Original Work Product Progress

Introduction

My final product is going to be an interactive database of information regarding breast,

prostate, and lung cancer. I am going to research the epidemiology, etiology, means of diagnosis,

and treatment in detail, and then compile all the information into a single source for my original

work. My final product will utilize this information by making it accessible to the public in an

online format. Me and Dr. Trillo have discussed this in the past and think that a website would be

particularly useful, because then he would be able to distribute it to his patients who are affected

by these diseases. The website would be easily accessible and would have all of the information

in clearly defined sections so that any person would be able to find what they are looking for.

Objective

The purpose of this website is to help in informing people about cancer. I have been

consistently surprised by how complex cancer is and how many people are affected by it. For

every type of cancer there are multiple scenarios that can change the treatment or even how the

cancer manifests in the body. It is different for everybody, and many people think of it in a

cookie cutter point of view. I hope to educate people regarding this so that they have a better

understanding of the way cancer works. There are also millions of people who are affected by

cancer. Over a quarter of a million people are estimated to be diagnosed with lung cancer alone

this year. Combined with all the cancers and the people who are already living with it, this is a

relatively huge proportion of the population. This is also why we chose breast, prostate, and lung,
because they are the most prominent cancers for women, men, and the overall population

respectively.

Materials

Harrisons Manual of Oncology 2nd Edition by Bruce A. Chabner and Dan L. Longo

The National Cancer Institute

Meetings

December 14, 2016

February 8, 2017

March 1, 2017

March 22, 2017

April 5, 2017

Description of Process

My first meeting with Dr. Trillo set up the baseline for our partnership. We would decide

a course of action and discuss my progress after the research had been completed. First we came

to the conclusion that my original work was going to be focusing on the treatment of breast,

lung, and prostate cancers. To get a baseline of information on these cancers I first had to

research the etiology and epidemiology of these cancers. At the next meeting, Dr. Trillo reviewed

the research and pointed me in a new direction, diagnosis. I completed my research on this and

am currently working on the final aspect of the research which is the treatment itself.
Result

Breast Cancer

Epidemiology-

232,340 new cases in 2013

39,620 deaths in 2013

Incidence rates stable between 1973-1980, then increased due to better technology

Incidence rate declined 2.3% between 2006-2010

Mortality rate declines an average of 1.9% each year due to better screening and

treatment

Etiology-

Women 100% more likely than men to develop breast cancer

Risk increases from ages 35-75, plateaus from 75-80, and then declines

Only 10% of patients have a direct relative with the disease

Ashkenazi Jews are more likely to have a BRCA1/BRCA2 mutation that greatly

increases risk

A history of breast cancer increases risk of developing new cancer

Women who begin menstruating earlier have a higher risk

Women who enter menopause after age 55 have a higher risk

Drinking increases risk

Obesity increases risk

 Birth control use increases risk

Smoking increases risk

Prostate Cancer

Epidemiology-

161,360 estimated new cases in 2017

26,730 estimated deaths in 2017

1/7 men will be diagnosed in their lifetime

3rd leading cause of cancer death in men behind lung and colorectal

1/39 men will die of prostate cancer

Etiology-

Risk rises rapidly after age 50

6/10 cases are in men over 65

More common in African American and Caribbean men

African Americans are twice as likely to die of prostate cancer than white men

Most common in North America, northwestern Europe, Australia, and the Caribbean

Familial history

BRCA 1 and 2 gene mutations can increase risk

High red meat and fatty dairy product diets may raise risk
 High calcium may increase risk

Possible link between Agent Orange and prostate cancer

Prostatitis may be linked

Maybe STDs

Maybe Vasectomy

Prevention includes physical activity, vegetables and fruits, vitamins, and medicines like

aspirin

Lung Cancer (Non-Small Cell?)

Epidemiology-

2nd most common cancer in both men and women

14% of all new cancers are lung cancer

222,500 estimated new cases in 2017 (116,990 in men and 105,510 in women)

155,870 estimated deaths in 2017 (84,590 in men and 71,280 in women)

Leading cause of cancer death

1/4 cancer deaths

More than colon, breast, and prostate combined

2/3 people diagnosed are over 65

Less than 25 under 45

Average age of diagnosis is 70

 1 in 14 chance a man will get it in his lifetime

1 in 17 chance a woman will get it in her lifetime

Smoking raises risk significantly

Black men have a 20% higher risk than white men

Rate is dropping for both men and women

More than 430,000 people alive with lung cancer

Etiology-

Tobacco smoking

Cigar smoking

Secondhand smoking

Radon exposure

Asbestos exposure

Radioactive ores such as uranium

Inhaled compounds

Diesel exhaust

Arsenic

Beta carotene

Air Pollution

Family history
 Prevented by not smoking, avoiding radon, avoiding carcinogens, and eating healthy

Lung cancer

Imaging

o Multidetector CT scan: Follow up to X-ray, detailed image of lungs and

surrounding organs.

o MRI: Look for an invasion of a tumor into the chest wall, diaphragm, or more.

o Pet CT: Shows metabolic activity of cells and shows what type of cells are

growing.

Biopsy

o Fine and core needle biopsies of the lung: Sample of tissue or fluid from the lung

is obtained with a fine needle.

o Bronchoscopy:Look inside the trachea and airways in the lung for abnormal areas,

bronchoscope inserted through the nose or mouth.

o EBUS: Combines bronchoscopy and ultrasound, visualizes lymph nodes, biopsy

without an incision.

o Navigational bronchoscopy: GPS-type guidance system combined with

bronchoscope.

o Surgery: Surgically remove a small sample of tumor for analysis.

Breast cancer

Diagnostic imaging
 o Mammogram: X-ray images of the breast, 2D image highlighting unusual

structures such as calcifications or masses.

o Tomosynthesis: 3D imaging that uses compression and X-rays to examine each

layer of the breast.

o MRI: Imaging that shows abnormal tissue.

o Ultrasound: Imaging that captures the size and structure of a tumor, often used

with mammograms.

Biopsy

o Fine needle aspiration: Insertion of a thin needle into the suspicious area of the

breast.

o Core needle biopsy: Hollow needle is inserted into the suspicious area and

removes a thin cylinder of tissue.

o Image-guided core needle biopsy: Ultrasound, stereotactic imaging, or MRI is

used to guide a hollow needle to the suspicious area.

o Surgical biopsy: Used when other methods do not provide enough information, all

or part of the suspicious mass is removed.

Prostate cancer

Tests

o Digital rectal exam: Gloved finger is inserted into rectum to search for enlarged or

lumped prostate.
 o Prostate-specific antigen: Measures the level of PSA in the blood

o MRI- Magnet, radio waves, and a computer creates an image of the body

o Transrectal ultrasound: Small probe is inserted into the rectum, bounces high

energy sound waves off of tissue to create a sonogram.

o Transrectal or transurethral biopsy: Removes cells, fluid, or tiny tissue samples

from prostate for viewing under a microscope.

Gleason Grading System

o Determines the aggressiveness of the cancer.

o Each cell pattern on the prostate cancer is assigned a number.

o More aggressive patterns receive a higher number.

o Score determined by combining score for most dominant cell type found and the

most aggressive cell type found.

o 6-7 = low risk

o 7-8 = intermediate risk

o 9-10 = high risk

This information has provided a solid foundation for completing my research. Once the

treatment will be completed it will be easy to transfer the information onto an online

database. Looking at this, it will be possible to complete my original work within the next

two mentor meetings.