Cancer Prevention and Screening

Current treatments of cancer are imperfect and entail risks. For many malignancies, the best “treatment” is to prevent the cancer from ever appearing in the first place. Cancer prevention refers to interventions that reduce the incidence of cancer. Such interventions can include reduction of exposure to known carcinogens (e.g., tobacco), treatment with drugs that lower cancer risk (chemoprevention), vaccination against infectious agents that cause cancer, surgery to remove organs at high risk of developing cancer in individuals with familial cancer syndromes, or the adoption of a “healthy lifestyle” that modifies cancer risk. Cancer screening shares some concepts with cancer prevention. A screening test like colonoscopy that results in the removal of polyps that have the potential of progressing to cancer can be a form of cancer prevention. Cancer screening is also utilized to find an established cancer at an early, treatable stage. Cancer screening tests are employed in healthy, asymptomatic patients so it is imperative that these tests are safe and effective. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will provide a brief review of cancer prevention and screening.https://escholarship.umassmed.edu/cancer_concepts/1025/thumbnail.jp

Principles of Multidisciplinary Management

This chapter in Cancer Concepts: a Guidebook for the Non-Oncologist describes the principles of multi-disciplinary management, meaning multi-specialty physician management of malignancies. Tumor Boards are the model for multi-disciplinary management. They may be site specific or include the entire spectrum of malignancy. At Tumor Boards, staging workup and treatment recommendations are made collectively, and then the treatments are delivered by the respective modality specialists and their individual teams. Improved clinical decision making leading to superior survival for patients with some diseases and better quality of life has been documented with multi-disciplinary management. Just like curative patients, palliative patients require multi-disciplinary management.https://escholarship.umassmed.edu/cancer_concepts/1006/thumbnail.jp

Cancer Biology

This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist focuses on DNA mutations that cause cancer, abnormal regulation of cell growth and death, and metastasis. Updated March 2016 version posted March 28, 2017.https://escholarship.umassmed.edu/cancer_concepts/1005/thumbnail.jp

Cancer as a Chronic Disease

Cancers which were once fatal are increasingly able to be managed as chronic diseases. While most metastatic cancers in adults may not be curable, they often can be controlled for long periods of time with a succession of treatments. In this chapter in Cancer Concepts: A Guidebook for the Non-Oncologist, we will examine those cancers with longer natural histories and those with extended survivals due to therapeutic advances. Finally, several cases will be presented that exemplify this new paradigm of cancer as a chronic disease.https://escholarship.umassmed.edu/cancer_concepts/1028/thumbnail.jp

Environmental and Infectious Causes of Malignancy

This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents a summary of the most relevant causative agents of cancer. Exposure to many environmental agents is associated with an increased incidence of certain malignancies, although causation is usually difficult to prove. Certain chemicals, infections (parasitic, viral, and bacterial) and ionizing radiation are known carcinogens. Variable genetic susceptibility to carcinogenesis is apparent. Up to 2/3 of human cancers are believed to have an environmental component.https://escholarship.umassmed.edu/cancer_concepts/1007/thumbnail.jp

Introduction to Cancer Concepts: A Guidebook for the Non-Oncologist

This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents an introduction to the Guidebook, which developed from the Cancer Concepts course at the University of Massachusetts Medical School.https://escholarship.umassmed.edu/cancer_concepts/1011/thumbnail.jp

Oncologic Emergencies and Urgencies

This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents a discussion of the risks to cancer patients for oncologic and metabolic crises. These effects may be caused by the cancer, the treatment provided to cure or palliate the cancer, and/or other medical conditions. They may occur at initial presentation, as a first sign of disease or during the disease course. Oncologists divide these crises into emergencies and urgencies, depending on the severity of the consequences of delay in treatment. Every health care provider should be aware of the signs and symptoms of oncologic urgencies and emergencies and initial management.https://escholarship.umassmed.edu/cancer_concepts/1010/thumbnail.jp

Staging of Cancer

The “stage” of a cancer is a short-hand way of describing the extent of cancer in a patient. Stage is based on macroscopic involvement of tissues by cancer. Staging of cancer occurs prior to the beginning of treatment, or at the first definitive surgery. Clinical staging, which includes radiography and exam findings, takes place initially. Pathologic staging, which is obtained from surgical specimens, can be acquired during the course of surgical treatment. Patients then carry either the clinical stage or the pathologic stage for the duration of their illness. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will describe principles of cancer staging.https://escholarship.umassmed.edu/cancer_concepts/1003/thumbnail.jp

Cancers of Unknown Primary

Cancers of unknown primary (CUP) are a heterogeneous group of histologically proven metastatic tumors whose primary site can\u27t be determined after a standard diagnostic and pathologic work-up. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents provides an overview of cancers of unknown primary, including initial evaluation and principles of treatment.https://escholarship.umassmed.edu/cancer_concepts/1016/thumbnail.jp

Nutrition and Cancer

This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents a summary of the nutritional concerns in oncology patients. Nutritional intake is frequently deficient in patients undergoing cancer treatment and should be assessed and treated. There are unique nutritional needs of the patient based on their site of cancer and effects of their particular treatment. There is little evidence that dietary manipulation or supplementation can produce a significant decrease in cancer risk.https://escholarship.umassmed.edu/cancer_concepts/1012/thumbnail.jp