1. Cancer Screening Education

2. Developed by: Walking Forward Program, John T. Vucurevich Regional Cancer Care Institute Native American Cancer Research Cancer Information Service Supported by National Cancer Institute Walking Forward Program, John T. Vucurevich Regional Cancer Care Institute Native American Cancer Research Cancer Information Service Supported by National Cancer Institute

3. Please turn off your cell phones or switch them to “vibrate” mode.

4. Cancer Screening & Early Detection Checking for cancer in a person who does not have any symptoms of the disease is called screening.

5. Cancer Screening & Early Detection The goal of early detection is to discover a cancerous tumor at the earliest stage possible. This way it can be stopped before it grows and spreads or metastasizes. The goal of early detection is to discover a cancerous tumor at the earliest stage possible. This way it can be stopped before it grows and spreads or metastasizes.

6. Breast – S creening mammogram, clinical breast exam, self-breast exam Cervix - Pap test Breast – S creening mammogram, clinical breast exam, self-breast exam Cervix - Pap test Screening Tests for Common Types of Cancer

7. Prostate - Digital rectal exam, prostate specific antigen blood test (PSA) Colon - Fecal occult blood test, colonoscopy, sigmoidoscopy, digital rectal exam Prostate - Digital rectal exam, prostate specific antigen blood test (PSA) Colon - Fecal occult blood test, colonoscopy, sigmoidoscopy, digital rectal exam

8. Barriers to Cancer Screening and Early Detection Examples of barriers include: –Difficulties of travel to the doctors and hospitals –Complicated health care system –Fear Examples of barriers include: –Difficulties of travel to the doctors and hospitals –Complicated health care system –Fear

9. Cancer Indian Health Service Reports on Cause of Death

10. Cancer Incidence Rates 1999-2004 U.S.Southern Plains Northern Plains AIAN All Cancers 368.4492.6538.1 Source: Cancer registries in Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries (NPCR) and National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results Program (SEER) D. Espey, Monograph Group.

11. What Is Cancer?

12. Video: Cancer in the Great Land

13. Risk Factors Cancer develops over time. It is a result of a combination of: –Lifestyle (daily behaviors) –Environment –Heredity/genetics Cancer develops over time. It is a result of a combination of: –Lifestyle (daily behaviors) –Environment –Heredity/genetics

14. Risk Factors Are Related to: Frequency –How often? Duration –How long? Intensity –How much? Frequency –How often? Duration –How long? Intensity –How much?

15. Common Risk Factors for Cancer Growing older Tobacco abuse Sunlight Ionizing Radiation Growing older Tobacco abuse Sunlight Ionizing Radiation

16. Common Risk Factors for Cancer Certain Chemicals and other substances Some viruses and bacteria Certain hormones Family history of cancer Alcohol Poor diet, lack of physical activity or being overweight Certain Chemicals and other substances Some viruses and bacteria Certain hormones Family history of cancer Alcohol Poor diet, lack of physical activity or being overweight

17. Possible Symptoms of Cancer There are many different symptoms known to be associated with certain types of cancers. A symptom is a sign that something is not right in the body. It does NOT always indicate cancer. There are many different symptoms known to be associated with certain types of cancers. A symptom is a sign that something is not right in the body. It does NOT always indicate cancer.

18. Possible Symptoms of Cancer, continued A change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening, lump, or swelling in any part of the body Indigestion or difficulty swallowing Recent change in wart or mole Nagging cough or hoarseness A change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening, lump, or swelling in any part of the body Indigestion or difficulty swallowing Recent change in wart or mole Nagging cough or hoarseness

19. Possible Symptoms of Cancer, continued Unexplained symptoms such as: –Progressive, unexplained weight loss –Fever –Fatigue, feeling tired all the time –Pain Unexplained symptoms such as: –Progressive, unexplained weight loss –Fever –Fatigue, feeling tired all the time –Pain

20. GUIDELINES FOR SCREENING ACS Guidelines for cancer screening for breast, prostate, colorectal, and cervical cancer are provided in your packets.

21. Anatomy of the Prostate Gland

23. What Is the Prostate Gland? Male sexual gland It makes up part the fluid that allows the sperm to swim / move –It is about the size of a walnut in the shell

24. Prostate Cancer in Indian Country

25. Prostate Cancer Incidence Rates 1999-2004 U.S.Southern Plains Northern Plains AIAN All368.4492.6538.1 Prostate105.4156.7174.5 Source: Cancer registries in Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries (NPCR) and National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results Program (SEER) D. Espey, Monograph Group.

26. Haverkamp D, Espey D, Paisono R, Cobb N. Cancer Mortality Among American Indians and Alaska Natives: Regional Differences, 1999- 2003, Indian Health Service, Rockville, MD, Feb. 2008.

