The application currently covers the three most common forms of cancer: Lung, Breast, and Prostate. The information presented is the best practices developed by the Oslo University Hospital in cooperation with leading international cancer treatment institutions.
In the Nordic countries, lung cancer (pulmonary cancer) is the most common form of cancer. In Norway, lung cancer is the most common cancer form in men and the third most common cancer form in women.
Lung cancers are primarily divided into non-small cell lung carcinoma (85%) and small cell lung carcinoma (15%). Together, non-small cell lung carcinoma and small-cell carcinoma constitute about 97% of all carcinomas in the lungs. They are highly malignant and have a strong positive correlation with smoking.
There are numbers of subtypes of non-small cell lung cancer; the most common types are squamous cell carcinoma and adenocarcinoma. Carcinoid tumors and carcinomas of the salivary gland type are rare and not related to smoking. Mesotheliomas are tumors originating from the pleura and in rare cases from the peritoneum.
In the Nordic countries, lung cancer accounted for 10.2 % of the annual new cancer cases for men and 9.1% for women in the period from 2008. Of the 2550 new lung cancer cases in Norway in 2008, there were 1474 cases of men and 1076 of women. In 2006, 2007 lung cancer patients died. From the beginning of the 1980’s, the incidence of lung cancer among men has started to decline. But for women, the number of lung cancer cases has increased by 5% per year.
Breast cancer is by far the most common form of cancer in women, and affects first and foremost women over the age of 50. Every 10th to 11th woman will develop breast cancer. In Norway in 2005, there were 2,780 women who received this diagnosis. In comparison, the disease affected 1,235 women in 1970. Breast cancer rarely strikes men. In Norway, less than 20 cases are diagnosed per year. With a few exceptions, the treatment is the same as for women.
The disease is characterized by a varied course, from rapidly growing tumors with early distant metastasis, to slow growing tumors which remain in the mammary glands without metastasizing. Twenty-five to 35% of breast tumors are aggressive. The majority of breast tumors are carcinomas. Sarcoma tumors are rare, but are important to be aware of, as they are treated differently from other breast carcinomas.
The prostate gland is attached to the bottom of the bladder and is located in front of the rectum. During orgasm and ejaculation the prostate gland produces a secretion that carries the sperm.
In most countries of the Western world, prostate cancer is the most common cancer form in men. The development of the disease varies and it may take up to 20 years from the start of cell changes via prostate intraepithelial neoplasia (PIN) and indolent (latent) cancer to overt clinical cancer.
The different tumor types have different levels of malignancy. Therefore, the treatment scheems should differ from no treatment to comprehensive multi modal treatment. To achieve optimal treatment results, it is important that the pateitnts are evaluated by multi treatment teams that include urologist, oncologist, radiation therapist and physicist.
During the last 10–20 years, PSA, or prostate specific antigen, has been used for early detection of prostate diseases, including cancer. This has often led to detection of cancer at earlier stages during the course of the disease. The PSA level, as measured by a blood test, is often high in the presence of prostate cancer. However a high PSA reading is not specific for cancer.
There are many controversial aspects in the treatment of prostate cancer. One of the questions is whether to detect the disease early by PSA-screening or whether the disease’s natural, untreated course is benign enough that curative treatment of early cancer with it’s subsequent serious side effects is unethical. There is no international or national consensus on this, which has led to differing treatment policies between countries, treatment centers, and specialists.