1. [INSERT NAME & TITLE] [INSERT ORGANIZATION] [INSERT DATE] Cancer Education 2014

2. What is Cancer? The result of out-of-control growth of abnormal cells Normal body cells grow, divide and die in an orderly fashion Cancer cells continue to grow and divide, instead of dying  They outlive normal cells and continue to form new abnormal cells

4. Types of Cancer Carcinomas  The most common type of cancer Sarcomas Lymphomas Leukemias

5. What’s in a Name? Primary Site  Place where cancer starts Metastasize  Can spread to other parts of the body Naming  Always named for the place it began  If breast cancer spreads to the liver it is still called breast cancer (Not liver)

6. Cancer in Numbers Second most common cause of death in U.S.  Heart Disease is #1 Half of all men, and a third of all women, will develop cancer during their lifetime Approximately 2 in 5 Hoosiers now living will eventually have cancer Cost of Cancer  $216.6 Billion (2009)

7. Cancer in Numbers Estimated New Cancer Cases for 2014  US – 1,665,540  IN – 35,560 Estimated Deaths for 2014  585,720 Americans  Nearly one in every four deaths  13,370 Hoosiers  23% of all Hoosier deaths in 2013 Estimated New Cases in Indiana for 2014  Female Breast – 4,590  Cervical – 260  Colon– 3,020  Melanoma – 1,550  Lung/Bronchus – 5,540  Prostate – 4,390

9. Risk Factors and Risk Reduction Nearly all cancers of the lung, bladder, mouth, and skin could be prevented Many cancer deaths (50-75%) 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

10. Strategies for Cancer Prevention Stop using tobacco! Maintain a reasonable weight Adopt a physically active lifestyle Eat a healthy diet, with a focus on plant fruits and vegetables. The more COLOR the more nutrients. Increase fiber and reduce fat Limit alcohol consumption Limit exposure to the sun

11. Lifestyle Behaviors Affect Our Risk for Cancer o Of all Indiana adults 22% of adults smoke (2013) 65% are considered overweight or obese (2013) 56% of adults get less than 150 minutes of physical activity a week (2013) o Of all Indiana High School Students 13.7% smoke (2013) 14% Overweight/obese (2011) 44% 60 minutes of Physical Activity a day (2011)

12. Why is weight so important? Weight contributes to 188,000 cancer deaths each year. One-third of the cancer deaths are attributed to poor nutrition, physical inactivity, overweight and obesity.

13. Early Detection/Screening Looking for cancer BEFORE there are symptoms May identify early cases of cancer that might never have become clinically apparent

14. What can you do? Have annual physicals (Pap test, CBE, skin exams, vaccinations) Avoid alcohol and tobacco products Limit exposure to direct sunlight Be aware of your body!

15. What is Breast Cancer? Breast cancer is not just one disease but a group of diseases. It occurs when breast cells that line the ducts become malignant (cancerous). Malignant tumors are made up of abnormal cells that grow without normal controls and invade normal breast tissue.

16. Breast Anatomy and Physiology Breasts are primarily fat and breast tissue Breast tissue is a complex network of lobules, lobes and ducts Many breast changes occur over a woman’s life

17. Breast Cancer Facts Breast cancer is the most common type of cancer found in women in the United States It is the 2nd leading cause of cancer death among women age 40-59 1 in 8 women will develop breast cancer in their lifetime When breast cancer is confined to the breast the 5 year survival rate is over 98 percent A woman dies from breast cancer every 74 seconds around the world Men can get breast cancer, while rare it does happen; 2,000 men will be diagnosed this year, 400 will die (National)

18. Genetics and Breast Cancer Gene mutations are spontaneous or inherited Several inherited mutations have been linked to breast cancer.  BRCA1 and BRCA2 Most breast cancers are spontaneous gene mutations

19. Risk factors do not cause breast cancer Risk factors are associated with an increased chance of getting breast cancer Some risk factors can be controlled and others can’t be changed Risk Factors

20. Two Major Risk Factors  Being a Woman  Getting Older Other Risk Factors? Modifiable factors can lower risk  Breastfeeding, physical activity, and maintaining a healthy body weight

