CANCER

RESEARCH

BRIEF C ANCER

January 2011









Cancer is a generic term that is used to describe Leading Cancers in the U.S. and Texas

over 100 different diseases. When the DNA of a Among the various cancers research has

cell becomes changed or damaged, mutations concluded that lung and bronchus, colon and

occur that affect normal cell growth resulting in rectum, breast (female) and prostate, account for

uncontrollable cell division. Abnormal cell more than half of cancer diagnoses and deaths

division oftentimes results in a mass of tissue (American Cancer Society [ACS], 2008).

called a tumor. When the tissue cells of the

The most recent statistical information reported

tumor remain in the same place where the cells

to the Texas Department of State Health

originated and cell division simply enlarges the

Services (TDSHS) regarding statewide mortality

tumor, the condition is considered to be benign

rates related to cancer only covers the years

(not cancerous). Cancer occurs when the

from 2002-2006. Based on this data TDSHS has

abnormally dividing cells migrate and invade

come up with an expected number of cancer

other body cells. The condition is considered

deaths for 2010. For the year, the state projects a

malignant because the migrating cells “take

total of 37,984 fatalities due to cancer. TDSHS

over” and the invaded cells die. Although

believes that lung and bronchus cancer will

tumors can be a classic symptom of cancer, not

continue to be the leading cause of mortality

all tumors are cancerous and not all cancers

with an estimated 14,358 new cases and 10,625

form tumors. (National Cancer Institute (NCI),

deaths. Prostate and breast cancer are

n.d.). Cancers are generally categorized

anticipated to have the highest incidence of new

according to type:

cases with approximately 15,718 and 15,447

 Carcinoma - cancer that begins in the skin new diagnoses respectively. TDSHS predicts

or in tissues that line or cover internal 2,770 women to pass away from breast cancer

organs. and 1,810 males from prostate cancer in 2010.

 Sarcoma - cancer that begins in bone, However, the second highest number of

cartilage, fat, muscle, blood vessels, or other expected deaths for the year will likely be

connective or supportive tissue. caused by colon cancer; though only 7,450

 Leukemia - cancer that starts in blood- people are estimated to be newly diagnosed with

forming tissue such as the bone marrow and this form of cancer, 2,987 mortalities are

causes large numbers of abnormal blood predicted. Cancer of the esophagus appears to

cells to be produced and enter the blood. have the closest connection between new

diagnoses and fatalities with 963 new cases

 Lymphoma and myeloma - cancers that

predicted and 819 deaths expected for 2010

begin in the cells of the immune system.

(TDSHS, 2010).

 Central nervous system cancers - cancers

that begin in the tissues of the brain and The following table lists the most recent

spinal cord. mortality rates reported to the TDSHS for the

(NCI, n.d.) state of Texas and the four counties of



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Cancer Research Brief January 2011





significance to the Kronkosky Charitable be an integral part of the solution to reducing

Foundation. the economic and social impacts of cancer.



Average Annual Mortality Rates per 100,000 Treatment

2002 – 2006 In the event of a cancer diagnosis the patient

will be overwhelmed with treatment options.

Texas Bexar Bandera Comal Kendall

The basic treatments include:

Total Cancer 181.3 174.0 188.3 170.9 180.2

Male 226.9 220.7 216.5 216.2 224.4  Chemotherapy- drug used to kill cancer

Female 150.0 142.6 163.3 137.1 153.6 cells, stop the cancer cell growth or to slow

Colorectal 17.4 16.5 20.0 15.0 24.4 the growth of cancer cells.

Male 21.5 20.5 19.2 16.4 34.5  Radiation therapy- injures or destroys cells

Female 14.3 13.4 20.3 14.0 17.7 in the area being treated by damaging their

Lung & Bronchus 52.0 42.0 41.9 42.3 53.3 genetic material, making it difficult for these

Male 70.7 60.4 49.8 57.8 65.8 cells to continue to grow and divide.

