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TYPES OF CANCER
BREAST CANCER
Malignant neoplasm of the breast
Most common malignancy in
American women
Leading cause of death for women
ages 40-55
2/3 of women affected by it are cured
1000 men affected annually
Breast Cancer
Usually presents as dominant mass in
one breast
May first become evident with nipple
discharge (bloody, brown, or serous),
nipple retraction, skin dimpling, or
asymmetric breast swelling
Breast lumpiness or nodularity are
most common symptoms
Breast Cancer
Pathology varies
1.
2.
3.
4.
5.
Ductal CA in situ- most localized form
that represents a preinvasive stage, if
left untreated will spread
Lobular CA
Infiltrating Ductal CA
Inflammatory CA
Paget’s Disease of the nipple
BREAST CANCER
Screening tools include BSE, professional
exam, and mammography
These may detect more benign lesions
than malignant
If suspicious mass ID’s, fine needle
aspiration, core biopsy, or excisional
biopsy used to obtain tissue for analysis
A biopsy is recommended for any mass
that doesn’t resolve spontaneously in 1-2
menstrual cycles
BREAST CANCER
Treatment includes combined modalities
(surgery, radiation, or drug therapy)
Treatment form depends on woman’s
menopausal status and disease
progression at diagnosis
At Stage I or II, offered modified radical
mastectomy or lumpectomy with axillary
dissection and radiotherapy
BREAST CANCER
Premenopausal women with tumors > 1 cm
will be treated with chemotherapy as
adjuvant treatment in order to try and
prolong survival rate by eliminating
microscopic metastasis
Chemotherapy regimens include CMF
(cyclophosphamide, methotrexate, and
fluourouracil) and CA (cyclophosphamide
and Adriamycine or doxorubicin)
BREAST CANCER
Postmenopausal women offered same
regimen for cancer that has spread to
axillary lymph nodes
Tamoxifen may be used in patients with
estrogen-receptor positive tumors as it
competes with estradiol at receptor sites
Breast reconstruction may be used with
implants or tissue reconstruction using
abdominal muscles
COLORECTAL CANCER
Malignant neoplasm of the colon or
rectum
3rd most common cause of death in
the U.S.
COLORECTAL CANCER
SYMPTOMS
Changes in usual bowel patterns,
especially in clients over age 40
Recent onset of constipation, diarrhea, or
tenesmus (spasmodic contraction of anal
or bladder sphincter with pain or persistent
desire to empty bladder or bowel with
ineffective straining efforts)
Bright red or dark red blood in stool
Lab findings may include iron-deficiency
anemia or positive fecal occult blood tests
COLORECTOAL CANCER
Diagnosis based on digital rectal exam,
anoscopy, proctosigmoidoscopy,
colonoscopy, barium enema exam, or
biopsy of suspicious lesions and polyps
Surgery is primary form of treatment.
Radiation therapy alone, or in combination
with surgery may be used. Chemotherapy
may be used as adjuvant therapy
ESOPHAGEAL CANCER
Adenocarcinoma or squamous cell carcinoma of
the esophagus
Most often occurs in men over age 60
Causes more than 10,000 deaths/year
Usually fungating (fast growing like fungus) and
infiltrating, and in most cases, tumor partially
constricts the esophageal lumen
Regional mets occurs early by way of lymph
system, often fatally affecting vital organs in chest
cavity
Liver and lungs are usual sites of distant mets
ESOPHAGEAL CANCER
Risk factors include chronic smoking and
excessive ETOH use
Symptoms include patient reporting feeling
of fullness, pressure, indigestion, or
substernal burning (may try using antacids
to relieve symptoms)
Later symptoms include weight loss and
dysphagia, hoarseness, chronic cough,
anorexia, vomiting and regurgitating food.
Some complain of pain on swallowing or
pain radiating to back
ESOPHAGEAL CANCER
Due to patients typically being diagnosed in
late stages, treatment is aimed more at
palliative than curative
Goal of treatment is to keep the esophagus
patent by using dilation, laser therapy,
radiation therapy, and insertion of
prosthetic tube
Radical surgery can excise tumor and
resection of esophagus or esophagus and
stomach
Chemotherapy and radiation can slow
tumor growth
ESOPHAGEAL CANCER
Prognosis tends to be poor with 5
year survival rate in less than 5% of
patients
Most patients die within 6 months of
diagnosis
SKIN CANCERS
Basal cell carcinomas
Squamous cell carcinomas
Melanomas
BASAL CELL CARCINOMAS
Skin malignancy that rarely metastasizes
but may be locally invasive
Typically, begins as small, shiny papule
Lesion enlarges to form a whitish border
around a central depression or ulcer that
may bleed
Removal method depends on size,
location, and appearance of lesion
SQUAMOUS CELL CARCINOMA
Carcinoma that develops primarily
from squamous cells on skin or in
mouth, lunges, bronchi, or esophagus
MELANOMA
Malignant tumor that begins in a
darkly pigmented mole and can
metastasize widely
Incidence rising more rapidly than any
other form of cancer
90% develops on skin, 5% in eye, and
2.5% on mucous membranes
MELANOMA
Caused by excessive exposure to UV
light, especially sunlight
More common in whites than blacks
Appears to have genetic factor in
some families
MELANOMA SYMPTOMS
Asymmetrical lesions
Irregular borders
Color variation
Usually >6 mm diameter (1/4”)
A change in mole appearance or size
often brings person for medical
attention
MELANOMA
Prevention includes sunscreen and
protective clothing
Rates of long term survival depend on
lesion depth at diagnosis (thicker more
dangerous), the histologic type, and
patients age and gender (older patients do
poorly, men outcome worse than women)
Treatment includes surgery to reomve
primary cancer lesion along with adjuvant
therapy to reduce metastasis
STOMACH CANCER
Gastric adenocarcinoma, lymphoma,
or sarcoma
Worldwide, is 2nd most common for of
cancer, following liver CA
In U.S, is relatively infrequent
STOMACH CANCER
Cause unknown
Some question if dietary or
environmental factors play a role
Suggestion that long term infection of
Helicobacter pylori may play role
STOMACH CANCER
Some patients have no symptoms
Indigestion, abdominal pain, weight loss,
feeling rapidly full following small meal,
nausea, vomiting
Surgical removal of stomach provides only
chance for cure
Prognosis depends on depth of tumor
invasion and spread to lymph nodes
On average, patients live 6-9 months
following diagnosis
PROSTATE CANCER
Malignant tumor (almost always
adenocarcinoma) of prostate gland
According to White, most common in
men and 2nd most common cause of
CA deaths in men
More common in African American
men
Is testosterone sensitive tumor
PROSTATE CANCER SYMPTOMS
Often asymptomatic
May present with difficulty urinating,
urinary hesitancy, nocturia,
symptoms of UTI
If spread to bone may have localized
or generalized pain
PROSTATE CANCER
Screening includes PSA (prostate
specific antigen), digital rectal exam,
ultrasound of prostate
Recommended that men over age 50
have screenings, especially if have
family history or African American
PROSTATE CANCER
Therapy may include surgical
resection, drug therapy to reduce
testosterone levels, radiation therapy,
and radiation therapy