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test 3 cancer Flashcards

1
Q

what is cancer

A

a large group of disease (over 200) characterized uncontrolled growth and spread of abnormal cells

  • is a “genetic” disease- disease of the DNA
  • not hereditary: one passed from parent to child through inheritance of a defective gene

all cancers are genetic, some are hereditary

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2
Q

explain the growth of cancer cells

A
  • reproduce every 2-6 weeks
  • one million cells = head of pin
  • one billion cells =size of grape
  • a person usually has cancer for several years before they know
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3
Q

what are malignant and benign cancer cells

A

benign: cancer tumor cells grow only locally and cannot spread by invasion or metastasis
malignant: cancer cells invade neighboring tissues, enter blood vessels and metastasize to different sites

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4
Q

differences between malignant and benign cancer cells

A

benign: slow growing, non-invasive, does not metastasize, well differentiated
malignant: fast growing, invasive, does metastasize, poorly differentiated

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5
Q

explain cancer as a leading cause of death

A
  • CVD is currently highest cause of death with cancer right below, but it is likely to flip soon
  • cancer cases projected to increase by 50%
  • cancer deaths projected to increase by 60%
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6
Q

what is the incidence rate of cancer

A

-current rate is 20% higher in men than women

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7
Q

what are the types of cancers

A

leukemia, lymphomas, sarcomas, and carcinomas

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8
Q

explain the differences in the different types of cancers

A
  • leukemia is blood cells
  • lymphomas are lymph nodes and tissues
  • sarcomas are cells in supportive tissues, bones and muscles
  • carcinomas are cells that cover internal and external body surfaces (epithelial tissues, 85% of all cancers)
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9
Q

explain the most common cancer in US

A
  • skin cancer
  • half of all american’s will develop basal cell and squamous cell at least once by age 65
  • more skin cancer cases than breast, prostate, lung and colon cancer combined
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10
Q

what is skin cancer and the two types

A

develops in the layers of your skin

1) melanoma
2) kerantinocyte (basal cell carcinoma and squamous cell carcinoma)

different types of skin cancer named after the cells they infect

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11
Q

explain carcinomas in skin cancer

A

can occur in any epithelial cell, but most common form is basal cell carcinoma (BCC)

  • 8 out of 10 skin cancers are BCC
  • 2 out of 10 carcinomas are categorized as squamous cell carcinoma (SCC)
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12
Q

how many people get sunburned at least once a year

A

42%

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13
Q

explain deaths of melanoma

A

1.5% of all cancer deaths
5.3% of call new cancer cases
92% survive in 5 years

skin cancers are categorized as the most treatable

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14
Q

explain melanoma prevalence by age

A
  • risk increase with age
  • most frequently diagnosed in 65-74 year olds
  • but 15% of cases occur before age 44
  • melanoma accounts for 4% of skin cancers, but majority of skin cancer deaths
  • more prevalent in older age groups, but it is the most common form of cancer for people in their 20s
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15
Q

explain skin cancer and race

A
  • caucasians more likely to develop melanoma than african americans, but it is more deadly for african americans
  • white survival rate is 90% black is 77%
  • more common in men than women, but women have a higher risk until age 40
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16
Q

what are the things to look for in skin cancer

A 
Asymmetry
Border
Color
Diameter
Evolving
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17
Q

where does skin cancer normally occur

A

ears, face, neck, scalp

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18
Q

explain tanning beds and skin cancer

A
  • tanning beds increase risk of skin cancer
  • 20% female high school students use indoor tanning and older white students are particularly likely to indoor tan
  • states are placing restrictions on indoor tanning (42 states regulate use of tanning beds)
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19
Q

explain risk of cancer and tanning beds

A

1=normal risk

  • relative risk = 1.2 (with tanning bed)
  • dose response = 1.8% increase risk for melanoma each use
  • use before age 35= relative risk of 1.87
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20
Q

where else can carcinomas occur

A

-cells that cover internal and external body surfaces

1) breast
2) lung
3) prostate
4) colon
5) melanoma

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21
Q

list the most common carcinomas after skin cancer

A

1) female breast cancer: 15% of all new cancer cases in US
2) lung cancer: 13% of all new cases
3) prostate cancer: 9% of all new cases
4) colon cancer: 8% of all new cases

