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WHAT IS CANCER
Group of diseases characterized by
abnormal cell growth and replication.
 Precancerous cells often are destroyed by
the immune system.
 If not destroyed, they may form tumors.

http://acs.healthology.com/hybrid/hybridautodetect.aspx?content_id=3790&focus_handle=lung-cancer&brand_name=acs
© 2008 McGraw-Hill Higer Education. All rights reserved.
CANCER CONTINUED
Tumors may be benign (don’t spread) or
malignant (metastasize) – both can be
dangerous but malignant cancer can move to
other sites in the body (metastasize).
 Malignant tumors: invade surrounding tissues,
spread through metastasis, grow
uncontrollably, are not capsulated, are usually
fatal if untreated.

CANCER: Group of diseases characterized by
uncontrolled growth and spread of abnormal cells
• CAUSES: External, Internal
• TREATMENT: Surgery, Radiation, Chemotherapy
• STAGES: I (Early or in situ); II (Local); III (Regional); IV (Distant or advanced)
• SURVIVAL: Five (5) year relative survival rate means patients who were
diagnosed and treated at least five years ago.
• SCREENINGS: One half of all diagnosed cancers can be detected by
screenings
• METASTASIS: Cancer cells break away from primary tumor and migrate to other
tissues through lymph or blood system
http://www.cancer.org/Cancer/BreastCancer/MoreInformation/breast-cancervideos
CANCER: Group of diseases characterized by
uncontrolled growth and spread of abnormal cells
• CAUSES:
• TREATMENT:
• STAGES: I (Early or in situ); II (Local); III (Regional); IV (Distant or advanced)
• SURVIVAL:
• SCREENINGS:
• METASTASIS:
• carcinomas
• Sarcomas
• lymphomas
• leukemias
• angiogenesis
• oncology
Cancer Statistics 2014
A Presentation from the
American Cancer Society
©2014, American Cancer Society, Inc.
100
4500
90
4000
80
3500
70
Per capita cigarette
consumption
3000
60
2500
50
Male lung cancer
death rate
2000
40
1500
30
1000
20
500
10
0
2000
2005
1995
1970
1960
1965
1950
1955
1940
1945
1935
1925
1930
1915
1920
1905
1910
1900
0
1985
1990
Female lung cancer
death rate
Age-Adjusted Lung Cancer Death
Rates*
5000
1975
1980
Per Capita Cigarette Consumption
TOBACCO USE IN THE US, 1900-2005
Year
*Age-adjusted to 2000 US standard population.
Source: Death rates: US Mortality Data, 1960-2005, US Mortality Volumes, 1930-1959, National Center for Health
Statistics, Centers for Disease Control and Prevention, 2006. Cigarette consumption: US Department of
Agriculture, 1900-2007.
RISK FACTORS
Primary Risk Factors: tobacco, sun exposure,
diet, inactivity, obesity.
 Secondary Risk Factors: excessive alcohol
intake, some viral infections, radiation, certain
chemicals.
 Approximately 80% of all cancers may be
related to lifestyle choices.

http://www.webmd.com/video/foods-after-cancer
PERCENTAGE OF CANCERS CAUSED
BY PREVENTABLE RISK FACTORS
UV rays 2%
Alcohol 3%
Viruses 5%
Occupation 5%
Environmental 5%
Tobacco 30% (87% of all lung cancers)
Diet/Obesity/Inactive lifestyle 35%
Lung Cancer
http://www.webmd.com/lung-cancer/slideshow-lung-cancer-overview
Normal lung 83 yr. old male
Diseased lung 41 yr. old female
Breast Cancer
http://www.cancer.org/Cancer/BreastCancer/MoreInformation/breastcancer-videos
http://www.webmd.com/breast-cancer/slideshow-breast-cancer-overview
Infiltrating Ductal Carcinoma
SCREENING GUIDELINES FOR THE EARLY DETECTION OF
BREAST CANCER, AMERICAN CANCER SOCIETY



