Chapter 15

Question 1

The second leading cause of death in the US. A condition characterized by the uncontrollable growth of cells. It develops from a single cell that goes awry, but a combination of events must occur before the cell turns into a tumor. With 30 billion cells in a healthy person, 1 out of 3 people can develop this.

Answer 1

Cancer

Question 2

What are the four most common cancers:

Answer 2

• lung
• colon
• breast
• prostate

Question 3

A mass of extra tissue created from a single cell producing thousands of copies of itself in an uncontrollable manner.

Answer 3

Tumor

Question 4

Divide when needed to replace cells that have died o been sloughed off.

Answer 4

Healthy cells

Question 5

Each time a cell divides, there is a possibility for this. Occur randomly, but the risk is increased by exposure to substances like tobacco smoke, radiation, and toxic chemicals. Can start a cell down a path towards cancer.

Answer 5

Mutation

Question 6

How mutations are dealt with:

Answer 6

-Enzymes within the nucleus of cells scan DNA as it replicates to look for errors
If error is detected: - enzyme backtracks and repairs it
If there is so much damage it can’t be prepared: - cells self-destruct
-cells divide till they are incapable of further division and die along with mutations that may occur with it
- immune system watch over cells and ones that aren’t growing normally are destroyed by immune system

Question 7

Often display an antigen, like a flag, on their cellular surface. When the antigen is detected by immune cells, the cell is labeled for destruction.

Answer 7

Cancer cells

Question 8

Do not differentiate into specific cell types (such as nerve, skin, or bone cells) during prenatal development and are capable of unlimited division. Have the ability to become different cell types. They are deep within tissues protected from exposure to sun, chemicals, and irritation as prevention to help prevent cancer. Stem cells have a self-destruction system if they do experience DNA damage or exposure to a toxin. A small number are found in most tissues to use for replacement of lost or damaged cell lines. Highest number of these are found in skin, blood, lung lining, intestines, endocrine cells, and liver.

Answer 8

Stem cells

Question 9

What cells are most susceptible to cancer risk because they do not have a predetermined number of cell divisions?

Answer 9

stem cells

Question 10

True or False?
Stem cells can become anything we need them to be which is why they are so important in research and treatment.

Answer 10

True

Question 11

How stem cells become cancer cells:

Answer 11

• mutated cells have to escape restraints made by healthy cells
  -carcinogens
• mutation of oncogene
• hyperplasia
• dysplasia
  -tumors
• metastasis

Question 12

A cancer causing substance or agent in the environment

Answer 12

carcinogen

Question 13

Mutation that causes a cell to grow and divide indefinitely ignoring signal from surrounding cells.

Answer 13

oncogene

Question 14

cell overgrowth

Answer 14

hyperplasia

Question 15

Develops at the site, and cells become abnormal.

Answer 15

dysplasia

Question 16

Grows slowly and is unlikely to spread. Dangerous if they grow in locations where they interfere with normal functioning and cannot be removed without destroying healthy tissue, as in the brain.

Answer 16

Benign tumor

Question 17

Capable of invading surrounding tissue and spreading. These cells do not stick together as much as normal cells, as this grows, some cancer cells may break off, enter the lymphatic system or bloodstream and travel to nearby lymph nodes or to distant sites of the body.

Answer 17

Malignant tumor

Question 18

At a new site, the cancerous cell can grow and become a secondary tumor or this. When a cancer spreads from one part of the body to another it is said to have done this.

Answer 18

metastasis or metastasized

Question 19

How cancers are classified:

Answer 19

• where the cancer originates called the primary site
• tumors are graded on how much cells resemble healthy cells (stages 0-IV)
• stages of disease depends on how far the cancer has spread
• prognosis depends on stage of tumor and type of cancer

Question 20

When a cancer is still at its primary site, it is said to be this.

Answer 20

localized

Question 21

When the cancer has metastasized, it is referred to has this.

Answer 21

invasive

Question 22

A process that helps guide treatment choices and predict prognosis.

Answer 22

diagnosis

Question 23

Outcome. Related to stage of tumor but also depends on the kind of cancer.

