Cancer Health & Healing - Canadian Cancer Statistics PDF

Health & Healing Modules 5 & 6: Cancer - Cancer is more common among women between the age of 20-59 years, primarily because of breast and thyroid cancer. - Nearly 40% of breast cancer cases are expected to be diagnosed in women aged 30-59 - In all other age groups, cancer is more c...

Health & Healing Modules 5 & 6: Cancer - Cancer is more common among women between the age of 20-59 years, primarily because of breast and thyroid cancer. - Nearly 40% of breast cancer cases are expected to be diagnosed in women aged 30-59 - In all other age groups, cancer is more common in men. [List the prevalence, incidence, and death rates of cancer in Canada] - Prevalence is a term used to describe the total number of people who are living with a diagnosis of cancer. - Prevalence is more often and more usefully defined as patients still alive 10 years after the initial diagnosis with cancer. - Over a lifetime, it is estimated that nearly one in two Canadians (45% male, 45% female) will develop a cancer - and one in four (26% male, 23% female) will die from it. - In 2017, cancer was the leading cause of death in Canada accounting for 30% of all deaths - Of the 220 400 cases of cancer predicted in 2019, the 5 leading causes of cancer death (lung, colorectal, pancreas, breast and prostate cancers) accounted for over 50% of all cancer deaths - Lung cancer remains the leading cause of premature death from cancer - Aside from tobacco use, known risk factors include: excessive body weight, lack of physical activity, unhealthy eating habits, alcohol consumption and excessive exposure to the sun - Two major dysfunctions present in the process of cancer are defective cellular proliferation (growth) and defective cellular differentiation - Cell proliferation originates in the stem cell and begins when the stem cell enters the cell cycle - Cancer cells grown in tissue culture are characterized by loss of contact inhibition. These cells breach cellular boundaries and will grow on top of one another and on top of or between normal cells. - Cancer cells proliferate at the same rate as normal cells but respond differently than normal cells to the intracellular signals that regulate the state of dynamic equilibrium. - Cell division in cancer is dysregulated and haphazard, proliferation of cancer cells is indiscriminate and continuous. - with each cell division creating two or more offspring cells, the tumour mass continuously doubles in size: 1 cell → 2 cells → 4 cells → 8 cells → 16 cells, and so on. This is termed the *pyramid effect.* The time required for a tumour mass to double in size is known as its doubling *time.* - Once the cell has mutated, one of three things can occur: (1) the cell can die, either from the damage resulting from the mutation or from initiation of a programmed cellular suicide called *apoptosis;* (2) the cell can recognize the damage and repair itself; or (3) the mutated cell can survive and pass along the damage to its daughter cells. Mutated cells. that survive have the potential to become malignant - Cancer cells produce an enzyme called *telomerase* that prevents telomere shortening and allows the cells to escape senescence and death. Telomerase thus promotes the immortalization of cells and has a role in the development of cancer, as well as in the process of aging. - In cellular differentiation, the phasing out of cellular potential is stable and orderly. Under normal conditions, the differentiated cell is stable and does not *dedifferentiate* (i.e., revert to a previous undifferentiated state). - **Proto-oncogenes** promote growth, whereas **tumour suppressor genes**, such as tumour protein 53, suppress growth. - Tumours can be classified as benign or malignant. In general, **benign neoplasms** are well-differentiated, and **malignant neoplasms** are undifferentiated. Malignant tumour cells have the ability to invade and metastasize, unlike benign neoplasms. Diagram of a cycle of cell division Description automatically generated [three phases of cancer development]  1. Initiation: a mutation in the cell's genetic structure resulting from an inherited mutation, an error that occurs during DNA replication or after exposure to a carcinogen or radiation. Women with mutations in the gene BRCA1 or BRCA2 have a 40-85% risk of developing breast cancer in her lifetime. 