1. Breast & Prostate Cancer Wednesday, October 17 2007

2. Introduction Who we are Why we’re here today What is breast cancer What is prostate cancer Statistics How this affects you –Prevention or Living with it

3. Breast Cancer

4. What is Breast Cancer? Cells in the breast tissue divide and grow without normal control 85% of breast cancer originate in the mammary ducts, 17% arise in the lobules Cancer in the breast usually grows very slowly, by the time a lump is found it could be 10years. There is a 12% chance a women will develop breast cancer at some point in life. As of 2007, 178,480 new cases were diagnosed in the United States There are however; 2.5 million breast cancer survivors

5. Percent of U.S. Women Aged 40 Years and Older Who Have Had a Mammogram in the Last 2 Years by State, 2006

6. Risk Factors Factors that may increase your chance of being diagnosed with breast cancer: –Getting older; the more you age, the greater the risk –Having inherited mutation in the BCRA1 or BCRA2 breast cancer genes –Breast cancer history in the family –Being exposed to large amounts of radiation –Starting menopause after age 55 –Never having children –Having your first child after 35 –High bone density –Not breast feeding –Being overweight –Current use of birth control –Continuous alcohol consumption

7. Diagnosis Breast Cancer is suspected when a lump is felt during a breast exam or by an abnormal mammogram. Best way to know for a FACT is follow up tests After follow up tests are performed and cancer can not be excluded a biopsy is the next step, this removes tissue or cells to closer examine them under a microscope There are two types of biopsy: –Needle Biopsy: uses one of the three different needles to remove tissue or cells directly from the breast tissue –Surgical Biopsy: this is an incision made into the breast to remove tissue There are advantages and disadvantages to each method This method produces a pathology report which contains a large amount of information 9 out of 10 women will not be diagnosed with breast cancer using these methods

8. Treatment Treatment is a necessity for a fully successful recovery Types of treatment: –Surgical –Radiation –Hormone Therapy –Chemotherapy –Targeted Therapies Types of Cancer: –DCIS (Ductal carcinoma in situ) –LCIS (Lobular carcinoma in situ) –Stage 1 and 2, Stage 3 (locally) –Stage IV (metastic) –Male breast cancer –Breast Cancer during pregnancy

9. After Treatment There are more than 2 million breast cancer survivors in the United States today! The best steps people can take is to continue regular medical treatments and continue regular screenings. The most common concerns with women and breast cancer: –Concerns for family members –Living with cancer –Being sexual –Having children –Postmenstrual hormones –Medical Costs –Stress and weight gain

10. Prevention Since there is no significant cause of breast cancer it is difficult to pin point ways to prevent it but there are some things that may help lower your risk of breast cancer; –Physical activity (30-60min. Most days of the week) –Annual check-ups with your doctor starting at 20years of age if breast cancer runs in your family or 35 for everyone else –Eating a healthy, green, leafy diet –Doing self-exams monthly –Eliminating smoking –Controlling alcohol consumption –Breast feeding

11. Support Groups Emotional support and practical help are very important for people living with breast cancer Social interactions are very important to maintain or create in the life of cancer survivors

12. Common Myths I’m only 25, breast cancer only happens in older women –While the risk increases with age all women are at risk You can prevent ever getting breast cancer There is no way to absolutely prevent breast cancer. If you develop it early, detection and treatment are the best methods for surviving If I have a mammogram every year that will increase the exposure to radiation which will increase my risk for breast cancer The small level of radiation is safe with the benefits outweighing the risks

13. Prostate Cancer

14. Prostate Facts Male Sex Gland Location (walnut size): –Front of rectum, below bladder –Surrounds urethra Function: –Helps in emptying urine –Makes most of semen to carry sperm Affected by: –Sex hormones (Testosterone)

15. Prevalence of Prostate Cancer

16. Cancer Facts What is Cancer? –Multiple, out of control cell growth  Tumor Benign vs Malignant Why is it Out of Control? –Chromosome changes within cell Cell loses ability to control growth Loss is due to: Genetics, infections and exposure to drugs, tobacco, chemicals, etc. How Does it Spread? –Blood vessels, lymph nodes Treatment? –Kill or control abnormally growing cells

