Texas Oncology Fast Facts 2019

COLORECTAL CANCER

Colorectal cancer is the second-leading cancer killer of men and women combined in the U.S. More than 90 percent of colorectal cancer cases are discovered in people age 50 and over. Screening is essential to diagnosing colorectal cancer because the disease typically lacks symptoms in the early stages. Approximately one-third of adults over 50 have not been screened. Colorectal cancer develops in the cells lining the colon and rectum. The stage is based on the extent of the spread of cancer through deeper layers, lymph nodes, and surrounding structures.

Statistics

  • In 2019, an estimated 145,600 cases of colon and rectal cancer will be diagnosed in the United States.
  • An estimated 51,020 people in the United States will die from colorectal cancer in 2019.
  • The five-year survival rate for colorectal cancer discovered early and before the cancer spreads is 90 percent, but only 39 percent of colorectal cancers are identified in this early stage.
  • In Texas in 2019, there are 11,533 expected new cases of colon and rectal cancer and 4,242 deaths.

Colorectal Cancer Risk Factors

  • Age: People age 50 and over have a higher risk of developing colorectal cancer. However, colorectal cancer in people under 50 is rising, accounting for 11 percent of cases.
  • Family History: People with a family history of colorectal polyps, along with a family history of colorectal cancer, are at greater risk and should consult a doctor about screening frequency.
  • Inflammatory Bowel Disease: People with inflammatory bowel disease have a higher risk of colorectal cancer and may need earlier or more frequent screening.
  • Diet: Diets that contain large amounts of red and processed meats can increase risk.
  • Personal Health: Overweight and inactive people are at a higher risk. Type 2 diabetes has been linked to an increased risk of colorectal cancer. People with a history of polyps are also at an increased risk, and may need earlier or more frequent screening. Long-term smoking and heavy alcohol use raise risk.
  • Inherited Syndromes: Lynch Syndrome (HNPCC) and familial adenomatous polyposis (FAP) increase risk of colorectal cancer. Lynch syndrome is responsible for 3 percent of colorectal cancers, and those with the condition have a lifetime risk of up to 80 percent of developing colorectal cancer. FAP, which can increase polyp development, causes about 1 percent of colorectal cancer cases. Genetic testing can determine if a person has the gene mutation associated with these syndromes.

Symptoms

Typically, people in the early stages of colorectal cancer do not have symptoms; symptoms become apparent as the disease advances. If a person experiences any of the following symptoms, he or she should consult a physician.

  • Abnormal bowel habits
  • Vomiting, diarrhea, constipation
  • Cramping or stomach discomfort
  • Frequent gas or feeling bloated
  • Bleeding from the rectum
  • Blood in the stool
  • Feeling of weakness or fatigue
  • Stools that are narrower than usual
  • Anemia
  • Unexpected weight loss
  • Decreased appetite
  • Feeling bowel doesn’t fully empty

Prevention

  • Screening: Men and women age 45 and older with an average risk for developing colorectal cancer should discuss the most appropriate screening test with their physician. Screening tests include annual guaiac-based fecal occult blood test (gFOBT) or fecal immunochemical test (FIT); multi-targeted stool DNA (MT-sDNA) test every three years; flexible sigmoidoscopy every five years; double-contrast barium enema every five to 10 years; virtual colonoscopy every five years; or colonoscopy every 10 years. Those with increased risk factors should consult their physician whether to begin screenings earlier than age 45. Those with symptoms or a positive test from another type of test should have a colonoscopy.
  • Lifestyle: Maintaining a healthy weight through a regular exercise schedule and healthy diet may decrease the risk of colorectal cancer. A healthy diet includes plenty of fruits, vegetables, and whole grains. Aspirin, ibuprofen, and naproxen are linked to lower risk of colorectal cancer and polyps. However, these drugs can have serious side effects. You should talk with your physician before taking them specifically to lower your risk.

Treatment Options

Main types of treatment for colorectal cancer include surgery, radiation therapy, proton therapy, chemotherapy, ablation, immunotherapy, and targeted therapies. Specific needs may be addressed by surgeons, gastroenterologists, or medical or radiation oncologists. For complex treatments, a team of specialists may be involved.

Sources: American Cancer Society, Centers for Disease Control and Prevention, Colorectal Cancer Alliance, National Cancer Institute, and Texas Cancer Registry

MEN AND CANCER

Men & Cancer

  • Nearly 125,000 Texans will be diagnosed with cancer in 2019.
  • While we can’t control everything about our health, the World Health Organization reports that 30 to 50 percent of all cancers may be preventable.
    • Lower your cancer risk by eliminating tobacco use, maintaining a healthy diet and exercise, and limiting alcohol consumption.
  • Men are more likely to get prostate, lung and skin cancers, according to the American Cancer Society. That’s why it’s important to manage cancer risks with early detection and a healthy lifestyle.

Prostate Cancer

  • In Texas, nearly 11,000 men will be diagnosed with prostate cancer in 2019.
  • Prostate cancer is the most common cancer found in men, other than skin cancer – one in nine men will be diagnosed with prostate cancer in his lifetime.
  • Prostate cancer develops mainly in older men and in African-American men.
  • If prostate cancer is detected early and before the cancer spreads, patients have a nearly 100 percent chance of survival after five years. With early diagnosis and treatment improvements over the past 25 years, survival rates have increased dramatically for all stages of prostate cancer.

Lung Cancer

  • In Texas, 14,750 people will be diagnosed with lung cancer in 2019.
  • More men have lung cancer — both small cell and non-small cell — than women.
  • It is the next most common cancer in men behind prostate cancer and is the deadliest, claiming more lives each year than colon, breast and prostate cancers combined.
  • About 90 percent of all lung cancer deaths are attributed to smoking. People who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke.
  • If you have a history of heavy smoking, screening with low-dose CT scans can help detect early stage lung cancer.