Answer 23

prognosis

Question 24

A description of how far the cancer has spread. Staging system for cancers. (Stage 0-IV) or (grade 0-IV).

Answer 24

Stage of disease

Question 25

Cancer in situ, an early cancer that is present only in the layer of cells where it began.

Answer 25

Stage 0

Question 26

Cancer is small and localized. Well-differentiated and low grade.

Answer 26

Stage I

Question 27

locally advanced and may or may not involve local lymph nodes.

Answer 27

Stage II and III

Question 28

Have metastasized to distant sites. Poorly differentiated and high grade.

Answer 28

Stage IV

Question 29

Arise from epithelial tissue, which includes the skin, the lining of the intestines and body cavities, the surface of body organs, and the outer portions of the glands.

Answer 29

Carcinomas

Question 30

Frequently shed and replaced. 80-90% of all cancers originate here.

Answer 30

Epithelial tissue

Question 31

Originate in connective tissue, such as bone, tendon, cartilage, muscle, or fat tissues.

Answer 31

Sarcomas

Question 32

Cancers of the blood and originate in the bone marrow or the lymphatic system.

Answer 32

Leukemias

Question 33

Originate in the lymph nodes or glands.

Answer 33

Lymphomas

Question 34

Risk Factors for Cancer:

Answer 34

• Age (occur mostly in 55 and older)
• Genetics ( likely to obtain cancer if your parent or sibling had it and how many relatives had it)
• tobacco
• balanced diet
• physical activity
• obesity

Question 35

What is the leading cause of preventable cancer in the US?

Answer 35

Tobacco

Question 36

What type of diets are associated with several cancers?

Answer 36

High in fat diets and red meat or processed meats

Question 37

Doing what with meat, poultry, and fish produces cancer causing compounds, especially if fat drips onto hot coals, causing smoke and flare-ups?

Answer 37

Grilling

Question 38

These rays are likely to cause sunburn and cause melanoma. Damage outer skin.

Answer 38

UVB rays

Question 39

Rays that tend to pass deeper into the skin and are now believed to cause skin cancer and premature aging of the skin.

Answer 39

UVA rays

Question 40

The most dangerous and is more related to timing and number of sunburns. Sunburns that occur during childhood seem to be most dangerous and the more, the greater the risk. People living near the equator or where the ozone is depleted are at greater risk.

Answer 40

Melanoma

Question 41

True or False?
Some viruses are known to cause cancer like HPV and Hepatitis B and C. Some strains of Epstein-Barr which causes mono are associated with lymphoma and stomach cancers. HIV can also cause cancer.

Answer 41

True

Question 42

A test given to a large group of people who have no symptoms of the disease being tested for to identify a smaller group of people who have cancer, precancer, or a significantly higher risk for a specific disease or condition.

Answer 42

screening test

Question 43

What is the leading cause of death for both men and women in the US? Rates have increased more for women than men.

Answer 43

Lung cancer

Question 44

Leading risk factors for lung cancer:

Answer 44

• Tobacco
• toxin exposure
• environmental tobacco smoke (ETS)

Question 45

Signs and symptoms include coughing with blood, chest pain, problems breathing, and recurrent lung infections. Often there are no symptoms until it is advanced. Small tumors are removed surgically. If this cancer is more severe, or because of a patient cannot tolerate surgery, there may be need of radiation or chemotherapy. The one year survival rate is 42%, and 5 year survival rate is 16%.

Answer 45

Lung cancer

Question 46

Are the third leading cause of death. Incidence declined in the 1990’s due to improved screenings and treatment and early detection and removal of colon polyps. The most important risk factor is AGE. More than 90% of cases are people over 50. Personal or family history of colon polyps or inflammatory bowel disease also increases the risk as does family history of colorectal cancer especially in a first degree relative. Other FACTORS include smoking, alcohol use, obesity, physical inactivity, a diet high in fat or red or processed meats, and not enough fruits and vegetables. Warning signs include a change in bowel movements, change in stool size or shape, pain in the abdomen, or blood in the stool. There are no signs until the disease is advanced. The American Cancer Society recommends people of average risk start screening at age 50. Surgery is the most common treatment. Chemo and radiation are added if the cancer is large enough to spread to other areas. The one year survival rate is 83%, and the 5 year survival rate is 65%.

