Cancer is the second leading cause of death in the United States.8 According to Surveillance, Epidemiology and End Result data, 12,549,000 Americans were living with the disease in 2009.47 Cancer is a disease in which dysfunctional cells are reproduced at a high rate. These cells cluster together in growths called tumors. Not all tumors are malignant, or cancerous. Because the body is constantly replicating cells from the DNA of older cells, some mistakes are to be expected. Normally, these mistake cells are identified and removed by the immune system before they overproduce. If not eliminated, these cells develop over time into larger masses that interfere with the processes of the organ or tissue in which they are situated. Diagnoses are specific to the structure or body system that has been disrupted. The most prevalent forms of cancer are breast, prostate, lung, colon, and skin.48 Table 1-2 shows that although lung cancer ranks third in diagnosis, it results in the greatest numbers of deaths.
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Epidemiology studies that look at the personal characteristics of those who are diagnosed with cancer and those who are cancer free have identified several modifiable risk factors associated with cancer. A modifiable risk factor is changeable, unlike age, gender, or genetic links to a disease. Although it may appear obvious that smoking is a risk factor for lung cancer or sunburns are a risk factor for skin cancer, there are risk factors that overlap multiple types of cancer. For example, tobacco use also increases one’s risk of prostate49 and liver cancer.50 Lack of physical activity is a modifiable risk factor for breast, colon, and lung cancers.51 An average of 30 to 60 minutes of physical activity a day reduces one’s risk by 20% to 24%.52,53 Other modifiable risk factors include tobacco use or exposure, obesity, low fruit and vegetable intake, diets high in animal protein and fat, and alcohol consumption. The American Cancer Society estimates that one-third of all cancer deaths are related to these lifestyle choices.54
Tremendous advances in cancer detection and treatment have improved the life expectancy for cancer patients in the past 50 years. In 1950, only 35% of all cancer patients survived 5 years postdiagnosis. That number has now increased to 69%.47 More health professionals are considering the role of physical activity in recovery. Although research is still limited, there are several reported benefits to increasing physical activity during and after cancer treatment. Physical activity may reduce fatigue, weight gain, and arm swelling that occurs in breast cancer patients.55,56 Women who participated in even small amounts of physical activity had better survival rates than those who reported no physical activity.57 This was also true of men with prostate cancer.58
Over the next 30 years, the number of Americans older than 65 years will more than double.59 An estimated 79 million will be living in the United States by 2040, making older adults more than one-third of the adult population.60 This shift will have a tremendous impact on the health care system. More citizens will require more services because the prevalence of chronic disease increases with age. In particular, Alzheimer’s disease will present challenges because treatment options are limited and the burden to family members is high.
Alzheimer’s disease is a progressive neurogenerative disorder of the brain that results in a severe loss of cognitive ability. It is the most common cause of dementia in older adults.61 More than memory loss, Alzheimer’s disease causes a complete disruption in the way nerves send messages to each other, making even self-care activities almost impossible.62 In 2010, an estimated 4.7 million adults were living with the disease.63 Early symptoms of Alzheimer’s disease include problems planning money, finding the right words, getting lost in familiar places, or displaying poor judgment in decision making. As the disease progresses, these lapses become more frequent and make normal daily tasks difficult. Mood and personality changes are also noted. It is at this stage that Alzheimer’s disease is usually diagnosed.62
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