Once seen as the equivalent of a death sentence, today a diagnosis of cancer more likely means dealing with a chronic disease with exacerbations and remissions. Breakthroughs in treatment are increasing the number of survivors each year. In fact, there are now more than 12 million cancer survivors in the United States and very likely include people you know. Advances in early detection and in treatment approaches have made a difference in the more common cancers such as breast, colon and prostate cancers. However, cancer is not a single disease and some cancers remain difficult to diagnose and treat. Two well-publicized examples of late include Senator Edward Kennedy’s death from brain cancer and Patrick Swayze’s death from pancreatic cancer a relatively short time after diagnosis. While there remain significant unknowns about cancer, we do firmly appreciate today that cancer is a result of genetic mutations—some caused by environmental factors, some by random errors, and some inherited.

The most common cancers in women are breast, lung and colon cancers. For men, it is prostate, lung and colon cancer. In both women and men, most fatalities are caused by lung cancer, although the correlative numbers are waning as the smoking rate decline.

With an estimated 1.5 million new cases of cancer expected for 2009, access to and cost of cancer care are still huge concerns. The table below includes a list of organizations that assist people with financial needs. Many nurses who care for people with cancer are not specialized in cancer care, and the Oncology Nursing Society (ONS) is developing educational resources for generalist nurses. Likewise, case managers benefit from understanding recent advances in cancer care and collaborating with oncology nurses. The following material highlights the current state of cancer care and future trends.

DIAGNOSIS

Genetic Markers

Discoveries in genetic research continue to expand our knowledge of how cancer is linked to an individual’s genes, environment and lifestyle. This information will lead to identification of individuals and their families who are at risk for cancer and determine personalized screening interventions. However, no single predictor or screening test will identify every cancer. The research on how good cells go bad is increasing the understanding of how cancer cells develop and is leading to improved targeted treatments.

Digital Mammography

Breast cancer is the second leading cause of cancer death in women today and it is estimated that more than 192,000 new cases of breast cancer will be diagnosed this year alone. A recent advancement for breast cancer screening is the use of digital mammography (DM). An electronic image of the breast is produced with an X-ray machine and is stored digitally. Two advantages of DM include electronic transmission and image manipulation, which allows for improved image analysis.

A 2005 National Cancer Institute (NCI) study showed that DM demonstrated significant improvement in breast cancer screening for women in three categories: those under the age of 50, those with dense breast tissue, and those who are pre- or perimenopausal.