1. Mens Health Issues: A cut, a shave and some good advice Birgit Bogler, MPA presentation to Barbers International Convention October 16, 2006

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3. Overview Barbers as trusted peer educators Skin cancer and the big myth Prostate cancer and the bigger myth Colorectal cancer and the biggest myth

4. Why am I here? Barbers can be trusted peer educators –Brother-to-Brother project (HIV risk reduction) –Centers for Disease Control Early detection of cancer University of Alabama at Birmingham University of North Carolina at Chapel Hill

5. The Big Myth Myth: only fair-skinned people get skin cancer

6. Fact

7. Skin Cancer Three major types –Basal cell carcinoma –Squamous cell carcinoma –Malignant melanoma Sun exposure responsible for 90% Most common cancer in U.S. –1.2 million basal & squamous cell carcinomas –60,000 melanomas Almost 10,000 Americans die each year

8. Quick Anatomy

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10. Basal Cell Chronic overexposure to the sun –Face, ears, neck, scalp, shoulders and back When not treated quickly, difficult to eliminate –Scars and disfigurement Low rate of metastasis

11. Basal Cell An open sore A reddish patch *chest, shoulders, arms, or legs A shiny bump *persistent, non- healing sore is early sign

12. Basal Cell A pink growth A scar-like area *White, yellow or waxy with uneven borders *Can indicate aggressive tumor

13. Basal Cell No one best method to treat –Cryosurgery, topical chemo, laser, radiation Almost all treatments in doctors office Most need only local anesthetic Cure rates 85-99%

14. Squamous Cell Chronic overexposure to the sun –All places exposed to sun –Rim of ear and lower lip especially vulnerable When not treated quickly, harder to treat –Scars and disfigurement

15. Squamous Cell 96-97% remain localized Those that spread can be fatal –SCC found on lip, ear, nose have high risk for metastases –In persons with weakened immune systems

16. Squamous Cell A wart-like growth A scaly-red patch A scaly-red patch An elevated growth with a central depression *can rapidly grow

17. Squamous Cell No one best method to treat –Cryosurgery, topical chemo, laser, radiation Almost all treatments in doctors office Most need only local anesthetic Cure rates 85-99%

18. Melanoma Most serious form of skin cancer –Causes the most skin cancer deaths If found early nearly 100% curable –If not, high chance of metastases –Can be hard to treat

19. Melanoma Malignant tumor in the melanocytes –Cells that produce pigment for skin, hair, eyes –Cells heavily concentrated in moles Melanoma is usually brown but can be pink, red or purple Increased risk –Sun exposure and tanning beds –Lots of moles –Fairer skin – but darker skin is no protection –Personal history of skin cancer or lymphoma –Weakened immune system

20. Melanoma ABCDs Asymmetry Border Color Diameter

21. Melanoma Thin, localized melanomas are surgically removed –Most done in doctors office using local anesthesia For more advanced disease, treatment varies –Melanoma can spread to lymph nodes and organs Cure rates continue to rise

22. The bigger myth Prostate cancer is solely an older (65+) mans disease

23. Prostate Screening FACT: the risk of developing prostate cancer increases beginning at age 40 –African American men have a 60% higher incidence rate and 2-fold higher mortality rate PSA testing is more sensitive than digital rectal exam for detecting prostate cancer

24. Talk about PSA There are considerations: –There is no normal PSA level The higher the PSA the more likely cancer is present –PSA alone cannot distinguish between cancer and benign prostate conditions –One abnormal PSA does not necessarily indicate the need for further diagnostic tests Benign prostate enlargement, inflammation, infection, age and race can elevate PSA

25. Encouragement Encourage men to get a PSA –African American men 45-70 years old –Men 45-70 years old with a first degree relative with prostate cancer –All men 50-70 years old

27. The biggest myth There is nothing I can do about getting colorectal cancer

28. Colorectal Cancer FACT: colon cancer can almost always be prevented –Colon cancer can almost always be cured if found early About 25% of people 50 and older have colon polyps More than 90% of colon cancer is found in people 50 and older –People of African American or Ashkenazi Jewish ancestry are at increased risk

29. Colonoscopy Encourage men to consider screening colonoscopy –Only test that can prevent colon cancer –Usually painless –Usually needed once every 10 years There are other colon cancer tests –Not as effective as colonoscopy –Any test is better than none

30. Barbers can help increase rates of screening for highly curable cancers Barbers can help decrease rates of mortality from highly curable cancers Barbers can help reduce health disparities in mortality from highly curable cancers Barbers can help save lives!

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