PSY 241 Intro to Health Psychology Chapter 11

Five-Year Relative Survival Rates by Race and Stage at Diagnosis

(See graph, slides and notes for details)

Prevalence of Cancer Screening among Five Racial and Ethnic Groups

(See graph/slides/notes for details)

Signs and Symptoms of Cancer

(See slides and notes for details)

Cancer

-A set of disease in which abnormal body cells multiply and spread in uncontrolled fashion, forming a tumor -Benign (noncan cerous); malignant (cancerous) -The second leading cause of U.S. deaths -Involves metastasis

Breast cancer

-African-Americans report more difficulties with physical function and daily living activities -Lower SES, African-American and Hispanic women more likely to perceive benefits from breast cancer diagnosis than European-Americans

Families with inherited breast cancer show:

-Breast cancer in 2 or more close relatives -Early onset -Breast cancer in more than one generation -Cancer in both breasts (one+ family members) -Frequent ovarian cancer -Ashkenazi (Eastern and Central European) Jewish ancestry, with family history of breast and/or ovarian cancer

Types of cancers

-Carcinoma -Sarcoma -Lymphoma -Leukemia

Treatment options

-Chemotherapy (use of medicines to treat cancer) -Immunotherapy (Chemotherapy with medications used to support/enhance immune system's ability to selectively target cancer cells) -Radiation therapy (Using x-rays/gamma rays to destroy malignant tumors) -Alternative treatments (generally unproven; many can relieve symptoms)

Surgery

-Diagnostic -Preventive (removal of a benign growth) -Staging (to determine the extent of disease) -Curative (to remove a tumor) -Restorative (to reconstruct a person's appearance or the function of an organ or body part)

Protective foods

-Garlic, onions, leeks -Selenium-rich foods (Fish, liver, garlic, eggs whole grains)

Tobacco use

-Implicated in 1 out of every 5 U.S. deaths -Single most lethal carcinogen -Most tobacco-related deaths result from cancer -Also linked to cancers of the mouth, pharynx, larynx, esophagus, pancrease, uterine cervix, kidney and bladder

Post-Traumatic Growth (PTG)

-Positive psychological change experienced as the result of struggle with a highly challenging life circumstance -Also referred to as benefit finding or thriving

AICR recommendations to reduce risk of developing cancer

-Reducing intake of foods and drinks that promote weight gain, namely foods high in saturated fats and sugar drinks -Eating mostly plant-based foods -Limiting intake of red meat and avoiding processed meat -Limiting consumption of alcoholic beverages -Reducing intake of salt and avoiding moldy cereals (grains) or pulses (legumes)

How might imagery help?

-The body reacts similarly to sensory events, whether real or imagined -Imagery triggers a state of relaxed concentration that increases sensitivity to health-promoting images -Using imagery gives the patient an increased sense of control and a decreased sense of helplessness over their treatment and disease -May trigger a placebo effect involving health-enhancing physiological changes

Possible food links to certain cancers

-Those that affect the cells that line bodily tissues, including those in the lungs, colon, bladder, stomach, rectum and to a lesser degree, the uterus, prostate, breasts and kidneys -Soy foods: isoflavones

Environmental and Occupational Hazards

-Toxic chemicals (asbestos, vinyl chloride, arsenic) -Radiation (40-50% of Americans who reach 65 develop skin cancer -Melanoma (potentially deadly form of cancer that strikes the melatonin-containing cells of the skin

Systematic Desensitization

A form of behavior therapy used for overcoming phobias -Person is exposed to a series of increasingly fearful situations while remaining deeply relaxed -Used to counter classically conditioned side effects of chemotherapy

Cancer susceptibility in population

African-Americans have the highest incidence rates for cancer in the U.S. -African-American women historically have been less likely to perform regular breast cancer screening -African-Americans tend to have less access to health insurance and health care facilities -Ethnic differences in diet, tobacco use and other risk factors play a role (African-Americans tend to smoke more and consume fattier diets)

Leukemia

Cancer of the blood and blood-producing system

Lymphoma

Cancer of the body's lymph system; including Hodgkin's disease and non-Hodgkin's lymphoma

Carcinoma cancer

Cancer of the epithelial cells that link the outer and inner surfaces of the body (breast, prostate, lung and skin cancer)

Coping with Cancer

Cancer surgery is associated with high levels of distress and slower rates of emotional recovery than other surgeries -Side effects of chemotherapy and radiation may include loss of hair, fatigue, loss of appetite, skin rashes -"Fighting spirit" among breast cancer patients is associated with a lower mortality rate than denial, helplessness or stoic acceptance

Sarcoma cancer

Cancer that strikes muscles, bones and cartilage

Carcinogen

Cancer-causing agent such as tobacco, ultraviolet radiation or an environmental toxin

Cancer-related masculine threat (CMT)

Common symptoms associated with prostate cancer treatment that threaten masculine self-image -High CMT scores related to poorer prostate-related functioning -Male cancers and cancer patients underrepresented in media/fewer role models -Less than 10% of American men opt for active surveillance (AS)

Stop and think!

