Chapter 11: Cancer

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A recent study found that breast cancer survivors who had experienced more adversities as children had higher ______, as well as more depressive symptoms and poorer sleep quality, than those with fewer childhood adversities

Epstein-Barr virus and CMV antibody titers

How is H. pyloria spread?

Fecal-oral contact, such as through water contaminated with human waste.

World Health Organization designated processed meats as a _______

Group 1 carcinogen

_____ can damage the inner layer of the stomach and lead to cancer over time.

Helicobacter pylori (H. pylori)

Globally, one third of cancer deaths are due to five behavioral and dietary risks:

High body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use

Non-Hodgkin's lymphoma:

Malignant cells are found at several sites

What are two food products that appear to cause cancer?

Meat that has been cooked or charred at high temperatures and meat that has been highly processed

Common side effects of chemotherapy?

Nausea and vomiting, hair loss, and fatigue. Less common side effects include bleeding, infections, and anemi

Benign tumors:

Noncancerous, remain localized and usually do not pose a serious threat to health

____ is used to help cancer patients get the nutrients they need to fight infection and keep up their strength.

Nutrition therapy

Research on the emotional and behavioral responses of cancer patients who undergo surgery consistently shows high levels of ____ both before and after the operation.

anxiety

Various chemicals are clearly carcinogenic, including ______

asbestos, vinyl chloride, and arsenic.

About 4 out of every 10 cancer cases and cancer deaths in the United States are linked to ______—and thus could be preventable

behavioral risk factors

Women of lower SES, as well as African American and Hispanic women, are more likely than European Americans to perceive ______ from a diagnosis of breast cancer, such as a renewed focus on relationships in their lives

benefits

Tobacco is a lethal ______, and the majority of smoking-related cancer deaths are from lung cancer.

carcinogen

Studies of cancer cells in the laboratory and in animals have provided some evidence that some isolated food components may be _____, while others seem to have _____ properties.

carcinogenic, anticancer

High-frequency radiation, ionizing radiation (IR), and ultraviolet (UV) radiation are proven ______.

carcinogens

HPVs are the main causes of ____ cancer, and they also contribute to some cancers of the ____ and _____.

cervical, mouth, throat

Examples of acute stressors that enhance natural immunity include: _______. In contrast, chronic stressors such as _________ produce global suppression of most measures of immune function.

challenging computer tasks, mental arithmetic, and loud noises bereavement, long-term caregiving, and suffering a traumatic injury

Unlike ______, which exposes the entire body to cancer-fighting chemicals, ______ is usually targeted to only the tumor and surrounding area.

chemotherapy, radiation therapy

Unlike surgery, which can destroy or damage cancer cells in a specific area, _______—medicines to treat cancer—can destroy cancer cells that have spread, or metastasized, to parts of the body far from the original, or primary, tumor. These _____ travel through the bloodstream to reach all areas of the body.

chemotherapy, systemic drugs

In addition, some researchers believe that exposure to _____-containing compounds found in some household cleaning and pest-control products may increase the risk of breast cancer and, possibly, other hormone-related cancers.

chlorine

Disruption in turn may cause ________, a search for meaning, and the rebuilding of a more positive life perspective.

cognitive restructuring

Numerous research studies have also linked processed meat—such as bacon, hot dogs, and salami—to ______ cancer.

colorectal

Prospective epidemiological studies have reported that high consumption of well-done, fried, or barbecued meats is associated with increased risks of ______

colorectal, pancreatic, and prostate cancer

However, when the immune system is overwhelmed by the number of cancer cells or weakened by stress or some other factor, the ______ is suppressed, and cancer may develop.

immune system's surveillance

In addition to growing at the site where they originated (______), malignant cells often have the ability to migrate and attack, invade, and destroy surrounding body tissues.

in situ

An estimated 15% to 20% of new cancers worldwide each year are attributable to _____

infection

Older age generally is associated with ____ distress among both cancer patients and cancer survivors

less

Although women are more commonly diagnosed with breast cancer and men with prostate cancer, ____ cancer accounts for 25.3% of all cancer deaths

lung

Common symptoms associated with prostate cancer treatment—such as erectile dysfunction, loss of libido, pain, fatigue, and feelings of vulnerability and fear—are linked to traditional gender role expectations and threatened _______ self-image

masculine

Ultraviolet B rays, which can damage DNA, cause more than 90% of all skin cancers, including ______, a potentially deadly form of cancer that forms in skin cells.

melanoma

More ___ (just under one in two) develop cancer than ____ (just over one in three), but ____ are more likely to develop any cancer before age 60.

men, women, women

Before _____, obese women have a lower risk of developing breast cancer than do women who are not obese. After ______, obese women have 1.5 times greater risk of developing breast cancer than women who are not obese.

menopause

Cancer develops over time, as _____ cells grow into tumors that may ______ to surrounding tissues.

neoplastic, metastasize

Although side effects are not always as bad as expected, their reputation makes chemotherapy an _____-provoking treatment.

anxiety

What does radiation do>

Delivers high doses of x-rays, gamma rays, or alpha and beta particles to cancerous tumors, killing or damaging them so that they cannot grow, multiply, or spread

Staging surgery:

Determine the extent of disease. In laparoscopy, for example, a tube is passed through a tiny incision in the abdomen to examine the abdomen's contents and remove tissue samples.

