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Lifetime risk of cancer is higher or lower for men than women?
Higher. Men = 44%, Women = 38% [think prostate cancer...every man gets it pretty much]
Men have a ___ chance of getting prostate cancer while women have a ____ chance of getting breast cancer.
(T/F) There is a substantial variability in 5-year survival rates by site.
True. Pancreas (5%), Prostate (99%)
Which type of cancer contributes to the most cancer mortality of any site?
Lung cancer. (30% mortality in men, 26% in women)
Incidence of cancer by site. Which ones are more common than the others?
- Non-melanoma skin cancer (most common)
- Colon and rectum
- Urinary bladder
- Non-hodgkin's lymphoma
- Corpus and uterus
There are nearly ____ million Americans living post-diagnosis of cancer.
Over ___ % of cancer survivors had prostate or breast cancer.
What is the single most important way that a person can prevent cancer?
Refraining from tobacco use
What is the second most preventale cause of cancer?
Dietary factors. [diets high in fruits and veggies are protective against oral, stomach and colorectal cancers]
What is the strongest predictor of risk for developing breast cancer?
Weight gain during adulthood
How do the BRCA1 and BRCA2 genes increase risk for cancer?
These are tumor suppressor genes. Without them, you have one less defense against cancer. Risk of breast cancer: general population = 12%, BRCA genes = 60%. Similar increase in risk for ovarian cancer
How is a patient's health, function and well-being affected after breast cancer?
- Cancer recurrance, second primary cancer, arm lymphedema, premature menopause, weight gain, cardiovascular disease
- Cognitive impairment, sexual dysfunction (loss of libido), infertility
- Psychosocial distress, symptoms of estrogen deprivation (hot flashes, sweats), fatigue, body image concerns
How is a patient's health, function and well-being affected after prostate cancer?
- Cancer recurrence, second primary cancer, osteoporosis, muscle wasting
- Sexual, bladder, bowel dysfunction, cognitive impairment
- Psychosocial distress
How is a patient's health, function and well-being affected after colorectal cancer?
- Cancer recurrence, second primary cancer
- Bowel, sexual dysfunction, infertility
- Psychosocial distress, peripheral neuropathy
How is a patient's health, function and well-being affected after Hodgkin's disease?
- Cancer recurrence, second primary cancer, hypothyroidism, CVD, impaired pulmonary function, increased risk of infection, nerve damage, osteoporosis, musculoskeletal atrophy, dental caries
- Psychosocial distress, fatigue
Chronic pain occurs in approximately ___% of survivors.
Risk of psychological distress in cancer survivors is higher among those who are:
Younger or older?
Single or married?
W/ or w/o health insurance?
Children or no children?
Co-morbidities or not?
Better or worse health status?
- Lack health insurance
- Have young children living at home
- Have co-morbidities
- Have worse health status
How are cognitive deficits related to cancer survivors?
- Deficits in attention, memory, processing speed etc.
- May be the result of direct treatments to the brain, chemotherapy and hormonal therapy (most commonly reported in breast cancer)
- Usually a latent/delayed side effect
Neurocognitive impairment is found in up to __% of childhood cancer survivors.
40% [associated with lower educational attainment, less household income and fewer marriages]
(T/F) Cognitive deficits are more common in childhood cancer survivors who received direct radiation to the brain compared to those who did not.
Risk of divore or separation is __ times higher in instances where the wife becomes ill with cancer compared to instances where the husband becomes ill.
6 times higher
(Majority, minority, 50/50) Number of cancer survivors who return to work after cancer.
What types of interventions do physicians provide to cancer patients?
- Health behavior interventions: smoking cessation, physical activity, nutrition and diet
- Medications: usually stimulants (i.e. Modafinil) to treat fatigue [but more research is needed]
- Psychological Support
- Mindfulness-based stress reduction: some evidence of improved immune function
- Acupuncture: little evidence of reduced pain, ddepressive symptoms, hot flashes, fatigue
The most important preventable cause of cancer is _____, and the second most important preventable cause of cancer is _____.
A. Tobacco, ionizing radiation
B. Diet, tobacco
C. Tobacco, diet
D. Obesity, tobacco
E. Tobacco, alcohol
Selena, age 36, just completed her final round of treatment for breast cancer. She recognizes that in addition to recurrence, she also faces increased risk of other late effects of cancer and cancer treatment. She asks you, her primary care doctor, about what kinds of risks she faces now. Which of the following is NOT a commonly recognized late effect in breast cancer survivors?
A. Premature menopause
D. Loss of libido
A year after her breast cancer treatment was completed, Selena arrives at your office for her annual physical exam. You notice she has gained a significant amount of weight since her last visit. You want to figure out what is contributing to her weight gain, what effect it might have on her health, and what can be done about it. Recalling what you know about weight gain and cancer survivors, you consider that all of the following could be true for Selena EXCEPT:
A. Selena is like many breast cancer survivors, who commonly experience weight gain
B. Selena should not worry too much about her weight: although overweight and obesity are risk factors for first cancer, there is little relationship between overweight/obesity and long term health in a cancer survivor if a person completed treatment successfully.
C. Following treatment for cancer, many cancer survivors experience persistant, debilitating fatigue, which can interfere with performance of daily activities. Perhaps Selena is experiencing fatigue, which may contribute to a sedentary lifestyle.
D. Selena may be like other cancer survivors who hold the attitude that "I got cancer, now I deserve to let myself do whatever I want." which might contribute to unhealthy eating habits.
E. It is important for Selena to control her weight because it could put her at higher risk for a recurrence and/or other co-morbidities associated with excessive weight gain.
Roy, age 62, is a retired AF colonel who recently completed treatment for colorectal cancer. After several rounds of aggressive treatment, Roy is wondering, "Now what?" He has little idea of what to expect regarding his health and health care in the years ahead. You would like to create a cancer survivorship plan for Roy. All of the following belong in a cancer survivorship plan EXCEPT:
A. A comprehensive review of Roy's cancer diagnosis and treatment
B. A will with clear directive for his wife and children who would survive him if his cancer recurs and cannot be treated successfully.
C. A "roadmap" describing the likely course of recovery, description and schedule of periodic screenings and tests, and a description of long term and late effects of treatment.
D. Resources and referral info for counseling, legal help or financial help, and other relevant providers.
E. Specific behavioral recommendations, such as quitting smoking, maintaining a healthy weight, using sun screen.
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