15: Cancer
Your Health Today, 9th Edition
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What Is Cancer?
Cancer is a condition
characterized by the
uncontrolled growth of cells.
Develops from a single cell The process is called clonal
that goes awry, but a growth. Replication of a
combination of events must single cell that produces
occur before the cell turns thousands of copies of itself
into a tumor. in an uncontrolled manner.
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Figure 15.1 The 10 most common types of cancer, by
estimated new diagnoses and estimated deaths, 2022.
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Sources: American Cancer Society. (2022). Cancer facts & figures 2022. Atlanta, GA: American Cancer Society.
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Healthy Cell Growth 1
Healthy cells have a complicated system of
checks and balances that control cell growth and
division.
Healthy cells divide when needed to replace cells
that have died or been sloughed off.
Each time a cell divides, there is the possibility of
mutation or an error in DNA replication.
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Healthy Cell Growth 2
Stem cells: undifferentiated cells that can
give rise to specialized cells.
Because they do not have a predetermined
number of cell divisions, they pose a risk of
cancer.
Stem cells are located deep within tissues
and are protected from factors that increase
the risk of genetic mutations (exposure to
the sun, chemicals, and irritation).
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Cancer Cell Growth 1
Cancer starts from a single cell that undergoes a
critical mutation.
An initiating event in the cell’s DNA allows a cell to
evade normal cell restraints.
• Error in duplication.
• Exposure to a carcinogen (cancer-causing substance).
• Radiation.
Escaping all the control mechanisms to become cancer
may take many years.
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Cancer Cell Growth 2
Oncogene: a gene that drives a cell to grow and divide regardless of signals from
surrounding cells.
Tumor: a mass of extra tissues that may form into either a benign or a malignant tumor.
Benign tumor. Slow growth, unlikely to Malignant tumor. Capable of spreading to
spread. surrounding tissues.
Metastasis: cancer that has spread from one part of the body to another.
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Classifying Cancers 1
Cancers are classified
according to the tissue Cancer still at its
When metastasized, it
in which they primary site is
is invasive.
originate, called the localized.
primary site.
The most common The greater the extent
sites of metastases are of metastasis, the
the brain, the liver, poorer the prognosis
and the bone marrow. (likely outcome).
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Classifying Cancers 2
The stage of the disease is a description of how far
cancer has spread.
One common staging system.
• Stage 0. Cancer in situ (present only in the layer of cells where
it began).
• Stage . Small and localized.
• Stages II and III. Locally advanced; may involve lymph nodes.
• Stage IV. Metastasized to distant sites.
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Types of Cancer
Carcinomas: arise from epithelial tissue (skin, lining of the
intestines and body cavities, surface of body organs, outer portions
of glands).
Sarcomas: arise in connective tissue (bone, tendon, cartilage,
muscle, fat tissues).
Leukemias: cancers of the blood that originate in the bone marrow
or the lymphatic system.
Lymphomas: cancers that originate in lymph nodes or glands.
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Risk Factors for Cancer 1
The majority of cancers occur as a result of exposure to
carcinogens—cancer-causing agents.
Individuals can limit their exposure by adopting
protective lifestyle behaviors.
Other measures are beyond individual control and
require action by local authorities, the larger society, or
even the global community.
• Air pollution, climate change, and access to health insurance.
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Risk Factors for Cancer 2
Family history.
• A family history of cancer alters some cancer
screening recommendations.
• Genes interact with environmental exposures and
lifestyle behaviors to alter risk.
Lifestyle factors.
• Tobacco use.
• Nutrition and physical activity.
• Overweight and obesity.
• Alcohol consumption and cancer risk.
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Risk Factors for Cancer 3
Social and Social determinants of health influence risk behaviors,
economic
factors.
exposure to environmental carcinogens, access to
health care, and quality of health care.
Researchers are increasingly looking at the role of
discrimination in general, and racism in particular.
Environmental Sunlight and other sources of ultraviolet radiation.
factors.
Other forms of radiation.
Chemical and physical carcinogens.
Infectious agents.