2. Promotion: characterized by the reversible proliferation of the altered cells. A period of time, ranging from 1 to 40 years, elapses between the initial genetic alteration and the actual clinical evidence of cancer. This period, called the *latency period,* is now theorized to comprise both the initiation and the promotion stages in the natural history of cancer 3. Progression: final stage, characterized by increased growth rate of the tumour as well as increased invasiveness and spread of the cancer to a distant site (metastasis) [Role of the immune system in relation to cancer] - The immune system has the potential to distinguish normal from abnormal cells - This can result in the body rejecting the organ infected - Lymphocytes continually check cell surface antigens and detect and destroy cells with abnormal or altered antigenic determinants. - Cytotoxic T cells play a dominant role in resisting tumour growth - NK cells are able to directly lyse tumour cells spontaneously without any prior sensitization - Monocytes and macrophages have several important roles in tumour immunity - TNF causes hemorrhagic necrosis of tumours and exerts cytocidal or cytostatic actions against tumor cells - B lymphocytes produce specific antibodies that bind to and destroy tumor cells by complement fixation and lysis [Classification systems for cancer ] Anatomical- tumour is identified by the tissue of origin, the anatomical site and the behaviour of the tumor Carcinoma- originates from embryonal ectoderm (skin and glands) and endoderm (mucous membrane linings of the respiratory, GI and genitourinary tracts) Sarcoma- originates in the connective tissue of the body (fat, muscle, blood vessels, nerves, bones or cartilage) Lymphomas and Leukemias- originate from the hematopoietic system Historical Analysis- the appearance of cells and the degree of differentiation are evaluated. 4 grades are used: 1. Cells differ slightly from normal cells and are well differentiated 2. Cells are more abnormal and moderately differentiated 3. Cells are very abnormal and poorly differentiated 4. Cells are immature and primitive and undifferentiated; the cell of origin is difficult to determine - *Stage 0:* cancer in situ - *Stage I:* tumour limited to the tissue of origin; localized tumour growth - *Stage II:* limited local spread - *Stage III:* extensive local and regional spread - *Stage IV:* metastasis TNM classification system- represents the standardization of the clinical staging of cancer by the Geneva-based internation union against cancer, used to determine the extent of the disease process of cancer according to three parameters: Tumor size (T) Degree of regional spread to the lymph nodes (N) Metastasis (M) Explain the role of the nurse in the prevention and detection of cancer. Explain the use of surgery, radiation therapy, chemotherapy, and biological therapy in the treatment of cancer. The nurse has a prominent role in the prevention and detection of cancer. Early detection and prompt treatment are directly responsible for increased survival rates among patients with cancer. Public education should include the following recommendations: 1\. Reduce or eliminate exposure to carcinogens and cancer promoters, such as cigarette smoke and sun exposure. 2\. Eat a balanced diet that includes fresh fruits, vegetables, omega-3 fatty acids, and fibre. Following *Canada's Dietary Guidelines* helps to ensure a healthy diet (Health Canada, 2021; see Chapter 42, Figure 42.1). 3\. Participate regularly (e.g., a minimum of 30 minutes, five times per week) in mild to moderate physical activity such as biking, walking, or running. 4\. Maintain a healthy weight for your body type.\ 5. Limit alcohol use to one or two drinks per day.\ 6. Get to know your body. Learn and practise self-examination , report changes 7\. Follow cancer screening guidelines (see the Resources at the end of this chapter). Early detection of cancer has a positive effect on prognosis.\ 8. Know the seven warning signs of cancer A close-up of a warning sign Description automatically generated  A close-up of a cell Description automatically generated  Intra-arterial chemotherapy is a specialized method of delivering cancer treatment directly to tumors through the arteries that supply them. Here\'s a summary of the key points about this technique: 1. Delivery method: The chemotherapy medication is administered directly into the artery that supplies blood to the tumor. 2. Applications: This approach has been used to treat various types of cancers, including: Osteogenic sarcoma (bone cancer) - Head and neck cancers - Bladder cancer - Brain cancer - Cervical cancer - Melanoma - Primary liver cancer - Metastatic liver disease 3. Administration technique: One common method involves surgically placing a catheter that is then connected to either an external infusion pump or an implanted infusion pump to deliver the chemotherapy agent. 4. Advantages: Intra-arterial chemotherapy generally results in reduced systemic toxicity compared to traditional chemotherapy methods. This means fewer side effects throughout the body. 5. Side effects: The specific toxic effects experienced by patients depend on two main factors: The toxicity profile of the particular chemotherapy agent used - The location of the tumor being treated This targeted approach allows for more concentrated delivery of medication to the tumor site while potentially minimizing the impact on healthy tissues elsewhere in the body. It\'s an example of how cancer treatments are becoming more precise and tailored to individual patient needs Intraperitoneal chemotherapy is a specialized treatment method for certain types of cancer that involves: 1. Purpose: Delivering chemotherapeutic agents directly into the peritoneal cavity (the space within the abdomen that contains the intestines, stomach, and liver). 