Female 38.2 29.8 34.8 29.6 45.9  Surgery- In most cases, the surgeon

Breast removes the tumor and some tissue around

23.4 23.5 29.4 19.9 22.9

Female it. Removing nearby tissue may help prevent

Prostate

24.2 23.4 27.2 27.3 20.2 the tumor from growing back. The surgeon

Male may also remove some nearby lymph nodes.

(TDSHS, 2009)

(NCI, 2006)

Risk Factors

Treatment generally depends upon the spread of

There is oftentimes no identifiable cause for

the cancer at the time of diagnosis. Localized

cancer. Factors such as age, tobacco use,

cancers respond well to surgery and radiation,

sunlight (UV rays), environment, ionizing

which are focused treatments aimed at removing

radiation, hormones, family history and poor

and destroying cancer cells, respectively.

diet can all play a role. However, the existence

Treatments are often used in conjunction with

of one or more of these factors does not

each other; for example, surgery performed

guarantee a cancer diagnosis, but does heighten

prior to radiation in an effort to improve the

the risk of eventually developing cancer in the

effectiveness of radiation treatment or radiation

future (NCI, 2006).

used before surgery to shrink the size of a tumor

Prevention and thereby reduce physical disfigurement.

Researchers estimate that up to two-thirds of all

Chemotherapy is given as a combination of

cancers can be prevented. With healthy

drugs that work together to destroy cancer cells.

behaviors linked to knowledge, values, attitudes,

The primary advantage of chemotherapy is that

and skills learned early in life, cancer rates can

it treats the entire body, not a localized area.

continue to decline (ACS, 2010). The Mayo

Since cancer cells can spread from the primary

Clinic advocates some simple steps that

site through blood or lymph vessels to

everyone can take to prevent cancer:

secondary sites, localized treatments may not be

 Eliminate tobacco use thorough enough to cure the cancer that is

 Eat healthy diagnosed (Mayo Clinic, 2009).

 Stay active

Although chemo, radiation and surgery have

 Protect yourself from the sun

been very traditional courses of treatment,

 Get cancer screenings

researchers have developed new treatments like

(Mayo Clinic, 2010)

gene and biological therapies that can be used to

Quality school-based health education, to work with the chemo and radiation, or used as a

include information on nutrition, physical primary source of treatment. While they are still

activity, and smoking, is therefore considered to in the clinical phase, these new treatments have

shown great promise, and studies have



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January 2011 Cancer Research Brief





suggested that the new techniques could ease concentrate. In a 10-year follow-up study it was

side affects associated with chemo and radiation determined that symptoms of depression were

(NCI, 2006). associated with a shorter survival time, so it's

crucial for cancer patients and survivors to seek

Cost for Cancer Treatment

treatment for depression as soon as possible

One of the biggest expenses associated with

(University of Texas MD Anderson Cancer

cancer is the treatment itself. In 2009, the NIH

Center, 2010).

estimated that the overall cost for cancer in the

U.S. for 2008 was $228.1 billion. In a break In many cases the social aspect can be as

down of the figures the NIH reported that $93.2 daunting as the emotional. It is not uncommon

billion was associated with direct medical costs for cancer survivors to experience amputations,

and $18.8 billion in loss of productivity due to disfigurement and loss of organs like the colon

illness. They also found that 24 percent of adults or bladder. How other people react to someone’s

aged 18-64, and 13 percent of children have illness is perhaps the biggest challenge faced by

been uninsured for the last part of 2008. Even if cancer survivors. Friends, coworkers and family

an individual has health insurance, it is expected members may feel awkward about discussing

that 1 in 5 people will be forced to go through the disease. Some may remain silent, avoidant

their savings to help with other costs associated or pretend nothing has happened. Because

with cancer (ACS, 2009). Other factors that cancer can be a long-term illness, overcoming

make health care expensive are the new cancer communication barriers early is essential to

treatments. The new treatments typically drive maintaining good relationships (University of

up the cost of prescription drugs and health care Texas MD Anderson Cancer Center, 2010).

becomes less accessible. It is believed that with

Re-entering social and professional life can

the disparity in the health care system, those

often be difficult. Many times worries of

who can not afford to pay for their care end up

infection, not having enough energy to get

with higher medical costs, poorer outcomes, and

through a workday; and anxiety about not being

could possibly face premature death.

able to think clearly because of "chemobrain" or

There were approximately 585,910 cancer cases memory loss can make the transition from

in Texas in 2007. The estimated cost of care was patient to ordinary person stressful (University

$7.7 billion. In Health Service Region 8 of Texas MD Anderson Cancer Center, 2010).

