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Cancer
What is cancer?
 “Abnormal, uncontrolled
growth of cells, which, if
left untreated, can
ultimately cause death.”
• (ACS)
 Terminology:




Benign
Malignant
Metastasis
In Situ
NCI, 2014)
OR vs US: Cancer Incidence
(CDC)
OR vs US: Cancer Deaths
(CDC)
Non-Specific Warning Signs
 CAUTION:
 C: changes in bowel or bladder habits
 A: a sore that doesn’t heal
 U: unusual thickening or discharge
 T: thickening or lump in the breast or any other part of the
body
 I: indigestion or difficulty swallowing
 O: an obvious change in wart or mole
 N: a nagging cough or hoarseness
Cancer Staging
 T: The extent of primary tumor
 N: absence of presence of lymph node involvement
 M: presence of distance metastasis
 Stages: I, II, III, IV
 Five year “Gold standard”
Lung Cancer
Lung Cancer continued
 Types:


Non-small cell
Small cell
 Symptoms:

Most lung cancers are
silent

When symptoms occur:

Cough, shortness of
breath, chest pain, loss of
appetite, blood in sputum.
Lung Cancer: Risk Factor
 Most common malignant disease worldwide
 Leading cause of cancer deaths.
 Tobacco smoke accounts for approximately 90% of
all lung cancers.

According to the WHO (n.d.), decreasing current smoking
rates by 50% could prevent 20-30 million deaths before 2025
and 150 million deaths by 2050.
Breast Cancer
Types of Breast Cancer
 Ductal cancer

Most common type of
breast cancer
 Lobular cancer
 Inflammatory breast
cancer
Mammograms
(National Cancer Institute, 2005)
Screening / Prevention
 Mammogram recommendation
 Starting at age 40 (unless family or personal history) and every
year as long as “in good health.”
 BSE (Breast Self-Exams)
 Starting at age 20, every month
 Clinical breast exam every year
 Chemoprevention
 Her2neu marker
Prostate Cancer
Prostate Cancer
 The most common
cancer for men.
 Lifetime risk: 1 in 6
 Risk of dying: 3%
Colorectal Cancer
Colorectal Cancer
 More common in Western societies.
 Almost 100% preventable with screening and polyp
removal.
Screening
 Colonoscopy
 Recommended first colonoscopy at age 50; every 5-10 years

Unless family history / personal symptoms

Good news: colon cancer usually slow growing

Other screenings:
FOBT (Fecal Occult Blood Test)
 sDNA (Stool DNA tests)

Skin Cancer
Skin Cancer
 Three types of skin
cancer:

Basal cell carcinoma



Most common type of skin
cancer
Squamous cell carcinoma
Melanoma

Deadliest form of skin
cancer
Skin Cancers
 Skin cancer is the most common form of cancer
 However…. Basal cell and squamous cell are not reported to
cancer registries

Basal cell


About 8 of 10 skin cancers
Squamous cell

About 2 of 10 skin cancers
Source: skin cancer foundation
Melanoma – ABC’s
Source: skin cancer foundation
Skin Cancer: Risk Factors
 SUN (Obviously!)
 Specifically UV exposure
 Age / Gender
 Before age 40 – higher risk for women
 After age 40 –higher risk for men
 Melanoma is one of the common cancers in people younger
than 30.
 Smoking
Skin Cancer Prevention
 “Slip, Slop, Slap … and Wrap” (ACS)
Wrapping up chronic diseases
 Responses differ from person to person
 Grief






Loss of body part, control, independence, security, certainty of
future
Physical / Mental fatigue
Depression
Shock / disbelief
Denial
Anger
Communication: A few do’s and don’ts
 Be “other-oriented”
 Please avoid cliches!

“I know what you’re going
through”

“Everything will be okay”

“Well we all have to die
sometime”
 It’s not about you
 Listen and listen some
more
 The patient is the boss

It’s their decision
 Offer specific help