Yearly mammograms are recommended starting at age 40.
A clinical breast exam should be part of a periodic health
examination, about every 3 years for women in their 20s and 30s.
Asymptomatic women aged 40 and older should continue to undergo
a clinical breast exam, preferably annually*.
Beginning in their early 20s, women should be told about the
benefits and limitations of breast-self examination. Women should
know how their breasts normally feel and report any breast changes
promptly to their health care providers.
__________
* Beginning at age 40 years, annual CBE should be performed prior to mammography
MAMMOGRAM PREVALENCE (%), BY EDUCATIONAL
ATTAINMENT AND HEALTH INSURANCE STATUS, WOMEN
40 AND OLDER, US, 1991-2004
70
All women 40 and older
60
Prevalence (%)
50
Women with less than a high school education
40
30
Women with no health insurance
20
10
0
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2002
2004
Year
*A mammogram within the past year. Note: Data from participating states and the District of Columbia were
aggregated to represent the United States.
Source: Behavior Risk Factor Surveillance System CD-ROM (1984-1995, 1996-1997, 1998, 1999) and Public Use Data
Tape (2000, 2002, 2004), National Centers for Chronic Disease Prevention and Health Promotion, Centers for
Disease Control and Prevention, 1997, 1999, 2000, 2000, 2001, 2003, 2005.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Breast self-examination.
Figure 12.5
12-6
Prostate Cancer
http://www.webmd.com/prostate-cancer/slideshow-prostate-cancer-overview
http://youtu.be/d0x7kqHAKRg
•Risk increases with age
•Only 25% of diagnoses are in men under the
age of 65
•African-Americans have a prostate cancer
incidence double that of Caucasians
•Men with a family history of prostate cancer
have 2-3 times the risk
•A diet high in saturated animal fat can double
your risk.
SCREENING GUIDELINES FOR THE EARLY DETECTION OF
PROSTATE CANCER, AMERICAN CANCER SOCIETY

Beginning at age 50, to men who have a life
expectancy of at least 10 years, health care providers
should discuss the potential benefits and limitations of
prostate cancer early detection testing with men and
offer the PSA blood test and the digital rectal
examination.*
___________
* Information should be provided to men regarding the benefits
and limitations of testing so that an informed decision
concerning testing can be made with the clinician’s assistance.
RECENT* DIGITAL RECTAL EXAMINATION (DRE) PREVALENCE
(%), BY EDUCATIONAL ATTAINMENT AND HEALTH INSURANCE
STATUS, MEN 50 YEARS AND OLDER, US, 2001-2004
60
57
53
50
Prevalence (%)
2001
50
44
2002
2004
42
37
40
29
30
26
22
20
10
0
Total
Less than a high school
education
No health insurance
*A digital rectal examination (DRE) within the past year. Note: Data from participating states and the District of
Columbia were aggregated to represent the United States.
Source: Behavioral Risk Factor Surveillance System Public Use Data Tape (2001, 2002, 2004), National Center for
Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2002, 2003, 2005.
RECENT* PROSTATE-SPECIFIC ANTIGEN (PSA) TEST
PREVALENCE (%), BY EDUCATIONAL ATTAINMENT AND HEALTH
INSURANCE STATUS, MEN 50 YEARS AND OLDER, US, 20012004
70
Prevalence (%)
60
58
2001
55
50
2002
2004
52
46
42
39
40
30
30
28
25
20
10
0
Total
Less than a high school
education
No health insurance
*A prostate-specific antigen (PSA) test within the past year. Note: Data from participating states and the District of
Columbia were aggregated to represent the United States.
Source: Behavioral Risk Factor Surveillance System Public Use Data Tape (2001, 2002, 2004), National Center for
Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2002, 2003, 2005.
Colon Cancer
http://www.webmd.com/colorectal-cancer/slideshow-colorectal-cancer-overview
Malignant Polyp
Metastatic
Carcinoma
COLONOSCOPY
http://www.webmd.com/video/colonoscopy
Normal Colon
Polyp Removal
Polyp
SCREENING GUIDELINES FOR THE EARLY DETECTION OF
COLORECTAL CANCER AND ADENOMAS, AMERICAN CANCER
SOCIETY 2008







Beginning at age 50, men and women should follow one of the
following examination schedules:
A flexible sigmoidoscopy (FSIG) every five years
A colonoscopy every ten years
A double-contrast barium enema every five years
A Computerized Tomographic (CT) colonography every five years
A guaiac-based fecal occult blood test (FOBT) or a fecal
immunochemical test (FIT) every year
A stool DNA test (interval uncertain)


