Scheduled maintenance: Saturday, March 6 from 3–4 PM PST
Upgrade to remove ads
Essentials to Oncology
Terms in this set (93)
Wilhelm Conrad Roentgen
Leading Causes of DEATH in 2013
1. Diseases of the heart
2. Cancer - Malignant Neoplams
Cost of Diseases (CDC)
17% of Gross Domestic Product in 2015, projected to rise to 19.8% in 2020.
Healthcare is 3rd largest industry in US
$3.2 Trillion (2016)
10k per person (2016)
Expected to exceed $47 trillion by 2021
Cost of Cancer (from NCI & ACS)
2010 - overall annual cost $124.57 Billion
2011 - Direct Medical (total of health expenditures)
2020 - Indirect mortality (cost of lost productivity due to premature death) $147.6 Billion
Top 4 Most Expensive Cancers (2010 statistic)
Breast - $16.50 billion
Colorectal - $14.14 billion
Lymphoma - $12.14
Lung - $12.12
Global Economic Cancer Burden
$1.8 Billion cost of reducing exposure to key risk factors like smoking, drinking and poor diet.
Cost Effective solutions:
$0.6 Billion to stop smoking causes
$0.8 Billion to stop drinking causes
$0.4 Billion to stop diet causes
Reality of the Cost of Cancer Video Recap
"Delivering High-Quality Cancer Care - System in Crisis"
More than 1.6 million people receive a new cancer diagnosis each year
66 is average age of diagnosis
First wave of baby boomers are turned 65 in 2011
70-80% patients are incorrectly believes there is a cure for their diagnosis
What are the actual needs of the patient vs. doctor's aggressive attack of the cancer. Only about half of all patients are asked what they want to do, instead are told the plan.
2030 - 2.3 million per year new cancer diagnosis, a 45% increase
Basically promoting that there needs to be a more comprehensive team to treat cancers - not enough talking to the patient and not enough of doctor to doctor interaction.
Leads to huge financial burden to patient
Biopsychosocial Model of Healthcare
BIOLOGICAL: genetic predisposition, infectious disease, physiological response, effect of treatment/ medication
PSYCHOLOGICAL: emotional responses, depression, anxiety, worry
SPIRITUAL: religion, spirituality, nature, giving back, happiness
SOCIAL: family, friends, culture, career, hobbies, isolation
STATE OF US HEALTH article (1990-2010)
From 1990 to 2010, the United States made substantial progress in improving health. Life expectancy at birth and HALE (Healthy Life expectancy) increased, all-cause death rates at all ages decreased, and age-specific rates of years lived with disability remained stable.
Morbidity and chronic disability now account for nearly half of the US health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations.
DISEASE vs. HEALTH
Disease: deviation from normal structure/function of any part, organ or system of the body
Health: state of physical & mental well-being
Primary (true prevention)
Avoid carcinogens, wash hands, wear gloves
Secondary (early detection)
Tertiary (treatment of active disease)
Once things are bad, fix them
How often diseases occur in different groups of people and why.
In cancer: population of people with cancer - who gets specific types - what factors may cause -familial contributions - personal habits
Lifetime probability of developing cancer in Males
1 out of 2
Lifetime probability of developing cancer in Females
1 out of 3
Test Example of probability in males developing cancer
In 1000 people (men and women) calculate how many people would develop cancer.
If 500 men out of the 1000, 250 would develop cancer (1/2)
if 500 women out of the 1000, 170ish would develop cancer. (1/3)
Top 4 leading causes of death
Compared between 2014 and 2015
Rated deaths per 100,000
Heart Disease: 2014 - 167
2015 - 168.5
Cancer: 2014 - 161.2
2015 - 158.5
Respiratory: 2014 - 40.5
2015 - 41.6
Accidental Injuries 2014 - 40.5
2015 - 43.2
2014 % distribution of top 5 leading causes of death -
PER SEX Epidemiology statistics
Men are more likely to develop cancer, heart disease, and other causes, than Women.
