Shedding New Light on Cancer Prevention and Early Detection

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Shedding New Light on Cancer Prevention and Early
Detection
Julie Hodorowski LaShawn Brown NCIs Cancer
Information Service
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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.

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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?

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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.

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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/en
  vironment
• Understanding Cancer Risk http//understandingrisk
  .cancer.gov

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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)

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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

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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.

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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

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Screening/Early Detection Techniques

• Breast Cancer
• 2nd leading cause of cancer death in women

• 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

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Screening/Early Detection Techniques

• Colon/Rectum
• Third most common cancer in both men and women

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Screening/Early Detection Techniques

• Beginning at Age 50
• Stool blood test annually
• Digital rectal exam annually
• Sigmoidoscopy
• Colonoscopy (virtual)

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

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Screening/Early Detection Techniques

• Prostate Cancer
• 2nd Leading cause of cancer death in men
• Beginning at Age 50
• DRE
• PSA

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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

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Screening/Early Detection Techniques

• Pelvic Exam
• PAP Test

• Cervical Cancer
• Screening should begin approx. 3 years after a
  women begins to have sexual intercourse, but no
  later than 21 years old.

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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.

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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

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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

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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.

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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

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National Cancer Institutes Cancer Information
Service

• www.cancer.gov
• 1-800-4-CANCER
• E-mail through www.cancer.gov
• Chat with us through LiveHelp