Understanding Cancer

Lauren O. Searls BSN RN OCN

What Is Cancer?
 Different Kinds of Cancer

Leukemias:
Some common
carcinomas: Bloodstream
Lung Lymphomas:
Breast (women) Lymph nodes
Colon
Bladder
Prostate (men)

Some common
sarcomas:
Fat
Bone

Muscle
 Naming Cancers

Cancer Prefixes Point to Location

Prefix Meaning
adeno- gland
chondro- cartilage
erythro- red blood cell
hemangio- blood vessels
hepato- liver
lipo- fat
lympho- lymphocyte
melano- pigment cell
myelo- bone marrow
myo- muscle
osteo- bone
 Example of Normal Growth

Dead cells
shed from
outer surface

Epidermis
Cell migration

Dividing cells
in basal layer
Dermis
 Loss of Normal Growth Control
Normal
cell division

Cell Suicide or Apoptosis

Cell damage—
no repair

Cancer
cell division

First Second Third Fourth or

mutation mutation mutation later mutation
Uncontrolled growth
The Beginning of Cancerous Growth

Underlying tissue
Invasion and Metastasis

1
Cancer cells invade
surrounding tissues
and blood vessels

2
Cancer cells are
transported by the
circulatory system
to distant sites

3
Cancer cells
reinvade and grow
at new location
 Malignant versus Benign Tumors
Benign (not cancer) Malignant (cancer)
tumor cells grow cells invade
only locally and cannot neighboring tissues,
spread by invasion or enter blood vessels,
metastasis and metastasize to
different sites

Time
Why Cancer Is Potentially Dangerous

Brain

Melanoma
cells travel
through
bloodstream

Liver

Melanoma
(initial tumor)
Cancer Detection and Diagnosis
 Biopsy

Pathology

Proteomic profile

Patient’s
tissue sample or
blood sample Genomic profile
Microscopic Appearance of Cancer Cells
 Cancer in 50+

WOMEN
MEN

• Lung
• Lung

• Breast
• Prostate

• Colon
• Colon

 Early detection/diagnosis

• Leads to better outcomes

• Many types of cancer have vague or no
symptoms

• Preventative measures

– Don’t smoke

– Sun protection

– Healthy diet & exercise

• Regular screenings

– Mammograms

– Pap smears

– Prostate exam

 Lung cancer

LOCAL SYMPTOMS
SYSTEMIC SYMPTOMS

• Cough
• Headache

• Wheezing
• Pain

• Difficulty breathing
• Anemia

• Chest pain
• Anorexia/weight loss

• Pneumonia
• Fatigue

• Swollen lymph nodes

 Lung cancer

INCIDENCE
RISK FACTORS

• Most common cancer • Tobacco exposure

for men & women in • Asbestos, arsenic, nickel
US
exposure

• Five-year survival= • Genetic predisposition

15%
• Inflammation (COPD,
• Incidence for women emphysema)

continues to rise
• Diet lacking in
• Deaths > breast and and carotenoids

all other gynecologic, • Age 65 older

breast, colorectal
cancers

 Lung Cancer

PROGNOSIS

• Clinical stage at time of diagnosis

• Size and accessibility of tumor

• Male and older = negative predictor of survival

• Co-morbidities

 Prostate Cancer

SYMPTOMS
STATISTICS

• Asymptomatic in early • Second most common
disease
tumor in men

• Decreased urinary flow
• Second-leading cause of
• Hesitancy
death

• Urinary frequency
• Accounts for 1/3 new
• Nocturia
cancers in men

• Hematuria/pain

 Prostate Cancer

RISK FACTORS
SCREENING

• Age (75% in men >65)
• Beginning age 50,
• African American race
digital rectal
• Family history
examination

• BRCA1/2 mutations in • Annual prostate-specific
family
antigen (PSA) blood test