Epidemiology death statistics , 2014 %'s by Age
1-9 Years old : 31.5% accidental deaths
10-24 years old: 39.7% accidental deaths
25-44 Years Old: 28.3% accidental deaths
45-64 Years Old: 30.5% cancer
20.8% heart disease
65 + years old: 25.5% heart disease
85+ years old: 29.2% heart disease
Age-adjusted death rates for selected populations in US
(2014 - 2015) rates per 100,000
Worst rates , increased from 1060 to 1070
2nd Highest rates, increase from 872 to 881
3rd Highest rates, no change 731
4th highest rates, increase from 633 to 644
2nd lowest rates, slight increase from 626 to 628
Best rates, slight increase from 437 to 438
Cancer Survival % rates by type of cancer
All sites: 49%, 55%, 69% (1975, 1989, 2011)
OVERALL: 2 out of 3 patients cured for 5 years or longer
Cancer Survival % rates by race (2005-2011)
Absolute difference 8%
*may be contributed to access of care
Deaths From all Causes per country
Highest/ Worst: USA 500 deaths per 100,000 ppl
Lowest/ Best: Japan 350 deaths per 100,000 ppl
From the greek "aitia" - CAUSE
The Study of Disease Causation
Disease Causation types
Exogenous - external factors/ carcinogens
Endogenous - internal factors/genetics
Number 1 cancer for adults (men and women)
Number 1 cancer for Woman
Number 1 cancer for Men
# of Cancer cases reported, internationally
Cancer is highest
North America (including canada)
Africa - doesn't register high typically because they die early from other causes
Colon Cancer observation
Low in Japan
Moderate in Japanese families in US
High in US
**may be an environmental/diet reasoning
Stomach Cancer observation
High in Japan
Moderate in Japanese families in US
Low in US
Breast Cancer factors
BRCA1 & BRCA2 gene mutations are genetic factors - however typically other factors are more significant causes
White Cat eye in pictures of children
Can be treated early - but can lead to bone cancer
Genetic increases probability
Historical Views of Cancer Etiology
17th Century: Cancer was Contagious
18th Century: Tobacco, soot & nulliparaty possible carcinogens
19th Century: infection, age, temperament, marriage and social status possible factors.
Leading Causes of Death by sex + age
Men: Heart Disease #1/Cancer #2
Women: Heart Disease #1/Cancer #2
Boys: Accidents (cancer #4)
Girls: Accidents (cancer #2)
Men: Accidents (cancer #5)
Women: Accidents (cancer #2)
Men: Cancer #1/ Heart Disease #2
Female: Cancer #1/ Heart Disease #2
Men: Cancer #1/ Heart Disease #2
Women: Cancer #1/ Heart Disease #2
Men: Heart Disease #1/ Cancer #2
Women: Heart Disease #1/Cancer #2
Estimated New Cases 2017
1. Breast 255,180
2. Lung 222,500
3. Prostate 161,360
4. Colo-rectal 135,430
Estimated Deaths 2017
1. Lung 155,870
2. Colo-rectal 50,260
3. Pancreas 43,090
4. Breast 41,070
No melanin - pigment cancers for albinos
Inherited disease that can lead to skin cancer
FAMILIAL ADENOMATOUS POLYPOSIS
Can lead to colon, rectum cancer
Suggested hereditary cancer, early onset of cancer
Breast before 45, Colo-rectal before 50
Gene testing can be done in children - colon cancer gene may help child to avoid exto-factors
Cancer Survival Rates %, by Race (2005-2011)
Absolute Difference 8%
Revolution of the Practice of Surgery (1847)
1847 - Ether Anesthesia
- Hand Washing
Geographic Statistics of Cancer
Lowest for Men : Arizona
Lowest for Women: Utah
(Utah has high Mormon population, don't smoke or drink)
Above the mean: NY
Florida: High (has many elderly)
What we do to ourselves
Causes of death in US:
Smoking: #1 cause of death and #1 preventable cause of death (leads to heart disease and cancer)
Smoking and being overweight are two high exogenous factors that we should avoid.
Historical views of cancer:
Medieval - SINS
17th Century - CONTAGIOUS
18th Century - TOBACCO, SOOT & NULLIPARTY possible carcinogens
19th Century - INFECTION, AGE, TEMPERAMENT, MARRIAGE & SOCIAL STATUS
US HEALTH ACHIEVEMENTS (1990-1999)
Control of Infectious Disease
Decline in deaths from Heart Disease & Stroke
Safer & Healthier Foods
Healthier Moms and Babies
Fluoridation of Drinking Water
Recognition of Tobacco as a Health Hazard
Hereditary and Breast Cancer
According to the National Cancer Institute (NCI)
only 1/20 woman with breast cancer had an inherited factor - the other 19/20 were due to other factors
Inherited Conditions that Increase Risk for Cancer
Hereditary Retinoblastoma => Retinoblastoma
Xeroderma Pigmentosum => Skin
Wilms' Tumor => Kidney
Li-Fraumeni Syndrome =>Sarcomas, brain, breast, leukemia
Familial adenomatous Polyposis =>colon, rectum
Paget's disease of bone => Bone
Fanconi's aplastic anemia =>Leukemia, liver, skin
Top 3 most preventable causes of death
Overweight & Obesity
Gallup-Healthways Well-Being Index
4 questions asked
Do you smoke?
Did you eat healthy all day yesterday?
