Table 15: Leading Sites of New Cancer Cases, by Gender, U.S., 2017 (Estimates) MALES
FEMALES
Number of New Cases
Percentage of New Cases
Number of New Cases
Percentage of New Cases
Site
Site
All sites Prostate
836,150 161,360
100% All sites
852,630 252,710
100% 29.6%
19.3%
Breast
Lung and bronchus
116,990
14.0%
Lung and bronchus
105,510
12.4%
Colon and rectum
71,420
8.5%
Colon and rectum
64,010
7.5%
Urinary bladder
60,490
7.2%
Uterine corpus
61,380
7.2%
Melanoma 5.0% Note . Adapted from Cancer Facts & Figures for 2017, by American Cancer Society (ACS), 2017. Retrieved from https://www.cancer.org/content/ dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2017/cancer-facts-and-figures-2017.pdf Table 16: Leading Sites of Cancer Deaths, by Gender, U.S., 2017 (Estimates) MALES FEMALES Site Number of New Cases Percentage of New Cases Site Number of New Cases Percentage of New Cases All sites 318,420 100% All sites 282,500 100% Lung and bronchus 84,590 26.6% Lung and bronchus 71,28 25.2% Colon and rectum 27,150 8.5% Breast 40,610 14.4% Prostate 26,730 8.4% Colon and rectum 23,110 8.2% Pancreas 22,300 7.0% Pancreas 20,790 7.4% Liver and intrahepatic bile duct 19,610 6.2% Ovarian 14,080 5.0% Note . Adapted from Cancer Facts & Figures for 2017, by American Cancer Society (ACS), 2017. Retrieved from https://www.cancer.org/content/ dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2017/cancer-facts-and-figures-2017.pdf This information is significant for multiple reasons. 52,170 6.2% Thyroid 42,470
Second, since metastasis is highly likely to be the cause of death in an individual with a solid primary tumor, the therapist needs to be familiar with: 1. The sites where metastases are most likely to occur with these common types of solid primary cancer. 2. The common presenting signs and symptoms of metastasis at those sites. cancer initially spreads invasively to local lymph nodes and moves on to distant lymph nodes, but it is most likely to form metastatic cancer in the liver and lungs (NCI, 2017b; Tappenden, Jones, Paisley, & Carroll, 2007). Pancreatic cancer is the fourth most frequent cause of cancer- related deaths in males and females (ACS, 2017; Jemal et al., 2010). This type of cancer has a propensity for early metastatic spread and responds poorly to treatment, resulting in a mortality rate that approaches 100% (ACS, 2017; Hermann et al., 2007). Pancreatic cancer commonly results in the formation of secondary cancer in the liver. Many of the signs and symptoms that occur as a result of the spread of cancer produce positive responses on one or more general health questions and the screening questions for specific physiological systems. The five most common sites for developing metastatic cancer are the lungs, brain, bones (bones with red marrow only), liver, and lymph nodes. However, the five most frequent sites for therapists to observe signs and symptoms of metastasis are the musculoskeletal system, pulmonary system, CNS, integument, and liver (Goodman et al., 2018).
First, new cancer cases originating at the five most common sites in males and females (see Table 15) form solid tumors and more than 90% of the deaths associated with these solid primary cancers are due to consequences of metastasis – that is, growth of new secondary tumors at another site – and are not due to growth of the primary tumor (Finger & Giaccia, 2010; Gupta, Kim, Prasad, & Aggarwal, 2010). Common sites of metastatic cancer Lung/bronchial cancer is the second most common site for new cancer in males and females, but the lung/bronchial cancer is the leading site of cancer-related deaths in both sexes (ACS, 2017; Jemal et al., 2010). Primary cancers of the lung most frequently spread to form metastatic cancers in the brain and axial skeleton (Goodman et al., 2018; NCI, 2017b). Prostate cancer is most likely to form metastatic cancer in the red bone marrow of the axial skeleton and/or pelvis, as well as the lungs, liver, and brain (Clarke, Hart, & Brown, 2009; Goodman et al., 2018; Logothetis & Lin, 2005; NCI, 2017b). Breast cancer has been shown to form metastatic cancer most frequently in the bones of the axial skeleton, shoulder, hips, lungs, and less frequently in the liver, brain, and adrenal medulla (Minn et al., 2005; NCI, 2017b). These figures for prostate and breast cancer do not include the frequency of metastasis to the lymphatic system (NCI, 2017b). Colorectal cancer is the second and third most frequent type of cancer resulting in cancer-related deaths in males and females, respectively (ACS, 2017; Jemal et al., 2010). Primary colorectal
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