2. Target conditions: Peritoneal metastases from primary colorectal and ovarian cancers - Malignant ascites (accumulation of fluid in the peritoneal cavity due to cancer) 3. Administration methods: a) Short-term delivery: Using temporary Silastic catheters such as Tenckhoff, Hickman, or Groshong catheters. These are inserted either percutaneously (through the skin) or surgically into the peritoneal cavity. b) Long-term delivery: Using an implanted port for repeated administration of chemotherapy drugs. 4. Potential complications: \- Abdominal pain - Catheter-related issues: occlusion (blockage), dislodgement, or migration - Infection This approach allows for direct application of chemotherapy drugs to cancer cells in the abdominal cavity, potentially increasing the effectiveness of treatment for certain types of cancers while possibly reducing systemic side effects compared to traditional intravenous chemotherapy. intrathecal and intraventricular chemotherapy: 1. Purpose: These methods are used to treat cancers that have metastasized to the central nervous system (CNS). 2. Common cancers treated: Breast cancer - Lung cancer - Gastrointestinal (GI) cancers - Leukemia - Lymphoma 3. Challenge: The blood-brain barrier often prevents conventional chemotherapy drugs from reaching the CNS effectively. 4. Intrathecal chemotherapy: Involves a lumbar puncture (spinal tap) - Chemotherapy drugs are injected directly into the subarachnoid space (the area around the brain and spinal cord) 5. Ommaya reservoir: A device used to improve drug distribution and ease of administration - It\'s a Silastic, dome-shaped disc with an extension catheter - Surgically implanted through the skull into a lateral ventricle of the brain 6. Benefits: a) Ensures more uniform distribution of drugs to the cisternal and ventricular areas b) Eliminates the need for repeated painful lumbar punctures These methods allow for direct delivery of chemotherapy drugs to the CNS, bypassing the blood-brain barrier and potentially improving treatment efficacy for cancers that have spread to this area. 7. The Ommaya reservoir, in particular, offers a more convenient and potentially more effective way to administer these treatments over time 8. Complications of intrathecal or intraventricular chemotherapy include meningitis and leukoencephalopathy Intravesical bladder chemotherapy is a treatment method primarily used for patients with superficial transitional cell cancer of the bladder. This approach is often employed when patients experience recurrent disease after traditional surgical therapy. Here are the key points: 1. Purpose: To destroy cancer cells and reduce the incidence of recurrent bladder cancer. 2. Benefits: Promotes destruction of cancer cells - Reduces the likelihood of disease recurrence - Leads to reduced urinary dysfunction - Results in reduced sexual dysfunction 3. Administration method: The chemotherapeutic agent is instilled directly into the bladder using a urinary catheter - The medication is retained in the bladder for 1 to 3 hours 4. Potential complications: Dysuria (painful or difficult urination) - Increased urinary frequency - Hematuria (blood in urine) - Bladder spasms This localized treatment approach allows for direct application of chemotherapy drugs to the bladder lining, potentially increasing the effectiveness of treatment while minimizing systemic side effects compared to traditional intravenous chemotherapy. It\'s particularly useful for managing superficial bladder cancers and preventing their recurrence.  External radiation, also known as external beam radiation therapy, involves directing radiation from outside the body towards a specific area to target cancer cells or other tissues. This is typically done using a machine that aims radiation beams at the affected area. Internal radiation, also called brachytherapy, involves placing radioactive material directly inside the body near the area requiring treatment. This can be done temporarily or permanently, depending on the specific treatment plan. A close-up of a chart Description automatically generated  A chart of medical information Description automatically generated with medium confidence  A screenshot of a medical survey Description automatically generated A blood pressure cuff and a tonometer Description automatically generated  **Septic Shock** Classification of Shock - 4 main categories of shock - Cardiogenic - Hypovolemic - Distributive - Obstructive [Shock caused by low blood flow] Cardiogenic Shock - occurs when either systolic or diastolic dysfunction of the heart's pumping occurs, resulting in reduced stroke volume, cardiac output and blood pressure - cardiogenic shock has a 50% mortality rate and is a leading cause of death following a myocardial infarction