Basic Introduction to Basic Introduction to CancerCancer

Linda Robb Blenderman

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PresentationPresentation

Cancer Statistics & Prevalence - Canada - Global What is Cancer? What is Staging? Detection of Cancer Overview of Cancer Therapy Symptom Management Along the Cancer Continuum The Cancer Treatment Journey at the Kingston Regional

Cancer Centre

What are the Seven Warning Signs of What are the Seven Warning Signs of Cancer?Cancer?

Statistics & Prevalence

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In Canada in 2003, an estimated 139,900 new cases of cancer and 67,400 deaths will occur.

On average every week, 2,690 Canadians will be diagnosed and 1,296 Canadians will die.

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Canadian women (2003)-an estimated 68,600 will be diagnosed and an estimated 31,600 women will die.

On average every week, 1,319 women will be diagnosed and 608 women will die of cancer every week.

 

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Canadian men (2003)-an estimated 71,300 will be diagnosed and an estimated 35,800 men will die.

On average every week, 1,371 men will be diagnosed and 688 men will die of cancer.

 

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Premature death in Canada-cancer is the leading cause of, being responsible for almost 31% of all potential years of life lost.

 Disease of older Canadians. Among men, 75% of new cancer cases and 82% of

deaths due to cancer occur among those who are 60 years of age and older.

Among women, 63% of new cases and 78% of cancer deaths occur among those who are 60 years of age and older.

 

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BREAST CANCERBREAST CANCER

In 2003, an estimated 21,200 women will be diagnosed and 5,300 will die of it.

  An estimated 140 men will be diagnosed and 40 will die

of it.

 

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BREAST CANCERBREAST CANCER

One in 9 women is expected to develop breast cancer during her lifetime. One in 27 will die of it.

  Breast cancer is the most frequently diagnosed

cancer in Canadian women.  Since 1988, breast cancer incidence rates have risen by

10% and death rates have dropped by 19%. 

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COLORECTAL CANCERCOLORECTAL CANCER

In 2003, an estimated 18,000 Canadians (9,800 men; 8,300 women) will be diagnosed with colorectal cancer and 8,300 (4,400 men; 3,800 women) will die of it.

   During a woman's lifetime she has a 1 in 16 chance of

developing colorectal cancer. One in 31 will die of it.  During a man's lifetime, he has a 1 in 15 chance of

developing colorectal cancer. One in 29 will die of it. 

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COLORECTAL CANCERCOLORECTAL CANCER

Since 1988, colorectal cancer incidence rates among women have dropped 14% and death rates have dropped 23%.

  Since 1988, colorectal cancer incidence rates among

men have dropped 8% and death rates have dropped 15 %.

 

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LUNG CANCERLUNG CANCER

In 2003, an estimated 21,100 Canadians (12,200 men; 9,000 women) will be diagnosed with lung cancer and 18,800 (10,900 men; 7,900 women) will die of it.

   One in 18 women will develop lung cancer during her

lifetime. One in 20 will die of it.  One in 11 men will develop lung cancer during his

lifetime. One in 12 will die of it.

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LUNG CANCERLUNG CANCER

Lung cancer, remains the leading cause of cancer death for both sexes in 2003. Almost one-third of the cancer deaths in men, and almost one-quarter of the cancer deaths in women, are due to lung cancer alone.

  Since 1988, among women, lung cancer incidence rates

have risen by 30% and death rates have increased by 46%.

  Since 1988, among men, lung cancer incidence rates

have dropped 22% and death rates have dropped 17 % 

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PROSTATE CANCERPROSTATE CANCER

In 2003, an estimated 18,800 men will be diagnosed with prostate cancer and 4,200 will die of it.

  One in 8 men will develop prostate cancer during his

lifetime, mostly after age 70. One in 28 will die of it.

 

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PROSTATE CANCERPROSTATE CANCER

Prostate cancer is the most frequently diagnosed cancer (excluding non-melanoma skin cancer) in Canadian men.

  Since 1988, prostate cancer incidence rates have risen

by 30% and death rates have dropped by 10%. 

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PREVALENCEPREVALENCE

The overall prevalence of cancer in the Canadian population is approximately 2% among men and 2.5% among women, or about 313,100 male cancer survivors and 366,700 female cancer survivors.

  Prevalence rates and counts refer to the total number of

people who are living with a diagnosis of cancer at a certain point in time. This year’s prevalence estimates are for the number of Canadians who were alive in 1998 within 15 years of their cancer being diagnosed.

  Totals may not add, due to rounding.

(www.cancer.ca-April, 2003)

Global Problem of CancerGlobal Problem of Cancer

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The most recent estimate of cancer indicates that 8.1 million new cases are diagnosed worldwide each year. The growth rate of cancer is 2.1% per year, a rate that is faster than the growth rate of the world population at 1.7% per year.