27. Prostate Cancer Risk Factors and Protective Behaviors

28. Known Risk Factors Age Family History Race Certain Prostate Changes Certain Genome Changes

29. Known Risk Factors Diseases/disorders (urinary tract infections) Chemical exposure (Cadmium exposure; rubber industry More common in Northern Plains Genetics/family history

30. Possible Protective Factors Regular physical activity Healthy lifestyle choices, such as low-fat diet, moderate to no alcohol use, and elimination of non- ceremonial tobacco use.

31. Screening for Prostate Cancer

32. Digital Rectal Exam (DRE): –This is a physical exam of the prostate gland. Prostate Specific Antigen (PSA) Test: –This is a blood test to detect elevated levels of prostate protein.

33. Digital Rectal Exam (DRE) Physical exam by the provider –Recommended as part of annual checkup for men over 50 years old Provider feels the prostate with a gloved finger through the wall of the rectum Provider feels for –Firmness –Unusual lumps –Uneven surfaces

34. Prostate Specific Antigen (PSA) Test Blood test Recommended as part of annual checkups –For men over 50 years old –For younger men who are at high risk for the disease

35. What is the “PSA” Test? Levels higher than 4.0 ng/ml can be caused by conditions other than prostate cancer A man who has prostate cancer will have higher PSA in the blood, because this is how his body fights the disease

36. What Besides Prostate Cancer Can Cause High PSA Levels? Benign Prostatic Hyperplasia (BPH) – enlarged prostate Infected or inflamed prostate Biopsy or operation on prostate Pre-cancerous cells in the prostate

37. Where Is Prostate Cancer Screening Available in the Northern Plains? Any health clinic with a lab Veterans Administration (VA) Hospitals and outreach clinics Indian Health Service Clinics Tribal or Urban Indian clinics –Ask if anyone is qualified to do a digital rectal exam (DRE) –Rural health clinics

38. Where Can I Get a PSA Blood Test? IHS VA Community Programs Medicare/Medicaid Private Insurance

39. Prostate Cancer Screening Results Make sure you get your results!!

40. Symptoms that May Be Related to Prostate Cancer

41. Prostate Cancer Symptoms Urinary problems (trouble passing your water) –Not being able to urinate –Having a hard time starting or stopping the urine flow –Need to urinate often, especially at night –Pain or burning during urination –Blood in the urine

42. Prostate Symptoms Frequent pain in the lower back, hips, or upper thighs Difficulty having an erection

43. Basics of Cancer Treatment

44. Cancer Treatment Treatment for cancer depends on several factors: –Type of cancer –The size, location, and stage of the disease –General health of the individual Treatment for cancer depends on several factors: –Type of cancer –The size, location, and stage of the disease –General health of the individual

45. Cancer Treatment Treatment for cancer can be either local or systemic. –Local treatment affects cancer cells in the tumor and the area near it Example: radiation therapy –Systemic treatment travels through the bloodstream reaching cancer cells all over the body Example: chemotherapy Treatment for cancer can be either local or systemic. –Local treatment affects cancer cells in the tumor and the area near it Example: radiation therapy –Systemic treatment travels through the bloodstream reaching cancer cells all over the body Example: chemotherapy

46. Cancer Treatment Treatment methods may include: –Surgery: Removal of the cancerous tumor and possibly the surrounding tissue and lymph nodes near the tumor –Chemotherapy: the use of drugs to kill cancer cells Treatment methods may include: –Surgery: Removal of the cancerous tumor and possibly the surrounding tissue and lymph nodes near the tumor –Chemotherapy: the use of drugs to kill cancer cells

47. Cancer Treatment Radiation Therapy: The use of high-energy rays to kill cancer cells or stop them from growing and dividing Hormone Therapy: Used against certain cancers that depend on hormones for their growth Biological Therapy (Immunotherapy): helps the body ’ s natural ability to fight disease (immune system), or protects the body from some of the side effects of cancer treatment Radiation Therapy: The use of high-energy rays to kill cancer cells or stop them from growing and dividing Hormone Therapy: Used against certain cancers that depend on hormones for their growth Biological Therapy (Immunotherapy): helps the body ’ s natural ability to fight disease (immune system), or protects the body from some of the side effects of cancer treatment

48. Cancer Treatment The treatment plan may also include the use of clinical trials. Clinical trials are research studies that evaluate new treatments and answer scientific questions about them. The treatment plan may also include the use of clinical trials. Clinical trials are research studies that evaluate new treatments and answer scientific questions about them.

49. Give Yourself a Hand! Thank YOU!!!!