heidi weinhold in you are watching ask the nature of that today's topic will be the prevention in early detection of cancer i would like to introduce today's guest to my viewers we have dr len robertson who is the associate director of cancer outreach for you p m c cancer center in pittsburgh and dr beth simon cancer control specialist with you p m c cancer centers welcome ladies and thank you for being here today thank you  do just to clarify since you introduced us as dr jeff and i both have advanced degrees in nursing and a doctorate in public health which lends itself to the type of work and you do a lot of work with with cancer out region in reaching out to the community and i wanted you to really to talk to our viewers today about some of the services that you are able to provide through the cancer outreach program at your p m c well a lot of what we do use education to groups in the community various groups are focuses mainly under served individuals but we will go and talk to any group and our focus as you said is on lowering your risk for cancer cancer screening what are some ways to stay healthy and to kind of prevent yourself from getting cancer which in some instances you can do through lifestyle change i'm so happy that  you said that and you talk about that because i think a lot of people today you still think the genetics is is the main risk factor for cancer in that it's a lot of our research dollars have been spent and in research and genetics and family history and yet you know a recent convention researchers came out and there's there is a sense of debate about lifestyle factors but they said especially like was in breast cancer he said about one third of all breast cancer could be prevented in women if women actually ate less and exercise more of a very searchers sensitive way of saying that but you know it's very true and it's for most of the cancers in actuality only three to five percent of cancers have a genetic experience and people come to see me and they have a family member with breast cancer or maybe their sister was diagnosed with breast cancer or their mother and then that prevents them from going to get screenings and what they have such fear that is it immobilizes them from from going to seek out your services for mammograms what do you say to these women part of what we say to them is there's a lot you can do to help decrease your risk not only to cancer but also other chronic diseases because many of those factors come into play and such things as you alluded to and beth did exercise right and how how frequently you should exercise at least thirty minutes a day if you're an adult and now they used to say five days a week now they're moving to seven days a week ok and that's children you know the kind of with children it's even more least an hour a day for your kids ok are some of the other services that you're able to provide think you mentioned a little bit about screenings for the for the community do you do you do screening that your center where you located or you go out on site how does this work both we have a prevention early detection center actually at the home and cancer center individuals can call schedule look point meant and they will be seen by one our nurse practitioner and the screen as appropriate for them of of how often women should be screened for mammograms and you know what in your opinion what is the formula for how often women should should get a mammogram and is it based on their respect or well it is definitely based on your risk factors you know although we did say that only about five percent of cancers have a hereditary component in many cancers and breast cancer is one of them and your risk can be higher if you have it in your family especially family members who have developed cancer at an early age so a woman or man should take always take your family history to your provider because that really does dictate when you would start being screened it might be earlier but what is the incidence right now is of breast cancer in this in this country well breast cancer is the number one cancer in women diagnosed in women and i believe the number two cause of cancer deaths in in women in the united states ok you know what is the charge for for women to come in to get to get a mammogram do you did i hear correctly that you also provide free the such a wonderful service and we go one step further not only will we go after the vulture we will schedule them a gram appointments and also determine if there are any other barriers such as transportation  excedrin and then facilitate them getting to where they need to go that is so needed that it's such a beautiful service to do it because it is truly i mean just to take the extra step to schedule it because there is there's a lot of fear which also also include screening for h p v but often the more of a community depending upon where we're asked they may have the facilities that they have a clinic where room or room that's set up as a clinic that we can do on site screenings we will only do them the whole if it's appropriate you know there's adequate facilities because we really respect all of our clients dignity and we don't want to do anything you know less comfortable for them as being in the nice environment was services you have available for men as regarding you know cancer screening and well we do have the availability of prostate cancer screening and again at our prevention and detection center and at some times in our community screenings again particularly in men you know in under served areas again we don't want to take we don't play the part of a man's primary provider you know we think it's important that men and women have a close relationship with their physician or practitioner and have that conversation about screening ok but many are not doing that and i think that's where we come in well i think you bring up a good point because there's a lot of controversy right now regarding prostate cancer screenings and testing p s a levels and men as a new england journal of medicine has said that a is a better marker for information