21. WHAT CAN I DO? Early detection and treatment offer the best chance of surviving breast cancer. Three-step early detection plan  Breast Self Awareness  Clinical Breast Exam (CBE)  Annual Screening Mammography

22. Breast Self Awareness Know your risk Get screened Know what is normal for you Make healthy lifestyle choices

23. Clinical Breast Exams (CBE) Your health care provider should perform your CBE during regular checkups During the CBE, the doctor will look for breast changes such as size, shape & color Your doctor will feel the entire breast and underarm areas for new lumps or changes Ask any questions you have about BSA, common breast changes, or your personal risk

24. Breast Changes That Should Be Evaluated By A Health Care Provider

25. Breast Changes That Should Be Evaluated By A Health Care Provider

26. Breast Cancer At My Age? Young women CAN and DO get breast cancer! There are more than 250,000 women 40 and under in the U.S. living with breast cancer, and over 11,100 young women will be diagnosed in the next year Know your body!

27. Cervical Cancer Risk Factors  Most often in women over 30  Having the Human Papilloma Virus (HPV)  HPV accounts for an estimated 90% of all cervical cancers Increased Risk  Using Birth Control pills for 5 or more years  Smoking  Having HIV

28. Cervical Cancer HPV  Main cause of cervical cancer  Common virus that is passed from person to person during sex  Can go away on its own, but if it does not it can cause cervical cancer Prevention  Get the HPV vaccine  Get regular Pap tests beginning at age 21  Don’t smoke  Use condoms during sex

29. Cervical Cancer Screening Guidelines

30. Skin Cancer Facts There are three types of skin cancer Early detection and treatment are very important with all types cancer More than TWO million cases of skin cancer are diagnosed in the United States each year.

31. Basal and Squamous Cell Carcinoma Basal Cell (Most common form)  80% of new skin cancer cases  90% found on the head, neck, and other high exposure areas  High cure rate  Once diagnosed 40% chance of getting another basal cell cancer within five years Squamous Cell (2 nd most common form)  90% cure rate  More than 300,000 new cases diagnosed annually

32. Melanoma Melanoma is the most deadly form of skin cancer One American dies of melanoma every hour Melanoma is the most common form of cancer for 25-29 year-olds The second most common form of cancer for 15-29 year-olds

33. Melanoma 76,690 expected new diagnoses in 2013 Ten times more common in whites than African- Americans Before age of 40  Rates are higher in women After age of 40  Rates are almost two times higher in men Rates are increasing by almost 3% per year since 2004

34. Melanoma Survival Rate Five year survival rate is 99% (if tumor is spotted when only a spot on the skin Five year survival rate drops to 15% if the fast growing cancer has spread

37. Avoid Sun Damage Wear hats and protective clothing when in the sun Do NOT visit tanning booths. Their effects can be as dangerous as the sun’s UV rays Wear sunscreen that protects from both UVA and UVB rays and use an SPF of 30 or higher (Natural ingredients like zinc oxide are helpful) Seek shade during the hours of 10:00 am to 4:00 pm if you do not have access to protective clothing Wear sunglasses to protect against ocular melanoma

38. Skin Cancer Summary Look for new spots  About 70% do not emerge from moles Women watch your LEGS  Women tend to get melanomas on their legs and calves Guys should monitor the top of your ears and head especially closely  Many hats for men don't shade the ears, and balding men often forget to protect their hairless pates. Both are common sites for squamous and basal cell carcinoma. Don't overlook the places where the sun doesn't shine  Many melanomas show up in armpits, hands, belly buttons, underneath hair, the bottom of the feet, and other places that don't get much direct light Have a second pair of eyes look

39. Possible Signs of Cancer Change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lumps in breast or elsewhere Indigestion or problems with swallowing Obvious change on wart or mole Nagging cough or hoarseness Several types of cancer MAY NOT provide symptoms before they cause changes in the body

40. Remember Have annual physicals (Pap test, CBE, skin exams). Avoid alcohol and tobacco products (including secondhand smoke). Limit exposure to direct sunlight. Know your body!