Onc part 1 stats Flashcards
Both genders cancer MC
Breast
prostate
lung
colon
gender specific x 2 + lung colon
Deaths MC male
lung
prostate
colon
pancreas
Deaths female MC
Lung
Breast
Prostate
Colon
Pancreas
Female MC cancer
Breast
Lung
Colon
Uterine
gender specific + lung, colon + gender specific
Male MC cancer
Prostate
Lung
Colon
Bladder
gender specific + lung, colon + gender specific
Overall trend
Number of new cases increasing but deaths decreasing
how many deaths caused by cancer
1 in 4
how many cancer cases projected in 2024?
2M+ cancer cases projected in 2024
What racial group is cancer most deadly
African American
Most significant risk factor for cancer
age
2/3 caused by those older than 65
Global cancer trends
India is lip and oral cavity cancer – from chewing tobacco
Globally lung is the most common for men, and breast cancer for women
Mongolia is liver – Hep, C and alcohol abuse
3 factors cause cancer
Exposure to certain environmental factors (including diet, hormones)
Genetic makeup
Age and gender
Example of primary prevention
a genetic test reveals someone at risk for breast cancer.
chemopreventive agents or prophylactic surgery to avoid the cancer altogether
promote a healthy lifestyle to avoid all cancer
How big of a part does genes play in developing cancer
5%
MC smoking cancer
lung #1
upper aerodigestive tract and bladder
cigars
doubles risk for
Oral cancer
Esophageal cancer
when compared to cigarretes
Smokeless tobacco
dental caries, gingivitis, oral leukoplakia, and oral cancer
esophageal
Primary prevention includes
Tobacco cessation
Physical activity
Eating right, dietary modifications
Avoiding alcohol
Diets high in fat…
Increase cancer of breast, colon, prostate, and endometrium
Female+male + colon
Dietary fiber
reduces risk of colon polyps and invasive colon cancer
Recommendation to avoid what for colon cancer?
Avoid red meat, limit fat, stay away from processed meat like hot dogs, ham, sausages, deli meat. red meats are beef, pork, and lamb.
Recommend to focus on plant foods and fiber.
Obesity also leads to cancer so another reason to eat healthy.
Alcohol cancer?
mouth –> stomach incl. esophagus.
liver
breast
Examples of secondary prevention?
early detection & treatment
screening for cervical, colon, prostate, breast for certain age groups
lung cancer based on hx
sens, spec, ppv, npv apply to the screening tests
Avoiding carcinogens is an example of what
primary prevention
breast cancer screening , how often
Ages 40-44 have the option to start screening with a mammogram every year.
Women 45 to 54 should get mammograms every year.
Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.
Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms.
CBE and/or SBE?
Clinical breast exam (CBE) is no longer recommended for women of average-risk
Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider.
Breast self-exam (BSE) is an option for women starting in their 20s.
The only time a clinical breast exam is done
In some situations, particularly for women at higher-than-average risk, for example, health care providers may still offer clinical breast exams.
breast cancer screening recommendations for HIGH risk patients
High risk = clinician exam, breast MRI yearly, mammo yearly, starting at age 30. the images are done 6 months apart.
Who is rated high risk for breast cancer?
- BRCA1/2 gene or 1st degree relative with it
-family history of breast cancer
- radiation therapy under 30
- Lifraumeni, Cowden, Bannavan-Riley-Ruvalcaba (or 1st deg. relative)
Colon Cancer screenings begin at
Age 45 through age 75.
Tests that only find colon cancer
yearly fecal occult test
yearly fecal immunochemical test
Stool DNA test
Tests that find both colon polyps and cancer
felxible sigmoidscopy every 5 years
colonoscopy every 10 years
double contrast barium enema every 5 years
CT colonography (virtual colonoscopy) every 5 years
How often are paps and HPV tests done
ACS - 25 and up - HPV every 5 yrs and paps are done every 3 yrs
USPTF - paps start at age 21, every 3 years. At age 30, same rec. as ACS
Staging vs monitoring
Monitoring detects reappearance. Staging detects extent, progression, and tx plan
What words to avoid and what words to use when delivering cancer news
Good = cancer, malignant
Bad = fatal, terminal
Chance of cancer causing depression and how to diagnose depression
at least 2 weeks.
3 or more factors.
Meds for cancer caused depression
fluexotine, sertraline, paroxetine
(SSRIs) or TCA
4-6 weeks for response, use for at least 6 months
first major determinant of treatment outcome/prognosis
Tumor burden
-understanding the extent of the disease
How does TNM contribute to staging
You have a chart w/ corresponding TMN sections that tell you what stage the patient is in
T = tumor size, invasion
N = lymph node
M = metastasis
which cancers don’t use the TNM staging method
hematopoietic tumors such as leukemia, myeloma, and lymphoma are often disseminated at presentation and do not spread like solid tumors.
What do we use to measure physiological reserve
Karnofsky, ECOG (Eastern cooperative oncology group)
-100 normal for karn (0 to 100), 0 dead
-5 is dead for ecog (0-5)
What is a bad physiological reserve
Old patient with Karn less than 70, or ECOG 3 or more
Can tumor markers diagnose?
No!
Only a tissue bx can.
Tumor markers are used to assess response to treatment.
CA-125
ovarian cancer, some lymphomas,
Menstruation, peritonitis, pregnancy
CA 19-9
Colon, pancreatic, breast cancer
Pancreatitis, ulcerative colitis
Prostate-specific antigen
Prostate cancer
Prostitis, prostatic hypertrophy
Lactate dehydrogenase
Lymphoma, Ewing’s sarcoma
Hepatitis, hemolytic anemia
Carcinoembryonic antigen
Adenocarcinomas of the colon, pancreas, lung, breast, ovary
a Fetoprotein
Hepatocellular carcinoma, gonadal germ cell tumor
Cirrhosis, hepatitis
Calcitonin
Medullary cancer of the thyroid
Human chorionic gonadotropin (HCG)
Gestational trophoblastic disease, gonadal germ cell tumor
Pregnancy
