1. TYPES OF CANCER

2. BREAST CANCER Malignant neoplasm of the breast
Most common malignancy in American women
Leading cause of death for women ages 40-55
2/3 of women affected by it are cured
1000 men affected annually

3. Breast Cancer Usually presents as dominant mass in one breast
May first become evident with nipple discharge (bloody, brown, or serous), nipple retraction, skin dimpling, or asymmetric breast swelling
Breast lumpiness or nodularity are most common symptoms

4. Breast Cancer Pathology varies
Ductal CA in situ- most localized form that represents a preinvasive stage, if left untreated will spread
Lobular CA
Infiltrating Ductal CA
Inflammatory CA
Paget’s Disease of the nipple

5. BREAST CANCER
Screening tools include BSE, professional exam, and mammography
These may detect more benign lesions than malignant
If suspicious mass ID’s, fine needle aspiration, core biopsy, or excisional biopsy used to obtain tissue for analysis
A biopsy is recommended for any mass that doesn’t resolve spontaneously in 1-2 menstrual cycles

6. BREAST CANCER
Treatment includes combined modalities (surgery, radiation, or drug therapy)
Treatment form depends on woman’s menopausal status and disease progression at diagnosis
At Stage I or II, offered modified radical mastectomy or lumpectomy with axillary dissection and radiotherapy

7. BREAST CANCER
Premenopausal women with tumors > 1 cm will be treated with chemotherapy as adjuvant treatment in order to try and prolong survival rate by eliminating microscopic metastasis
Chemotherapy regimens include CMF (cyclophosphamide, methotrexate, and fluourouracil) and CA (cyclophosphamide and Adriamycine or doxorubicin)

8. BREAST CANCER
Postmenopausal women offered same regimen for cancer that has spread to axillary lymph nodes
Tamoxifen may be used in patients with estrogen-receptor positive tumors as it competes with estradiol at receptor sites
Breast reconstruction may be used with implants or tissue reconstruction using abdominal muscles

9. COLORECTAL CANCER Malignant neoplasm of the colon or rectum
3rd most common cause of death in the U.S.

10. COLORECTAL CANCER SYMPTOMS
Changes in usual bowel patterns, especially in clients over age 40
Recent onset of constipation, diarrhea, or tenesmus (spasmodic contraction of anal or bladder sphincter with pain or persistent desire to empty bladder or bowel with ineffective straining efforts)
Bright red or dark red blood in stool
Lab findings may include iron-deficiency anemia or positive fecal occult blood tests

11. COLORECTOAL CANCER
Diagnosis based on digital rectal exam, anoscopy, proctosigmoidoscopy, colonoscopy, barium enema exam, or biopsy of suspicious lesions and polyps
Surgery is primary form of treatment. Radiation therapy alone, or in combination with surgery may be used. Chemotherapy may be used as adjuvant therapy

12. ESOPHAGEAL CANCER
Adenocarcinoma or squamous cell carcinoma of the esophagus
Most often occurs in men over age 60
Causes more than 10,000 deaths/year
Usually fungating (fast growing like fungus) and infiltrating, and in most cases, tumor partially constricts the esophageal lumen
Regional mets occurs early by way of lymph system, often fatally affecting vital organs in chest cavity
Liver and lungs are usual sites of distant mets

13. ESOPHAGEAL CANCER
Risk factors include chronic smoking and excessive ETOH use
Symptoms include patient reporting feeling of fullness, pressure, indigestion, or substernal burning (may try using antacids to relieve symptoms)
Later symptoms include weight loss and dysphagia, hoarseness, chronic cough, anorexia, vomiting and regurgitating food.
Some complain of pain on swallowing or pain radiating to back

14. ESOPHAGEAL CANCER
Due to patients typically being diagnosed in late stages, treatment is aimed more at palliative than curative
Goal of treatment is to keep the esophagus patent by using dilation, laser therapy, radiation therapy, and insertion of prosthetic tube
Radical surgery can excise tumor and resection of esophagus or esophagus and stomach
Chemotherapy and radiation can slow tumor growth

15. ESOPHAGEAL CANCER
Prognosis tends to be poor with 5 year survival rate in less than 5% of patients
Most patients die within 6 months of diagnosis

16. SKIN CANCERS
Basal cell carcinomas
Squamous cell carcinomas
Melanomas

17. BASAL CELL CARCINOMAS
Skin malignancy that rarely metastasizes but may be locally invasive
Typically, begins as small, shiny papule
Lesion enlarges to form a whitish border around a central depression or ulcer that may bleed
Removal method depends on size, location, and appearance of lesion

18. SQUAMOUS CELL CARCINOMA
Carcinoma that develops primarily from squamous cells on skin or in mouth, lunges, bronchi, or esophagus

19. MELANOMA
Malignant tumor that begins in a darkly pigmented mole and can metastasize widely
Incidence rising more rapidly than any other form of cancer
90% develops on skin, 5% in eye, and 2.5% on mucous membranes

20. MELANOMA Caused by excessive exposure to UV light, especially sunlight
More common in whites than blacks
Appears to have genetic factor in some families

21. MELANOMA SYMPTOMS Asymmetrical lesions Irregular borders
Color variation
Usually >6 mm diameter (1/4”)
A change in mole appearance or size often brings person for medical attention

22. MELANOMA Prevention includes sunscreen and protective clothing
Rates of long term survival depend on lesion depth at diagnosis (thicker more dangerous), the histologic type, and patients age and gender (older patients do poorly, men outcome worse than women)
Treatment includes surgery to reomve primary cancer lesion along with adjuvant therapy to reduce metastasis

23. STOMACH CANCER Gastric adenocarcinoma, lymphoma, or sarcoma
Worldwide, is 2nd most common for of cancer, following liver CA
In U.S, is relatively infrequent

24. STOMACH CANCER Cause unknown
Some question if dietary or environmental factors play a role
Suggestion that long term infection of Helicobacter pylori may play role

25. STOMACH CANCER Some patients have no symptoms
Indigestion, abdominal pain, weight loss, feeling rapidly full following small meal, nausea, vomiting
Surgical removal of stomach provides only chance for cure
Prognosis depends on depth of tumor invasion and spread to lymph nodes
On average, patients live 6-9 months following diagnosis

26. PROSTATE CANCER
Malignant tumor (almost always adenocarcinoma) of prostate gland
According to White, most common in men and 2nd most common cause of CA deaths in men
More common in African American men
Is testosterone sensitive tumor

27. PROSTATE CANCER SYMPTOMS
Often asymptomatic
May present with difficulty urinating, urinary hesitancy, nocturia, symptoms of UTI
If spread to bone may have localized or generalized pain

28. PROSTATE CANCER
Screening includes PSA (prostate specific antigen), digital rectal exam, ultrasound of prostate
Recommended that men over age 50 have screenings, especially if have family history or African American

29. PROSTATE CANCER
Therapy may include surgical resection, drug therapy to reduce testosterone levels, radiation therapy, and radiation therapy