Cultures of Cancer Mid-term – Flashcards
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Latency period is the time between
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time in between the exposure to environmental or lifestyle factors that could cause cancer diagnosis of cancer. Ex: latency period for skin cancer may be from -the time at which the rays of sunlight hit one's skin to the -moment the individual is diagnosed for a melanoma. The length of the latency period varies for each cancer and some are longer than others. We discussed in class that the latency period is often difficult to pinpoint in American society because our society moves and changes so quickly.
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Percival Pott
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Mentioned in Emperor of All Maladies, Percival Pott was the first surgeon/scientist to discover that cancer may be caused by environmental carcinogens. In the late 1700s, this London surgeon realized a correlation between exposure to soot and greater likelihood of scrotal cancer among chimney sweeps. Chimney sweeps were young boys that cleaned chimneys. Living in squalid conditions, these boys did not wash frequently, and their skin was continually exposed to soot from the chimneys. Pott's discovery lead to legislation (Chimney Sweepers Act of 1788) that tried to stop this form of child labor.
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Cancer/disease incidence
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Incidence is the rate of new cases of a disease. It is reported as the number of new cases occurring within a given time period. A cancer incidence rate is the number of new cancers of a specific type. It is usually expressed as the number of cancers per 100,000 at risk. Incidence rates provide information about current risk of contracting a disease instead of prevalence which is how widespread it is.
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Relative risk
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The idea of relative risk was discussed in Frankenberg's article on risk and the anthropological/epidemiological narratives of prevention. According to his definition, relative risk is the "ratio of incidence of those with a risk factor to those without." For a cancer-related example, relative risk could be measured between two groups of people that are similar, but one is exposed to air pollution from a nearby factory, whereas the other group is not. Depending on the number of cancer incidents from each group, one could create a risk ratio to measure the relative risk of air pollution on cancer. One of the three different kinds of risk that epidemiologist study.
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Hippocrates
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The father of western medicine, who named cancer. He described breast cancer as resembling a crab by the way it spreads in the breast. He also believed that disease comes from some kind of imbalance in one's environment. Mentioned in the Dread Disease, he counseled against heroic therapy. He thought that if treated then patients would die quickly so he was against performing surgery.
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Galen
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Galen was a Greek physician and philosopher (130-200 AD) who first used the word "oncos" (Greek for swelling) to describe tumors. He contributed greatly to Hippocratic understanding of pathology. He promoted the bodily humors theory, that differences in human moods are consequences of imbalances in the four bodily fluids: black bile, yellow bile, blood and phlegm. He believed that cancer, like depression, was caused by an overdose of black bile. Through his dissection of monkeys and pigs, Galen made several important discoveries, including the concept that the circulatory system consists of two separate systems of distribution. Described in the Emperor of All Maladies
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EPA
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EPA, which stands for the Environmental Protection Agency, is an agency that is part of the United States federal government. Its role is to protect the human and environmental health by writing laws and enforcing laws passed by Congress. Started in the 1970s, this agency was created in response to environmental concerns with agricultural pesticides, especially DDT which the EPA banned in 1972. Regarding cancer, the EPA reviews chemicals for its potential carcinogenicity. Also, the agency provides information on other risk factors, such as for skin cancer incidence.
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Frederic Hoffman
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He was the chief statistician of the Prudential Insurance Co. In 1915, did a lot to establish the orthodox view that cancer was increasing and becoming a threat to Western civilization. He found that cancer mortality in the US was riding at 2.5% per year. It was faster for males than for females. His findings were depressing so many people challenged his conclusions. -dread disease is reading by patterson
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Dr. Halstead
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American surgeon born in 1852. Spent some time practicing/studying abroad and was inspired to address breast cancer with radical mastectomies, believing them to be more effective than traditional mastectomies. He introduced and popularized the radical mastectomy in the United States in 1882. ["The patient was a young lady whom I was loath to disfigure."] Experimenting with cocaine as an anesthetic on himself led to a lifelong cocaine (and later morphine) addiction.
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Leo Chavez
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One of the authors of "Beliefs Matter: Cultural Beliefs and the Use of Cervical Cancer-Screening tests". The article investigates the impact cultural beliefs have on behaviour, significantly cervical cancer risk factors and pap smears. The study found many of the elements Latina immigrants gave a high ranking to as a risk factors for cervical cancer, was given a lower ranking by physicians, and vice versa.