Consideration of immediate consequences may be a more important determinant of health behaviors than consideration of future consequences (CFC)

Cancer Treatment

Early detection can dramatically improve a person's chances of survival -Detecting breast and testicular cancer (source of detection of majority of tumors) -Clinical breast exams (every three years for women between 20 and 40; annually thereafter)

Global Immunosuppression Model

Early theory that proposed that stress always suppresses immune responses

Alcohol

Excessive drinking is a major risk factor for cancer of the upper respiratory and digestive tracts (May also contribute to breast, colorectal and liver cancer) Consuming 2+ alcoholic drinks per day creates at least 25% greater risk of breast cancer (Animal research shows that drinking the equivalent of two to four drinks per day increases the growth of an existing tumor)

Consideration of Future Consequences (CFC)

Extent to which individuals consider, and are influenced by the potential future outcomes of their behavior

Cognitive Behavior Interventions

Focus on stress/pain relief, control of aversive reactions to treatment, enhancement of emotional well-being; in children, focus on increasing adherence and reducing suffering -Among most widely used are hypnosis, progressive muscle relaxation with guided imagery, systematic desensitization, biofeedback, cognitive distraction Questions of prolonging life remains controversial, but can help manage distress levels

Childhood adversity

Has been associated with greater emotional and physiological sensitivity to stress -More difficulty dealing with adulthood stress -More pronounced cortisol and autonomic stress response -Disrupted cellular immune function and immune system dysregulation

Overweight and obesity

Increases risk of cancer in endometrium, colon, kidney, esophagus, pancreas, ovaries, gallbladder -2012: Centers for Disease Control and Prevention (CDC) reported that 34% of U.S. adults are overweight; 35.9% are obese -NIH-AARP Diet and Health Study Exact casual mechanisms not known; possible mechanisms include alterations in sex hormones, insulin, IGF-1

Risk factors for cancer

Involve carcinogens, tobacco use, diet and possible food links to certain cancers

Physical activity

Lack of physical activity may be a risk factor for colon cancer -Nurse's Health Study -Women's Health Initiative Cohort Study: physically active women have lower rates of breast cancer than do sedentary women

Carotenoids

Light-absorbing pigments that give carrots, tomatoes and other foods their color and are rich in antioxidants

Cancer susceptibility

Many individual factors, such as gender, age and ethnicity affect susceptibility -The older people become, the greater than chances of developing and dying of cancer -Prevalence of different cancers varies by age group

Diet

Primary factor in one-third of all cancer deaths -Foods to avoid include saturated fats, red meats

Knowledge, Control and Social Support

Procedural information regarding treatment has wide-ranging benefits (fewer negative emotions, reduced pain, briefer hospital stays) -Emotional disclosure associated with better prognosis -Behavioral and psychosocial interventions may lower stress hormone levels, improve immune function

Metastasis

Process by which malignant body cells proliferate and spread

Biphasic model

Proposes that only the most chronic stressors cause global immunosuppression, short-term stressors may have no clinical significance

Estimates New Cancer Cases and Deaths by Type and Gender in 2013 vs. 2015

See notes and slides for details

Coping

The idea that people can overcome challenges to experience a more hardy state is relatively new in health and disease research -Post-Traumatic Growth (PTG)

Immunocompetence

The overall ability of the immune system at any given time to defend the body against the harmful effects of foreign agents

Immune Surveillance Theory

The theory that cells of the immune system play a monitoring function in searching for and destroying abnormal cells

Guided imagery

The use of one or more external devices to assist in relaxation and the formation of clear, strong images

Why Do People Sunbathe?

Those with the deepest tans: -Are least knowledgeable about skin cancer -Are most relaxed -Are more sensitive to the influence of peers who value a good tan -Tend to take other health risks -Are more focused on their appearance

Nurse's Health Study

Women who consumed 5 or more servings of fruits and vegetables were 23% less likely to develop breast cancer