Cancer Chapter 10: Behavioral Factors

Chapter 10: Behavioral Factors in Cancer

• Cancer deaths peaked in 1991, after a century of rising rates, followed by a gradual decline.
• Factors contributing to decline include improved treatments, decreased lung cancer rates, improved diets, and increased physical activity.
• Lung, breast, prostate, and colorectal cancers account for roughly half of all cancer deaths in the US. Mortality rates for these are declining. Stomach cancer has seen a significant drop in mortality rate.
• Some cancers, such as liver cancer, are experiencing increasing incidence and mortality rates.
• Melanoma, a skin cancer, is seeing an increase in incidence but a decrease in mortality, largely due to improved treatments and early detection. Thyroid cancer is increasing for men and decreasing for women.
• Some people are frightened of cancer despite declining mortality rates for many common cancers. Some experts in cancer care and patient advocacy argue this is because many types are now considered chronic diseases, where people may live for years while being treated for these diseases.

Warm-Up Activity

• Students are to break into small groups of no more than three.
• In groups, students identify actions they take or do not take to avoid cancer.
• As a class, the common themes are discussed.

Tonight's Objectives

• Explain the two factors that contributed to the decline in cancer deaths in the US.
• Describe how an increase in cancer incidence doesn't necessarily equate to increased death rates (for some cancers).
• Refute the statement that genetic factors cause 60% of cancers.
• Identify three environmental risk factors and describe how people encounter them.
• Rank behavioral risk factors for cancer based on severity, with reasoning.
• Evaluate the role of optimistic bias in behavioral risk factors for cancer.

Chapter Objectives (3 of 3)

• Evaluate the role of psychosocial factors in cancer development.
• Describe the advantages and drawbacks of common cancer treatments.
• Describe three factors associated with good cancer adjustment and three with poor adjustment.
• Discuss the importance of social support for cancer patients and survivors and the best sources for social support.

Inherent Risk Factors for Cancer

• Inherited risk factors include genetics, family history, ethnic background, and age.
• Age is a risk for everyone with the risk of developing and dying from cancer increasing in older age groups.
• Ethnic background can significantly affect cancer risk, with some ethnic groups, like African Americans, having higher rates for nearly all cancers.
• Family history and genetics are factors in about 5-10% of all cancers.

Environmental Risk Factors for Cancer

• Environmental risks include radiation, asbestos, pesticides, herbicides, motor exhaust, chemicals like arsenic, benzene, chromium, nickel, vinyl chloride, and various petroleum products.
• Radon, a natural radioactive gas, can cause lung cancer.
• Some diseases and chronic infections increase the risk of certain cancers.

Behavioral Risk Factors for Cancer

• Risk factors are not necessarily causes but rather predictors of likelihood.
• Smoking is a significant factor for cancer mortality globally, with a strong positive correlation between smoking and lung cancer rates.
• Diet plays a role, with some foods suspected of being carcinogenic due to contaminants or additives. Excess fat is a risk for colon cancer and cholesterol issues.
• Obesity increases the risk of esophageal, breast, endometrial, and kidney cancers.
• Certain foods like an adequate intake of fruits and vegetables are thought to offer some level of protection against several types of cancer.
• Alcohol is a risk factor for oral, esophageal, breast, and liver cancers, correlated with cirrhosis of the liver.
• Excessive drinking, especially combined with smoking, increases cancer risk significantly beyond the individual risks of each.

Sedentary Lifestyle and Cancer

• A sedentary lifestyle increases risk for colon, endometrial, breast, lung, and pancreatic cancers.
• Physical activity reduces the risk of these cancers.

Ultraviolet Light Exposure and Cancer

• Exposure to UV light, particularly from the sun, is a known cause of skin cancer. Cumulative and severe sunburns are strongly linked to subsequent risk.
• The most fatal form of skin cancer is malignant melanoma, often found in light-skinned people.
• Skin cancer damage often begins in childhood.
• Vitamin D production from sun exposure can help reduce the risk of several forms of cancer by promoting vitamin D synthesis.

Sexual Behavior and Cancer

• Some sexual behaviors contribute to cancer, especially those related to AIDS (Kaposi's sarcoma, non-Hodgkin's lymphoma).
• Exposure to HPV increases the risk of cervical and oral cancers.
• A vaccine exists against HPV, but vaccination rates remain low in some key demographic groups.

Psychosocial Risk Factors in Cancer

• There is limited evidence linking specific personality types to cancer risk factors.
• Negative emotionality and the tendency to repress emotion may be some of the factors influencing cancer outcomes.

Living with Cancer

• Cancer diagnosis is highly stressful, causing fear, anxiety, and anger in patients.
• Social support is strongly correlated with increased likelihood of survival amongst cancer patients.
• Psychologists can offer emotional support and coping mechanisms.

Problems with Medical Treatments for Cancer

• Most treatment methods for cancer, including surgery, radiation therapy, chemotherapy, etc., have negative side effects that can add stress to patients and their families.
• Side effects can be painful, unpleasant, and long-lasting.
• Newer treatments like hormonal therapy and immunotherapy have been added to the treatment arsenal.

Adjusting to a Cancer Diagnosis

• Adjusting to a cancer diagnosis is a challenge for everyone, but some manage better than others.
• Factors like negative emotionality and social inhibition can be indicators of poorer adjustment to diagnosis.
• Optimism is strongly related to adjusting well to a diagnosis but its direct effects on long-term outcomes are not definitively clear.

Social Support for Cancer Patients

• Marriage reduces a man's chance of dying from cancer by 27% and a woman's by 19%.
• Economic factors and better quality healthcare may at least partly explain this, but stronger emotional support from a partner shows a larger effect.
• Peer support groups are helpful for those who lack marital support.

Psychological Interventions for Cancer Patients

• Group and individual therapy techniques can help patients cope with cancer diagnoses.
• Effective interventions can either improve emotional well-being, increase survival time, or both.
• Psychological interventions generally provide short-term benefits such as stress reduction and improved coping mechanisms in cancer patients. "One-size-fits-all" approach should not be taken in intervention methods, individual needs and effectiveness should be a consideration.

Additional Considerations

• Students should reflect on what they've learned about reducing cancer risks related to their own risk factors. They should determine if any changes are necessary.

This quiz explores the impact of behavioral factors on cancer incidence and mortality rates through various studies highlighted in Chapter 10. It covers trends in cancer deaths, the decline of certain cancers, and the rise of others, emphasizing the importance of diet, exercise, and early detection. Test your understanding of these critical factors in cancer care.