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.

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.

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?

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.

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

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)

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

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.

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

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

Screening/Early Detection Techniques

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

Screening/Early Detection Techniques

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

 Lung Cancer Leading cause of cancer death

Routine chest x-rays no proven benefit.

Screening Clinical Trials (e.g., National Lung Screening Trial)

Screening/Early Detection Techniques

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

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 CA125

Screening/Early Detection Techniques

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

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.

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

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

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.

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