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Cancer Screening
Treatment is more successful the earlier the cancer is
identified.
Screening tests: given to a large group of people to
identify a smaller group who are at higher risk for a
specific disease or condition.
• Key to early detection of cancer.
• With some cancers, no test has been shown to be effective
without increasing harm.
• The COVID-19 pandemic has had significant impacts on
cancer screening.
• Genetic screening, currently reserved for members of high-
risk families, can help assess cancer risk.
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Cancer Treatments 1
Surgery. Remove cancer or remove the affected organ; may still be
part of treatment even if the cancer has spread.
Chemotherapy. Drug treatment administered to the entire body to kill
rapidly dividing cancer cells.
Also kills rapidly dividing normal cells, including hair,
stomach lining, and white blood cells.
Radiation. Directed to a specific area; used with surgery or
chemotherapy, or to control pain.
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Cancer Treatments 2
Biological therapies.
• Aim to enhance the immune system’s ability to fight cancer
(immunotherapy) or reduce the side effects of
chemotherapy.
Stem cell transplantation.
• Initially for cancer of the white blood cells (leukemia,
lymphoma); now sometimes used when bone marrow cells
have been killed in chemotherapy.
Gene therapy and genetic testing.
• Gene therapy is still in the clinical trials stage.
• Genetic testing may become important in precision medicine.
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Cancer Treatments 3
Clinical trials.
• Research studies to test new drugs and treatment regimens.
Complementary and integrative medicine.
• Used at higher rates by cancer patients and survivors, but
none of the medicines have been shown to cure cancers.
• Some supplements may interact with cancer treatments and
should be used with caution and under supervision.
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Breast Cancer 1
The second leading cause of cancer death in women.
Risk factors.
• Older age and female.
• Early first menstruation.
• Late onset of menopause.
• Family history.
• Having no children or having children after 30.
• Obesity.
• Tobacco use.
• Hormone replacement after menopause.
• More than two alcoholic beverages a day.
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Breast Cancer 2
Signs and symptoms.
• Persistent lump; skin swelling, redness, or bumpiness; and
change in nipple appearance or discharge.
Screening and detection.
• Mammography, ultrasound, and MRI; testing of nearby
lymph nodes.
Treatment.
• Lumpectomy. Removal of the tumor and some breast tissue
around.
• Mastectomy. Removal of the entire breast.
The five-year survival rate for all stages is 90 percent.
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Prostate Cancer 1
The most commonly diagnosed cancer in men and the second
most common cause of cancer death in men.
Risk factors.
• Age, family history, and being Black.
• Possibly a high-fat diet.
Signs and symptoms.
• In early stages, usually none.
• In advanced prostate cancer, difficulty urinating, pain in the pelvic region,
pain with urination, or blood in the urine.
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Prostate Cancer 2
Screening and detection.
• Digital rectal exam and prostate-specific antigen (PSA) test.
Treatment.
• In early stages and younger men. Surgery and radiation,
sometimes in combination with chemotherapy, and hormonal
medication.
• In later stages. Chemotherapy, radiation, and hormonal
medication.
• Vaccine can be used in advanced prostate cancer.
The 10-year survival rate for all stages is 98 percent.
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Lung Cancer 1
The second most commonly diagnosed cancer and the
leading cause of cancer death in the U.S.
Risk factors.
• Use of tobacco products in any form.
• Exposure to carcinogenic chemicals, arsenic, radon, asbestos,
radiation, air pollution, and environmental tobacco smoke.
Signs and symptoms.
• Coughing, blood-streaked sputum, chest pain, difficulty breathing,
and recurrent lung infections.
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Lung Cancer 2
Screening and detection.
• No recommended screening for the general population.
• Low-dose computed tomography (CT) screening for high-risk individuals.
• Bronchoscopy. Fiber-optic device inserted into the lungs to examine lung
tissue for signs of cancer.
Treatment: surgery, radiation, or a combination of radiation and
chemotherapy.
The five-year survival rate is 22 percent.
• If detected early, which is rare, survival increases to 60 percent.
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Colon and Rectal Cancer 1
The third leading cause of cancer diagnosis and cancer
death in men and women.
