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 gt98,000 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 gt1 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 gt5yrs, 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 gt5 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 gt65
• 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
• gt100 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

1. DO NOT SMOKE
2. Healthy Body Weight
3. Eat Fruits and Vegetables
4. Be Active
5. Limit Alcohol
6. Protect Yourself in the Sun
7. 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