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
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
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
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
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%
6
Q
what is the incidence rate of cancer
A
-current rate is 20% higher in men than women
7
Q
what are the types of cancers
A
leukemia, lymphomas, sarcomas, and carcinomas
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)
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
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
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)
12
Q
how many people get sunburned at least once a year
A
42%
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
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
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
16
Q
what are the things to look for in skin cancer
A
Asymmetry Border Color Diameter Evolving
17
Q
where does skin cancer normally occur
A
ears, face, neck, scalp
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)
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
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
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
22
Q
how much of deaths by cancer does lung cancer account for
A
1/4
23
Q
what other cancers also account for high % of cancer deaths
A
colon pancreas and breast
24
Q
is the order of top cancers consistent
A
no it changes year to year
25
explain breast cancer stats
- 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
26
explain recommendations for early detection of breast cancer
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%
27
explain age of breast cancer
- median age of diagnosis is 62
| - more than 30% of breast cancer cases are diagnosed prior to the age of 54
28
explain race in breast cancer
-incidence is highest in whites, but death rate is higher in black women
29
explain lung cancer stats
- 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
30
explain lung cancer prevalence of morbidity and mortality
- 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
31
explain demographics of lung cancer
- 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
32
explain prostate cancer stats
- 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
33
explain prostate diagnosis stats
- 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
34
explain race in prostate cancer
black men most likely to get it and die from it
35
explain colon and rectum cancer stats
- 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
36
explain colon and rectum cancer age stats
- median age diagnosis at 67
| - becoming a bigger concern for younger generations, rising in GenX and millenials
37
explain demographics in colon and rectum cancers
more common in men and black individuals, which is mirrored by the mortality rates
38
explain stats for pancreatic cancer
- 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**
39
what are sarcomas and 2 types
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
40
explain soft tissue sarcomas
- 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
41
explain bone sarcoma
- 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
42
what is Leukemia and the two main types
affects blood producing tissues (ex. marrow)
1) myeloid leukemia
2) lymphoblastic leukemia
* *both are characterized by abnormal white blood cell increase**
43
what are the two onsets of leukemia
1) acute: develops quickly
| 2) chronic: develops slowly
44
explain the subtypes of leukemia by most prevalent to least prevalent
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
explain the survival rates for AML and ALL
higher for kids
| -these are the only two types that children get
46
how is leukemia diagnosed
bone marrow (where cancer resides) biopsy
47
explain leukemia stats
- 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
explain demographics of leukemia
- 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
what are lymphomas
cancer that affects the lymphatic system, which helps to produce white blood cells (lymphocytes)
-lymphnodes: filters for harmful substances
50
explain what lymphnodes are
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
what are the subtypes of lymphoma
1) hodgkin lymphoma
| 2) non-hodgkin lymphoma
52
what is hodgkin lymphoma
involves the reed-sternberg cell
- 6 types
- 86% survival rate, 0.5% of new cancer cases
53
what is non-hodgkin lymphoma
- 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
what are the demographics of lymphoma
more likely in men than in women
| white men and women more likely to get it
55
explain age and lymphoma
- non-hodgkin lymphoma: risk increase with age
| - hodgkin lymphoma rates fairly consistent independent of age group
56
explain overall cancer rates in people
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
explain the top three cancers and three deaths in high human developmental areas for men and women
men: prostate, lung, colon
women: breast, colon, lung
men deaths: lung, colon, prostate
women deaths: lung, breast, colon
58
explain the top three cancers and three deaths in low human developmental areas for men and women
men: prostate, liver, colon
women: breast, uterine, colon
men deaths: prostate, liver, colon
women deaths: uterine, breast, colon
59
explain incidence of types of cancers
depends on location
| -less variability in most common diagnosed cancer in area for women than men (mostly all breast cancer)
60
explain the genetic markers of breast and ovarian cancers
- 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
explain the risk of breast cancer with genetic markers
- 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
explain genetic markers in colon cancer
- 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
what does the international agency for research on cancer do
- 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
what is the national toxicology program
- 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
what is asbestos
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
what can smoking due aside from cause lung cancer
- 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
explain infectious agents
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
explain diet and physical exercise
- 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
explain reproductive habits
- child bearing and breast feeding protective risk
| - oral contraceptives and hormone replacement therapy increase risk
70
explain early detection in mammograms
- 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
explain insurance coverage mammograms
- 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
explain controversy about mammograms
leads to a lot of false positives and unnecessary procedures
73
explain prostate exam recommendations
- 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
explain controversy of prostate exam recommendations
- 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
explain colorectal screenings
- recommended routine screenings at age 50
| - 60% adults report getting these screenings, could get better, no difference between men and women
76
what is the insurance coverage of colonoscopies
- 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
what is a common treatment option for cancer
surgery, there are many different types of surgery for cancer related options
**usually done in conjunction with other treatments**
78
what are the different kinds of surgery
preventative surgery, diagnostic and staging surgery, curative surgery, debulking surgery and palliative surgery
79
what is preventative surgery
done before cancer actually present, usually due to presence of pre-cancerous cells or genetic risk
ex. mastectomy for breast cancer
80
what is diagnostic and staging surgery
done to gain more knowledge about the presence and severity of cancer
81
what is curative surgery
done when cancer has not metastasized and can easily be removed
82
what is debulking surgery
remove some of the cancer but not all, because removal of all causes too much damage
83
what is palliative surgery
done to make a patient more comfortable, but not done for curative purposes
84
what is radiation
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
what is chemotherapy
using medicine or drugs to treat cancer
| -stops division and growth of cells
86
explain breast cancer treatment in early vs. late stages
- early stages: use surgery more often (breast conservation)
| - late stages: use chemo more often (and mastectomy)
87
what breast cancer treatment is the best
- 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
what are the side effects of breast cancer treatment
- 60% of women experiencing 1 or more adverse treatment effects 6 years after diagnosis
- weight gain, fatigue, etc
89
explain prostate cancer surgery/treatment
- 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
does it make sense to take out prostate
-percentage of men who died from any cause was similar to group that got prostate removed and group that did not
91
explain lung cancer treatments at the different stages
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
what is biotherapy
immunotherapy, works by training immune system to function better
-stimulating immune system to work harder to attack cancer cells
93
what is hormonal therapy
decreasing hormone production to lower chance of cancer cells
94
what is stem cell treatment
does not work to destroy cancer directly (can in leukemia) but aids in recovery after other forms of treatment
95
explain complementary approaches
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
explain health care providers and CAMs
- movement for health care providers to embrace these methods
- 60% of plans had CAM components
97
explain controversial cancer treatments
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
what can you do if you cannot treat the body in cancer
in worst case scenario, cancer is terminal, while we may not be able to treat the body we can still treat the mind
99
what is cognitive behavioral therapy (CBT) in cancer
type of therapy aimed at developing beliefs, attitudes, thoughts and skills to make positive changes in behaviors
100
what is one kind of CBT
acceptance and commitment therapy (ACT) which encourages acceptance of condition by focusing attention on other valuable goals and activities
101
what can social-emotional support do
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
how can social support from a spouse be a problem
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
how can cancer change a relationship with a significant other
- roles
- responsibilities
- needs
- sexuality/intimacy
- future plans
104
explain the influence of cancer diagnosis on family and friends
- 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
explain social emotional support in the family
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