or infection than it is for for prostate cancer and it's a very sensitive test but not exactly specific for detecting prostate cancer now do you continue to screen all we still to encourage if the individual does not have a primary care physician that they have a conversation with one of us or a nurse practitioner determining if they have risk factors their age in a variety of other things and along with screening with the p s a we also encourage them to have a digital rectal exam which we can do and you can do that you can even do that on one site correct as long again as there's adequate privacy in the that allows us to do that it's difficult to just with all the controversy to get a pat answer is how often you have it generally yearly more important is that you go back to the same place particularly the same lab because you need to track the values it's not one value in and of itself it's the tracking to see if the value has been his research very correctly what do you look at like how much of the a variance do you is like if you don't even how much you know that's very individual so a doctor may do more that's the reason the primary care physician so important because even a slight rise do you agree but yes ok so it's important that like i said  we're doing this in public with men and we tell them you know this value is not just a normal or abnormal value this is something that you need to track that you need to share with your provider if you have one and hopefully they do so that they're tracking it they're not just taking this test and putting it in their file cabinet and in the past i think it was a p s a levels of it was it was under four it was considered good and today is it is it under two that those days can we still more and less go along the lines a lot of what's normal for that individual ok i mean i can that can be a general guideline but i would not like all our eggs in one basket wouldn't necessarily say it's in younger individuals ok what we're dealing with is is a unique copulation ok we're getting ready to come to a break but when we come back i'm going to ask you a couple more questions about prostate cancer because it is so common in men and there's there's still some more questions about about the p s a levels a stay with us we'll be back what is to cause you to go halfway around the world something then like you can control and this booklet can help from keeping your family healthy to saving for retirement or to your free copy now from the american diabetes association because we want everyone to be healthy and happy cancer outreach for you p m c cancer centers and pittsburgh and dr beth simon the cancer control specialist with the p m c cancer centers before the break we were talking a little bit about about prostate cancer and dr robertson can you can you expand a little bit more about just some of the other risk factors and men for developing prostate cancer and what they can do to decrease their risk or one of the things we all can do is sort of what our grandmothers told us a good diet and it's including all the food groups and then particularly making the biggest part of your diet fresh fruits and vegetables and not processed foods not a lot of on heavy fat content lean meats and small amounts for instance about the size of the palm of your hand the size of your  so you know some of the things that our parents and grandparents have told of are pretty important people ask also well what about you know vitamin supplementation that takes the place we generally say if you have a good diet it may not hurt you to take a multiple vitamin exciter where no i hear the prescribe that you can always check that out with your physician but adding a multitude of supplements should not be necessary s but my opinion that if i did because it has a nature path a doctor i really do believe in lifestyle and how that is you know in the past conventional medicine they considered prevention as early detection and it was it was all soley based on testing and it's so refreshing to me to see that the that it's shifting it was shift is now towards you know lifestyle and really prevention as diet exercise which which is all the tenants of nature patent medicine and really we as nature pass we really stress for remember with prostate cancer living with prostate cancer do you and shoot for like eight to ten vegetables a day which is which is high but a lot of of people can get all of that in their their diet and then we do you know stress as far as you know maybe it's official essential fatty acids i don't think we get enough in our diet there's just some things that i think in there's a lot of correlation i know with with search with cancer levels even if i am indeed efficiently and i don't know do they do they test for vitamin d deficiency and you p m c cancer center well as part of our program  know but you know of course the various physicians and departments do have that capacity ok because i do think that that's important we're finding a lot of vitamin d deficiency relating to prostate colon and breast cancer and then it's it's interesting i know there's a shift to it a lot of finding more information in the diet being connected to to cancer risk what are your thoughts on the role of information i mean if you look at some of the basic research it does look like that is you know a factor so you know you hear about the things like stress reduction and various things you can do to kind of keep you know everything in good working order and you know other things that may come into play with inflammation like chronic infection and things like that so i mean think about h p v incidence of cervical cancer and it's true you know so do you do you think stress and depression do you consider that are a risk factor for cancer i don't know that we could say risk factor i mean i think maybe you have to look at the fact that if you're depressed and you're stressed are you doing the things you need to be doing to really have a healthy lifestyle and i don't know what your thoughts are best i go i think it you know it it's all part of being healthy you