In the last seven days, on how many days did you get 30 minutes of exercise of more?
In the last seven days, on how many days did you have five or more servings of fruits and veggies?
( + contributions to health)
$7.5K per month
(- contributions to health)
50% or more cancers can be prevented by:
Smoking cessation & improved dietary habits - like reducing fat consumption, increasing fruits and veggies. Physical activity & weight control also contribute to cancer prevention.
Top 10 cancer risk factors
UV light/Ionizing Radiation
Cigarettes cause about 1 of every 5 deaths in US, yearly.
Contributes to 30%+ of cancer mortality
About 443,000 US deaths attributed each year to Cigarette Smoking:
29% Lung Cancer = 128,900
28% Ischemic Heart Disease = 126,000
21% Chronic Obstrc. Pulmonary Disease
10% Other Diagnosis
8% Other Cancers
What is the LAG TIME between smoking and lung cancer?
Obesity Trends in the US
1992 - less than 50% of most residence by states were obese
1995 - 1998 : 50-55% obese
2010 - All 50 States more than 55% residence are obese
Obesity Trends in the US
(1971-74) 5% were obese
(1999-02) 10% were obese
(2009-10) 12% obese
(1971-74) 4% obese
(1999-02) 16% obese
(2007-08) 20% obese!!!
(2009-10) 18% obese
(1971-74) 6% obese
(1999-02) 16% obese
(2009-10) 18% obese
Correlation between Meat Consumption & Colon Cancer
Rates in Different Countries
New Zealand - Highest consumption of meat + Highest number of colon cancer per 100k people
US- 2nd highest consumption of meat & 2nd highest occurrence of colon cancer
Nigeria and Japan - Lowest consumption of meat and lowest rate of colon cancer...
DIET: LIMIT FAT AND CALORIES...CONSUME FRUITS / VEGGIES
www.healthypeople.gov video recap
After 75 it is found that it is more important to your health to stay active AND have a social network than just activity alone.
Cancer risk factors: Smoking #1
Tobacco: cigarette smoking causes 1 out of every 5 deaths in US each year
Obesity and risk of cancer are correlated
Nutrition: meat and colon cancer are directly correlated and US is 2nd highest.
Biology 101 video recap
10,600 people die per week of cancer
Cancer isn't just one disease, it's hundreds of diseases
Cancer is a collection of diseases in many places of the body:
-Breast (epithelial cells in duct of breast)
-Colon/carcinoma (cancer of epithelial cells of the colon)
smoking or drinking vs. smoking AND drinking
Heavy drinking + smoking increases the risk of oral cancer for men much more than each habit separately. (Around 30% more prevalence)
Alcohol abuse/-ism effect in the US
Nearly 88k people die from alcohol related causes annually
3rd preventable US death
31% of driving fatalities were caused by alcohol-impaired driving
Physical Fitness and Cancer
Physical activity may play a role in prevention/survivorship of:
Lung (not as clear for woman)
Prostate (not clear)
UV Radiation and Skin Cancer Incidence by regions(states)
Detroit - lowest annual sunshine rate and lowest skin cancer incidence
Pittsburgh - moderate levels of annual sunshine rate & skin cancer
Dallas - highest levels of both
Viruses and Infections contribute to what percentage of cancer mortality?
Human Cancer Viruses and their results:
Epstein-Barr virus = Burkitt's Lymphoma
Human Papillomavirus = Cervical Cancer
Hepatitis B Virus = Liver Cancer
Human T-cell lymphotrophic virus= Adult T-cell leukemia
Kaposi's sarcoma-associated herpesvirus = Kaposi's sarcoma
HPV cancer correlation for women...
HPV cancer correlation for men...
Oral Cavity Cancer
Life Style Etiologic Factors
Patterns of Reproduction
Pollution (approx 2% of ca. mortality)
Workplace (approx 3% of ca. mortality)
Common Workplace Carcinogens
Arsenic - lung, skin, liver
Asbestos - lung
Benzene - Leukemia
Radon - Lung
Wood Dust - Nasal
a malignant neoplasm of epithelial origin or cancer of the internal or external lining of the body. Carcinomas, malignancies of epithelial tissue, account for 80% to 90% of all cancer cases.
Location of Epithelial Cells (Carcinoma)
is present in the skin, as well as the covering and lining of organs and internal passageways, such as the gastrointestinal tract.
CARCINOMA typically affect the following organs
affect organs or glands capable of secretion, such as the breasts, which produce milk, or the lungs, which secrete mucus, or colon or prostate or bladder.
Sarcoma refers to cancer that originates in supportive and connective tissues such as bones, tendons, cartilage, muscle, and fat. Generally occurring in young adults, the most common sarcoma often develops as a painful mass on the bone. Sarcoma tumors usually resemble the tissue in which they grow.
