FRCS Director

YOU HAVE A CHOICE! Dr S Andaz MD, FACS, FRCS Director Center for Minimally Invasive Thoracic Surgery and Thoracic Surgical Oncology South Nassau Hospital New York.

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YOU HAVE A CHOICE! Dr S Andaz MD, FACS, FRCS Director

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  1. YOU HAVE A CHOICE! Dr S Andaz MD, FACS, FRCS Director Center for Minimally Invasive Thoracic Surgery and Thoracic Surgical Oncology South Nassau Hospital New York

  2. Heart Disease StatisticsEvery 20 seconds has a heart attack. Every 34 seconds a person dies from heart disease. More than 2,500 deaths from heart disease each day

  3. “Symptoms - COSTLY mistakes” • “I feel great.” • “ I just had a check up and I am just fine” • SILENT KILLERS • Cadiovascular • Cancer

  4. Anatomy

  5. Plaques

  6. Major Risk Factors • Smoking • Cholesterol - LDL( < 70) HDL (>40) • Hypertension • Family history • Obesity • Diabetes

  7. Warning Signs Chest discomfort. Discomfort in other areas of the upper body. Shortness of breath. Other signs: cold sweat, nausea or lightheadedness

  8. Angina v/s “heart attack”

  9. Investigations • EKG • CXR • Blood work • Stress Test • Ultrafast CT and Total Body Scanners • Cardiac Cath

  10. Management • Medical • Aspirin • BP control • Statins - Liver and muscle damage • Diabetes control • Lifestyle changes!!!! • smoking • exercise • diet changes

  11. Coronary Stents

  12. S/P Agioplasty stenting

  13. S/P angioplasty

  14. Surgical - CABG

  15. Surgical - CABG

  16. Cardiac Surgery - New Frontiers

  17. Cancer Statistics

  18. 2004 Estimated US Cancer Cases • 32% Breast • 12% Lung & bronchus • 11% Colon & rectum • 6% Uterine corpus • 4% Ovary • 4% Non-Hodgkin lymphoma • 4% Melanoma of skin • 3% Thyroid • 2% Pancreas • 2% Urinary bladder • 20% All Other Sites Prostate 33% Lung & bronchus 13% Colon & rectum 11% Urinary bladder 6% Melanoma of skin 4% Non-Hodgkin lymphoma 4% Kidney 3% Oral Cavity 3% Leukemia 3% Pancreas 2% All Other Sites 18% Men699,560 Women668,470

  19. 2004 Estimated US Cancer Deaths Lung & bronchus 32% Prostate 10% Colon & rectum 10% Pancreas 5% Leukemia 5% Non-Hodgkin 4%lymphoma Esophagus 4% Liver & intrahepatic 3%bile duct Urinary bladder 3% Kidney 3% All other sites 21% • 25% Lung & bronchus • 15% Breast • 10% Colon & rectum • 6% Ovary • 6% Pancreas • 4% Leukemia • 3% Non-Hodgkin lymphoma • 3% Uterine corpus • 2% Multiple myeloma • 2% Brain/ONS • 24% All other sites Men290,890 Women272,810

  20. Lifetime Probability of Developing Cancer, by Site, Men, US, 1998-2000 Site Risk All sites ?????? Prostate 1 in 6 Lung & bronchus 1 in 13 Colon & rectum 1 in 17 Urinary bladder 1 in 29 Non-Hodgkin lymphoma 1 in 48 Melanoma 1 in 55 Leukemia 1 in 70 Oral cavity 1 in 72 Kidney 1 in 69 Stomach 1 in 81

  21. Lifetime Probability of Developing Cancer, by Site, Men, US, 1998-2000 Site Risk All sites 1 in 2 Prostate 1 in 6 Lung & bronchus 1 in 13 Colon & rectum 1 in 17 Urinary bladder 1 in 29 Non-Hodgkin lymphoma 1 in 48 Melanoma 1 in 55 Leukemia 1 in 70 Oral cavity 1 in 72 Kidney 1 in 69 Stomach 1 in 81

