Cancer

Cancer

It is estimated that 40 percent of all Americans will face a cancer diagnosis and that one in five will die of the disease. Increased public awareness and the availability of improved cancer screening techniques have led to earlier detection and consequently more successful treatment of many types of cancer. However, the bottom line is that lifestyle issues and personal behaviors that could dramatically reduce cancer death rates are still not embraced by many.

Cancer is the second leading cause of death for seniors and a major chronic condition for this age group (Vierck & Hodges, 2003). Seniors account for 59 percent of all cancers diagnosed annually. Senior men are nearly twice as likely as their female counterparts to be diagnosed with cancer.

What is Cancer?

Under normal circumstances, human cells multiply in a very tightly controlled process. When new cells are made, they remain in a specific location within the body. For example, heart muscle cells always stay in the heart and are created only in response to a specific stimuli. A heart muscle cell that is damaged destroys itself through a process known as apoptosis-cellular suicide-to prevent the genetic error from being passed on.

Cancer cells behave quite differently in that they multiply without regard to any of the body’s normal messages to stop. For example, cancer cells expand their support network of blood vessels and become larger (forming tumor masses). Cancer cells also frequently migrate through the bloodstream to establish themselves in other locations.

The following principles help explain the most common terminology used in cancer diagnoses. A primary tumor occurs when a genetic mutation in a cell causes it to reproduce abnormally. As this group of cells grows in size and continues to mutate genetically, it becomes large enough that it can be felt as a lump or be seen on diagnostic tests. A cancer in situ is one that has grown in size but remained confined in its original location. Many cancers progress to invade surrounding tissues (invasive cancer) or migrate to distant locations (metastatic cancer). Invasion and metastasis are the common characteristics of malignant (harmful) tumors. The goal of detecting cancers early is to identify and treat cells that are just beginning to change their appearance (dysplasia) or that have not begun to invade surrounding tissues.

Although the causes of cancer are not fully understood, they are becoming much clearer at a rapid pace. What is known is that the genes we inherit from our parents contribute directly to a very small number of cancers, causing fewer than 5 percent of all cancer deaths (Trichopoulos, Li, & Hunter, 1996). In addition, many environmental factors (e.g., overexposure to sun, cigarette smoke, or chemicals) damage cells. Tobacco smoke, for instance, is the most lethal cancer-causing agent in the United States and is responsible for an estimated 30 percent of all cancer deaths (Trichopoulos et al.) Diet rivals tobacco smoke and accounts for another 30 percent of cancer deaths through the ingestions of saturated fats and red meat. Infections such as HIV, Hepatitis B, and Epstein-Barr virus account for approximately 5 percent of all cancers.

Types of Cancer

Listed below are the leading types of cancer and the estimated number of cases Americans in 2003 (ACS, 2003):

  • Prostate (220,900)
  • Breast (211,300)
  • Lung (171, 900 cases)
  • Colorectal (147,500)
  • Bladder  (57,400)
  • Melanoma of the skin (54,200)
  • Non-Hodgkin’s lymphoma (53,400)
  • Uterine (40,100)
  • Ovarian (25,400)
  • Kidney (19,500)
  • Leukemia (17,900)

There are numerous ways to impact the development of cancer. For example, the projected number of deaths each year from lung cancer is greater than the combined total of annual deaths from colorectal, breast, and prostate cancer. Though few cases occur in the absence of a history of smoking, the elimination of tobacco smoke could almost eradicate lung cancer. Additionally we are now beginning to understand the impact of secondhand smoke on the development of lung cancer.

Early detection of cancer through screening has generated substantial progress in reducing the impact of cancer and cancer deaths. Finding a cancer when it is more responsive to treatment can result in a cure or in a significant extension of life. Testing stools, breast self-examinations, mammograms, Pap smears, rectal exams combined with blood tests for prostate-specific antigen (PSA), and colonoscopy are common screening tests that can dramatically improve treatment results.

Medicare covers several screening measures including annual mammograms for women over 40 a Pap smear every two years or annually for those at high risk, and both annual PSA tests and digital rectal exams for men over 50. According to current Medicare rules, annual fecal occult blood tests and flexible sigmoidoscopic exams every four years are considered the general preventive screening measures after age 50 for early detection of colorectal cancer. Medicare allows beneficiaries at high risk of colon cancer to receive a colonoscopy exam every other year. Many seniors do not take advantage of these opportunities, but you should encourage them to do so.

Treatment

Cancer is treated in basically one of four ways: surgery, radiation, chemotherapy, or genetically. Surgery is the most common intervention for many forms of cancer that are accessible to the surgeon’s knife and have not spread throughout the body. At times, removal of the tumor with a sufficient margin (to include the edges where tumor growth may not be clearly visible) creates a major loss of function or physical appearance that is more difficult to live with than the disease itself.

Another alternative, radiation therapy, uses x0rays or gamma rays to kill tumor cells in difficult-to-reach locations. Radiation is also used to eliminate a tumor without destroying large amounts of health tissue. By nature, radiation therapy creates some injury to surrounding good tissue, but healing can occur over time.

Chemotherapy circulates very powerful chemicals through the body via the bloodstream to kill tumor cells. While this mode of treatment is advantageous in reaching virtually all parts of the body, it also kills a large number of good cells, which makes the patient quite sick. A person undergoing chemotherapy will experience nausea, vomiting, diarrhea, and a reduction in blood cells, which increase the susceptibility to bleeding and infection. Often these approaches are used in combination with other cancer treatments to maximize results.

The newest forms of cancer treatment involve genetic and biologic approaches that, for example, use the body’s immune system to attack the cancer cells. Health Maintenance Organizations (HMO’s) or insurance companies may deny coverage of these procedures due to their experimental status.

The above information was provided by the Society of Certified Senior Advisors (SCSA)