Extent and Effects of Cancer:
Cancer as a Clinical Problem
Folder: Clinical
Clinical.ppt; See also Cancer2013_ACS_TPFEdit2015.ppt
1. Impact of cancer in human populations
2. What does understanding the clinical
manifestations of cancer tell us about cancer
biology and what we can do about cancers?
Updated: January 26, 2015
Causes of Death in the 20thCentury
Causes of Death 1900-1960
Causes of Death 1960 - 1980
Causes of Death 1900-1976
Cx 1900-1975
% Cause of Death
Increasing Effect of Neoplastic Diseases as Causes of Deaths in the United
States: 1973 to 1990
Years of Life Lost
Costs of Diseases
Comparative
costs of
diagnosing
and
managing
malignant
neoplastic
diseases.
Cancer Incidence and
Mortality in Ageing
Populations
Colorectal Cancer
Presentation on Cancer Epidemiology will address the effects
of ageing on incidence and mortality of cancers in general
Figure 16.45a The Biology of Cancer (© Garland Science 2007)
Figure 16.45c The Biology of Cancer (© Garland Science 2007)
Cancer Mortality and
Spread to Distant Sites
(Metastases)
Effects of prevention and early diagnosis
on death rates from cancers
Figure 16.1a The Biology of Cancer (© Garland Science 2007)
Melanoma Incidence and Mortality:
Melanoma Mortality as a Function of Stage at Diagnosis. (Fig 16.46A, p. 789)
Figure 16.46a The Biology of Cancer (© Garland Science 2007)
Survival and Progression
Figure 14.51b The Biology of Cancer (© Garland Science 2007)
Figure 14.50b The Biology of Cancer (© Garland Science 2007)
Figure 14.50a The Biology of Cancer (© Garland Science 2007)
The Boy Policeman from Raleigh, North Carolina
http://abclocal.go.com/wtvd/story?section=news/local&id=7531763
http://www.msnbc.msn.com/id/26184891/vp/38084943#38084943
About Kuyler Van Nocker
and
Neuroblastoma
Experimental FDA-Approved Cancer Therapy
(FDA = Food and Drug Administration)
Who will pay for approved but experimental therapy?
(Played in Class: January 21, 2014)
http://www.msnbc.msn.com/id/3036677/#39049661
A Lesson from Lung Cancer and the Cigarette Industry
1940 to 1970:
The Human Devastation and Societal Costs of
Commercially-Motivated Anti-Science Denials
Lung cancer in males after 1985
Figure 16.1b The Biology of Cancer (© Garland Science 2007)
Some Chilling Calculations:
Lung Cancer Death Rate in Men at Peak Year (1990):
90 per 100,000 or about 1 per 1,000 men
Number of Men in the US in 1990: About 150 Million
Deaths of Men from Lung Cancer in 1990: 150,000
Clear Demonstration of Tobacco-induced Lung Cancer: ~1940
Action to curb advertising and to control tobacco epidemic: ~1970
Time required to reverse the rising death-rate: ~ 30 Years
Number of Men Killed by the 30-Year Delay: ~4,500,000
Number of Women killed by the Same Delay: ~2,000,000
The Messages from the History of Cigarettes and
the Human Devastation They Caused:
1. Evidence-based Science and Medicine:
Denial of evidence does not change the facts.
Nature doesn’t care what we believe or how much we stand to
gain economically.
If we deny the evidence, the consequences can be
horrendous.
2. The Response to Corrective Action
The time-delay between accepting the evidence, orchestrating
a response, and gaining control of the problem (if control is
still possible) can be decades.
The devastation during that time delay can be monumental.
In 1990 we saw the full impact of the failure to respond to
the evidence of cigarettes and lung cancer.
Lung cancer incidence and deaths in both men and
women began to drop.
In 2040 will we see the impact of failing to respond to
greenhouse gases and global climate change in 2013?
Will effective response still be possible in 2015 or 2030?
Please clear desks for Turning Point Questions
No devices other than the NXT Transmitter are
allowed.
If each person can move along sending in their
answers it reduces the opportunity for any one
to cheat.
The first three slides are multiple choice so they
shouldn’t take much time.
When you get the clear screen for sending in your responses with the NXT
transmitter, please respond to this multiple choice question:
Throughout the 20th Century there was a stunning 15-fold increase in
___________ cancer.
(two more multiple-choice questions follow)
1.
2.
3.
4.
5.
6.
7.
8.
Pancreatic
Breast
Stomach
Liver
Lung
Colorectal
Virtually every cancer
No single cancer
Throughout the 20th Century there was a remarkable and initially
unexplained major decrease in ___________ cancer.
1.
2.
3.
4.
5.
6.
7.
8.
Pancreatic
Breast
Stomach
Liver
Lung
Colorectal
Virtually every cancer
No single cancer
The major decrease in this cancer was eventually traced to a
decline in a major causative source for this disease. This source
was found to be ___________________
1.
2.
3.
4.
5.
6.
An infectious bacterium
Chemical carcinogens in
the diet
Over-nutrition
A virus
Mercury poisoning
Poor refrigeration
0%
0%
1.
2.
0%
0%
0%
0%
3.
4.
5.
6.
Slides 32 to 58 in this presentation
were covered in different form under
Cancer Statistics 2013 by the
American Cancer Society as edited
by TPF and are not presented again
under Clinical.ppt
Clinical Manifestations of
Different Neoplastic Diseases
Cancer Incidence 2002: 1,285,000. Cancer Deaths 555,000. 43% Death Rate
Cancer Incidence 2009: 1,479,000. Cancer Deaths 562,000. 38% Death Rate
Introduction of PSA (prostate specific
antigen) test to screen for prostate cancer
Cancer Incidence and
Mortality in Children Ages
0 to 14
Cancer and Obesity
2015
To Here: January 22, 2015
Cancer Prevention
Colorectal Cancer Screening
Figure 16.45b The Biology of Cancer (© Garland Science 2007)
Figure 11.8b The Biology of Cancer (© Garland Science 2007)
Cancer as the Leading Cause
of Death in the US
2015
Science: March 25, 2011; Cancer Crusade at 40. Cancer Research and the $90 Billion Metaphor. Vol 331, p. 1540
Please clear desks for Turning Point Questions
No devices other than the NXT Transmitter are
allowed.
If each person can move along sending in their
answers it reduces the opportunity for any one
to cheat.
Fill-in-the Blank Question
3% of cancers diagnosed in men or women in the United
States are Pancreatic cancers.
6% of Cancer Deaths in the U.S. are caused by Pancreatic
cancer.
How can that be? What does that mean about pancreatic
cancers?
This graph shows a change in the pattern of prostate cancer beginning around 1990.
Why did that happen?
Note the terrifying increase in deaths from lung
cancer:1930 to 1986.
Why was that happening?
What could be done about it?
Can we change the trajectory of that curve?
Cx Types 1930-1990
Note Stunning drop in deaths from stomach cancer: 1930 to 1985
What could possibly be the cause of this dramatic and very
favorable event?
Why did uterine cancer death rate go down in the 1950’s?
Can we apply the lessons from stomach and uterine cancers to
other cancers?
Lung cancer in males after 1985
Figure 16.1b The Biology of Cancer (© Garland Science 2007)