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American Society for the Control of Cancer
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Mentioned in Dread Disease. American society for the Control of Cancer was formed in New York in 1913 in response to an alliance between the optimistic upper middle class, leading doctors, and the press. John D. Rockefeller Jr. was a major benefactor of the society. It relied on the contributions of wealthy people and was dominated by doctors and specialist surgeons. Women began the organization but it was soon dominated by men and doctors.
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Radical mastectomy
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Radical mastectomy, a technique popularized by Halsted in the 1880s, is an extremely invasive form of breast cancer surgery that removes the breast, chest muscles, and all of the surrounding lymph nodes. Popular into the mid-1970s, surgeons used radical mastectomies to attempt to completely root out the cancer. However, critics argued that if breast cancer is in its local stage, then a more conservative mastectomy can be used and if the breast cancer has metastasized to other parts of the body, it can no longer be removed by surgery. Nowadays, radical mastectomies are rarely performed for the reasons above unless the tumor has spread to the chest muscles.
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Metastasis
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Metastasis is when stagnation is broken in the cancer cells and the cancer cells are able to travel through the body. The word comes from the Latin roots "meta" and "stasis", meaning beyond stillness. It is used to describe the migration of cancer from one site to another (The Emperor of all Maladies)
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Disparities
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The National Cancer Institute describes cancer health disparities as differences in cancer incidence, cancer survivorship, and the burden of cancer that exist among specific population groups in the US. For example, a low socioeconomic status or lack of access to healthcare can contribute to bearing a greater burden of disease as compared to the rest of the population. Other factors such as income, education level, and exposure to environmental carcinogens can also lead to health disparities (Cancer in the Community). -in the intro to confronting cancer and dianne weiner - professor
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Disclosure
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Good: "American Oncology and the Discourse on Hope" Norms of disclosure vary widely between cultures and countries, characterizing differing opinions towards the nature of a doctor-patient relationship. Cancer was initially a taboo word and many doctors in the US did not disclose the patient's cancer to them for fear of upsetting the patient (as was evident in the film "Dark Victory") and, thus, a conspiracy of silence shrouded cancer diagnosis. However, in the 1960s, doctors were forced to tell their patients about their cancer due to legal reasons, such as insurance. According to "American Oncology and the Discourse on Hope", today there is unamity in the US on the legal and ethical obligation to disclose the diagnosis, but this is not always the case in other countries, particularly in Italy and Japan. In Italy and Japan, the norms of disclosure often require doctors to disguise or hint around the truth, if they choose to disclose information at all.
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Apoptosis
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Programmed cell death. It is a self-destruction mechanism which helps to eliminate cells without the release of harmful toxins. Cells which signal for apoptosis are usually older cells, ones less desired by the organism at the time, and nonfunctional cells. Apoptosis is the mechanism that usually prevents abnormal cells from developing. If apoptosis is inhibited, there is uncontrolled cell growth, typically resulting in cancer and metastasis.
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P53
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A tumor suppressor gene which regulates the growth of cells during the S phase of development. Usually, an individual inherits two functional copies from each parent. One functional copy of the p53 gene results in a predisposition to cancer and increases the possibility of tumors at a young age.
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Mustard nitrogen gas
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Colorless, blistering liquid produced by reacting the solvent thiodiglycol with boiling hydrochloric acid. Its distinctive smelled earned it the nickname mustard gas. Long term effects of mustard gas included depletion of certain populations in the bone marrow and loss of almost all white blood cells in the blood. In 1942, it was used to treat a lymphoma patient and lead to temporary remission.
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-Interleukin
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glycoprotein produced by leukocytes to regulate immune response; -used as a cancer drug; -in emperor of all maladies
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RCT´s
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randomized control trial; A trial in which the treatment and control group are randomly assigned. English ; Statistician Bradford Hill proposed randomly assigning patients to treatments with streptomycin (a new antimicrobial drug in the 1940s) and a placebo. This would ensure that neutrality would be enforced and a hypothesis could be strictly tested. This had implications for cancer research because the NCI's trials became systematic and sequential. They were now objective, randomized with clear, unbiased criteria to assign patients and measure responses.
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Hodgkin's
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Referenced in the Emperor of All Maladies, Hodgkin's disease (lymphoma) is a cancer that impacts white blood cells (lymphocytes) and the lymph system/lymphoid tissue. Because there is lymphoid tissue throughout the body, Hodgkin disease can start anywhere. Most often it starts in the upper lymph nodes in the chest, neck or under the arms. The cancer was named after Dr. Thomas Hodgkin, a 19th century physician, who was the first to recognize it. He discovered the disease while organizing anatomical specimens (teaching tools). The scientific world was unimpressed until later this specific cancer was used to test radiation. It helped cancer scientists to realize that not all cancers are the same.
