Cancer Awareness

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Cancer Awareness

• Theresa Menocal, M.S.
• Oncology Outreach Education Coordinator

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Why Talk About Cancer?

• Everyone is touched by cancer
• US 1.4 million new cases
• Florida 98,000 new cases
• Lifetime risk 1 in 4
• Leading cause of death
• US 560,000
• Florida 40,000 deaths
• Prevention
• Early detection

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What Is Cancer?

• A zodiac sign (June 22 July 23)
• A class of diseases characterized by uncontrolled
  cell division and the ability of these cells to
  invade other tissues, it is caused by a series of
  mutations (changes) to DNA within cells that
  define the cell functions and removes normal
  control of cell division.

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Cancer and Genetics

• All cancers are genetic
• Most cancers are sporadic
• Approximately 5-10 of cancers are inherited
• Inherited versus Familial
• Pathology

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Statistics

• Impact our decisions
• Help to evaluate our personal risk
• Can be frightening
• Can be motivating

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2006 Estimated US Cancer Cases
Men720,280
Women679,510
31 Breast 12 Lung bronchus 11 Colon
rectum 6 Uterine corpus 4 Non-Hodgkin
lymphoma 4 Melanoma 3 Thyroid
3 Ovary 2 Urinary bladder
2 Pancreas 20 All Other Sites
Prostate 33 Lung bronchus 13 Colon
rectum 10 Urinary bladder 6 Melanoma of
skin 5 Non-Hodgkin
lymphoma 4 Kidney 3 Oral Cavity 3 Leukemia 3
Pancreas 2 All Other Sites 18
Excludes basal and squamous cell skin cancers
and in situ carcinomas except urinary
bladder. Source American Cancer Society, 2006.
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Skin Cancer

• Most common of all cancers
• US 1 million cases
• Main cause
• unprotected and excessive sun (UV radiation)
  exposure.

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Skin Cancer Risk Factors

• Too much sun exposure
• Includes tanning lamps and booths
• Fair skin
• Personal history of skin cancer
• Males are 2x as likely as females
• Chemical exposure (arsenic)
• Radiation exposure
• HPV
• Reduced immunity
• Skin conditions severe skin inflammation/injury,
  tx for psoriasis, xeroderma pigmentosum, basal
  cell nevus syndrome, etc)

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Breast Cancer

• Most common cancer among women
• Lifetime risk 1 in 7
• US 213,000 new cases 41,000 deaths
• Florida 13,000 new cases 3,000 deaths
• Florida ranks 3rd in nation for total number of
  new cases and deaths
• In Florida 1 million women over 40 have NEVER
  had a mammogram

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Breast Cancer Risk Factors

• Age
• Personal history of breast or ovarian cancer
• Family history
• mother, daughter or sister with breast cancer
• Genetic predisposition BRCA1, BRCA2
• Biopsy confirmed atypical hyperplasia or
  carcinoma in situ

• Exposure to estrogen
• Long menstrual history, never having children,
  HRT, birth control pills for 5yrs, late
  menopause
• Exposure to low-level ionizing radiation
  (frequent x-rays for treatment)
• Obesity after menopause
• Lifestyle factors alcohol, diet, exercise
  smoking

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Breast Cancer WarningSigns and Symptoms

• Mammogram finding
• Breast lump or mass
• CHANGES
• Size or shape of one breast
• Texture thickening, scaliness or pitting
• Skin temperature or color
• Unusual drainage or discharge from the nipple
• Nipple pain, ulceration, itching or retraction
• Swelling in the upper arm
• Pain (with advanced cancer)

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Cervical Cancer

• For invasive cervical cancer
• 11,150 new cases in U.S.
• 3,670 deaths in U.S.
• Non-invasive is 4x as common

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Risk Factors for Cervical Cancer

• HPV (human papilloma virus) infection
• Other STD Chlamydia, HIV
• Sex at early age
• Many sexual partners
• Diet
• DES (diethylstilbestrol) exposure
• Taking birth control pills 5 years
• Family history
• Progression to cancer may be influenced by
• smoking, having had many children, suppressed
  immune system.

