Prevention in Plain Language

Often, an article in the paper or a story on the national news will present a lot of great information about cancer prevention. Sometimes, the information can be confusing, and viewers might have a difficult time pulling out the details in the story that apply to their daily lives in real time. New diets and fitness routines can seem too complicated to begin or maintain, and medical research stories don't make it clear how the new findings apply to individuals' daily lives, so it becomes easy to dismiss the information entirely.

To help you navigate the sometimes confusing messages we hear in the media, we've asked our Director of Cancer Prevention and Outreach, Casey Shelor,to answer a few questions for us. Casey is one of our Certified Health Education Specialists who work in the community of Northwest Arkansas providing education and information in group settings and to individuals.

Q: Recently, reports have shown that more young people are being diagnosed with skin cancer than in previous years. What is causing that trend, and how can it be reversed?

A: Most young people don't equate tanned skin with damaged skin, but that's what is actually is. Dr. Bob Burns, PhD in the Department of Neurobiology and Developmental Sciences at the UAMS College of Medicine explains:

"All skin cancers are caused by unprotected exposure to ultraviolet radiation. Research has proven that the cause of skin cancers is not necessarily related to a lifetime of unprotected exposure to UV radiation, but to unprotected exposure such as sunburns or tanning booth exposures in early childhood/adolescent years. Unprotected exposure in the younger years not only causes the development of skin cancers... these skin cancers develop [faster]."

Avoiding unprotected exposure to UV radiation, both natural and mad-made, would reverse the upward trend of skin malignancies in younger people.

Q: Does ending a smoking habit really make a difference for people who have been smoking for decades? 

A: Absolutely. The benefits of quitting smoking (even if you have smoked the majority of your life) can be seen almost immediately - within 20 minutes! According to the American Cancer Society, after you quit smoking the following are benefits you will see over time:

• 20 minutes after quitting: Your heart rate and blood pressure drop.
• 12 hours after quitting: Your carbon monoxide level in your blood returns to normal.
• 2 weeks - 3 months after quitting: Your circulation improves and lung function increases. 
• 1-9 months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) start to regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs and reduce risk of infection.
• 1 year after quitting: The excess risk of coronary heart disease is cut to half that of a continuing smoker. 
• 5 years after quitting: Risk of cancer of the mouth, throat, esophagus, and bladder are cut in half. Cervical cancer risk falls to that of a non-smoker. Stroke risk can fall to that of a non-smoker after 2-5 years. 
• 10 years after quitting: The risk of dying from lung cancer is about half that of a person who is still smoking. The risk of cancer of the larynx (voice box) and pancreas decreases. 
• 15 years after quitting: The risk of coronary heart disease is the same as that of a non-smoker.

No matter how long you have smoked - 1 year or 50 years - it is never too late to quit. You will see benefits for years to come!

Q: The HPV vaccine is supposed to prevent cervical and other cancers caused by the sexually-transmitted Human Papillomavirus (HPV). But if my children are not sexually active, do they still need to have the vaccine?

A: I would definitely recommend the vaccination to any young female or male. It is actually recommended that to receive the maxiumum benefit from the HPV vaccination, an individual should complete all three doses before sexual activity begins.

The vaccination protects against the types of HPV that cause most cervical cancers. It can be administered between the ages of 9 and 26 years, but the recommended age for receiving the vaccination is 11 or 12 years of age.

Q: If you were recommending just one thing people could do to reduce their risk of being diagnosed with cancer, what would it be? 

A: I would urge people to quit, or never start, using tobacco products. According to the American Cancer Society, tobacco use is responsible for most cases of lung cancer and it increases the risk for cancers of the mouth, lips, nasal cavity (nose) and sinuses, larynx (voice box), throat, esophagus, stomach, pancreas, kidneys, bladder, uterus, cervix, colon/rectum, ovaries, and acute myeloid leukemia.

Cancer can not only increase the risk of being diagnosed with cancer, but is also responsible for at least 30% of all cancer deaths and 87% of lung cancer deaths.


Thanks to Casey for all this great information! Share your cancer prevention-related questions with us and we will post another Q & A in the future based on your questions.

Cancer Prevention: You Can Help

The following information is borrowed from the American Cancer Society's website and is used with permission.  

