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123 Cards in this Set

  • Front
  • Back
Describe the normal process of cell functioning in the body.
The cells of the body grown and divide in a controlled way to produce more cells as they are needed. When cells become old or damaged, they die and are placed with new cells
Why does cancer occur?
The DNA of cells becomes damaged, producing mutations that affect normal cell grwoth and division. WHen this happens, cells do not go through apoptosis when they should and new cells form when the body does not need them. THese cells may form a tumor
ToF: risk of cancer increases with age
T
___% of all cancers are diagnosed in people older than 55
78
What % of cancers are hereditary?
5%
What are the major categories of external risk factors for cancer?
-tobacco
-alcohol
-chemicals
-infectious organisms
-radiation
Which nuclear agent accumulates in the thyroid gland and has a half life of 8 days?
Radioactive I-131
Describe the course of Cesium 137.
-Half life of 30 years
-Accumulates in the body's soft tissues and bone marrow.
What are the 3 classes of internal risk factors for developing cancer?
1. inherited mutations: BRCA 1
2. Hormones
3. Immune conditions: lupus, rheumatic, transplants
Cancer prevention is achieved through __, ___, and ___ methods.
primary, secondary, tertiary
How is cancer prevented?
strategies that focus on modifying environmental and lifestyle risk factors which promote cancer
Which form of prevention aims to reverse the carcinogenic process through lifestyle modification?
Primary
Screening and early detection methods that seek to detect cancers at the earliest stage is a form of ___ prevention.
Secondary
For those that already have been diagnosed with cancer, the act of monitoring for early signs of recurrence or development of 2nd malignancy is considered ___ prevention
tertiary.
___ chemicals in tobacco are known to be harmful.
250
how many carcinogens are known in tobacco?
70
Carcinogens may induce __ __ and lead to cancer development.
genetic mutations
What are the types of cancer that have been linked to cigarette, cigar and pipe smoking?
-lung
-mouth
-bladder
-colon
-kidney
Cigarette smoking causes __% of all cancer deaths in the US.
30
ToF: Chewing tobacco and snuff increases the risk of lung cancer and second hand smoke increase the risk of oral cancer.
F; other way around
ToF: cellular damage and tissue inflammation from tobacco smoke are immediate.
True
ToF: inhalation of tobacco even once can cause DNA damage and increase the risk of cancer.
True
Smoking causes more than ___% of lung cancer
85
According to the CDC, in 2009 what % of high school students smoke? % girls? % boys?
HS: 17.2%
Girls 14.8%
Boys: 19.6%
What is the name of the Act that made it a federal law that gives the FDA the power to regulate the tobacco industry?
The Family Smoking Prevention and Tobacco Control Act
What rule came out of the family smoking prevention and tobacco control act?
required warnings for cigarette packages and advertisements that graphically depict the consequence of smoking
In the longitudinal study about smoking posted in pediatrics in 2011, what % of children began smoking
13
ToF: a study showed that the incidence of smoking in adolescents was not related to the amount of exposure they had to advertisements?
FALSE: it was related
Combination therapy for smoking cessation lead to success rates of __ to __%, dropping to __ to __% at 1 year.
40-60; 25-30
What is the success rates that people have when trying to quit smoking on their own?
< 10%
Describe behavioral therapy for smoking cessation.
-it helps identify triggers and stressors that lead to smoking
-Teaches the patient to cope with these triggers by avoiding triggers and teaching new habits.
List the classes of nicotine replacement therapies available for patients.
-Transdermal
-Oral lozenges
-gum
-nasal spray
-oral inhaler
What are some common medications used to help with smoking cessation?
-Buprorion SR (Zyban)
-Varencicline (Chantrix)
What are the Risk factors for Skin Cancer?
1. UV exposure
2. Caucasian
3. Fair skin
4. Red or blond hair
5. Family Hx
6. Immune suppression
7.Xeroderma pigmentosum
What is xeroderma pigmentosum?
Rare mutation that a child is born with that causes skin cancer by age 10
___ to the sun is the greatest risk factor for all types of skin cancer.
overexposure
__% of nonmelanoma skin cancers and _% of melanoma felt to be directly related to UV rays from the sun
90; 65
ToF: UV radiation is not considered a known carcinogen?
FALSE, it is
Which rays penetrate deeper layers of the skin and are responsible for premature aging
UVA
What do UVB rays effect?
affect the epidermis and primary cause of sunburns
How much does indoor tanning increase the risk of developing melanoma?
20%
ToF: the risk of melanoma is about 40% for people who use tanning beds prior to age 35.