Answer 46

Colon and rectal cancer

Question 47

Occurs in both women and men. Noncontrollable risk factors include the early onset of menstruation, late onset of menopause, family history in a FIRST degree relative, older AGE, higher socioeconomic status, and the breast cancer GENE. Controllable risk factors include NEVER having had children or having a first child after the age of 30, begin OBESE after menopause, taking HORMONE replacement therapy, and drinking more than 2 ALCOHOLIC beverages a day. Breastfeeding, exercising, and maintaining healthy body weight decrease risk. Early stages have no symptoms or symptoms that can only be detected on a mammogram. Later symptoms include a persistent lump, swelling, redness, or bumpiness of the skin, and nipple discharge. Mammograms have shown a decrease in the number of women who die from breast cancer. The American Cancer Society recommends annual mammograms after age 40. They also, clinical breast exams for women in their 20’s and 30’s every 2-3 years and every year after age 40. Self breast exams should be taught but don’t have to be done, according to the American Cancer Society. Treatment usually involves surgery, either a lumpectomy or mastectomy. Radiation and chemo and hormone therapy are often used. The 5 year survival rate is 90% for all breast cancers. For localized cancer, it is 98%. For cancer that has spread regionally, it is 84%. For cancer that has metastasized distantly, it is 23%.

Answer 47

Breast Cancer

Question 48

The second most common cause of cancer death in men. The rates are significantly higher among Black men as is the death rate. Better screenings led to higher diagnosis rates in the early 1990’s that leveled off after 1995. Death rates for Black men remain twice as high as those for White men. More than 70% of cases are diagnosed in men 65 and over. Other risk FACTORS include age, family history, being Black, and high fat diet. The risk of dying also increases with increasing body weight. Early stages have no signs or symptoms. Advanced associated with difficulty urinating, pain in the pelvic region, pain with urination or blood in the urine. These symptoms are also common in noncancerous conditions like enlarged prostate and bladder infections. The American Cancer Society recommends men start screenings at age 50, and Black men and men with a family history begin screenings at age 45. Routine use of PSA screenings (a blood test for prostate cancer) is controversial because many prostate cancers progress slowly and would not cause symptoms before the man could die of something else. Treatments can cause erectile dysfunction and incontinence. These effects have to be balanced against risk of cancer progression and spreading. In early stages, it is usually treated with surgery and radiation sometimes with chemo and hormone medications. Later stages require chemo, radiation, and hormone medications. The 5 year survival rate for all prostate cancers is 99%. For cancers detected at local or regional stages, it is 100%. At 10 years, the survival rate is 93% and 79% at 15 years.

Answer 48

Prostate Cancer

Question 49

Rates of this cancer has declined in the past few decades due to improved detection and treatment because of the PAP test. There are no symptoms in early stages. Signs of this cancer when advanced, include abnormal vaginal discharge or bleeding. Pain in the pelvic area can be a late sign. Pap tests occasionally give false positive or false negative results. Treatments include removing or destroying precursor cells through heat, freezing, or surgery. It can be combined with radiation and chemo.

Answer 49

Cervical cancer

Question 50

DIAGNOSED more in White women than Black women, but the death rate is twice as high in Black WOMEN. Black women tend to have more advanced cancer when diagnosed. Risks include exposure to estrogen due to obesity or estrogen replacement therapy. Pregnancy and oral contraceptives decrease risk. Warning signs include abnormal uterine bleeding, pelvic pain, and low back pain. Pain is usually a late sign. It is frequently detected earlier in postmenopausal women due to bleeding. Treatment is usually a hysterectomy and perhaps radiation, chemo, and hormone therapy.

