Escolar Documentos
Profissional Documentos
Cultura Documentos
2/17/2009 2
AGE IS THE SINGLE
GREATEST RISK FACTOR
FOR CANCER
2/17/2009 3
2/17/2009 4
THEORIES ON INCREASE
CANCER WITH AGE
2/17/2009 6
CANCER LESS AGGRESSIVE?
2/17/2009 7
COMMON CANCER
PROSTATE
LUNG BREAST
COLON COLON
LUNG
STOMACH
2/17/2009 8
RISK FACTORS
PROSTATE CANCER
Age
Family history
Black race
High fat diet (minor RF)
RR>3x if father had prostate ca and >8x if 2 or
>1st relatives have prostate ca
9% of prostate ca has a genetic basis
BPH does not increase risk
2/17/2009 9
RISK FACTORS
BREAST CANCER
Age
H/o previous breast ca
Family h/o breast ca in
mother or sister
Menarche before age 12
First birth after age 35
Menopause after 53
Exogenous estrogens
2/17/2009 10
RISK FACTOR
LUNG CANCER
SMOKING
2/17/2009 11
PASSIVE SMOKING
5%
Filter
70 %
25 % ETS
direct Passive
smoker Smoking
2/17/2009 12
ENVIROMENTAL TOBACCO
SMOKE
2/17/2009 15
TREATMENT ISSUES
Elderly Patients
present with more
advanced disease
Bias against
Aggressive Treatment
Patient present with
co-morbidities
Age relevant Clinical
Trials are inadequate
2/17/2009 16
TREATMENT SELECTION
HETEROGENEITY
comorbid conditions,
functional status,
social situation
willingness of the
patient to tolerate
side effects of
treatment.
2/17/2009 17
AGGRESSIVE VS
CONSERVATIVE
Response to
treatment,
Extent of spread,
Comorbid
conditions that
could limit therapy,
and
Patient's wishes.
2/17/2009 18
TREATMENT ISSUES
Treatment Outcomes
are comparable in
young vs. old
Chemo alone can cure
certain ca
Adjuvant chemo and
radiation produces
substantially increased
survival
2/17/2009 19
END OF LIFE ISSUES
2/17/2009 21
TREATMENT
Co - Morbidity
The Tumor
Cancer Prevention
Biology & Impact
& Control
Of Disease
Integrate all to
Achieve Optimal Functional Outcome
Care Quality of Life
2/17/2009 22
JOVITO SALONGA
2/17/2009 23
2/17/2009 24