Shedding New Light on Cancer Prevention and Early Detection

1. Shedding New Light on Cancer Prevention and Early Detection Please note that the NCI Cancer Information Service is no longer in existence. For more info on cancer, contact Sloan-Kettering Cancer Center in NYC.

2. Goals • Reduce fear and misinformation through cancer information and education. • Increase awareness of cancer prevention, screening and early detection strategies. • Increase knowledge of healthy lifestyle choices that may reduce cancer risk. • Describe sources of information and support if you have questions.

3. CAN WE PREVENT CANCER? • Why take the chance when you can do something about it! • What can we do to reduce our risk of developing cancer?

4. Risk Factors & Risk Reduction • Nearly all cancers of the lung, bladder, mouth and skin could be prevented • 50-75% of cancer deaths are related to personal behaviors or habits • 30% or more of all cancer deaths related to cigarette smoking • 30% of all cancer deaths in the U.S. are related to poor nutrition & inactivity leading to obesity • Risk may be reduced by increasing consumption of fruits & vegetables and limiting high-fat foods • Source: Cancer Trends Progress Report - 2005 Update, National Cancer Institute, NIH, DHHS, Bethesda, MD, December 2005, http://progressreport.cancer.gov.

5. Risk Factors • Viruses (e.g., Human Papilloma Virus-HPV, hepatitis B and C ) and bacteria (helicobacter pylori) • Number of pregnancies and age at first pregnancy • Environmental and occupational exposures (e.g., radiation, second-hand smoke, radon, asbestos, organic vapors, and pesticides NCI sources: Understanding Cancer Series: Cancer and the Environment: www.cancer.gov/cancertopics/understandingcancer/environment Understanding Cancer Risk http://understandingrisk.cancer.gov

6. Risk Factors • Genes known to be involved or suspected of being involved in familial cancer syndromes (e.g., BRCA1) • Interactions of genes with lifestyle factors, environmental, and/or occupational exposures (e.g., variations in carcinogen metabolism associated with our genes)

7. Strategies for Cancer Prevention • Stop using tobacco • Maintain a reasonable weight • Increase physical activity • Eat 5-9 fruits and vegetables daily • Increase fiber and reduce fat • Limit alcohol consumption • Limit exposure to the sun

8. Early Detection/Screening • Screening for cancer means looking for cancer BEFORE there are symptoms. • Screening may identify early cases of cancer that might never have become clinically apparent.

9. Barriers to Screening • Lack of knowledge/awareness of symptoms of cancer • Cost/lack of insurance • Lack of physician recommendation • Language barrier • Cultural beliefs • Psychological factorsSocioeconomic Status (poverty, education, unemployment) • Institutional racism • Fear

10. Breast Cancer 2nd leading cause of cancer death in women Screening/Early Detection Techniques • Breast Self Exam • Mammograms • Ages 40-49 every one to two years • Age 50 and over - yearly • Clinical Breast Exam • High risk women may need to begin screening at earlier ages

11. Colon/Rectum Third most common cancer in both men and women Screening/Early Detection Techniques

12. Screening/Early Detection Techniques • Beginning at Age 50: • Stool blood test annually • Digital rectal exam annually • Sigmoidoscopy • Colonoscopy (virtual)

13. Lung Cancer • Leading cause of cancer death • Routine chest x-rays no proven benefit. • Screening Clinical Trials (e.g., National Lung Screening Trial)

14. Screening/Early Detection Techniques • Prostate Cancer • 2nd Leading cause of cancer death in men • Beginning at Age 50: • DRE • PSA

15. Screening/Early Detection Techniques • Ovarian Cancer • Annual pelvic exam should be performed to try and detect an ovarian mass. • CA-125 not accurate for screening ALL women for ovarian cancer. • Pelvic ultrasound with vaginal probe may become routine in combination with the CA-125

16. Cervical Cancer Screening should begin approx. 3 years after a women begins to have sexual intercourse, but no later than 21 years old. Screening/Early Detection Techniques • Pelvic Exam • PAP Test

17. Other Screening Possibilities • Tumor Markers • EX: PSA – Prostate Cancer, CA-125 Ovarian Cancer • Can be useful when used along with other tests. • CAN NOT be used alone as a screening tool.

18. Diagnostic Tests • Physical Exam • Examination of the entire body • Lymph node bearing areas • Abdomen is checked to detect enlargement of any organs • Exam of the pelvic area in women, including PAP smear. • Digital rectal exam for men and women

19. Diagnostic Tests • Lab Tests • If cancer is present blood tests can show any effects of the disease on the body. • FOBT - fecal occult blood test • Urinalysis – examination of the urine • CBC - complete blood count

20. Diagnostic Tests • The physical exam, lab and imaging tests may identify an abnormality but a BIOPSY is the only sure way to know whether cancer is present. • In a BIOPSY, the doctor removes a sample of tissue from the abnormal area or may remove the whole area. A pathologist will examine the tissue to see whether cancer cells are present or not.

21. Discussion Questions • List three common myths and fears about cancer. • Name the number one risk factor for cancer. • Explain how the following relate to cancer risk: • ultraviolet radiation • ionizing radiation (cosmic rays, cell phones) • chemicals and other substances • List one health related action you can take if you have a family history of cancer. • State one phone number and Web site you can use for cancer information