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22
Q

how much of deaths by cancer does lung cancer account for

A

1/4

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23
Q

what other cancers also account for high % of cancer deaths

A

colon pancreas and breast

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24
Q

is the order of top cancers consistent

A

no it changes year to year

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25
Q

explain breast cancer stats

A
  • 15% of new cancer cases, 6% of all cancer deaths
  • 1 in 8 women diagnosed in her life
  • 5 year survival rate is close to 90%
  • similar to he prevalence rate of prostate cancer in men, but associated with slightly higher mortality
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26
Q

explain recommendations for early detection of breast cancer

A

1) women older than 40=mammogram yearly
2) women 20-30= breast exam every 3 years
3) women in 20s= regular self exams
4) women at high risk= MRI and mammogram yearly, if lifetime risk is 20-25%

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27
Q

explain age of breast cancer

A
  • median age of diagnosis is 62

- more than 30% of breast cancer cases are diagnosed prior to the age of 54

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28
Q

explain race in breast cancer

A

-incidence is highest in whites, but death rate is higher in black women

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29
Q

explain lung cancer stats

A
  • 13% of new cancer cases, 25% of all cancer deaths
  • % of cancer deaths double the % of all new cancer cases
  • morbidity does not always speak to mortality
  • 18% 5 year survival rate
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30
Q

explain lung cancer prevalence of morbidity and mortality

A
  • lung cancer is 2nd more prevalent cancer, but most likely cause of cancer related death
  • lung cancer deaths each year are greater than the combined deaths due to other top 4 cancers
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31
Q

explain demographics of lung cancer

A
  • men more likely to have lung cancer
  • black men more likely than other men
  • white women more likely than other women
  • prevalence rates for races different for men and women
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32
Q

explain prostate cancer stats

A
  • 9% of new cancer cases, 4% of all cancer deaths
  • 98% 5 year survival rate
  • usually a slow growing cancer which may be the reason for a lower mortality, compared to morbidity
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33
Q

explain prostate diagnosis stats

A
  • 1 in 7 men diagnosed with prostate cancer during his life
  • median age diagnosis is 66
  • prostate screenings should begin between 40 and 50 depending on one’s relative risk
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34
Q

explain race in prostate cancer

A

black men most likely to get it and die from it

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35
Q

explain colon and rectum cancer stats

A
  • 8% of new cancer cases, 8% of all cancer deaths
  • 64% 5 year survival rate
  • colorectal cancer is 4th most prevalent cancer, but 2nd leading cause of cancer related death
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36
Q

explain colon and rectum cancer age stats

A
  • median age diagnosis at 67

- becoming a bigger concern for younger generations, rising in GenX and millenials

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37
Q

explain demographics in colon and rectum cancers

A

more common in men and black individuals, which is mirrored by the mortality rates

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38
Q

explain stats for pancreatic cancer

A
  • 3% of new cancer cases, 7% of all cancer deaths
  • 8% 5 year survival rate (low)
  • % of cancer deaths double % of all new cancers
  • 11th most common cancer overall, 3rd most common cause of cancer death

may not seem like a great survival rate, but it has almost quadrupled from 1975

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39
Q

what are sarcomas and 2 types

A

malignant tumor that can be divided into 2 groups, cells in supportive tissues and it often spreads to other areas

1) bone sarcomas: arising from bone cartilage
2) soft tissue sarcomas: arising from tissue such as fat, muscle and nerves

1% of adult cancers, 15% of childhood cancers

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40
Q

explain soft tissue sarcomas

A
  • most common in arms and legs
  • then GI tract, then abdominal area, then head and neck
  • can get in fat, nerves, blood vessels, lymph vessels, etc
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41
Q

explain bone sarcoma

A
  • soft tissue sarcoma is more prevalent than bone, but both are quite rare (less than 1%)
  • a very small % of people can get “Ewing Sarcoma” which can infect both bone and soft tissue
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42
Q

what is Leukemia and the two main types

A

affects blood producing tissues (ex. marrow)

