Chapter 33 Cancer

Effect of Aging on the Incidence of Cancer Elderly have the highest rate of most cancers and lowest rate of receiving early detection tests. –Their disease may be in an advanced stage when diagnosed. Many elders have other health conditions elevating the risk of complications of cancer. There is concern as to how the older patient’s already compromised organs will tolerate chemotherapy. –Other cancer therapies could impact treatment decisions.

Theories Attempting to Explain High Rate of Cancer in Elderly Biological changes impair the ability to resist cancer. –Reduced mitochondrial activity –Changes in the immune system Effects of exposure to carcinogens over the years increase risk of cancer. –Emphasizes the importance of reducing controllable risk factors.

Risk Factors for Cancer Heredity Diet Nitrates Tobacco Alcohol Radiation

Risk Factors for Cancer (cont.) Ultraviolet radiation Occupational exposure to carcinogens Radon

Diet and Cancer High fat diets are linked to certain cancers. –Diets rich in fiber and antioxidants can offer protection against some cancers. Cooking certain meats at high temperatures may increase cancer risk. Diets including high intake of well-done fried or barbequed meats may increase risk.

Examples of Carcinogens in the Environment Asbestos Nickel Cadmium Uranium Radon Vinyl chloride Benzene

Risk Factors for Cancer in Women Age over 50 Women who had their first menstrual period before the age of 12 or experienced menopause after age 55 Women who had their first child after age 30 Women who have a first-degree relative or other relative with breast and/or ovarian cancer

Risk Factors for Cancer in Women (cont.) Women whose mothers took diethylstilbestrol (DES) during pregnancy Women with relatives who have had colon cancer Women using long-term hormonal replacement therapy

Preventive Measures for Cancer Avoid tobacco products. Limit exposure to the sun. Eat a diet rich in fiber, fruits, and vegetables. Maintain weight within an ideal range. Protect against occupational or other exposure to carcinogens. Limit alcohol consumption.

Preventive Measures for Cancer (cont.) Exercise and be physically active. Practice safe sex and limit the number of sexual partners. Discuss chemoprevention with your physician if family history increases risk of breast cancer.

Recommended Cancer Screening for Older Adults Annual check-up Annual mammogram Annual fecal occult blood test Flexible sigmoidoscopy every 5 years Double contrast barium enema every 5 years Colonoscopy every 10 years

Recommended Cancer Screening for Older Adults (cont.) Pap test: every 2-3 years Annual endometrial biopsy for women at high risk for hereditary nonpolyposis colon cancer Annual Prostate-Specific Antigen (PSA) and Digital Rectal Examination beginning at age 50

Conventional Cancer Treatment Surgery Radiation Chemotherapy Biologic therapy

Complementary and Alternative Methods of Cancer Care Relationship-centered care Support Healing partnerships Comfort Hope

American Cancer Society “CAUTION” Change in bowel or bladder habits A sore that does not heal Unusual bleeding or drainage Thickening or lump in the breast or elsewhere Indigestion or swallowing difficulty Obvious change in a wart or mole Nagging persistent cough or hoarseness

Categories of Complementary and Alternative Therapies Alternative medical systems (e.g., homeopathic medicine and traditional Chinese medicine) Mind-body interventions (e.g., visualizations and relaxation) Manipulative and body-based methods (e.g., chiropractic and massage) Biologically based therapies (e.g., vitamins and herbal products) Energy therapies (e.g., qigong and therapeutic touch)

Source Eliopoulos, C. (2005). Gerontological Nursing, (6 th ed.). Philadelphia: Lippincott, Williams & Wilkins (ISBN ).