Colorectal Cancer

  • Colorectal cancer is the third-leading cancer killer of men and women combined in the U.S.
  • More than 90 percent of colorectal cancer cases are discovered in people age 50 and over. However, new cases of colorectal cancer are occurring at an increasing rate among younger adults.
  • Screening is essential to diagnosing colorectal cancer because the disease typically lacks symptoms in the early stages. Colorectal cancer deaths can be prevented if everyone age 45 and over is screened routinely and treated appropriately.

LEUKEMIA

Leukemia is a cancer that starts in the bone marrow, the soft tissue inside the bone where blood cells develop. Abnormal blood cells are generated within the bone marrow, multiply, and can spread throughout the body, crowding out healthy white and red blood cells, and platelets. These abnormal cells make it difficult for normal white blood cells, red blood cells, and platelets to function properly within the body, making a person prone to infection, anemia, bruising, and bleeding. The four most common types of leukemia are: acute lymphocytic leukemia (ALL); acute myeloid leukemia (AML); chronic lymphocytic leukemia (CLL); and chronic myeloid leukemia (CML). Acute leukemia is characterized by rapidly growing cells and quickly diminishes a person’s health, and chronic leukemia develops and progresses slowly over time.

Statistics

  • In 2018, it is estimated that 60,300 Americans will be diagnosed with new cases of leukemia.
  • It is estimated that 24,370 Americans will die from leukemia in 2018.
  • In 2018, approximately 3,499 Texans will be diagnosed with leukemia, resulting in an estimated 1,820 deaths.
  • Leukemia accounts for about 1 in every 3 cancer cases in children, making it the most common childhood cancer.
  • Most leukemias, 92 percent, are diagnosed in adults, most often in adults age 55 and older.
  • ALL accounts for 74 percent of leukemias in people age 19 and under. ALL risk is highest in children younger than 5 and rises again after age 50.
  • Although rarely diagnosed before age 45, AML is the second most common leukemia in both adults and children. Average age of diagnosis is 68.
  • CLL, which is rare in children, is the most diagnosed leukemia type in adults. Average age of diagnosis is 70.  
  • CML, also rare in children, accounts for about 10 percent of all leukemias. Average age of diagnosis is 64.

Risk Factors

  • Radiation and chemotherapy: People exposed to high levels of ionizing radiation, like cancer patients, can be at a greater risk for developing leukemia. Leukemia can be a complication of chemotherapy treatments.
  • Exposure to certain chemicals and workplace environments: Exposure to benzene, a chemical found in cigarette smoke, solvents, gasoline, rubber production, chemical plants, oil refineries, shoe manufacturing, and some glues, art supplies, cleaning products, and paints, can raise acute myeloid leukemia risk.
  • Smoking: Cigarette smoke is a direct risk for contracting AML as cancer agents in tobacco smoke enter the bloodstream and can be transported through the body.
  • Blood disorders: People with certain blood disorders including polycythemia vera, essential thrombocythemia, idiopathic myelofibrosis, and myelodysplastic syndrome are at an increased risk.
  • Genetic diseases: People with congenital syndromes such as Down syndrome, Trisomy 8, Fanconi anemia, Bloom syndrome, ataxia-telangiectasia, Diamond-Blackfan anemia, Schwachman-Diamond syndrome, Li-Fraumeni syndrome, neurofibromatosis type 1, Klinefelter syndrome, Wiskott-Aldrich syndrome, familial platelet disorder syndrome, and Kostmann syndrome are at a greater risk.
  • Family history: Having relatives with CLL raises risk for developing CLL.

Symptoms

  • Swollen lymph nodes that are not painful
  • Frequent fevers or sweating at night
  • Feelings of weakness or tiredness
  • Shortness of breath
  • Reoccurring infections
  • Pain or fullness in upper abdomen
  • Enlargement of liver or spleen
  • Bleeding and bruising easily
  • Unexplained weight loss
  • Appetite loss
  • Joint or bone pain
  • Pinpoint flat spots on the skin, called petechiae

Treatment Options

Treating leukemia varies depending on the type of leukemia, age, medical history, general health of the patient, stage of the cancer, and the patient’s treatment goals. However, patients with acute leukemia must be treated immediately due to the rapid progression of the disease. Treatment options for leukemia include:

  • Watchful waiting (for those with chronic leukemia)
  • Chemotherapy
  • Targeted therapy
  • Radiation therapy
  • Surgery
  • Stem cell transplant
  • Monoclonal Antibodies

Sources: American Cancer Society, American Society of Clinical Oncology, National Cancer Institute, Leukemia & Lymphoma Society, Texas Cancer Registry

Skin Cancer

  • In Texas, 4,200 people will be diagnosed with skin cancer in 2019.
  • Melanoma is more than 20 times more common in whites than in African Americans.
  • Basal cell and squamous cell are the most common skin cancer types and are highly curable if caught early.
  • Melanoma is much less common than basal cell and squamous cell skin cancers, but is more dangerous because it’s much more likely to spread to other parts of the body if not caught early.
  • While skin cancer is the most common form of cancer, many cases are easily preventable by limiting exposure to the sun’s harmful rays, applying sunscreen and avoiding indoor tanning.
  • Moles or unusual spots on your skin should be reported to your doctor, especially if you notice changes in them.

 

Testicular Cancer

  • Testicular cancer is a very rare form of cancer. About one in 250 males will have testicular cancer in their lifetime.
  • The average age at the time of diagnosis of testicular cancer is about 33. This is largely a disease of young and middle-aged men.
  • The incidence rate of testicular cancer has been increasing in the US for several decades. Experts have not been able to find reasons for this. Lately, the rate of increase has slowed.