1) myeloid leukemia
2) lymphoblastic leukemia
* *both are characterized by abnormal white blood cell increase**

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43
Q

what are the two onsets of leukemia

A

1) acute: develops quickly

2) chronic: develops slowly

44
Q

explain the subtypes of leukemia by most prevalent to least prevalent

A

1) acute myeloid leukemia (AML) -lowest survival rate
2) chronic lymphoblastic leukemia (CLL)- highest survival rate
3) acute lymphoblastic leukemia (ALL)
4) chronic myeloid leukemia (CML)

45
Q

explain the survival rates for AML and ALL

A

higher for kids

-these are the only two types that children get

46
Q

how is leukemia diagnosed

A

bone marrow (where cancer resides) biopsy

47
Q

explain leukemia stats

A
  • 3% of new cases, 4% of cancer deaths
  • 61% 5 year survival rate (has greatly increased, doubled since 1975)
  • median age of diagnosis is 66
48
Q

explain demographics of leukemia

A
  • men have higher occurrence
  • white men and women most likely to be diagnosed
  • most common type of cancer in children younger than 20 years (26.7%) but it is still much more common in older adults
  • less than 9% of all cases occur in those younger than 20
49
Q

what are lymphomas

A

cancer that affects the lymphatic system, which helps to produce white blood cells (lymphocytes)
-lymphnodes: filters for harmful substances

50
Q

explain what lymphnodes are

A

we have 500-700 lymphnodes

  • shouldnt be able to feel them unless swollen
  • swell near infection
  • certain diseases cause wide spread swelling (strep throat, chicken pox, autoimmue and cancer)
51
Q

what are the subtypes of lymphoma

A

1) hodgkin lymphoma

2) non-hodgkin lymphoma

52
Q

what is hodgkin lymphoma

A

involves the reed-sternberg cell

  • 6 types
  • 86% survival rate, 0.5% of new cancer cases
53
Q

what is non-hodgkin lymphoma

A
  • any lymphoma that does not have the presence of reed-sternberg cells is considered to be this type
  • 61 distinct types
  • account for 90% of lymphomas
  • 71% survival rate, 4% of new cancer cases
54
Q

what are the demographics of lymphoma

A

more likely in men than in women

white men and women more likely to get it

55
Q

explain age and lymphoma

A
  • non-hodgkin lymphoma: risk increase with age

- hodgkin lymphoma rates fairly consistent independent of age group

56
Q

explain overall cancer rates in people

A

1/2 men and 1/3 women will develop cancer
-black men higher incidence than white men, white women have higher incidence than black women, but more black people die than white

57
Q

explain the top three cancers and three deaths in high human developmental areas for men and women

A

men: prostate, lung, colon
women: breast, colon, lung
men deaths: lung, colon, prostate
women deaths: lung, breast, colon

58
Q

explain the top three cancers and three deaths in low human developmental areas for men and women

A

men: prostate, liver, colon
women: breast, uterine, colon
men deaths: prostate, liver, colon
women deaths: uterine, breast, colon

59
Q

explain incidence of types of cancers

A

depends on location

-less variability in most common diagnosed cancer in area for women than men (mostly all breast cancer)

60
Q

explain the genetic markers of breast and ovarian cancers

A
  • BRCA 1 & 2 account for 20-25% of hereditary breast cancers
  • account for 15% of ovarian cancers
  • mutations also linked to other kinds of cancer (prostate, pancreatic, leukemia)
61
Q

explain the risk of breast cancer with genetic markers

A
  • BRCA 1&2 linked to overall increased lifetime risk and earlier onset (especially linked to ethnic groups like Jewish women)
  • women with first degree relative with breast cancer are 2x more likely to develop breast cancer

coverage provided to those with gene deficiency for genetic testing

62
Q

explain genetic markers in colon cancer

A
  • 5-10% of people who develop colorectal cancer have inherited gene changes
  • most common inherited syndromes linked with colorectal cancers are familial adenomatous polyposis and lynch syndrome (hereditary colorectal cancer)
63
Q