There are nearly 13.7 million people in America who have survived cancer, and the increasing number of survivors each year is due in large part to ongoing research being performed around the world. Many of you may make monetary gifts to organizations that support cancer research, but did you know there is another way you can help prevent cancer in future generations?

The American Cancer Society's Epidemiology Research Program is inviting men and women between the ages of 30 and 65 years who have no personal history of cancer to join an historic research study - the Cancer Prevention Study 3 (CPS-3). The ultimate goal is to enroll at least 300,000 adults from various racial/ethnic backgrounds from across the U.S. By joining CPS-3, you can help researchers understand how to prevent cancer, which will save lives and give people more of their most precious resource: time.

How Does the CPS Saves Lives?
The American Cancer Society (ACS) first began conducting long-term prospective studies in the 1950s. For these studies, large groups of individuals were recruited through a successful partnership between the ACS researchers and volunteers. The study population provides information (e.g. lifestyle, medical, or behavioral) and then are followed over time to assess their health outcomes and to determine how those outcomes are related to the previously collected exposure data. The commitment of the study participants and the volunteers who recruited them has been vital to the success of these studies.

Past long-term follow-up studies have played a major role in cancer prevention. More than 300 scientific articles by ACS epidemiologists have been published from these studies, significantly contributing to tobacco-related research, and  the understanding of obesity, diet, physical activity, hormone use, air pollution, and various other exposures in relation to cancer and other diseases.

Past American Cancer Society long-term studies include:
Hammond-Horn Study (1952-1955): Included 188,000 U.S. men recruited by 22,000 volunteers. This study was the first large prospective study to examine the effect of cigarette smoking on death rates from cancer and other diseases. This study set the methodologic foundation for the two subsequent Cancer Prevention Studies (CPS-I and CPS-II).

Cancer Prevention Study (CPS)-I (1959-1972): CPS-I included approximately one million men and women recruited by 68,000 volunteers in 25 states. In contrast to the Hammond-Horn Study, CPS-I was designed to address a wide range of potential exposures, in addition to tobacco use, that may increase or decrease cancer risk.

Cancer Prevention Study (CPS)-2 (1982-ongoing): CPS-II includes 1.2 million subjects recruited by 77,000 volunteers in 50 states, Washington, DC, and Puerto Rico. All participants have been followed for over 20 years to determine causes of death. Like CPS-I, this study was designed to address a wide range of environmental and lifestyle exposures that may increase or decrease cancer risk.

CPS-2 Nutrition Cohort (1992-ongoing): 185,000 CPS-II participants from 21 states were enrolled in the new CPS-II Nutrition Cohort, a study designed to better understand how diet affects cancer risk. We periodically mail questionnaires to CPS-II Nutrition Cohort members to update exposure information and follow them for both cancer occurrence and all causes of death. For many members of the CPS-II Nutrition Cohort, biological specimens (blood and buccal (cheek) cells) have also been collected. The CPS-II Nutrition Cohort was designed to address a wide range of potential exposures, behavioral, environmental, and genetic, that may increase or decrease cancer risk.

Results from previous American Cancer Society long-term follow-up studies have demonstrated:

• The link between cigarette smoking and lung cancer
• The significant impact of being overweight or obese on risk of cancer occurrence and death
• The impact of hormones, physical activity, diet, various medications and vitamins, and various other factors in relation to cancer risk
• The impact of air pollution on cardiopulmonary conditions motivating the Environmental Protection Agency to propose more stringent limits on particulate air pollution
• the link between aspirin use and reduced risk of colon cancer
• the link between postmenopausal hormone replacement therapy and various gynecologic cancers (such as breast and ovarian cancer)
• the link between diabetes and cancers of the pancreas and colon
• the link between physical activity and lower risk of various cancers (including breast, colon, and aggressive prostate cancer)

Why a New Study?
Because the current study population (CPS-2) is aging, we must recruit a new study population for the next generation of research. Also, the environment and individuals' lifestyles change over time. New follow-up studies like CPS-3 are needed to understand these changes. We will be studying CPS-3 members for the next 20 to 30 years. This younger study population will have environmental and lifestyle exposures that may be meaningfully different from our previous populations and will help us further advance our understanding of the factors that cause or prevent cancer.

Finally, as we improve our understanding of what causes cancer, CPS-3 will allow us to explore new and emerging hypotheses related to cancer. Through this landmark new study, we will continue our work to eliminate cancer as a major health concern for future generations.

