1. CANCER AND ADOLESCENTS Contemporary Health 2 Caroline Montagna Matt Lorup

2. Overview What is cancer? Incidence Predisposition Treatment Adolescent Cancer and the Dimensions of Wellness Future Impacts References

3. What is Cancer? Disease caused by an uncontrollable division of abnormal cells in a part of the body Caused by both internal factors and external factors. These causal factors may act together or in sequence to initiate or promote the development of cancer. Ten or more years often pass between exposure to external factors and detectable cancer.

4. Incidence of Cancer According to the American Childhood Cancer Organization, more than 1.6 million people were expected to develop cancer in 2012 in the United States. According to the National Cancer Institute, about 70,000 adolescents and young adults are diagnosed with cancer each year in the United States.

5. Common Adolescent Cancers Lymphoma Cancer of immune system lymph system, lymphocytes Symptoms: unexpected weight loss Fullness in abdomen Night sweats Hodgkin Lymphoma (most common) Leukemia Cancer of blood cells Starts in bone marrow Makes abnormal white blood cells grow faster than normal cells, Symptoms - bone pain, lump on neck, swelling on left side of belly

6. Common Adolescent Cancers (cont’d.) Germ Cell Tumor Masses of tissue formed by immature cells, which in a healthy body would develop mature eggs or sperm 90% of GCT’s are gonadal, meaning they begin in the reproductive system Can develop in CNS Symptoms - Excessive hair growth, early entry to puberty, frequent urination Melanoma Skin cancer Unrepaired DNA damage to skin cells Develops moles (black or brown) Genetically disposed + constant UV rays Symptoms - change in size, shape, or color of a mole or other skin growth, such as a birthmark

7. Treatments Lymphoma: Chemotherapy Radiation therapy Induction therapy Biological therapyLeukemia: Stem cell transplantation Radiation therapy Chemotherapy Immunotherapy

8. Treatments (cont’d.) Germ Cell Tumor: Chemotherapy Surgery Melanoma: Depends on stage Surgery Target therapy Chemotherapy Radiation therapy

9. Adolescent Cancer and the 7 Dimensions of Wellness

10. Cancer and the Physical Dimension Chemotherapy Nausea and vomiting Fatigue Radiation Therapy Damage of normal, healthy cells near the cancer Anemia Deficiency of red blood cells Pain Tumor compression Surgery

11. Cancer and the Intellectual Dimension Some cancers and treatments can result in cognitive changes that affect thinking, learning, processing or remembering information. These changes can affect many aspects of life such as the ability to work or even to do everyday tasks.

12. Cancer and the Emotional Dimension Distress Anxiety Fear Depression Guilt

13. Cancer and the Social Dimension Patients with cancer and their families often experience an enhanced need for social support. Social support has been found to be related to influencing health outcomes. Social support may reduce: Anxiety and stress, emotional distress and depression, fatigue Social support may improve: Mood, self-image, ability to cope with stress, feelings of control

14. Cancer and the Spiritual Dimension Many survivors find that life takes on new meaning after cancer, and will renew their commitment to spiritual practices or organized religion. Research suggests that spirituality improves quality of life through a strong social support network, adaptive coping, lessened depression and better physiological function.

15. Cancer and the Occupational Dimension Reluctance to reveal that you are undergoing cancer treatment to your employer or coworkers for fear of being treated differently or even losing your job and health insurance. Re-entering social and professional life can be accompanied by many fears: worry about being out in the world with an increased risk of infection not having enough energy to get through a workday anxiety about not being able to think clearly because of "chemobrain" or memory loss.

16. Cancer and the Environmental Dimension Exposure to radiation Exposure to smoking Being around an environment that does not enhance your risk of further spreading the cancer.

17. Future Impacts

18. The number off adolescents with cancer will increase because of link with obesity. Programs will continue to be made to help adolescents cope with their cancer. Cure Search - leader in funding children's cancer research. Cure rates have increased from approximately 40% to 80%. American Childhood Cancer Organization - The 5 year survival rate for childhood cancer is close to 80%. Currently there are estimated to be 270,000 survivors of childhood cancer in the U.S.

19. References American Childhood Cancer Association http://www.acco.org/information/aboutchildhoodcancer/childhoodcancerstatistics.aspx National Cancer Institute http://www.cancer.gov/cancertopics/cancerlibrary/what-is-cancer Children’s Cancer Research Fund http://www.childrenscancer.org/main/germ_cell_tumors/ National Library of Medicine http://www.nlm.nih.gov/medlineplus/lymphoma.html American Cancer Society http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin- cancer-treating-general-info American Society of Clinical Oncology (ASCO) http://www.cancer.net/coping-and-emotions/managing-emotions Susan G. Komen Foundation http://ww5.komen.org/BreastCancer/BenefitsofSocialSupport.html