what does the international agency for research on cancer do

A
  • look at naturally occurring exposures (ultraviolet light, radon gas, etc)
  • medical treatments (chemo, radiation, etc)
  • workplace and household exposures
  • pollution
  • recognize 900 carcinogens currently, 119 carcinogenic to humans and 373 are possibly carcinogenic
64
Q

what is the national toxicology program

A
  • updates reports on carcinogens
  • 2 groups of ages: 1) known to be human carcinogens 2) reasonably anticipated to be human carcinogens
  • doesnt list substances found not to be carcinogens (only 250)
65
Q

what is asbestos

A

excessive exposure leads to mesothelioma (lung cancer) and low to middle income countries still have big threat due to lenient regulations
-we are required to give warnings about dangerous things in US

66
Q

what can smoking due aside from cause lung cancer

A
  • can cause other cancers
  • women and men 25 x more likely to develop lung cancer after smoking
  • second hand smoke also causes lung cancer
  • smoking causes 16 types of cancer and accounts for 1/5 of global cancer threats
67
Q

explain infectious agents

A

16% of all cancer due to infectious agents (nearly all cases of cervical cancer due to HPV)

  • bacteria Heliobacter pylori is responsible for 90% of stomach cancers and 33% of all infection related cancers
  • not many cancers caused by infection in US, but a lot in Africa and China
68
Q

explain diet and physical exercise

A
  • can be risk or protective factor
  • for some cancer sites excess body weight accounts for a large proportion of cases (esophageal, breast, kidney, colorectal, endometrial)
69
Q

explain reproductive habits

A
  • child bearing and breast feeding protective risk

- oral contraceptives and hormone replacement therapy increase risk

70
Q

explain early detection in mammograms

A
  • 14-40% of women actually do monthly self exams
  • other preventative measures are mammogram x-ray of tissue
  • used to recommend 40 years or older to get one, but not many women are doing it because of insurance and education level
71
Q

explain insurance coverage mammograms

A
  • cover mammograms for women 40+, some can get them at no cost
  • medicare and medicaid also cover screenings depending on age history and symptoms

medicare: screen every 12 months
medicaid: exam annually if meet history and symptoms requirements

72
Q

explain controversy about mammograms

A

leads to a lot of false positives and unnecessary procedures

73
Q

explain prostate exam recommendations

A
  • age 50 for men at average risk of prostate cancer and expected to live 10+ years
  • age 45 for men at high risk (men who have first degree relative and are african american)
  • age 40 for men at higher risk (more than one first degree relative)

insurance can fully cover prostate screenings if at high risk

74
Q

explain controversy of prostate exam recommendations

A
  • goal is to detect clinically significant prostate cancers at stage when intervention reduces morbidity and mortality
  • findings: high false negative results with only 30% of men with positive result actually having cancer
  • not clear if early detection leads to change in outcomes
  • research shows it detects some cancers that would have never been detected and leads to over treatment
75
Q

explain colorectal screenings

A
  • recommended routine screenings at age 50

- 60% adults report getting these screenings, could get better, no difference between men and women

76
Q

what is the insurance coverage of colonoscopies

A
  • plan started after 2010, colonoscopies are covered
  • medicare: every 2 years for those at high risk, every 10 for those at average risk
  • medicaid: varies by state and depends on risk/symptoms
77
Q

what is a common treatment option for cancer

A

surgery, there are many different types of surgery for cancer related options

usually done in conjunction with other treatments

78
Q

what are the different kinds of surgery

A

preventative surgery, diagnostic and staging surgery, curative surgery, debulking surgery and palliative surgery

79
Q

what is preventative surgery

A

done before cancer actually present, usually due to presence of pre-cancerous cells or genetic risk
ex. mastectomy for breast cancer

80
Q

what is diagnostic and staging surgery

A

done to gain more knowledge about the presence and severity of cancer

81
Q

what is curative surgery

A

done when cancer has not metastasized and can easily be removed

82
Q

what is debulking surgery

A

remove some of the cancer but not all, because removal of all causes too much damage