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Cervical Cancer WarningSigns Symptoms

• In early cases of cervical cancer there are often
  no signs or symptoms.
• Any unusual discharge from the vagina (not your
  normal period)
• Blood spots or light bleeding other than your
  normal period
• Bleeding or pain after sex, douching, or after a
  pelvic exam

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Colorectal Cancer

• The third most common cancer among men and women
• US 107,000 new cases 55,000 deaths
• Florida 9,400 new cases 4,000 deaths

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CRC Risk Factors

• Smoking
• Alcohol consumption
• Obesity
• Physical inactivity
• Diet high in fat and/or red meat or processed
  meat
• Diet low in fruits and vegetables
• Genetic susceptibility / Family history

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CRC Warning Signs Symptoms

• In early stages there may not be any symptoms of
  cancer.
• A change in bowel habits, such as diarrhea,
  constipation or narrowing of the stool, that
  lasts for more than a few days
• A feeling that you need to have a bowel movement
  that doesnt go away even after you do have a
  bowel movement
• Bleeding from the rectum or blood in the stool
• Cramping or gnawing stomach pain
• Decreased appetite
• Weakness and fatigue
• Jaundice (yellow-green color of the skin and
  white part of the eye)

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Lung Cancer

• More Americans die each year from lung cancer
  than breast, prostate and colorectal cancers
  combined.
• US 213,380 new cases 160,390 deaths
• Florida 12,900 new cases 12,000 deaths
• About 30 of all cancers are tobacco related
• No screening test available

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Lung Cancer Risk Factors

• Smoking
• Causes 8 out of 10 cases
• 30 increased risk for second hand exposure
• Occupational/environmental exposures
• Arsenic, asbestos, radon, air pollution
• Marijuana
• Radiation to the lung
• Personal and family history
• Diet low in fruits and vegetables

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Lung Cancer WarningSigns Symptoms

• A cough that does not go away
• Chest pain, often made worse by deep breathing
• Hoarseness
• Weight loss and loss of appetite
• Bloody or rust-colored sputum (spit or phlegm)
• Shortness of breath
• Infections such as bronchitis and pneumonia that
  keep coming back
• New onset of wheezing

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When lung cancer spreads to distant organs, it
may cause

• bone pain
• weakness or numbness of the arms or legs
• dizziness or seizure
• yellow coloring of the skin and eyes (jaundice)
• masses near the surface of the body, caused by
  cancer spreading to the skin or to lymph nodes in
  the neck or above the collarbone

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Prostate Cancer

• 3rd leading cause of cancer death in men
• Lifetime risk 1 in 6
• US 234,460 new cases 27,350 deaths
• Florida 15,000 new cases 2,400 deaths
• The survival rate for prostate cancer has
  increased from 67 to 97 over the past 20 years

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Prostate Cancer Risk Factors

• Age
• 2 out of every 3 men with prostate cancer 65
• African-American men
• North American men
• Family history
• Diet high in red meat, dairy, less fruits and
  vegetables
• Exercise men over 65 who exercise regularly had
  a lower risk

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Prostate Cancer WarningSigns Symptoms

• Early prostate cancer often causes no symptoms.
• Symptoms of advanced prostate cancer could
  include the following
• Trouble having or keeping an erection (impotence)
  
• Blood in the urine
• Pain in the spine, hips, ribs, or other bones
• Weakness or numbness in the legs or feet
• Loss of bladder or bowel control

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Vaccines

• Stimulate the immune system to attack cancer
  cells without harming normal cells
• Therapeutic
• To strengthen natural defenses against cancers
  that have already developed
• Prevent recurrence
• Eliminate cancer cells not killed during
  treatment
• Prophylactic
• To target cancer causing viruses
• Prevent viral infection

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Vaccines to Prevent Cancer

• Hepatitis B
• Hep B virus associated with liver cancer
• Decrease in prevalence from 10.5 in 1984 to 1.7
  in 1992
• Liver cancer incidence was reduced by 50

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Human Papillomavirus (HPV)

• 20 mil people affected in U.S.
• 80 of females acquire HPV infection by age 50
• 100 different types
• Types 16 18 account for 70 of cervical cancer
  worldwide
• No symptoms of HPV infection
• 6 million new cases of genital HPV in US every
  year 74 of them occur in 15-24year olds.
• Worldwide, cervical cancer is the second most
  common cancer in women and is estimated to cause
  over 470,000 new cases and 233,000 deaths each
  year

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Vaccines to Prevent Cancer

• Gardasil
• 3 injections over 6 month period
• 9-16 year old females
• Most insurance companies cover

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What Are My Risks?

