Transcript No Slide Title

Health Psychology
Chapter 10: Cancer
Spring 2000
Mansfield University
Dr. Craig, Instructor
1
Cancer Facts and Terms
 In 1997 was the 2nd leading cause of death
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201/100,000 population
40-60% of premature deaths due to life and
environmental factors
 Cancer- new cells that grow out of control and
can affect other healthy organismic functioning.
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tumors
Can affects all cell-based creatures
 Mutation- change in cell function
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can be generated by external agents (x-ray,
benzene, asbestos)
Cancer Terms continued
 Mutated Cells: “neoplastic cells”
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cause autonomous“neoplastic growth” that robs
organism of nutrients (provides no benefit).
 Benign cells
localized growth
 Malignant cells
“metastasize”, that is spread and setup new
colonies.
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Typically through blood or lymphatic system.
Types of Cancer
 Carcinomas- cancer of cells that provide outer and inner
lining to the body
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stomach, skin, lung
85% of cancers
risk increase with age
Carcinogens- substances increase rate of carcinomas
 Sarcomas- cancers of connective tissue
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bone, muscle
2% of cancers
 Leukemia- blood or blood forming cells
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stem cells in the bone marrow (make immune cells)
 Lymphoma- cancer of lymphatic system
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relatively rare
Changes in Cancer Mortality Statistics
 Cancer death 3x greater now than in 1900
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Why?
1. More accurate techniques for diagnosis
2. Some decline in CV mortality (live longer)
3. Rapid rise of AIDS-related cancer deaths
4. Sharp increase in lung cancer tied to cigarette
smoking
Variations in Cancer Mortality
 All-Cancer mortality dropping since 1950 for men
and women across all ages (Fig. 10.2 & 3)
 Lung Cancers- curve rising for women (10.5),
high, but recent decrease for men (10.4).
 Major sites for Men:
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lung, prostate, colo-rectal, pancreas
 Major site for Women:
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lung, breast, colo-rectal, pancreas
breast cancer 5 year survival improved, but little change in
total mortality statistics
colo-rectal rates declining for women, but not men.
Behavioral Risk Factors for Cancer
 Smoking
• account for 400,000 deaths annually (including other
than deaths)
• the leading cause of cancer deaths
• 9x increase risk of cancer death (strongest single factor
in behavioral science)
 Dose-response relationship between cancer risk
and cigarettes smoked
 15-25 year lag in mortality statistics
• faster declines in smoking among men 25-years ago,
equates to more drastic decrease in LC mortality now.
 Breast Cancer- Dose-response relationship but increased
risk not as great as LC (75% for those 40 or more cigs/day)
Smoking Continued
 Synergistic effects with environmental factors
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pollution, SES, occupation, ethnicity, building
materials
 ETC...
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Optimistic Bias- “recognize problem exist for
everyone else... but not me”
• clear in HS students
• heavy smokers
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Pipe and Cigars- 2.5 and 2.9x increase in cancer
rates respectively. Combine with cigarettes 8.1 and
6.9 increase risk!!!
Potential BRF: Diet
 Estimated that 1/3 of cancers may be related to
dietary choices
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(Fats- bad, F & Vegs- Good)
 Bad Foods?
• spoiled foods
• weight gain after 18 years old
• proteins and non-vegetable fats
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50% of cals from fat = 3x risk of breast cancer
high cholesterol level- 2x risk of LC in men
 Good Food
• Vit. A & beta-carotene (carrots, sweet potatoes) (weak)
• Pizza (lycopene)- cooked tomatoes
• Vit. C- (ascorbic acid)- inhibits carcinogen nitrosamine
BRF: Alcohol, Physical Activity
 Alcohol- potential secondary RF
• little evidence in the way of direct causal relationship
• set stage for weakened response (cirrhotic liver)
• synergistic effects with smoking
 Physical Activity (or inactivity)
• Breast Cancer
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50% less in women who began exercising regularly in early life
(by early adulthood ?)
less in women who exercise at least 4 hrs weekly (particularly in
pre-menopausal women)
• Prostate Cancer
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low activity jobs/sendentary behavior raises risk in later
life
regular exercise markedly reduces risk
• Colon Cancer- “jury is still out”
BRF: Exposure to UV Light, Sexual Behavior
 Skin Cancer• particularly a problem with fair-skinned people, light hair,
blue eyes
• risk of exposure greatest among young
 Why is it not taken more seriously?
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Low threat of mortality
 Sexual Behavior
• cancers resulting form AIDS
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Kaposi’s Sarcoma- purple nodules with skin lesions (internal
and external) more likely in gay men than other AIDS patients
• Cervical Cancer
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early partnering, multiple partnering, hygiene, not using barrier
forms of contraception
protection appears offered by childbirth early in life
RF over which we have little control
 Environment
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radiation, asbestos, pesticides, chemicals
 Nuclear Power plants- long term exposure to work environment
appear to increase many chronic forms of mortality, including cancer.
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living in the vicinity of a power plant does not!!
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Study of 40 million people over 35 years
 High Power Lines
• NO EVIDENCE after many good studies-- a myth
 Inherent Risk Factors
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most cancers are not heritable
FH of Cancer
• breast cancer risk is 2-3x greater
Inherent Risk Factors
 Ethnic Background
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40-50% greater incidence in AA than Eur. A
EA greater than Asian, Native Americans
• believed to be related to social/behavior factors not
genetic structure
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SES, knowledge about cancer and its treatment, attitudes
toward disease (optimistic bias), access to good health
care.
 Age
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see figure 10.6
steep increase after 45 years especially for men.
Psychological Factors and Cancer
 The “Type C” Personality
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no global personality trait linked to cancer.. However…
 Suppression of Emotion
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suppression of emotion, denial of anger significantly
increased changes of breast cancer 5-years follow-up after
biopsy (Greer & Morris)
MMPI measured suppression predicted male-cancer
diagnosis 10 years later
Physicians who suppressed and were “loners” were 16x
more likely to have cancer in a 30 year follow-up!
 Depression
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a RF for dying of cancer, but not contracting it.
Psychosocial Factors and Survival
 Key Variables:
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“Fighting spirit”, Marriage/social support, Therapy
 Be a fighter
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better adjusted, less hostile, less angry... More likely to die
why do you think?
 Married people seems to survive longer
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why? (they’re diagnosed earlier.. explains a little)
social support appears to enhance personal control and
healthy behaviors, reduce optimistic bias?)
Speigel- breast cancer and supportive group psychotherapy
(video clip)