True
What is the most deadly form of skin cancer?
melanoma
Melanoma is the __th most common type of new cancer diagnosis in men and the __th in women
5th; 6th
What age groups and races have the most profound numbers of melanoma?
young white women (ages 15-39) and older white men (>65 years)
ToF: melanoma is more than 5 times more common in caucasians than in african americans.
False: 10 times
What are the hours in which we should avoid direct sunlight?
10am to 4pm
What BMI corresponds to obesity according to the NIH?
BMI > 30
Obesity is associated with __ in __ cancer related deaths in men and __ in __ deaths in women.
1 in 7; 1 in 5
Obese women have an increases risk of which forms of cancer?
-breast
-endometrial
-cervical
-kidney
-GB
-ovarian
Which cancers are obese men at higher risk for?
-colon ca
-gastric cancers
-esophageal
ToF: total dietary fat intake has been found linked to colon and breast cancer?
False
Which cancer has had convincing links between it and dietary fat intake?
prostate
What connection has been dietary fiber and cancer?
reduction of risk of heart disease and diabetes, but its effect on cancer risk reduction is less certain
Why has physical activity been found to reduce the risk of cancer>?
-improves energy metabolism
-reduces circulating concentrations of estrogen, insulin and insulin-like growth factor
Which cancers have been found to have a reduced risk with increased physical activity?>
-breast
-colon
-endometrial
-lung
-prostate cancer
What are the % can diabetes increase cancer in men and women?
Men: 17%
Women: 11%
What forms of cancer are generally at higher risk with diabetes?
Colon, rectum and liver
What form of cancer has been found to decrease in diabetic patients?
prostate
Describe chemoprevention
For several cancers, prophylactic medication can reduce cancer risk for high risk individuals. The risk/benefit ratio for chemoprevention must be evaluated for individual cases
What is the use of natural, synthetic agents to interrupt carcinogenic progression called?
Chemoprevention
Which chemopreventive drug has been found to have a 49% reduction in invasive and noninvasive breast cancer in high risk and postmenopausal women?
Tamoxifen
What is Raloxifene?
Chemopreventive drug that is approved for breast cancer risk reduction in POSTMENOPAUSAL women and high risk for invasive breast cancer.
What did the STAR trial find?
Compared tamoxifen and Raloxifene for effectiveness as a breast cancer reduction agent. Found that they were comparable.
What is the name of the drug that was found to decrease the number of polyps in the colon and thus decrease the risk of colon cancer
Celecoxib
What type of drug is Celecoxib?
COX 2 inhibitor
___ at 400mg ___ FDA approved for the prevention of adenomatous polyps in patients with FAP
Celecoxib; BID
What is FAP
Familial adiposis polypsus
generally leads to colon cancer
What is the name of the 5 alpha reductase inhibitor that blocks the conversion of testosterone to DHT and thus reduces the risk of prostate cancer?
Finasteride
What were the outcomes of the alpha-tocopheral, beta carotene cancer prevention trial and smokers?
18% more lung cancer and 8% more deaths seen in beta carotine arm
ToF: beta carotene has been found to be a benefitical chemopreventive drug for lung cancer with smokers?
FALSE
ToF: Vitamin E therapies can decrease the risk of prostate cancer in men?
FALSE; increases the risk
What is the age group for Gardasil?
9-26
what is gardasil used to prevent?
cervical, vulvar and vaginal cancers
and for males and females: anal cancers, precancerous or dysplastic lesions and genital warts caused by HPV
What are the 2 requirements for screening to be efficacious?
1. A test or procedure must be available to detect cancers earlier than if the cancer were detected as a result of the development of symptoms
2. Evidence must be available that treatment initiated earlier as a consequence of screening results in an improved outcome.
What are the aspects of an effective screening test?
-sensitivity
-specificity
-positive predictive value
-negative predictive value
What is the most commonly diagnosed cancer in women and the 2nd leading cause of death after lung cancer?
Breast cancer
What are the NCCN guidlines for breast cancer screening for women > 20; >40
>20: Clinical breast exam every 1-3 years and breast awareness
> 40; CBE and mammogram annually and breast awareness
What form of breast cancer screening helps to reduce the # of deaths among women ages 50 to 74 by about 17%
mammograms
When mammograms are started at age 40, how much is the mortality decreased by?
20%
T or F: there is a direct benefit in screening women for breast cancer with mammograms under age 40 and over 74
FALSE
What are the potential harms from screening mammograms?
1. Finding cancer thru screening does not always mean saving a life
2. false negatives
3. false positive
4. overdiagnosis and overtreatment
5. radiation exposure
What is the 4th most commonly diagnosed cancer is men and the 9th in women in the US, and the 7th leading cause of solid cancer related deaths?
Bladder cancer
What are the risk factors for bladder cancer?