Most cancers can be classified as one of four types:

1. Carcinomas 2. Sarcomas 3. Lymphomas 4. Leukemias

Imagery may be beneficial for several reasons:

1. Imagery triggers a state of relaxed concentration that enhances the person's sensitivity to health-promoting images. 2. Imagery gives the patient an increased sense of control and a decreased sense of helplessness over stressful aspects of disease or treatment. 3. Imagery also may work through the placebo effect. In fact, people who believe that imagery and relaxation have the potential to improve their health may experience physiological changes that enhance their ability to fight disease.

The rise in melanoma cases can be attributed to three factors:

1. frequency of sunburns during childhood 2. thinning of earth's ozone layer which filters skin-damaging UV radiation 3. increase in suntanning and use of tanning booths

Infections can increase a person's risk of developing cancer in at least three ways:

1. some viruses can insert their own genes into healthy cells, causing them to grow out of control 2. some infections trigger chronic inflammation leading to changes in affected cells that can lead to cancer 3. some infections can suppress the immune system and reduce its ability to protect the body from cancer

In 2017 alone, the FDA approved a record ___ new cancer therapies

18

Environmental toxins in the air, soil, and water are estimated to contribute to about __% of fatal cancers, mainly of the bladder and the lungs.

2

Up to ____% of lung cancer patients who smoked prior to diagnosis continue to do so

20

Epidemiologists suggest that less than ____% of all cancers would develop anyway as a result of uncontrollable genetic and biological processes

25

Women who consume two or more alcohol-containing drinks a day have at least a ____% greater risk of developing breast cancer than women who do not use alcohol

25

Across all forms of cancer, an estimated _______ are caused by inherited mutations of genes, with breast, prostate, ovarian, and colorectal cancers being most likely to arise from family history

5% to 10%

Carcinogens:

A cancer-causing agent such as tobacco, ultraviolet radiation, or an environmental toxin.

Melanoma:

A potentially deadly form of cancer that strikes the melatonin-containing cells of the skin.

Cancer:

A set of diseases in which abnormal body cells multiply and spread in uncontrolled fashion, often forming a tissue mass called a tumor.

Emotional intelligence (EI):

Ability to perceive, understand, express, and regulate emotions accurately

What is the strongest risk factor for cancer?

Advancing age

What are the benefits of AS?

Avoiding comorbidities such as impotence and incontinence and reduced quality of life

____ infections can also cause cancer.

Bacterial

Anticancer chemotherapy drugs are made to kill fast-growing cells; however, what can happen?

Because these drugs travel throughout the body, they can also affect normal, healthy cells.

What is the second-leading cause of death globally?

Cancer (1/6 deaths)

Leukemia:

Cancer of the blood and blood-producing system. Proliferation of WBC in bloodstream and bone marrow, impairing immune system Strikes more adults than children

Lymphomas:

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

Carcinomas:

Cancer of the epithelial cells that line the outer and inner surfaces of the body; includes breast, prostate, lung, and skin cancer.

Sarcomas:

Cancer that strikes muscles, bones, and cartilage.

Malignant tumors:

Cancerous, consists of renegade cells that do not respond to the body's genetic controls on growth and division

What is the most common type of cancer?

Carcinomas (1/5 people) and skin cancer is the most common and rapidly increasing type

Immunotherapy:

Chemotherapy in which medications are used to support or enhance the immune system's ability to selectively target cancer cells.

UV tanning devices were reclassified by the Food and Drug Administration from ___ (low to moderate risk) to ____ (moderate to high risk) devices

Class 1, Class II

Nevertheless, the ACS advises that only a small percentage of breast cancer cases are directly inherited. The vast majority (nearly 95%) are linked to a combination of genetic and nongenetic risk factors. What are nongenetic risk factors?

Obesity, younger age at menarche (first menstruation), lack of exercise, smoking, poor diet, use of oral contraceptives, the presence of other diseases of the breast, radiation exposure, and use of alcohol.

Diagnostic surgery:

Obtain a tissue sample for laboratory testing to confirm a diagnosis and identify the specific cancer. A procedure to remove all or part of a tumor for diagnostic tests is called a biopsy.