• Age
• Family and personal history
• Race

• Lifestyle issues
• Smoking
• Diet
• Weight
• Exercise

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What Can You Do?
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DONT SMOKE!
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Lee Health Solutions

• Smoking cessation program
• 8 week series -- 125
• Call 573-5720 for more information

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Seven Cancer Prevention Tips

• DO NOT SMOKE
• Healthy Body Weight
• Eat Fruits and Vegetables
• Be Active
• Limit Alcohol
• Protect Yourself in the Sun
• Follow Screening Recommendations

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Healthy Diet

• Balance caloric intake with physical activity
• Choose food or beverages in amounts that help
  achieve and maintain a healthy weight.
• Eat 5 or more servings of a variety of vegetables
  and fruits every day.
• Choose whole grains in preference to processed
  (refined) grains.
• Limit consumption of processed and red meats.

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Be Active

• Adults
• Engage in at least 30 minutes of moderate to
  vigorous physical activity, above usual
  activities, on 5 or more days of the week 45 to
  60 minutes of intentional physical activity are
  preferable.
• Children and Adolescents
• Engage in at least 60 minutes per day of moderate
  to vigorous physical activity at least 5 days per
  week.

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Sun Safety

• Wear sunglasses that block UV rays
• Use a sunscreen with an SPF of 15 or higher
• Wear a hat
• Cover up
• Limit direct sun exposure during midday
• Avoid sunlamps and tanning booths
• Check your skin regularly

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Screening

• What? How? When?
• All recommendations are
• for people at average risk

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Screening for Skin Cancer

• Practice skin self-exam once a month and have any
  suspicious changes checked by a qualified
  clinician.
• See your doctor if new growths or any changes in
  the appearance of a mole or skin color occur.
• Clinical skin exam as part of periodic health
  exam beginning at age 20.

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Look for Danger Signs

• Asymmetry
• Border
• Color
• Diameter
• Evolving

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Screening for Breast Cancer

• Clinical Breast Exam
• Every 1-3 years for ages 20-39
• Yearly with mammogram beginning at 40
• Annual Mammogram beginning at 40
• Breast Awareness
• Optional self breast exam beginning
  at age 20

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Screening for Colorectal CancerBeginning at age
50

• Annual fecal occult blood test (FOBT) or fecal
  immunochemical test (FIT)
• Annual FOBT and flexible sigmoidoscopy every 5
  years
• Flexible sigmoidoscopy every 5 years
• Double-contrast barium enema every 5 years
• Colonoscopy every 10 years

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Colon Cancer
Polyp
Advanced Colon Cancer
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Screening for Lung Cancer

• Currently there is no effective screening method
  for lung cancer.
• National Lung Screening Trial (NLST)
• Studying spiral CT scanning as screening

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Screening for Prostate Cancer

• Age 50 and over with at least 10 year life
  expectancy
• Annual digital rectal exam
• Annual PSA blood test

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Take Home Message

• Cancer affects everyone
• Prevention and early detection are key
• Healthy behaviors
• Discuss with health care providers
• Screening
• Get involved

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Call 239-335-7595 to Register Today! Space is
limited Free 5-week session at Cape Coral
Hospital. All classes are 6 8
pm. Aug. 28 Fueling up on Low-fat Foods
Favoring Fiber Sept. 4 Discovering Dairy
Alternatives Sept. 11 Replacing Meat Sept
18 Planning Healthy Meals Antioxidants /
Phytochemicals Sept. 25 Immune-Boosting Foods
Maintaining a Healthy Weight
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The Cancer Advocacy Center877-680-0008