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. These slides were prepared with help from: -Jessica Gilbertson- Spirit of EAGLES and NCI ’ s Cancer Information Service -Native American Cancer Research www.natamcancer.org

22. Objectives 1.Anatomy 2.Risk Factors for Colorectal Cancer 3.Protective Factors 4.Signs and Symptoms 5.Screening

23. What is the intestinal tract? The intestinal tract is 26 feet long The intestinal tract helps move waste matter (from undigested foods) from the body The colon and rectum are two different sections of the intestinal tract

24. What is the colon? The colon is the latter portion of the intestinal tract (5-7 feet) The left over food products that were not used by the body move from the small intestine to the colon Water is absorbed from the left-over foods while the waste is in the colon

25. What is the colon? Bacteria in the colon break down the food left-overs to create “ waste ” material The colon then moves the left-over waste into the rectum

26. What is the rectum? The rectum is the last several inches of the large intestine The rectum is a storage holder for our body ’ s waste Muscles in the rectum move the stool out of the body through the anus (rectal opening)

27. Colorectal Cancer

28. Why are the colon and rectum important? They provide a way to absorb needed vitamins and nutrients and water from the food we eat. A healthy colon and rectum get rid of waste matter (stool) that is not needed by the body.

29. What is a risk factor? Risk factors are conditions that increase the chance that cancer might occur. The conditions that influence the development of cancer are related to heredity, lifestyle, and the environment.

30. Colon Cancer Normal Colon Colon CancerAdenomatous Polyp Slides Courtesy of Dr. David Perdue

31. Colon Cancer Normal ColonColon CancerPolyp Adenoma-carcinoma sequence responsible for 95% of colorectal cancer Slides Courtesy of Dr. David Perdue

32. Colon Cancer

34. Colon Cancer Incidence Rates 1999-2004 U.S.Southern Plains Northern Plains AIAN All Cancers368.4492.6538.1 Colon Cancer 46.360.272.5 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.

35. Common Colorectal Cancer Risk Factors Age over 50 Colorectal Polyps Family History of Colorectal Cancer Personal History of Cancer

36. Common Colorectal Cancer Risk Factors Ulcerative Colitis or Crohn ’ s Disease Diet Cigarette Smoking Genetic Alterations

37. What is a risk factor? Heredity: This refers to genes that are passed from parent to child. Lifestyle: Some types of cancer are related to how we live. Environment: Some types of cancer are related to where we work and live.

38. What We Can Change Approximately one third of all cancers diagnosed in 2001 were related to nutrition, physical activity and other lifestyle factors. Approximately 30% of all cancer deaths were related to commercial tobacco use* *Source: Ries LAG, Eisner MP, Kosary CL, et al. (eds). SEER Cancer Statistics Review, 1975–2001, National Cancer Institute. Bethesda, MD, 2004 Ries LAG, Eisner MP, Kosary CL, et al. (eds). SEER Cancer Statistics Review, 1975–2001, National Cancer Institute. Bethesda, MD, 2004

39. Learn about Colon Cancer Risk Native American Cancer Research Online Tool: –www.natamcancer.org –Bottom Right “ Free Resources ” “ Colon Cancer Risk Factors ”

40. Healthy Lifestyles and Protective Factors Ways an individual can lead healthy lifestyles: Maintain a healthy weight Physical activity every day Don ’ t smoke or use commercial tobacco Eat healthy foods Limit alcohol consumption

41. Five-Year Survival Rates for CRC by Stage at Diagnosis (1995-2000) Adapted from American Cancer Society. Colorectal Cancer Facts & Figures Special Edition 2005. Atlanta: American Cancer Society, 2005. Adapted from American Cancer Society. Colorectal Cancer Facts & Figures Special Edition 2005. Atlanta: American Cancer Society, 2005. Local spreading Survival rate (%) All stages Stage at diagnosis Regional Distant spreading Stage I and II Stage III Stage IV

42. Cancer Screening and Prevention Screening is checking for cancer in a person who does not have any symptoms of the disease. The goal of early detection is to discover and stop a cancerous tumor before it grows and spreads (metastasizes).

43. Colon Cancer Screening Recommendations All men and women 50 and over should be getting one or a combination of the following Colon/Rectum (Colorectal) cancer screening tests –FOBT yearly –Flexible Sigmoidoscopy every 5 years –Colonoscopy every 10 years –FOBT yearly plus Flexible Sigmoidoscopy every 5 years

44. Fecal Occult Blood Test (FOBT) What is FOBT? Who should do FOBT screening? How often should you have the FOBT?

45. Flexible Sigmoidoscopy What is Flexible Sigmoidoscopy? Who should have this done? How often should you get a Flexible Sigmoidoscopy?

46. Colonoscopy What is a Colonoscopy? Who should have a colonoscopy? How often should you have a colonoscopy?

47. Removal of Polyps Can be done during colonoscopy Doctor removes polyps that may be found Finding and removing polyps may prevent colorectal cancer!

48. MYTH: Because colon cancer is a common disease, most people are already screened for it by their physicians

49. FACT: Despite colon cancer screening recommendations, most Americans are currently not having it done. It's estimated that less than 40% of the population is screened regularly for colon cancer.

50. MYTH: Colon cancer occurs mostly in people with a family history of cancer

51. FACT: About 75% of all new cases of colon cancer occur in people with no known risk factors.

52. MYTH: Colon cancer always causes symptoms that are easily recognized.

53. FACT: Colon cancer may initially have no symptoms at all, or only vague symptoms that are often ignored. A delayed diagnosis can affect chances for successful treatment and healthy survival

54. Colon Cancer Facts Colon screening tests may actually find a growth before it becomes cancer (the test may be preventive!). Early detection is the most important way to control or prevent colon cancer. Both males and females can get colon cancer.

55. Community Screening Navigators Walking Forward 1-800-232-0115, ext. 2305 Eagle Butte, Raylene Miner (605) 391-6256 or (605) 964-8854 Pine Ridge –Dave Lone Elk, (605) 391-6587 Rosebud –Caroline Spotted Tail, (605) 391-6257 Rapid City –Mary Reiner, (605) 719-2317

56. Basics of Cancer Treatment

57. 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

58. 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

59. 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

60. 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

61. 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.

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