Page 32 Complete Your CE Test Online - Click Here inflammation continues is not always known. Chronic inflammation may be caused by infections that do not go away, abnormal immune reactions to normal tissues, or conditions such as obesity. Over time, chronic inflammation can cause DNA damage and lead to cancer. For example, people with chronic inflammatory bowel diseases, such as ulcerative colitis and Crohn disease, have an increased risk of colon cancer [154]. Sex Hormonal influences mean that women are much more likely to get breast cancer than men. Obviously, women do not develop prostate cancer nor men ovarian or uterine cancer. There are some cancers which affect both sexes that predominate in one sex or the other, but nothing that skews quite as much as breast cancer, which women are nearly 100 times more likely to develop than men. Some of the increased incidence of one sex or another relates to specific behaviors [125]. For example, men developed lung cancer a lot more than women, but after women began smoking at higher rates, their lung cancer incidence increased as well. Smoking rates in women never quite reached the same level as men, and lung cancer is still somewhat less common in women than in men. Men get more oropharyngeal, urinary, rectal, liver, and skin cancers, as well as leukemias and lymphomas; women get more thyroid and anal cancer. Overall, more women get cancer each year, but more men die from it [14]. Disproven carcinogens and cancer myths Below are some of the popular theories about cancer causation that have been investigated. Either no evidence was found to support these hypotheses or evidence that specifically does not support them was found. “A positive attitude can beat (or prevent) cancer” To date, there is no convincing scientific evidence that links a person’s “attitude” to his or her risk of developing or dying from cancer [158]. It is normal for people with cancer to feel sad, angry, or discouraged sometimes; cancer often brings a number of losses (such as body image, changes in relationships, changes in self-efficacy, fertility and sexuality changes, concerns over their ability to perform important tasks or functions, among others) that must be grieved. This process can take months or even longer. Not only is this myth false, it can cause emotional harm. Jimmie Holland, a psychiatrist who pioneered mental health care for people with cancer, coined the phrase “the tyranny of positive thinking.” According to her observations, our expectations of a cheery outlook and condemnation of any sign of sadness or anger constitute an additional burden on the person with cancer. For many people, being expected to be cheerful and upbeat all the time is profoundly discouraging and in some cases, guilt-producing, when they are unable to “be positive” all the time [102]. Worse, the popular interpretation of the mind-body connection sometimes blames the patient’s attitude or emotional state for his or her cancer. There are people who truly believe that if they allow themselves to feel distressed, angry, or upset it will make their cancer grow faster [102]. It is true that it can be helpful to patients to approach treatment with the idea that they can get through it; people with self-efficacy might be more likely to adhere to their cancer treatment regimen, maintain social connections, and stay active. But adherence to the treatment regimen is likely to be the most important component in healing and recovery [158]. Patients who have concerns over their “negativity” should be informed very clearly that feeling sad, angry, or depressed did not cause their cancer and does not make cancer grow. “Mind over matter” does not work well with nausea, fatigue, and other aspects of cancer. All other factors being equal, pessimistic people do just as well with cancer as optimistic ones. It is unfortunate that many patients are afraid to allow themselves to feel distressed, but until that myth fades into the background, health professionals may have to keep telling patients that it will not affect their outcome if they allow themselves have “negative” emotions. “Sugar feeds cancer feeds cancer (or makes it grow)” This is a common Internet myth that many patients will undoubtedly repeat or ask about. Nurses are aware that normal cells require glucose to function, and that the body can turn almost any kind of food into glucose if needed. Although research has shown that cancer cells consume more glucose than normal cells, no studies have shown that eating sugar will cause cancer, or make it worse. No studies have shown that, if a person stops eating sugar, their cancer will shrink or disappear [158]. However, a high-sugar diet can contribute to excess weight gain, and obesity is associated with an increased risk of developing several types of cancer. But there are many other factors that cause people to gain weight, which have the same effect [158]. It might become a problem when a patient eats so much processed sugary or starchy food that more nutrient-dense foods like whole grains, fruits, and vegetables, are neglected, but having occasional sweets along with a healthy diet does not cause cancer or hinder its treatment. “Cancer surgery or biopsy causes cancer to spread” The chance that surgery will cause cancer to spread to other parts of the body is extremely low. Following standard procedures, surgeons use special methods and take many steps to prevent cancer cells from spreading during biopsies or surgery to remove tumors. One example is that if they must remove tissue from more than one area of the body, they use different surgical tools for each area [158]. This myth might have begun when others saw a person they thought was healthy get observably worse after surgery or a biopsy, without knowing that the person already had metastatic cancer before the procedure (and indeed, would not have had the procedure at all if they were not symptomatic in some way). “Cancer gets worse if exposed to air” Exposure to air will not make tumors grow faster or cause cancer to spread to other parts of the body [158]. If this were true, surgery could never cure cancer, which as we all know it sometimes does. Like the above, this myth may come from observing someone who already had advanced cancer, who may feel worse (or whose cancer may continue to progress) after surgery. “Artificial sweeteners cause cancer” Researchers have conducted studies on the safety of the artificial sweeteners (i.e. sugar substitutes): saccharin (Sweet ‘N Low®, Sweet Twin®, NectaSweet®); cyclamate; aspartame (Equal®, NutraSweet®); acesulfame potassium (Sunett®, Sweet One®); sucralose (Splenda®); and neotame, and found no evidence that they cause cancer in humans. All of these artificial sweeteners except for cyclamate have been approved by the Food and Drug Administration for sale in the U.S. [158]. “Cell phones cause cancer” According to the best studies completed so far, this does not appear to be true. Cancer is caused by genetic mutations, and cell phones emit a type of low-frequency energy that does not damage DNA [158]. “Power lines cause cancer” Power lines emit both electric and magnetic energy. The electric energy emitted by power lines is easily shielded or weakened by walls