TYPES OF CANCER

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

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

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

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

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

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)

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

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

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

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

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

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

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

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

SKIN CANCERS Basal cell carcinomas Squamous cell carcinomas Melanomas

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

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

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

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

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

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

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

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

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

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

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

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

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