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Quacks
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As discussed in The Emperor of all Maladies, the term "quacks" is mostly used by Western biomedicine to refer to any kind of treatment/therapy that is alternative. As was discussed in class, there were healers before there was biomedicine and many alternative therapies are used to treat cancer today, many deriving from Eastern medicine traditions. Some of these therapies are alternatives, meaning that the patient has refused chemotherapy and opted for these treatments, while others are supplementary, meaning that they are used in addition to the standard three stage. Cycle: surgery, radiation, and chemotherapy. Mentioned in Dread Disease → Two famous ones: Baker and Hoxsey who appealed to the poor and ill-educated classes. Bother capitalized on the hostility against orthodox medical professions.
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Oncogene
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A gene that has the potential to transform a cell into a tumor under certain circumstances, such as genetic mutations or increased expression.
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Robert Koch
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Mentioned in the Dread Disease. In 1882 he identified the causative agents responsible for tuberculosis, then the year after discovered the one responsible for cholera. He developed bacteriology (founder of modern bacteriology).
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Farber
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Went from the "bench to the bedside" through his cancer research. Born in Buffalo, New York and educated in Germany. Brilliant pathologist who investigated cutting edge research on childhood leukemia. He discovered antifolates which provided a few months of remission for the cancer patients despite the recurrence of cancer. Research was ethically questioned since he used real life patients (children) as test subjects in the hospital, without proper consent.
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"Cancer Ward"
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Novel by Solzhenitsyn. The book is about patients in a cancer ward, many of whom either benefited from Stalinism or resisted the regime. The main character, Oleg, has a large tumour in his abdomen and spent time in a labour camp. Some themes present in the novel are the rights and autonomy of the individual as opposed to the will of the healthcare system and cancer as a moral punishment. There is also the idea of cancer as a disease vs illness present. A parallel is drawn between the Stalin regime and cancer - there may be periods of remission but no escape (the damage of Stalin's great purge and regime was too great). The femininity and sexuality of cancer patients and in the context of the cancer ward also comes into question with the interactions between patients and their care providers.
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-NIH
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emperor of all maladies? National Institute of Health. Moonshot cure for cancer (President Obama, VP Joe Biden)
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ACS
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In 1945, the American Society for Control of Cancer underwent several changes and became the American Cancer Society. Mary Lasker became involved with ACS in 1943 and her advertising and fundraising efforts largely renewed the ASCC and led to its renaming as ACS. The society's goals are to fund and conduct research and provide information.
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Dr. Payton Rous
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Dr. Payton Rous, described in Emperor of All Maladies was a virologist at the Rockefeller Institute in New York who first diagnosed a hen with a tumor on its back as sarcoma. After filtering the cancer cells from one chicken and observing that when injected into another, the cancer still spread he determined there must be something smaller than a cell that is responsible. Thus, he proposed the virus theory of cancer and in 1966 was awarded a Nobel Prize for his work. Despite acknowledging that there were very few cancers in humans that could be directly attributed to a virus, fear started spreading that cancer might be contagious. (Mukharjee 201-204)
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President Grant
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President Grant died in 1885 after complaining of dryness and pain in his throat in 1884. His case was one of the first publicized cancer cases since there was such a silence surrounding the word cancer and what it actually was. The diagnosis of his cancer was slow. It was discovered that he was a cigar smoker who developed cancer of the mouth, but his physician denied the rumours. A specialist eventually recognized that he had this particular cancer and gave him opiates to relieve the pain. The truth was finally revealed by newspapers, drawing attention to cancer which was rare at the time since the public use of the word cancer did not happen often. In investigating Grant's notes that he wrote his physicians, it was found that the treatment he received consisted of gargling, pain-killers, morphine, brandy, cocaine, and codeine. The religious take was that praying prolonged his life, but Grant's health continued to deteriorate quietly until he passed away in 1885.
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Linda Hunt
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Looks at moral themes in causal explanations of cancer discussed by research subjects (oncologists and patients) in Santo Domingo, Mexico. Overall: Connecting cancer to life events creates a sense of order and denies the "arbitrariness" of cancer and that the remedy of cancer lies within the self. "the anthropology who did the research in Mexico" - from professor