  22. Lifetime Probability of Developing Cancer, by Site, Women, US, 1998-2000 Site Risk All sites ????? Breast 1 in 7 Lung & bronchus 1 in 17 Colon & rectum 1 in 18 Uterine corpus 1 in 38 Non-Hodgkin lymphoma 1 in 57 Ovary 1 in 59 Pancreas 1 in 83 Melanoma 1 in 82 Urinary bladder 1 in 91 Uterine cervix 1 in 128

  23. Lifetime Probability of Developing Cancer, by Site, Women, US, 1998-2000 Site Risk All sites 1 in 3 Breast 1 in 7 Lung & bronchus 1 in 17 Colon & rectum 1 in 18 Uterine corpus 1 in 38 Non-Hodgkin lymphoma 1 in 57 Ovary 1 in 59 Pancreas 1 in 83 Melanoma 1 in 82 Urinary bladder 1 in 91 Uterine cervix 1 in 128

  24. THE HUMAN COSTS OF TOBACCO USE

  25. Smoking kills more people than alcohol, AIDS, car accidents, illegal drugs, murders suicides combined.

  26. There is a funeral • 1150 times every day • 48 times every hour Because somebody was addicted to cigarettes

  27. SYSTEMS AFFECTED • CARDIOVASCULAR • LUNG

  28. Cardiovascular Disease • Stroke • Sudden Death • Heart Attack • Peripheral Vascular Disease • Aortic Aneurysm 180,000 Deaths per Year

  29. LUNG DISEASE • Pneumonia • Influenza • Bronchitis • Emphysema 90,000 Deaths per Year

  30. Healthy Lung Advanced Emphysema

  31. ONLY LUNG CANCER???????

  32. Smoking causes other cancers! • Laryngeal cancer • Oral cancers • Esophageal cancer • Stomach cancer • Pancreatic cancer • Kidney cancer • Bladder cancer • Cervical cancer • Leukemia

  33. When does it all START? KIDS Lighting the FIRST cigarette !!!!

  34. Protecting our children and grandchildren • More than 3 million kids age 12-17 are current smokers. • More than 5 million children under age 18 alive today will eventually die from smoking-related disease. • More than 40% of high school boys report tobacco use.

  35. HOW SEVERE IS SECOND HAND SMOKING????

  36. SECONDHAND SMOKE Secondhand smoke contains over 4000 chemicals and 43 known carcinogens. Among the chemicals are formaldehyde, cyanide, arsenic, carbon monoxide, methane and benzene. Smoke filled rooms have up to 6 times the air pollution of a busy highway.

  37. “PRIDE IN TOBACCO” • Winston-Salem, NC – the home of R.J. Reynolds Tobacco Co. • This town depends on the tobacco dollar: 8200 factory workers produced 142 billion cigarettes last year. • Winston-Salem is a company town. • Smoking is allowed almost everywhere. • There is one place where smoking is banned…….. • smoking is banned at the R.J. Reynolds Tobacco Plant • that’s for the benefit of the machines. • One delicate machine makes 2000 filters a minute, while another produces 400 packs a minute

  38. ONLY 1/3!!!! LUNG CANCERHOW MANY CAN BE SAVED?

  39. ONLY 1/3 PRESENT AS EARLY LUNG CANCER!!!Stage IStage II

  40. 2/3 PRESENT AS ADVANCED LUNG CANCER!!!Stage IIIStage IV

  41. Stage IV Incurable. Most die within 12 months

  42. Trends in Consumption of Five or More Recommended Vegetable and Fruit Servings for Cancer Prevention, Adults 18 and Older, US, 1994-2002 Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape (2000), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 1999, 2000, 2001.

  43. Trends in Overweight* Prevalence, Children and Adolescents, by Age Group (%), US, 1971-2000 *Overweight is defined as at or above the 95th percentile for body mass index by age and sex based on reference data. Source: National Health Examination Survey 1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

  44. Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to 74, US, 1960-2000 *Obesity is defined as a body mass index of 30 kg/m2 or greater. Source: National Health Examination Survey 1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

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