Examples of SARCOMAS
Osteosarcoma or osteogenic sarcoma (bone)
Leiomyosarcoma (smooth muscle)
Rhabdomyosarcoma (skeletal muscle)
Mesothelial sarcoma or mesothelioma (membranous lining of body cavities)
Fibrosarcoma (fibrous tissue)
Angiosarcoma or hemangioendothelioma (blood vessels)
Liposarcoma (adipose tissue)
Glioma or astrocytoma (neurogenic connective tissue found in the brain)
Myxosarcoma (primitive embryonic connective tissue)
Mesenchymous or mixed mesodermal tumor (mixed connective tissue types)
Myeloma is cancer that originates in the plasma cells of bone marrow. The plasma cells produce some of the proteins found in blood.
Leukemias ("liquid cancers" or "blood cancers") are cancers of the bone marrow (the site of blood cell production). The word leukemia means "white blood" in Greek. The disease is often associated with the overproduction of immature white blood cells. These immature white blood cells do not perform as well as they should, therefore the patient is often prone to infection. Leukemia also affects red blood cells and can cause poor blood clotting and fatigue due to anemia.
Examples of LEUKEMIA
Myelogenous or granulocytic leukemia (malignancy of the myeloid and granulocytic white blood cell series)
Lymphatic, lymphocytic, or lymphoblastic leukemia (malignancy of the lymphoid and lymphocytic blood cell series)
Polycythemia vera or erythremia (malignancy of various blood cell products, but with red cells predominating)
Lymphomas develop in the glands or nodes of the lymphatic system, a network of vessels, nodes, and organs (specifically the spleen, tonsils, and thymus) that purify bodily fluids and produce infection-fighting white blood cells, or lymphocytes. Unlike the leukemias which are sometimes called "liquid cancers," lymphomas are "solid cancers." Lymphomas may also occur in specific organs such as the stomach, breast or brain.
2 Types of Lymphomas
Mixed Type Cancer examples
mixed mesodermal tumor
Stage refers to the extent of your cancer, such as how large the tumor is, and if it has spread.
TMN Staging System
The T refers to the size and extent of the main tumor. The main tumor is usually called the primary tumor.
The N refers to the the number of nearby lymph nodes that have cancer.
The M refers to whether the cancer has metastasized. This means that the cancer has spread from the primary tumor to other parts of the body.
(T) Staging Ranges
TX: Main tumor cannot be measured.
T0: Main tumor cannot be found.
T1, T2, T3, T4: Refers to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T's may be further divided to provide more detail, such as T3a and T3b.
(N) Regional lymph nodes
NX: Cancer in nearby lymph nodes cannot be measured.
N0: There is no cancer in nearby lymph nodes.
N1, N2, N3: Refers to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer.
(M) Distant metastasis
MX: Metastasis cannot be measured.
M0: Cancer has not spread to other parts of the body.
M1: Cancer has spread to other parts of the body.
Stage 0 Meaning
Abnormal cells are present but have not spread to nearby tissue. Also called carcinoma in situ, or CIS. CIS is not cancer, but it may become cancer.
Stage I, II, III
Cancer is present. The higher the number, the larger the cancer tumor and the more it has spread into nearby tissues.
The cancer has spread to distant parts of the body.
Abnormal cells are present but have not spread to nearby tissue.
Cancer is limited to the place where it started, with no sign that it has spread.
Cancer has spread to nearby lymph nodes, tissues, or organs.
Cancer has spread to distant parts of the body.
Tumor grade is the description of a tumor based on how abnormal the tumor cells and the tumor tissue look under a microscope.
It is an indicator of how quickly a tumor is likely to grow and spread. If the cells of the tumor and the organization of the tumor's tissue are close to those of normal cells and tissue, the tumor is called "well-differentiated ."
Grading systems differ depending on the type of cancer. In general, tumors are graded as 1, 2, 3, or 4, depending on the amount of abnormality.
Tumor Grading Scale
GX: Grade cannot be assessed (undetermined grade)
G1: Well differentiated (low grade)
G2: Moderately differentiated (intermediate grade)
G3: Poorly differentiated (high grade)
G4: Undifferentiated (high grade)
Principles of Screening
YOU MIGHT ALSO LIKE...
KIN235 Test 3
health chapter 12
OTHER SETS BY THIS CREATOR
Jude : Early People of the Americas
Dosimetry Quiz 1
Imagining Final_Elton Garvin_2017
OTHER QUIZLET SETS
hlth 200 first exam
pt assessment (overview)
CHAPTER 11 - Mental Health
Public Health - Cancer