83
Q

what is palliative surgery

A

done to make a patient more comfortable, but not done for curative purposes

84
Q

what is radiation

A

uses high energy particles or waves to damage or destroy cancer cells
-one of most common treatments either by itself or with other treatments

85
Q

what is chemotherapy

A

using medicine or drugs to treat cancer

-stops division and growth of cells

86
Q

explain breast cancer treatment in early vs. late stages

A
  • early stages: use surgery more often (breast conservation)

- late stages: use chemo more often (and mastectomy)

87
Q

what breast cancer treatment is the best

A
  • study with 3 groups (breast conservation-partial removal, mastectomy-full removal, and mastectomy and radiation)
  • 5 year survival rates: 97%, 94% and 90%
  • perhaps most invasive methods lead to less survival
88
Q

what are the side effects of breast cancer treatment

A
  • 60% of women experiencing 1 or more adverse treatment effects 6 years after diagnosis
  • weight gain, fatigue, etc
89
Q

explain prostate cancer surgery/treatment

A
  • those younger than 65 more likely to have radical prostatectomy (with or without radiation), but regardless of risk level 1/5 of group does nothing (because its slow growing)
  • only 10% occur in those younger than 55
  • prostatectomy can cause sexual, urinary and bowel impairments
90
Q

does it make sense to take out prostate

A

-percentage of men who died from any cause was similar to group that got prostate removed and group that did not

91
Q

explain lung cancer treatments at the different stages

A

early stage: surgery most common
late stage: chemo more common
-only 15% of lung cancers diagnosed at early stage
-once late stage surgery is not usually an option, most common treatment is chemo and radiation

92
Q

what is biotherapy

A

immunotherapy, works by training immune system to function better
-stimulating immune system to work harder to attack cancer cells

93
Q

what is hormonal therapy

A

decreasing hormone production to lower chance of cancer cells

94
Q

what is stem cell treatment

A

does not work to destroy cancer directly (can in leukemia) but aids in recovery after other forms of treatment

95
Q

explain complementary approaches

A

cancer treatment plans incorporate multiple treatment options

  • CAMs is very common in cancer patients
  • more CAMs with increases in severity, education, accessibility and distress
96
Q

explain health care providers and CAMs

A
  • movement for health care providers to embrace these methods
  • 60% of plans had CAM components
97
Q

explain controversial cancer treatments

A

ex. injecting with HIV virus t-cells to attack cancer cells
- many of these treatments may not be covered by insurance so people seek alternative payment methods
- gofundme blocked abilities to do this

98
Q

what can you do if you cannot treat the body in cancer

A

in worst case scenario, cancer is terminal, while we may not be able to treat the body we can still treat the mind

99
Q

what is cognitive behavioral therapy (CBT) in cancer

A

type of therapy aimed at developing beliefs, attitudes, thoughts and skills to make positive changes in behaviors

100
Q

what is one kind of CBT

A

acceptance and commitment therapy (ACT) which encourages acceptance of condition by focusing attention on other valuable goals and activities

101
Q

what can social-emotional support do

A

effective coping strategies in conjunction with a good social support structure results in better outcomes

  • use of engagement style coping as opposed to disengagement
  • most important social support system comes from spouse
102
Q

how can social support from a spouse be a problem

A

can be a problem in hetero relationships where each person’s needs and understanding of other’s needs may differ

  • men are good at supporting physical needs, but not as good with emotional needs
  • men aren’t as likely to seek social support, but it doesn’t mean they need it less
103
Q

how can cancer change a relationship with a significant other

A
  • roles
  • responsibilities
  • needs
  • sexuality/intimacy
  • future plans
104
Q

explain the influence of cancer diagnosis on family and friends

A
  • patients have higher depression when they have surgery, while the opposite is true for their relatives
  • 21% of variance in depression and 15% of variance in anxiety was accounted for by different relationships with family members
105
Q

explain social emotional support in the family

A

ability of families to act openly and express feelings directly (expressiveness) were associated with lower levels of depression
-communication and emotion focused coping is important for all people involved not just patient

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