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
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
Non-Specific Warning Signs
CAUTION: C: changes in bowel or bladder habits A: a sore that doesn’t 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
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”
Types of cancer: Leukemia
Involve blood-forming cells (white blood cells) which are chiefly in bone marrow. Acute, chronic
(National Cancer Institute)
Source: cancerhelp.org.uk
Types of cancer: Sarcoma
Connective & fibrous tissue
Examples: muscle, bone, cartilage, membranes covering
muscle/fat
Source: media.collegepublisher.com
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
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.
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.
Breast Cancer
The most frequently diagnosed cancer in women.
Risk factors: Age, female gender, personal family history
Types of Breast Cancer
Ductal cancer Most common type of breast cancer
Lobular cancer
Inflammatory breast cancer
Breast Cancer: Risk Factors
Gender 100x more common in
women
Age
Genetics BRCA1 BRCA2
Diet Alcohol
Physical activity
MenarchePregnanciesBreast-feedingMenopause
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
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
Colorectal Cancer
More common in Western societies.
Almost 100% preventable with screening and polyp removal.
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
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)
Sun Safety Quiz
“I can’t get skin cancer, because my normal routine (such as work, drive to work, hobbies, and vacations) doesn’t include any outdoor activities” False
“If I’m 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)
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
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
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
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