_____ mostly affect the lungs, skin, bladder, and blood-forming systems of the body

Occupational cancers

Preventive surgery:

Performed to remove a growth that is not presently malignant but is likely to become so if left untreated. Sometimes, preventive surgery is used to remove an organ when a person has an inherited condition that makes development of a cancer likely.

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.

Biphasic model:

Proposes that only the most chronic stressors cause global immunosuppression

Curative surgery:

Removal of a tumor when the tumor appears to be localized and there is hope of taking out all of the cancerous tissue.

Restorative (or reconstructive) surgery:

Restore a person's appearance or the function of an organ or body part. Examples include breast reconstruction after mastectomy and the use of bone grafts or prosthetic (metal or plastic) bone or joint replacements after surgical treatment of bone cancer.

Psychoneuroimmunology:

Risk for many diseases (including cancer), the course that a particular disease follows, and the remission and recurrence of symptoms are all influenced by the interaction of behavioral, neuroendocrine, and immune responses.

What is the oldest form of cancer treatment?

Surgery

Treatment Options

Surgery, chemotherapy, radiation therapy, hormone therapy, adoptive T-cell and gene therapy, and combination regimes, such as those involving both bone marrow transplantation and radiation therapy.

Consideration of future consequences:

The extent to which individuals consider and are influenced by the potential future outcomes of their behavior.

Immunocompetence:

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

Metastasis:

The process by which malignant body cells proliferate in number and spread to surrounding body tissues

Comparative optimism:

The tendency to think that one will experience more positive and fewer negative events than others do.

Immune surveillance theory:

The theory that cells of the immune system play a monitoring function in searching for and destroying abnormal cells such as those that form tumors.

Guided imagery:

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

________ may lead to positive feelings and improved quality of life, while _______ may lead to negative consequences in which the patient feels inferior.

Upward identification, upward contrast

The relationship between obesity and breast cancer risk is strongest in women with a large amount of ______.

abdominal fat

Once prostate cancer has been diagnosed, masculinities may affect treatment, including men's attitudes toward _______.

active surveillance (AS)

Many of the symptoms of cancer, as well as the side effects of cancer treatment, have similarities to symptoms of depression:

disturbances of sleep and appetite, fatigue, concentration difficulties, and pain.

Childhood stressors also may promote long-term immune system dysregulation. In addition, childhood adversity seems to heighten the impact of later-life caregiving stress, being associated with _________

elevated inflammation, shorter telomere length, and poorer localized immune response to tumors

Compared with patients who are having surgery for benign conditions, cancer surgery patients have higher overall levels of distress and slower rates of ________.

emotional recovery

For individuals with family histories of cancer, ______ has become a useful method of early detection.

genetic screening

Cancer-causing infections, such as ______, cause 25% of cancer cases in low- and middle-income countries

hepatitis and human papilloma virus (HPV)

Certain chemicals, called _________, are formed when beef, pork, fish, or poultry are prepared using high-temperature methods, such as pan frying or grilling over an open flame.

heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs)

These findings are consistent with other data showing that consideration of _______ consequences may be a more important determinant of health behaviors than consideration of _______ consequences

immediate, future

Reducing intake of oat-based, corn-based, wheat-based, and rice-based breakfast cereals—such as Cheerios, Cornflakes, Total, and Rice Krispies—which may contain ______—a potentially cancer-causing by-product of mold

ochratoxin

Heavy or regular alcohol use increases the risk of developing cancers of the ____

oral cavity, pharynx (throat), larynx (voice box), esophagus, liver, breast, colon, and rectum

The AICR's model plate for a cancer preventive diet aims for meals that are made up of at least two thirds ____-based foods, and one third (or less) ____ protein

plant, animal

CMT = cancer-related masculine threat Men who scored high in CMT had ______ prostate-related functioning over time, including sexual, urinary, and bowel functioning. Men with higher CMT were also _____ likely to process their cancer-related emotions and ____ likely to engage in rumination and other less constructive forms of emotional processing

poorer, less, more

For instance, expression of both positive and negative emotions can be beneficial in adjusting to a diagnosis of cancer Emotion-focused coping and denial of the diagnosis may be ______ traits for cancer victims

positive

In one study, breast cancer patients' presurgery expectations were significant predictors of their ________

postsurgery pain, fatigue, and nausea

On the positive side, thousands of people have become cancer-free after receiving ______ treatments alone or in combination with _______.

radiation, surgery or chemotherapy

Hodgkin's disease:

rare form of lymphoma that spreads from a single lymph node

Although some normal cells may be affected by radiation, most of these appear to _____ themselves and ___ fully after the treatment.

repair, recover

Possible mechanisms in obese people include alterations in _____ (estrogen, progesterone, and testosterone) as well as in ______ (a hormone similar to insulin) that may cause increased risk for cancers of the breast, endometrium, and colon

sex hormones, insulin and IGF-1


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