Overall rates of diagnosis of colorectal cancer are
decreasing, but rates of diagnosis and deaths in people
under the age of 55 have actually been increasing since
2004.
Risk factors.
• Age.
• Personal or family history of colon polyps, inflammatory bowel
disease, or colorectal cancer.
• Smoking, alcohol use, obesity, physical inactivity, a diet high in
fat or red or processed meat, and inadequate fruits and
vegetables.
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Colon and Rectal Cancer 2
Signs and symptoms.
• Change in bowel movements, change in stool size or
shape, pain in the abdomen, and blood in the stool.
Screening and detection.
• Flexible sigmoidoscopy. A fiber-optic tube inserted into
the rectum and lower third of the colon.
• Colonoscopy. A longer scope to view the entire colon.
• Double-contrast barium enema. Filling with contrast
material and then X-rays.
• Computed tomography (CT) colonoscopy. A “virtual”
colonoscopy using a CT scanner.
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Figure 15.2 Colon.
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Source: Fahey, T. (2015). Fit & well: Core concepts and labs in physical fitness and wellness (11th ed.). New York, NY: McGraw Hill Education.
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Colon and Rectal Cancer 3
The American Cancer Society (ACS) now recommends people
of average risk start colorectal cancer screening at age 45.
• For people with higher-than-average risk, earlier and more frequent
screening is recommended.
Treatment: surgery, radiation, and/or chemotherapy.
The five-year survival rate is 65 percent.
• If detected at a localized stage, 91 percent.
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Skin Cancers
The three forms of skin cancer are basal cell carcinoma,
squamous cell carcinoma, and melanoma.
• Basal cell and squamous cell carcinomas are often curable.
• Melanoma is more likely to be fatal.
All forms are linked directly to ultraviolet (UV) light
exposure—both UVA and UVB.
• Stay out of the sun during midday.
• Wear protective clothing.
• Use a broad-spectrum sunscreen with a sun-protective factor
(SPF) of 30 or higher.
• Wear sunglasses with UV protection.
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Melanoma
Risk factors.
• Personal history and a large number of moles.
• Fair skin and sun sensitivity increase risk.
Signs and symptoms: changes in a mole.
Screening and detection: self-exam and evaluation by a health care provider.
Treatment: surgery, chemotherapy, and immunotherapy in advanced stages.
The overall five-year survival rate is 93 percent.
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Figure 15.3 The ABCDE evaluation of moles for melanoma.
Source: American Academy of Dermatology. (2022). Detect Skin Cancer: How To Perform a Skin Self-Exam.
Retrieved from https://www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/detect/what-to-look-for
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Basil Cell and Squamous Cell Carcinomas
Fair skin; blonde, red, or light brown hair; blue,
Risk factors. green, or hazel eyes; and freckles and moles.
Cumulative sun exposure and age.
Basal cell. A new skin growth; a raised,
domelike lesion; or a sore that never heals.
Signs and symptoms. Squamous cell. A red, scaly area that does not
go away; a sore that does not heal; or a raised,
crusty sore.
Screening, detection, and treatment: monitoring
and evaluation, and local removal and destruction.
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Oral Cancers
Cancers develop in the mouth or the pharynx.
• Risk factors: tobacco, high alcohol consumption, and HPV.
Signs and symptoms: persistent sore in the mouth,
lump, or bump; white or red along the gums or cheeks.
• Late signs include pain or difficulty swallowing or chewing.
• Screening and detection. Doctor or dentist as part of routine
care.
• Treatment. Surgery, chemotherapy, and radiation.
The five-year survival rate for all stages is 67 percent,
but survival is much lower in Blacks than in whites.
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Living With Cancer
If you or a family member is diagnosed with cancer.
• Participate in decisions about treatment.
• Be an informed consumer.
• Consider how you will interact with others.
• Consider school or work obligations.
• Enlist support.
• Know what physical changes are likely to occur.
• Consider sperm or egg donation and freezing.
• Spiritual beliefs and practices can be important.
• Don’t think about cancer all the time.
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