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Cancer

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Title: Cancer


1
Cancer
2
What is cancer?
  • Abnormal, uncontrolled growth of cells, which,
    if left untreated, can ultimately cause death.
    (American Cancer Society)
  • Terminology
  • Benign
  • Malignant
  • Metastasis
  • In situ

3
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4
Cells and Cancer
  • Two-stage model of cancer development
  • Initiators
  • Accumulation of DNA mutations
  • Genetic insults
  • Promoters
  • Do not cause cancer but help it grow
  • Oncogenes and Tumor Suppressors
  • Good proto-oncogene
  • Bad oncogene
  • Tumor suppressors

5
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6
OR vs US Cancer Incidence
(CDC)
7
OR vs US Cancer Deaths
(CDC)
8
Non-Specific Warning Signs
  • CAUTION
  • C changes in bowel or bladder habits
  • A a sore that doesnt heal
  • U unusual thickening or discharge
  • T thickening or lump in the breast or any other
    part of the
  • body
  • I indigestion or difficulty swallowing
  • O an obvious change in wart or mole
  • N a nagging cough or hoarseness

9
Cancer Staging
  • T The extent of primary tumor
  • N absence of presence of lymph node involvement
  • M presence of distance metastasis
  • Stages I, II, III, IV
  • Five year Gold standard

10
Types of cancer Leukemia
  • Involve blood-forming cells (white blood cells)
    which are chiefly in bone marrow.
  • Acute, chronic

(National Cancer Institute)
11
Types of cancer Sarcoma
  • Connective fibrous tissue
  • Examples muscle, bone,
  • cartilage, membranes covering
  • muscle/fat

Source cancerhelp.org.uk
12
Types of Cancer Lymphomas
  • Involve lymph nodes
  • Hodgkins, non-Hodgkins

Source newsimg.bbc.co.uk
13
Types of Cancer Carcinoma
  • Epithelial cells
  • Cover external body surfaces or line internal
    tubes and cavities
  • Most common type
  • Examples skin, breast, uterus, prostate, lungs,
    GI tract

Source media.collegepublisher.com
14
Lung Cancer
15
Lung Cancer continued
  • Types
  • Non-small cell
  • Small cell
  • Symptoms
  • Most lung cancers are silent
  • When symptoms occur
  • Cough, shortness of breath, chest pain, loss of
    appetite, blood in sputum.

16
Lung Cancer Risk Factor
  • Most common malignant disease worldwide
  • Leading cause of cancer deaths.
  • Tobacco smoke accounts for approximately 90 of
    all lung cancers.
  • According to the WHO, decreasing current smoking
    rates by 50 could prevent 20-30 million deaths
    before 2025 and 150 million deaths by 2050.

17
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18
Breast Cancer
19
Breast Cancer
  • The most frequently diagnosed cancer in women.
  • Risk factors
  • Age, female gender, personal family history

20
(National Cancer Institute, 2005)
21
Types of Breast Cancer
  • Ductal cancer
  • Most common type of breast cancer
  • Lobular cancer
  • Inflammatory breast cancer

22
Breast Cancer Risk Factors
  • Gender
  • 100x more common in women
  • Age
  • Genetics
  • BRCA1
  • BRCA2
  • Diet
  • Alcohol
  • Physical activity
  • Menarche
  • Pregnancies
  • Breast-feeding
  • Menopause

23
Mammograms
(National Cancer Institute, 2005)
24
Screening / Prevention
  • Mammogram recommendation
  • Starting at age 40 (unless family or personal
    history) and every year as long as in good
    health.
  • BSE (Breast Self-Exams)
  • Starting at age 20, every month
  • Clinical breast exam every year
  • Chemoprevention
  • Her2neu marker

25
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26
Prostate Cancer
27
Prostate Cancer
  • The most common cancer for men.
  • Lifetime risk 1 in 6
  • Risk of dying 3

28
Risk Factors / Screening
  • Age
  • Strongest risk factor
  • Race / ethnicity
  • Diet
  • Red meat
  • High-fat dairy
  • Genetics
  • PSA blood test
  • DRE digital rectal exam
  • Good news
  • Prostate cancer is not always life threatening

29
Colorectal Cancer
30
Colorectal Cancer
  • More common in Western societies.
  • Almost 100 preventable with screening and polyp
    removal.

31
Colorectal Cancer Risk Factors
  • Age
  • Over 50
  • Diet
  • Physical inactivity
  • Obesity
  • Link stronger in men
  • Smoking
  • Alcohol
  • Diabetes (type 2)
  • Increased risk
  • Less favorable outcome

32
Screening
  • Colonoscopy
  • Recommended first colonoscopy at age 50 every
    5-10 years
  • Unless family history / personal symptoms
  • Good news colon cancer usually slow growing
  • Other screenings
  • FOBT (Fecal Occult Blood Test)
  • sDNA (Stool DNA tests)

33
Skin Cancer
34
Sun Safety Quiz
  • I cant get skin cancer, because my normal
    routine (such as work, drive to work, hobbies,
    and vacations) doesnt include any outdoor
    activities
  • False
  • If Im wearing sun screen, I can stay in the sun
    as long as I want.
  • False
  • Getting a base tan at an indoor tanning salon
    is a good way to prevent sunburn when I go to the
    beach later this summer.
  • False (American Cancer Society)

35
Skin Cancer
  • Three types of skin cancer
  • Basal cell carcinoma
  • Most common type of skin cancer
  • Squamous cell carcinoma
  • Melanoma
  • Deadliest form of skin cancer

36
Skin Cancers
  • Skin cancer is the most common form of cancer
  • However. Basal cell and squamous cell are not
    reported to cancer registries
  • Basal cell
  • About 8 of 10 skin cancers
  • Squamous cell
  • About 2 of 10 skin cancers

37
Source skin cancer foundation
38
Melanoma ABCs
Source skin cancer foundation
39
Skin Cancer Risk Factors
  • SUN (Obviously!)
  • Specifically UV exposure
  • Age / Gender
  • Before age 40 higher risk for women
  • After age 40 higher risk for men
  • Melanoma is one of the common cancers in people
    younger than 30.
  • Smoking

40
Skin Cancer Prevention
  • Slip, Slop, Slap and Wrap (ACS)

41
Wrapping up chronic diseases
  • Responses differ from person to person
  • Grief
  • Loss of body part, control, independence,
    security, certainty of future
  • Physical / Mental fatigue
  • Depression
  • Shock / disbelief
  • Denial
  • Anger

42
Communication A few dos and donts
  • Be other-oriented
  • Its not about you
  • Listen and listen some more
  • The patient is the boss
  • Its their decision
  • Offer specific help
  • Please avoid cliches!
  • I know what youre going through
  • Everything will be okay
  • Well we all have to die sometime
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