There are variations in the frequency of cancer between developed and developing countries. The most common cancers in developed countries are lung, stomach, breast, colorectal, and prostate cancer. The most common cancers in developing countries are lung, stomach, breast, cervical, and esophageal cancers.

About 5.2 million deaths occur each year, 55% of which, occur in developing countries.

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The leading causes of worldwide cancer deaths: Lung cancer accounts for over 900,000 deaths Stomach cancer accounts for 600,000 deaths Colorectal cancer accounts for 400,000 deaths Liver cancer accounts for 400,000 deaths

Leading causes of cancer deaths in women: Breast cancer Stomach cancer Lung cancer

Leading causes of cancer deaths in men: Lung cancer Stomach cancer Liver cancer (http://reach.ucf.edu/~OncEduc1/)

What is Cancer?What is Cancer?

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Many definitions for the word cancer:Many definitions for the word cancer:

Any definition must embody two characteristics:

The property of uncontrollable growth of cells originating from normal tissue.

The property of killing the host by means of local tissue invasion and/or distant spread (metastasis).

Cancer is a group of diseases characterized by uncontrolled cellular growth with local tissue invasion and/or systemic metastasis.

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Metastasis-spread of cells, from a primary tumor via the lymphatic and circulatory systems to a distant body part, where cells give rise to another cancer.

Micro metastasis-metastasis too small to be detected by conventional diagnostic methods.

Tumor-abnormal growth that can be benign or malignant.

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Anaplasia-loss of structural organization and useful function of the cell. ‘Undifferentiated’ –literally impossible to determine the tissue of origin e.g. muscle cells, nerve cells.

Dysplasia-disturbance in the size, shape and organization of cells and tissues.

Hyperplasia-an increase in the number of cells in a tissue or organ causing causing an increase in the bulk of the organ.

Note-hyperplasia and dysplasia often precede the development of many tumors by months or years, recognition and proper treatment at this early stage in the development process may help to prevent malignancies e.g. Pap Smear.

What is Staging?What is Staging?

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A process to determine the extent of disease, and is related to the size of the primary mass, nodal involvement and systemic spread.

TNM classification system for many cancers:

T=tumor size and/or extent of invasionN=nodal involvementM=presence or absence of metastases

Detection of CancerDetection of Cancer

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Mammography F 50-69High Risk

Every 2 yrs.Unless…

Clinical breast exam F All women Every 2 yrs.

BSE F Adult women Regularly

Pap test/Pelvic exam F Sexually active and non-sexually active women.

Every 1 to 3 yrs. (province).

Skin Examination F/M All Ages Regularly

Fecal Occult Blood Tests F/M Age 50 and overHigh Risk

Every 2 yrs.Unless…

Digital Rectal Exam F/M Age 50 and over

Prostate Specific Antigen (PSA) M Age 50 and overHigh Risk

Testicular Self-examination M Age 15 and over Regularly

An Overview of Cancer TherapyAn Overview of Cancer Therapy

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SurgerySurgery

Primary method for curing one-third of all cancers. Local treatment.Indications: Pre-cancerous lesions. Palliative-reduce tumor burden and/or to relieve symptoms. Diagnosis and/or staging. Second-look operation.Techniques: Biopsy Local excision Block dissection

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RadiotherapyRadiotherapy

Curative or palliative intent. Local treatment. Uses X-rays to damage DNA within the cancer cells.Indications: Localized tumors-skin, cervix, endometrium, breast,

larynx, Hodgkin’s disease. High-risk surgical candidates. CNS-treatment of choice. Palliative-pain relief for bony metastases. Radiosensitzer with chemotherapy.Techniques: External beam-teletherapy Internal beam-brachytherapy

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Chemotherapy Chemotherapy

Systemic treatment. Chemical agents that kill rapidly growing cells. Most act by damaging DNA.Indications: Curative Adjuvant Neo-adjuvant PalliativeAdministration/Cycle: One drug or a combination of drugs. Given monthly, weekly or daily depending on the

disease and drug.

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Hormonal TherapyHormonal Therapy

Some cancers arise from tissues sensitive to hormonal growth control (breast, prostate, endometrium) and retain their sensitivity, even after malignant change.

The growth of a hormone-sensitive tumor may be ‘turned-off’ for many months.

Whether a tumor responds to a hormone depends on the presence of receptors for that hormone in the tumor tissue.

BiotherapyBiotherapy Includes immunotherapy and biologic response

modifier therapy.

Symptom Management Along the Cancer Symptom Management Along the Cancer ContinuumContinuum

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Symptoms occur alone or in clusters.

Symptoms may vary throughout Diagnosis to Palliation

Cancer-related (oncological emergencies)

Treatment related (acute and/or delayed)

Seven Warning SignsSeven Warning Signs

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Change in bowel or bladder habits.

A sore that does not heal.

Unusual bleeding or discharge.

Thickening or lump in breast or elsewhere.

Indigestion or difficulty in swallowing.

Obvious change in wart or mole.

Nagging cough or hoarseness.