-smoking
-occupational exposures such as rubber, chemical and leather
-male
-older age
-Caucasians
- family history
ToF: screening for bladder cancer for the average population is NOT recommended?
TRUE
How do they screen for bladder cancer>?
Microscopic UA for hematuria, urine cytology and urine biomarkers (BTA): for people with previous bladder tumor
What is the most commonly diagnosed cancer in women and the 2nd leading cause of death after lung cancer?
Breast cancer
What are the NCCN guidlines for breast cancer screening for women > 20; >40
>20: Clinical breast exam every 1-3 years and breast awareness
> 40; CBE and mammogram annually and breast awareness
What form of breast cancer screening helps to reduce the # of deaths among women ages 50 to 74 by about 17%
mammograms
When mammograms are started at age 40, how much is the mortality decreased by?
20%
T or F: there is a direct benefit in screening women for breast cancer with mammograms under age 40 and over 74
FALSE
What are the potential harms from screening mammograms?
1. Finding cancer thru screening does not always mean saving a life
2. false negatives
3. false positive
4. overdiagnosis and overtreatment
5. radiation exposure
What is the 4th most commonly diagnosed cancer is men and the 9th in women in the US, and the 7th leading cause of solid cancer related deaths?
Bladder cancer
What are the risk factors for bladder cancer?
-smoking
-occupational exposures such as rubber, chemical and leather
-male
-older age
-Caucasians
- family history
ToF: screening for bladder cancer for the average population is NOT recommended?
TRUE
How do they screen for bladder cancer>?
Microscopic UA for hematuria, urine cytology and urine biomarkers (BTA): for people with previous bladder tumor
What is the mean age of diagnosis for endometrial cancer?
60
What are the risk factors for endometrial cancer?
-Early menarche
-late menopause
-polycystic ovary disease
-granulosa cell tumor of ovary
-tamoxifen
-HNPCC
Why is tamoxifen not ideal, even though it has been found to decrease the risk of breast cancer?
It can increase the risk of endometrial cancer
What is the screening technique recommended for HNPCC?
Endometrial cancer risk factor: use a TVU and endometrial biopsy beginning ages 25-35
Which cancer accounts for 3% of all cancers among women?
Ovarian cancer
What are the risk factors for ovarian cancer?
nulliparity and continuous ovulation
Who should be screened for ovarian cancer?
High risk
-strong family history; BRAA 1 and 2 and HNPCC
What is used to screen for ovarian cancer?
TVU and CA-125 (after day 5 of menstruation cycle. Not that great of a screening tool.
According to the PLCO cancer screening trial, only ___ out of 100 women who testes positive for signs of ovarian cancer with TVU and CA-125 actually had cancer.
1.6
What what age does screening against colorectal cancer begin for the average risk population?
50
What are the screening methods for >50
-Colonoscopy every 10 years
-Flex sigmoidoscopy every 5 years
-Virtual colonscopy every 5 years
-Stool based Guaic testing or fecal immunohistochemical testing annually
What the the ACG recommend the age of screening for African American men against colon cancer?
Colonoscopies at age 45
What has been found to have a greater positive screening capability against lung cancer; CXR or helical CT?
Helical CT
Who is considered High risk for lung cancer by the NCCN?
-Age 55-74 and > or equal to 30 pack year history of smoking and smoking cessation of < 15 years
-age > or equal to 50 years and > or equal to 20 pack year history of smoking and one additional risk factor (other than second hand smoke)
What are the screening tools for lung cancer?
Low Dose CT or CXR
What is the most commonly diagnosed cancer in american men and 2nd leading cause of cancer related death?
prostate cancer
What are the screening techniques for prostate cancer?
DRE and PSA testing
T or F: PSA and DRE testing is recommended up to age 80
False: not recommended after age 75
How often should normal PSA testing occur between 40 and 50 years old and thereafter?
40; 45; 50 and annually thereafter
ToF: as men age the average normal range of PSA decreases in size?
FALSE; it increases
What rate of change in PSA in one year is considered an increased risk factor for PC?
0.75ng/mL/year
ToF: the free PSA (ratio of free to total PSA) is reduced in men with prostate cancer?
TRUE
What is the most common solid tumor in men between 15-35 years of age?
testicular cancer
What are the risk factors for testicular cancer?
-cyrptochidism, klinefelters syndrome and family history
What is the recommended age group to have testicular examinations annually?
15-40
What is the name of the breast cancer risk assessment tool?
Gail model
What can APN's do for cancer treatment?
-in a position to educate patients and the public regarding risk reduction and screening guidelines
-Focus on health promotion and disease prevention
-"screening to prevent disease and promote wellness" ONS