(includes Bandera, Bexar, Comal, and Kendall

The Future

counties) the 2007 cost for cancer care was

The future for research and prevention continues

$842.1 million. That cost can be further broken

to broaden both on a national and state level. On

down to reflect various stages of care which

September 1, 2009, the National Institute of

include:

Health and Human Services (NIH) awarded

 Initial phase (12 months after diagnosis)

more than 12,000 grants, totaling $5 billion to

$232.9 million

research institutions throughout the United

 Continuing phase (all months between initial

States. This investment, through the

phase and last year of life) $429.9 million

government’s recovery act, will give efforts

 Final phase (last 12 months of life) $179.3

such as The Cancer Genome Atlas (TCGA) aid

million

in mapping the genomes of at least 20 cancers

(Tan, Freeman, Freeman, Zhang, et al., 2009)

over the next five years. This type of data will

Social and Emotional Impacts of Cancer enable researchers to catalog genetic changes

Other costly effects of cancer can be a person’s related to oral cancers, test plant extracts known

emotional health. It is estimated that 70% of to possess anti-cancer properties, and use

cancer survivors experience depression at some microRNA to predict which patients have

point in their treatment. Depression can be tumors that are more likely to spread throughout

difficult to diagnose because it mirrors many the body (The Whitehouse, 2009).

symptoms of cancer treatment, including weight

loss, fatigue, insomnia and inability to

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Cancer Research Brief January 2011





In 2007, Texas took a key role in cancer http://www.livestrong.org/pdfs/07LAF_AR_WEB14

prevention and research. With bipartisan 4-PDF

assistance and a grassroots effort launched on Mayo Clinic. (2009).Chemotherapy: Definition. Retrieved

behalf of Lance Armstrong and the Lance December 09, 2010, from

Armstrong Foundation, the Texas legislature http://www.mayoclinic.com/health/chemotherapy/M

approved Proposition 15 (Lance Armstrong Y00536

Foundation, 2007). The bill was passed by

Mayo Clinic. (2010). Cancer prevention: 7 steps to

Texas voters on November 6, 2007 with reduce your risk. Retrieved December 09, 2010, from

overwhelming support. The bill allowed for the http://www.mayoclinic.com/health/cancer-

establishment of the Cancer Prevention and prevention/CA00024

Research Institute of Texas. The institute will be

responsible for issuing $3 billion in general National Cancer Institute. (2006). What You Need To

Know About: Cancer. Retrieved December 09, 2010,

obligation bonds over ten years to fund grants from

for cancer research and prevention (Cancer and http://www.cancer.gov/pdf/WYNTK/WYNTK_Canc

Prevention Research Institute of Texas, 2010). er.pdf



Despite the decline of cancer incidences and National Cancer Institute. (n.d.). What is cancer?

mortality in recent years, it still remains a Defining cancer. Retrieved December 09, 2010, from

prevalent threat today. Researchers feel that http://www.cancer.gov/cancertopics/what-is-cancer

with enough funding there is the possibility of a

Tan, A., Freeman, D.H., Freeman, J.L., Zhang, D.,

cure in the coming years. Until then, prevention Dayal, H., and Philips, B. (2009). The cost of cancer

awareness, early detection and effective in Texas, 2007. Retrieved December 09, 2010, from

treatment will be the only means of preventing http://www.texascancer.info/pdfs/Cost_of_Cancer_in

or treating someone with cancer. _Texas-090309.pdf



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(2009). Texas cancer registry. Retrieved December

American Cancer Society. (2008). Report says half a 09, 2010, from

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rate drop. Retrieved December 09, 2010, from

http://pressroom.cancer.org/index.php?s=43&item=9 Texas Department of State Health Services (TDSHS).

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http://www.cancer.org/docroot/MIT/content/MIT_3_

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