know and having solid immune system to help your body fight and i agree with you  i think it does little lower your immune system and i think it makes you more more susceptible or even if it's interesting and i don't there's probably not a studies on this but just clinically b c people if they last like a loved one after a long at the end and they develop an illness or or something like cancer but it seems like there has to be some kind of connection there what do you feel about like the what are the the screenings for colon i ask of these there's there's a lot of discrepancy there  family history because and colon cancer if you have a family member or close family member first degree relative who has had colon cancer particularly a little bit younger your physician will probably want you to be screened at an earlier age so you need to take your family history to your practitioner to be it for diabetes or heart disease cancer or whatever it is very important so yeah and if individuals have a type of princes very often they are screened earlier ok ition and depending upon where you're looking the recommendations for african americans are actually forty five to start cancer screening and that's because  everybody knows and they're they're at a higher risk correct word for colon cancer and we don't quite know why ok correct they are at high risk so you know and there's there's a lot of fear i think too in the african american community also in getting screened do you how do you reach out to them how  you what do you say what we do is we develop relationships within communities so we don't go in with you know communities sort of here is what we have to offer you we for instance may establish relationship with a local library or the y or community center and we become known so that we're regular presence there maybe once a month ok offering some educational sessions and then coming along with the screening and it's amazing once the trust factor once you're a known entity how people will come to you and inquire and what they should or shouldn't be doing so that's that's the basis of how we work ok it's loaded with chemicals and i think there has to be some kind of environmental also correlation what i did was to say that i would have been talking like a correlation between plastics use and breast cancer but what's the data on that that that's a common question when their last name well is it safe to microwave food in a plastic container i mean people ask this all the time for the answer to that question no  with the heat and i learned that many many years ago from a chemist husband who was telling me that and i never listened ok but that's what there is evidence to that but asked to a call create connection or correlation between plastics and breast cancer i don't think that's out there ok we do know that there are plastics that should be avoided what are those the ones with the the p b a ok content in them and a lot of that's being removed now you'll see p p a for your water bottle and various toys and things along those lines ok ok what about cosmetics investment when we we i was so impressed with you we met it at a health care and you were talking a lot about of environmental risk factors and it's really some good websites to do that when they could write a find i think you know that what what we use personally it's very important to get back to nature because you know we don't we don't know the cause and effect of all of these things but you know it it it makes good sense you know  chemicals in your body that you don't you don't know what they're going to do so yeah i think that you know we well we don't they use this brand or you don't use a brand you know to me the fewer ingredients the more ingredients that i've never heard out before i can now announce a lot of the word right i tend to stay away from from things like that ok well what about women have asked me to if there's a correlation between caffeine and breast cancer not evidence based at this point the guy actually women have come into my office and they say well there's the study if you drink six cups of coffee you're going to have a decreased risk of breast cancer and i look at that  it out there appears to be an increase in women diagnosed with lung cancer who have never smoked and i wanted to ask you a little bit with what are some of the risk factors for developing lung cancer well your statement is true we do know that lung cancer is increased in women has increased in women that are nonsmokers and what that is going to be from of though it's not proven yet some factors they're looking at is occupational exposure environmental poser a question hand smoke working in a variety of places that might have a specificity up of things then it is a variety of things but it's not concrete at this point in time but they are going a lot of research along those lines or for skin cancer we generally refer our our patients who have an abnormal to to a dermatologist ok for a good thorough screening  and we also do world screenings oh oh you know we can do store testing with the cards for colorectal cancer ok i think another thing that people are not aware of is we also we we so much believe in what we teach and what we and about you know a certain type of cancer that they're interested in and about healthy lifestyle about environmental issues like we talked about so that's a big part of of our program how can people get ahold of you what was the best way or what this number for people to call i think the least risk lashing it during this program but if there is a group that that would like you to come and speak it is for one two six two three twelve sixty six  information for the public and for people to know and that that there is a place for people if you don't have health insurance and you do feel a lump in your breast to go and call and get get a mammogram get get it checked out you know get get get a pap smear and that this services is available i think it's so beautiful and i thank you for for being here today and and for your time and sharing this information and by viewers thank you for