Cancer Lecture 1
Introduction
Otto Sanchez, professor at the Faculty of Health Sciences, and associate dean
Specializes in cancer research, discussing cancer in the context of prevention
Overview of Presentation Themes
Cancer trends in Canada as a chronic disease
Natural history of cancer
Cancer biology concepts relevant to prevention
Case studies in cancer prevention
Cancer Trends in Canada
Cancer is a leading cause of death, accounting for 28%-30% of deaths in recent years
Transition from cardiovascular disease to cancer as the top cause of death over past decades
Cardiovascular death rates decrease due to better fitness and diet
Cancer's prominence highlights the need for focus on prevention
Canadian Cancer Statistics (2015)
Approx. 200,000 Canadians diagnosed with cancer in 2015
This translates to about 540 new cases every day
Estimated 80,000 cancer-related deaths in 2015 (approximately 214 per day)
Most diagnosed individuals survive; death rates lower than incidence rates
Cancer Survival Rates by Type
Cancer types vary in survival rates; some are acute while others are chronic
Slow progression cancers (e.g., pancreatic, lung) have lower survival rates
Chronic cancers (e.g., thyroid, testicular) have higher survival rates
Trends in Cancer Mortality
Overall decline in cancer mortality observed in recent decades
Improvements in diagnosis and treatment lead to higher survival rates in men (lung, colorectal, prostate cancers)
Women show similar trends, except lung cancer remains a concern due to historical smoking patterns
Historical Context of Cancer Treatment
Significant advancements in treatment occurred after 1948, introducing chemotherapy and radiotherapy
Introduction of leukemia treatments dramatically improved survival rates, particularly in children
Natural History of Cancer
Cancer progresses over years, with long latency periods between exposure and diagnosis
Importance of understanding cancer's evolution from initial mutation to metastatic disease
Dormancy concept: cancer cells can remain dormant after treatment, posing a risk of recurrence
Carcinogenesis Model
Initiation, promotion, and progression define the cancer development process
Two-hit hypothesis: carcinogen exposure followed by promoting factors is necessary for cancer growth
Example: Aflatoxins as carcinogens needing additional promoting agents like hepatitis B for liver cancer
Carcinogen Definitions and Classifications
Carcinogens are substances that induce cancer, often acting through DNA damage
Classified by the International Agency for Research on Cancer (IARC), with Group 1 being carcinogenic to humans
Examples: Tobacco, asbestos, pollution, some chemicals, and biological agents like viruses
Environmental Factors
Questions about controllable vs. uncontrollable environmental carcinogens
Well-established carcinogens include solely tobacco and UV radiation
Ongoing debates on less certain agents (e.g., cell phone radiation, air pollution)
Cancer Prevention Strategies
Four levels of cancer prevention: primordial, primary, secondary, and tertiary
Primordial: Addressing socio-environmental factors that affect health
Primary: Reducing exposure to carcinogens (e.g., tobacco control)
Secondary: Early-stage cancer detection to prevent progression
Tertiary: Minimizing suffering and complications for diagnosed individuals
Existential Questions Regarding Cancer
Questions faced by cancer patients around causation, lifestyle, early detection, and mortality
Highlights the personal impact of cancer on individuals and families
Conclusion
Importance of education on cancer trends and prevention for future healthcare professionals
Presentation encourages active participation in cancer awareness and prevention efforts
Next Steps
Follow-up discussions in class will delve deeper into case studies and specific cancer prevention methods.