17. Prostate Cancer Facts 240,000 American Men per year –#1 Cancer Among Men 1/6 Men = Diagnosed –1/35 Die from Prostate Cancer Men <40 yrs = RARE –>65% of cases, Men >65 yrs (Avg = 70 yrs) Cause  Idiopathic –Early detection is key

18. Risk Factors (Non-Modifiable) Age – #1 Risk Factor Ethnicity –African-Americans = Highest RF –White Americans = 2 nd Highest –Not common in Asian or American Indian men Genetics –Father, Brother = Highest RF Closer the family member, higher RF

19. Risk Factors (Modifiable) Diet –High in animal fat (saturated fat) = Highest RF –High in vegetables and fruit = Lowest RF Current Studies –Obesity, inactivity –Smoking, excessive drinking –Radiation Exposure –Sexually Transmitted Disease –Enlarged Prostate or BPH –Vasectomy

20. Prevention Primarily Unknown –Research Inconclusive What is known… –Avoid high fatty diets (primarily animal fat) Saturated Fats –Increase Fruits and Vegetables

21. What Can I do? Regular screenings –Start: 50 yrs Earlier if known high risk (45 yrs) –Family members, genetics, chemical exposures –Ethnicity –At least a 10-yr life expectancy Prostate cancer is a slow-growing cancer Likely cause of death would be otherwise –New American Cancer Society (ACS) guidelines

22. Symptoms Difficult to Identify –Often mistaken with Enlarged Prostate or BHP STD Urination-Related Symptoms –Frequent urination (primarily at night) –Difficulty starting urination or stopping –Inability to urinate –Weak or interrupted flow of urine –Painful or burning urination –Blood present in urine

23. Symptoms (con’t) Sex-Related Symptoms –Difficulty having an erection –Painful ejaculation –Pain or stiffness in lower back, hips, upper thighs Enlarged Prostate or BHP –All symptoms similar STDs –Some symptoms similar

24. Diagnosis American Cancer Society recommends: –Digital Rectal Exam (DRE) Doctor feels for lumps Problems: Occasionally lumps are small –Prostate Specific Antigen (PSA) Blood test used for measurement Higher than normal Other Tests –Ultrasound, X-Ray, Fine Needle Biopsy

25. Diagnosis (con’t) Staging of Cancer –Stage I Cancer too small to be felt via DRE, no symptoms –Found by chance –Stage II Cancer confined to prostate Lumps large enough to be felt via DRE PSA may be increased

26. Diagnosis (con’t) Staging of Cancer (con’t) –Stage III Cancer has spread outside of prostate –Spread to other near tissues Problems urinating may be occuring –Stage IV Cancer has spread to lymph nodes around the body –Common in bones Complications with urination, sex-related, fatigue, weight loss

27. Treatment Several Treatments –Individual basis for treatment Consider: age, health, feelings surrounding treatment, side- effects –Types of treatment Surgery (Radical prostatectomy) Radiation Therapy (5d/wk, several wks) –Kill cancer cells, shrink tumor(s) –Side-effects: impotence, bowel function Hormonal –Deprive cancer cells of hormones needed to stay alive –Side-effects: Impotence, hot flashes, decreased sex drive, bone thinning

28. Current Research Predicting Risk Factors –Increased Testosterone Prevention –Increased Vitamin E, Selenium (via supplements) –Tomato-based food consumption –Finasteride (affects male hormone levels) –Cryosurgery Freezing and destroying cancer tumors

29. Conclusion More Research is Needed –Prevention, Cause Everyone is Affected –Age, Ethnicity Best Way to Help Yourself –Regular Check-ups

30. Thank You For Your Time Next Lunch and Learn: November 14 th, Diabetes!

31. References www.cdc.gov www.nih.gov www.komen.org www.acs.com