# Presentation: 433632

## Shedding New Light on Cancer Prevention and Early Detection

- Julie Hodorowski
- La’Shawn Brown
- NCI’s Cancer Information Service

## 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?

**Notes:**
Brief description of who we are and the role of the CIS.  
Research findings to provide evidence to support prevention methods and early detection and screening techniques.
Today we will present some of what know works for cancer prevention -heart disease and diabetes. Influence of our lifestyle.

## 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.

**Notes:**
Challenges faced in changing behavior.  
Aging population will result in increased incidence rates.
Relationship to stress relief?

## 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)

**Notes:**
< 5% related to inheritable 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

**Notes:**
La’Shawn to address

## 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)

- 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 CA-125

## 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

## National Cancer Institute’s Cancer Information Service

- www.cancer.gov
- 1-800-4-CANCER
- E-mail through _[www.cancer.gov](http://www.cancer.gov/)_
- Chat with us through *LiveHelp*