Diagnosing and Treating Adult Cancers and Associated Impairments (2021) / Chapter Skim
Currently Skimming:
Summary
Summary
Pages 1-16
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 1... ...
. The median age for a cancer diagnosis in the United States is 66 years; thus, approximately half of all newly diagnosed cancer patients are working-age adults.
|
From page 2... ...
SSA's current Listing of Impairments for adult cancers focuses predominantly on terminal and metastatic cancers with a high likelihood of death and do not include, for the most part, impairments and functional limitations that may result from cancer treatments. COMMITTEE'S CHARGE In order to keep the information on which it bases its disability listings for adult cancers up to date, in 2019, SSA asked the National Academies of Sciences, Engineering, and Medicine (the National Academies)
|
From page 3... ...
Provide an overview of the current status of the diagnosis, treatment, and prognosis of adult cancers including, but not limited to, breast cancer and lung cancer, and the relative levels of associated functional limitation typically associated with these cancers, common treatments, and other considerations in the U.S. population age 18 and older; 2.
|
From page 4... ...
At the committee's request, SSA provided data for cancer disability claims and claims overall for 2015– 2019. These data informed the committee's considerations of other cancers -- specifically colorectal cancer, pancreatic cancer, liver and bile duct cancers, leukemias, lymphomas, multiple myeloma, ovarian cancer, head and neck cancers, and melanoma -- in addition to breast cancer and lung cancer, in its overview of the current status of the diagnosis, treatment, and prognosis of select common adult cancers.
|
From page 5... ...
cancer deaths and breast cancer is the fourth leading cause of cancer deaths. Pancreatic cancer, ovarian cancer, liver cancer, and esophageal cancer have particularly high mortality rates relative to their incidence rates. Cancer mortality rates have fallen since 1991, primarily due to declines in mortality for breast, colorectal, prostate, and particularly lung cancer.
|
From page 6... ...
Lung cancers are classified by the microscopic appearance of the cancer cells to distinguish SCLC from NSCLC as well to differentiate between the subtypes of NSCLC. In addition, using immunohistochemistry testing and molecular biomarker testing, lung cancers may be further classified by whether the cancer cells exhibit specific genetic abnormalities, such as mutations of the epidermal growth factor receptor gene, and by their expression of the programmed cell death ligand-1–cell surface receptor protein.
|
From page 7... ...
After a patient receives a diagnosis of cancer and begins treatment planning with the cancer care team (a) , supportive and palliative care along with survivorship care may be initiated regardless of whether the patient is to be treated with curative intent (b)
|
From page 8... ...
Long-term effects from radiation can include lymphedema, tissue scarring, heart disease, and the development of other cancers. Systemic therapies include chemotherapy, endocrine therapy, targeted therapy, immunotherapy, and stem cell therapy.
|
From page 9... ...
Radiation therapy to the whole breast is standard of care, but partial breast irradiation techniques may also be used for some patients; postmastectomy radiation is generally used for patients with stage III breast cancer. Systemic treatment for localized breast cancer may include endocrine therapy (e.g., tamoxifen or an aromatase inhibitor)
|
From page 10... ...
The committee defined new treatments as therapeutic approaches adopted recently in clinical practice or established treatments for one cancer that are being studied for other cancers, and emerging therapies as novel therapeutic approaches under scientific investigation that have demonstrated promising results in early stage research, but have not yet been accepted as a standard of care. In addition to considering new and emerging treatments for breast cancer and lung cancer, the committee also considered advances in treatment for colorectal cancer, pancreatic cancer, liver and bile duct cancers, leukemias, lymphomas, multiple myeloma, ovarian cancer, head and neck cancers, and melanoma.
|
From page 11... ...
A growing number of new systemic treatments include targeted therapies, antibody drug conjugates, and immunotherapies. Many targeted therapies, such as PARP inhibitors, are standard of care for one cancer, but are emerging therapies for other cancers.
|
From page 12... ...
Lung cancer is one of the deadliest cancers with more than half of people dying within 1 year of diagnosis. The 5-year survival rate for allstage NSCLC is 24% and 6% for SCLC.
|
From page 13... ...
Impairments associated with lung cancer and its treatments include respiratory problems, fatigue, pain, neuropathy, ototoxicity, and psychological distress. Impairments associated with other common cancers include cachexia (e.g., for gastrointestinal cancers)
|
From page 14... ...
For example, chronic obstructive pulmonary disease can cause shortness of breath and limit a survivor's participation in rehabilitation treatments. Symptom clusters -- two or more concurrent symptoms that are related and may or may not have a common cause, such as fatigue and pain -- can have significant and synergistic effects on cancer-related impairments and functional limitations.
|
From page 15... ...
Such complex cases have become more common because of the growing number of cancer survivors who are benefiting from life-prolonging cancer treatments but who also may have impairments and functional limitations from those treatments.1 SURVIVORSHIP CARE Survivorship care provides cancer-related and supportive interventions that address the individual needs of each survivor. It includes a cancer 1 This text has changed since the release of the prepublication version of this report to clarify SSA's current disability listings and why the listings might need to change in the future due to the complex nature of cancers and cancer treatments.
|
From page 16... ...
While these advances have contributed to improvements in cancer treatment outcomes, much less is known about the long-term and late-onset effects of these treatments compared with the conventional surgery, chemotherapy, and radiation approaches that have been used for more than 50 years. Managing cancer-related impairments and functional limitations as part of a patient-centered, survivorship care program should be a lifelong process.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.