Answer 50

Uterine or endometrial cancer

Question 51

Has a LOW rate of survival because most cases are not diagnosed until they have spread beyond the ovaries. If diagnosed early, the survival rate is 95%. Between 90-95% of women with it have no risk factors. The strongest risk factor is family history in a first degree relative. Women with the breast cancer gene also have an increased risk. The risk is also greater if a woman has a personal history of breast, colon, or endometrial cancer. Oral contraceptives, pregnancy, and breastfeeding decrease the risk. Early stages have few signs and symptoms. At later stages, women may notice swelling of the abdomen, bloating, or a vague pain in the lower abdomen. Typically, all or part of the ovaries, uterus, and fallopian tubes are surgically removed and lymph nodes are biopsied to see if cancer has spread. It may require chemo and radiation. There is currently research into vaccinations, targeted drugs, and immunotherapy.

Answer 51

Ovarian Cancer

Question 52

Occurs more in WHITES. From SUN exposure especially early in life. Rates have increased from 1970-2000 but have been stable since. The mortality has decreased for people under 50 probably due to early detection. The risk is greatest for people with a personal history of this, a large number of moles, or a family member with melanoma. The risk is greatest for people with fair skin and sun sensitivity. It can occur on any body part but is directly related to sun exposure from sun or tanning beds. Exposure in childhood or adolescence may be particularly dangerous. Early detection comes from monitoring your skin yourself and evaluation by your health care provider as part of regular exams. Treatment includes surgical removal and biopsy of suspicious lesions. Chemo and immunotherapy may be added for advanced stages. The overall 5 year survival rate is 91%, and if diagnosed early, the 5 year survival rate is 99%. Sun-exposed areas of the body are susceptible to basal cell and squamous cell cancers. People at high risk have fair skin; light hair; blue, green, or hazel eyes; and freckles or moles. Other risk factors are cumulative sun exposure and age with increased rates over age 50. However, they are increasing in younger people. Treatment usually involves local removal and destruction of the cancer by surgery, heat, or freezing with some use of radiation.

Answer 52

Melanoma

Question 53

Accounts for only 1% of all cancers in men, but it is the MOST common malignancy in men aged 20-35 years of age. The incidence has nearly doubled worldwide in the past 40 years. The survival rate has increased. It occurs nearly 4.5 times more often in White men than in Black men. The risk is 3-17% higher in men with a history of an undescended testicle. Other factors include family history, personal history of testicular cancer in the other testicle, abnormal development of the testes, and infertility or abnormal sperm. Warning signs include a painless lump on the testicle and swelling or discomfort in the scrotum. Back pain and difficulty breathing can develop in later stages after the cancer metastasizes. The American Cancer Society recommends a testicular exam by a health care provider every 3 years for men over 20 and annually after 40. It is treated with surgery to remove testicle, and radiation and chemo may be needed. It is highly treatable with more than 90% of cases at all stages being cured. The CURE RATE is 99% if the cancer is diagnosed early. It can even be cured in late-stage and with extensive metastases.

Answer 53

Testicular Cancer

Question 54

Have been declining since the 1980’s, and death rates have been stable since 2000. It is more common in MEN than women. A major risk factor is TOBACCO use. High ALCOHOL use also increases risk. Early signs include a sore in the mouth that does not heal or bleeds easily, a lump or bump that does not go away or increases in size, or a patch of redness or whiteness along the gums or skin lining the inside of the cheeks. Late signs include pain or difficulty swallowing or chewing. It is usually detected by a doctor, dentist, or the individual. Treatment involves surgery to remove as much as possible along with local radiation. Chemo is added in advanced cases. The 5 year survival rate is 61%.

Answer 54

Oral Cancer

Question 55

A group of cancers that originate in the bone marrow or other parts of the body where white blood cells form. It is the overproduction of one type of white blood cell which prevents the normal growth and function of other blood cells and can lead to an increased risk of infection, anemia, and bleeding. Risk factors include cigarette SMOKING and exposure to certain CHEMICALS, particularly benzene which is found in gasoline products and cigarette smoke. People who survive other cancers are at greater risk as a result of radiation treatment. Symptoms include fatigue, increased incidence of infection, and easy bleeding and bruising. Because symptoms are nonspecific, early detection is difficult. The most effective treatment is chemo. There may also be a need blood transfusions, antibiotics, drugs to boost function of healthy blood cells, and drugs to reduce side effects of chemo. Bone marrow transplant can be effective for certain types.