Tests that detect adenomatous polyps and cancer
Tests that primarily detect cancer
People who are at moderate or high risk for colorectal cancer should talk with
a doctor about a different testing schedule
AND COLONOSCOPY PREVALENCE (%), BY EDUCATIONAL
ATTAINMENT AND HEALTH INSURANCE STATUS, ADULTS OLDER,
US, 1997-2004
50
45
45
39
Prevalence (%)
40
35
1997
1999
2001
2002
2004
41
36
34
32 33
31
28
30
29
25
18 19
16 16 17
20
15
10
5
0
Total
Less than a high school
education
No health insurance
*A flexible sigmoidoscopy or colonoscopy within the past five years. Note: Data from participating states and the
District of Columbia were aggregated to represent the United States.
Source: Behavioral Risk Factor Surveillance System CD-ROM (1996-1997, 1999) and Public Use Data Tape (2001,
2002, 2004), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention and Prevention, 1999, 2000, 2002, 2003, 2005.
TRENDS IN RECENT* FECAL OCCULT BLOOD TEST PREVALENCE
(%), BY EDUCATIONAL ATTAINMENT AND HEALTH INSURANCE
STATUS, ADULTS 50 YEARS AND OLDER, US, 1997-2004
30
1997
Prevalence (%)
2001
2002
2004
24
25
20
1999
20
22
21
19
18
16 16
16
14
15
12
10
8
9
9
9
5
0
Total
Less than a high school
education
No health insurance
*A fecal occult blood test within the past year. Note: Data from participating states and the District of Columbia were
aggregated to represent the United States.
Source: Behavioral Risk Factor Surveillance System CD-ROM (1996-1997, 1999) and Public Use Data Tape (2001,
2002, 2004), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention and Prevention, 1999, 2000, 2002, 2003, 2005.
SCREENING GUIDELINES FOR THE EARLY DETECTION OF
CERVICAL CANCER, AMERICAN CANCER SOCIETY





Screening should begin approximately three years after a women begins having vaginal
intercourse, but no later than 21 years of age.
Screening should be done every year with regular Pap tests or every two years using
liquid-based tests.
At or after age 30, women who have had three normal test results in a row may get
screened every 2-3 years with cervical cytology (either conventional or liquid-based Pap
test) alone, or every 3 years with a human papillomavirus DNA test plus cervical cytology.
Women 70 and older who have had three or more consecutive Pap tests in the last ten
years may choose to stop cervical cancer screening.
Screening after a total hysterectomy (with removal of the cervix) is not necessary unless
the surgery was done as a treatment for cervical cancer.
Cervical Cancer Prevention
The vaccine now in use requires a series of 3 shots over a one-year period. It has
been approved by the FDA and should be covered by most insurance. The American
Cancer Society recommends the vaccine for girls when they are 11 or 12, before they
begin having sex. It is also recommended as a “catch up” for women aged 13 to 18,
and that women age 19 to 26 talk to their doctor about whether the vaccine is right
for them. It is important to realize that the vaccine doesn’t protect against all cancercausing types of HPV, so Pap tests are still needed.
The second way to prevent cancer of the cervix is to have a Pap test. The Pap test
can detect HPV infection and pre-cancers. Treatment of these problems can stop
cervical cancer before it develops fully into an invasive cancer.
SKIN CANCER



Exposure to the sun is the main cause of skin
cancer.
1 in 6 Americans will have skin cancer, making it
the most common cancer.
Prevention is the key:





avoid prolonged exposure
plan activities during morning and evening
use sunscreen
avoid tanning
protect children from the sun – even one exposure
could increase risk for future cancer, use screenings
and prevention techniques
© 2008 McGraw-Hill Higher Education. All rights reserved.
Basel Cell Carcinoma
An Open Sore
A Pink Growth
← A Reddish Patch
A Scar-Like Area →
A Shiny Bump
SQUAMOUS CELL CARCINOMA
A wart-like growth
that crusts and
occasionally
bleeds.
A persistent, scaly
red patch with
irregular borders
that sometimes
crusts or bleeds.
An open sore
that bleeds and
crusts and
persists for
weeks
An elevated growth
with a central
depression that
occasionally bleeds.
Melanoma
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
ABCD test for malignant melanoma.
http://www.webmd.com/video/cancer-guide-creators
12-5
Photo credit: Courtesy of Gwen Robbins/Debra Powers/Sharon Burgess
Skin self-exam.
Figure 12.3
12-4
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Testicular Cancer
http://www.webmd.com/video/testicular-cancer-protection
Testicular Cancer
http://www.webmd.com/video/markstesticular-self-exam
Normal testicle
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Testicular selfexamination.
Figure 12.6
12-10
http://www.webmd.com/cancer/pancreatic-cancer/slideshow-pancreatic-canceroverview