1. CANCER PREVENTION WHAT WE KNOW Megan Oden PA-C SOAR program co-lead

2. WHY IS CANCER PREVENTION SO IMPORTANT?  Over half a million people die from cancer each year in the United States despite improvement in survival rates.  Cancer is the number one cause of death in the US, outranking cardiovascular disease (heart disease, stroke).  Aging is the single largest risk factor for developing cancer.

3. AGING AND CANCER  All about the telomeres  As our DNA ages, the telomeres shorten  The shortening of the telomeres is also believed to be associated with cancer cell development.

5. CAN CANCER BE PREVENTED?  Only 5-10% of cancers are hereditary  It is estimated that 50% of cancer is preventable  It is never too late to cut your risk!

6. PREVENTION VS SCREENING  Both screening and prevention can reduce the likelihood of dying from cancer.  Screening is used to detect cancer before there are symptoms. - colonoscopy, mammogram, PSA, pap smear, etc  Prevention focuses on changes you can make to limit risk factors that promote cancer.  These preventable risk factors account for TWO-THIRDS of all cancers in the US.

7. MODIFY YOUR RISK  Tobacco  Alcohol  Sun exposure  Physical activity  Weight  Diet  Supplements

8. TOBACCO  Tobacco is THE most preventable cause of cancer accounting for 21% of all cancer deaths worldwide  The risk is not limited to smoking cigarettes  Its not just about lung cancer -leukemia, cancers of the mouth, nose, sinuses, throat, esophagus, pancreas, liver, stomach, cervix, kidney, colon and bladder  Benefits of quitting go beyond cancer and it is NEVER too late to quit

10. WATCH THE RAYS  Skin cancer is the most common form of cancer in the US. - More cases than breast, prostate, lung and colon cancers combined  Many skin cancers are curable (basal cell, squamous cell) but the incidence of melanoma continues to rise - estimated 9,710 deaths from melanoma in 2014  Radiation from the sun is the primary cause of all skin cancers  Intense exposures and blistering burns may be more dangerous than cumulative sun exposure over many years.

11. HOW TO PROTECT YOURSELF  Seek the shade, especially between 10am and 4pm  No tanning beds- UV exposure from these is now classified as a carcinogen  Avoid sun burns  Use a broad spectrum sunscreen with UVA and UVB coverage - For prolonged outdoor activity minimum SPF of 30 - apply 30 minutes before going outside and every 2 hours  See your physician annually for a skin check

12. ABCDE

13. STAY ACTIVE!  25% of US adults are almost entirely sedentary  Decreased physical activity appears to increase your overall risk of developing cancer - Most compelling data shown in colon cancer and breast cancer  Aside from smoking cessation, exercise is one of the most important changes you can make to decrease your cancer risk.  How much do you need? - 2 ½ hours of moderate-intensity activity weekly - Muscle strengthening activity on 2 or more days a week

15. EXCESS WEIGHT  Excess weight/obesity associated with increased risk of colorectal, breast, endometrial, kidney, and esophageal cancer  Estimated to cause 20% of all cancers  Risk can be reversible with weight loss - Bariatric surgery associated with significant reduction in the risk of dying from cancer- 60%  Weight gain itself may increase your risk

17. DIET DILEMA  Still a long way to go  Results of studies are inconsistent and at times conflicting  Break it down - Fat - Red meat - Fruits and vegetables - Supplements

18. DOES FAT INTAKE MATTER?  No clear link between fat intake and colon or breast cancer risk  May be an association with prostate cancer  Verdict is still out

19. RED MEAT  High intake of red meat is associated with an increased risk of colorectal cancer in both men and women - beef, pork, veal, lamb  Shown to increase risk of cancer mortality  Why? Maybe from overcooking meat - carcinogens may be formed when cooking meat at very high temps - prepare by baking, broiling or poaching  Choose fish, poultry or beans over red meat

20. EAT YOUR VEGGIES  Results have been very inconsistent  The American Cancer Society recommends following a diet rich in plant based foods - 2 ½ cups and fruits/vegetables daily  Emphasis is on WHOLE fruits and vegetables  Variety is important  Plant based diet? - diet centered on whole unrefined plants. Based on fruits, vegetables, tubers, whole grains, legume Excludes or minimizes meat, dairy, eggs refined flour, sugar and oil *

21. VITAMIN D  Vitamin D may reduce the risk of colon cancer  Vitamin D deficiency may be a risk factor for developing prostate cancer  Get you Vitamin D level checked!  Factors that effect your Vitamin D level - Geographic location and season - skin tone - age - body weight

22. CALCIUM  Associated with a reduced of colorectal cancer BUT…  May be associated with increased prostate cancer risk - higher calcium intake  Should you take a supplement? - consider dietary sources: green leafy vegetables, sardines/salmon, dairy(milk, yogurt, cheese), non-dairy milks (almond, soy, coconut) - evaluate your risk for colon cancer

23. MEDITERRANEAN DIET  High intake of fruits, vegetables, nuts, legumes, whole grains, fish, olive oil  Associated with a decreased risk of cancer. No single cancer type has been identified  “Western” diet has been associated with a 30% increase in colon cancer risk - the “meat-sweet” diet - high in processed red meat, sugary desserts and drinks, high fat foods (dairy), and refined grains.  Dietary patterns may play more of a role than individual components of diet

24. ANTIOXIDANTS  Free radicals are chemicals that can damage cells which may lead to cancer  Antioxidants block the activity of these free radicals  Results of studies have been inconsistent  May have other health benefits  Antioxidant supplements are not recommended.

25. ALCOHOL  Excess intake increases the risk of multiple cancers  Studies have shown that moderate alcohol consumption increased the risk for breast cancer.  Even light consumption ( 1 drink/day) may increase the risk of some cancers  Moderate alcohol use has other health benefits

26. THE HYPE  - Vit E  -Vit C  - Fiber  -Sugar  -Omega 3

27. KNOW YOUR BODY  Know your skin  Know your bowel/urinary habits  Know your weight  Women, know your breasts  Know your DNA

28. THE BASICS  Avoid tobacco  Be physically active and STAY physically active  Maintain a healthy weight  Eat a diet rich in fruits, vegetables, whole grains and low in saturated fats  Limit your alcohol  Avoid excess sun exposure and SUN BURNS

29. QUESTIONS?