Answer 55

Leukemia

Question 56

Are cancers that originate in the lymph system, part of the body’s immune system. There are two main TYPES: Hodgkin’s and non-Hodgkin’s. It can start ANYWHERE because lymph system exists throughout the body. Rates have nearly doubled in the past 30 years. About 95% occur in adults with an average age of diagnosis in the 60’s. Risk factors include infections, medications, or genetic changes that weaken the immune system. HIV explains some of the increase in rates. Radiation, herbicides, insecticides, and some chemical exposures also increase risk. The majority of people do not have clearly identified risk factors. General symptoms include weight loss, fever, night sweats, and severe itchiness. Treatment often includes a combination of surgery, chemo, and radiation. It can sometimes involve immunotherapy or bone marrow transplant. The 5 year survival rate for non-Hodgkin’s is 67% and 85% for Hodgkin’s.

Answer 56

Lymphomas

Question 57

What cancers are not recommended for screening tests because no test has been shown to improve detection without increasing harm?

Answer 57

Lung and ovarian

Question 58

Cancer Treatments:

Answer 58

• Surgery
• Chemotherapy
• Radiation
• Immunotherapy
• Bone Marrow Transplantation
• Gene Therapy
• CAM practices

Question 59

A drug treatment administered to the entire body to kill any cancer cells that may have escaped from the local site. Different combinations are used for different cancers. They interfere with rapid cell division. Other normal tissues that divide rapidly are also harmed by chemo including hair, stomach lining, and white blood cells. Researchers are looking toward treatments that will do less harm to normal cells.

Answer 59

Chemotherapy

Question 60

Causes damage to cells by altering their DNA. It can destroy cancer cells with minimal damage to surrounding tissues. Local treatment can be used before or after surgery or in conjunction with chemo. It can be used to control pain in patients with cancer that cannot be cured.

Answer 60

Radiation

Question 61

Enhance the immune system’s ability to fight cancer or reduce side effects of chemo. They include vaccines that can be given after diagnosis and some are preventative. Medications can also be used to boost the immune system and others improve the health of damaged immune system components by increasing the number of white blood cells, red blood cells, and platelets.

Answer 61

Biological practices

Question 62

Boosting the immune system with social support from friends, family, or cancer support groups. Prolonged cancer survival is associated with good support systems and a positive outlook.

Answer 62

Immunotherapy (part of biological therapy)

Question 63

Used for leukemia and lymphoma and is now sometimes used for other cancers when healthy bone marrow cells are killed by high doses of chemo.

Answer 63

Bone marrow transplantation

Question 64

Would allow mutated genes to be replaced with functional genes, decreasing the risk that cancer will occur or stopping a cancer that has started to develop. Genes could be inserted into immune cells to increase their ability to fight cancer cells or could be inserted into the cancer cells themselves, causing them to self-destruct or making the cancer more susceptible to chemo. Still in clinical trials at this time.

Answer 64

Gene Therapy

Question 65

A new term to describe the potential future use of genetic testing to identify the specific genetic changes in an individual’s cancer, which can then guide treatment. Expected to allow more accurate predictions of how a cancer will behave, which chemotherapy drugs will work best, and which patients will benefit most from chemo.

Answer 65

Precision medicine (genetic testing)

Question 66

Usually it is used as an adjunct to standard treatment options with the goal of reducing side effects of cancer or cancer treatment, speeding recovery, improving pain control, and increasing chances of survival. Dietary and nutritional supplements are most commonly used, but there is concern they may interfere with traditional treatments, so they are not generally recommended. Have shown benefits like acupuncture, massage, hypnosis, Qigong, and meditation.

Answer 66

CAM

Question 67

How to live with cancer:

Answer 67

• participate in decisions about your treatment
• ask a person that already has cancer for advice
• research your cancer
• have social support
• use spiritual and religious beliefs as strength to get through it