• High fat diet
• For high risk
individuals, screening
may begin earlier

Prostate Cancer Screening
 Breast Cancer

• Signs and symptoms

• Redness, dimpling of breast

• Peau d’orange

• Changes in breast shape

• Bloody or yellow discharge from breast

• Nipple retraction or deviation

• Lump or thickening in or near breast/underarm
area

 Breast Cancer

INCIDENCE
RISK FACTORS

• 1 in 8 women will • Female

develop breast cancer
• Increasing age

• Men account for 1% of • Family/personal history

all breast cancer
• No children, or having
• Survival rates are high
children later in life

– 89%= 5 years after dx
• Hormone therapy after
– 82%= 10 years after dx
menopause

– 77%= 15 years after dx

• Alcohol use

• Obesity

Breast Cancer Screening
 Colon Cancer

STATISTICS
SCREENING

• Third most commonly • Age 50+ (average risk)

diagnosed cancer in US
– Fecal occult blood test
• Third leading cause of (FOBT) annually OR

cancer deaths for both – Colonoscopy every 10
men & women
years

– Contrast barium enema
every 5 years

 Colon Cancer

SIGNS AND SYMPTOMS

• Change in bowel habits

• Blood in stool

• Cramping pain in lower abdomen

 Colon Cancer

NON-MODIFIABLE
MODIFIABLE

• Age
• Diet high in red &
• History of polyps
processed meat

• History of FAP or • Diet low in fruits/
Lynch syndrome in vegetables

family
• Obesity

• Inflammatory bowel • Physical inactivity

disease
• Heavy alcohol use

• Ashkenazi Jews and • Smoking

African Americans

• Diabetes

Colon Cancer Screening
 What Causes Cancer?
Some viruses or bacteria

Some chemicals Radiation

Heredity
Diet
Hormones
 Low-Strength Radiation

High

Dallas

Skin
Cancer
Incidence
Pittsburgh
Detroit

Low
Least Most
Annual Sunshine
(UV radiation)
 Tobacco Use and Cancer
Some Cancer-Causing Chemicals in Tobacco Smoke
 High-Strength Radiation

High

Leukemia
Incidence

Low
Least Most
X-ray Dose
(atomic radiation)
Examples of Human Cancer Viruses

Some Viruses Associated with Human Cancers

Heredity Can Affect Many Types of Cancer

Inherited Conditions That Increase Risk for Cancer

Genetic Testing
 Cancer Risk and Aging

Cancer Risk and Aging

400
Colon

300
Breast
Number of
Cancer Cases
200
(per 100,000
people)
100

0 20 40 60 80
Age of Person (in years)
Cancer Tends to Involve Multiple Mutations
Benign tumor cells Malignant cells invade
grow only locally and neighboring tissues, enter
cannot spread by blood vessels, and
invasion or metastasis metastasize to different sites

Time
Mutation Cells Mutations Proto-oncogenes More mutations,
inactivates proliferate inactivate mutate to more genetic
suppressor DNA repair oncogenes instability,
gene genes metastatic
disease
 Cancer Prevention

Carcinogenic
chemicals
Carcinogenic
radiation

Cancer viruses
or bacteria
 Avoid Tobacco

Lung Cancer Risk Increases

with Cigarette Consumption
15x

10x
Lung
Cancer
Risk
5x

0 15 30
Non-smoker
Cigarettes Smoked per Day
Protect Yourself From Excessive Sunlight
Limit Alcohol and Tobacco
Combination of Alcohol and Cigarettes
Increases Risk for Cancer of the Esophagus
40x

30x
Risk
Increase
20x

10x

Alcoholic Drinks
Consumed per Day
AND
Packs of Cigarettes
Consumed per Day
 Diet: Limit Fats and Calories
Correlation Between Meat Consumption and
Colon Cancer Rates in Different Countries

40

30
Number of Cases
(per 100,000
people)
20

10

0 80 100 200 300

Grams (per person per day)
Diet: Consume Fruits and Vegetables
 Avoid Cancer Viruses

HPV Infection Increases

Risk for Cervical Cancer
High

Cervical
Cancer
Risk

Low
Noninfected Women
women infected
with HPV
Avoid Carcinogens at Work

Some Carcinogens in the Workplace

 Industrial Pollution

Incidence of
Most Cancers

1930 1950 1970 1990

Year
Is There a Cancer "Epidemic"?
Questions?