In Northwest Arkansas, connect with the ACS through their Facebook page. Study enrollments are currently scheduled in Fort Smith for April 2-3, and in Benton and Washington Counties in September with specific dates TBA.

Will you sign up? Feel free to share this information with everyone you know - the more people who are involved in the study, the more useful the results will be.

Cancer Prevention: What's on the Horizon?

As early as 2006, we were seeing news articles about the possibility of a vaccine coming to market to fight cervical cancer. At that time, the HPV vaccine was in the final stages of research, and was under review by the FDA. In the summer of that year, the vaccine was approved for girls and young women, and was later approved for males as well. It is now considered a vital tool in the prevention of cervical cancer in men and women, and is as close to being a "cure" as we have seen to date.

Just like those conducted on the HPV vaccine, there are hundreds more clinical research trials being done every day that are investigating the effectiveness of newly developed drugs and procedures. Clinical trials are a vital key to removing the word cancer from "household word" status.

Cancer research trials are conducted for many reasons. Some are simply focused on finding a "cure". Sometimes, these lead to discoveries that were unexpected - such as a medication that was being used to treat one kind of cancer that is then found to be effective on another type, or even another disease altogether. In other studies, researchers may be trying to discover ways to manage symptoms or after-effects of treatment such as "chemo-brain" and post-radiation nerve damage. Trials are also conducted that study the psychological impact of medical treatments and offer new "best practices" for doctors in order to prevent patients from suffering emotional distress during their treatment and recovery.

For a patient, the decision to participating in a clinical trial can be a difficult one to make. Many trials are "double-blind", meaning that the doctor and the patient don't know if the syringe or i.v. of fluid being administered is actually a newly created medication, or a placebo. Entering into that kind of study means placing faith in the importance of the study, not necessarily in any improvement that might be seen by the patient themselves.

There are many benefits to participating in a clinical trial. They offer a level of care that may be a step up from the standard if the treatment you are receiving is found to be effective. Participation can empower a patient and allow them take a lead role in their treatment plan. The psychological effect of this can be beneficial to many patients - feeling "helpless" is a common complaint of cancer patients who are undergoing cancer treatment and request counseling support. Finally, participation in clinical trials allows patients to become part of the important work being done to improve cancer treatment and find cures on a national and global scale. The ongoing legacy of cancer trial participants is significant.

Of course, there can be drawbacks to participation, and patients have to discuss them with their physician as well. There could be side-effects that doctors are not yet aware of. Even if the new treatment has benefits, it may not work on every patient. Health insurance does not always cover all the costs of a research study. New treatments may simply not be any better than the standard of care, which would mean that money spent and side-effects endured may be of no benefit to the individual patient. That's where the ongoing legacy comes in... the more people that are involved in trials, the more quickly the most effective treatment options and cures will be discovered.

More information on clinical trials being conducted in Northwest Arkansas is available on the Highlands Oncology Group website. Their research staff is on the fore-front of the cancer fight and can provide additional information for patients interested in looking at all their treatment options.

Cancer Prevention: Eat to Defeat!

Most of us have the general understanding that some foods are "good" for us and others are "bad". Food, and our relationship with it, has become part of the daily dialogue at work, school, and even on the nightly news. Recent reports say that 1 in 3 adults are considered obese and our kids are following our example and becoming obese themselves.

But even after reading the statistics, it's still difficult for most of us to include enough fruits, vegetables and whole grains in our diets to meet the recommended daily intake and to reduce fats, sugars and empty calories in our meals. You already know that dietary changes can change your body shape and make you "healthier", but would it make a difference in your eating habits to know that some foods may actually help prevent cancer?
 

We mentioned in this month's first blog post that many cancers include "obesity" in their list of risk factors. From the Centers for Disease Control: 

"Research has shown that being overweight or obese substantially raises a person's risk of getting endometrial (uterine), breast, prostate, and colorectal cancers. Overweight is defined as a body mass index (BMI) of 25 to 29, and obesity is defined as a BMI of 30 or higher."

In addition to reducing the risk of obesity, some foods have been found to be beneficial because of health benefits they provide in and of themselves. Antioxidants and phytochemicals in particular have been getting a lot of attention as possible G.I. Joe soldiers in the battle against many diseases, cancer included. There are, in fact, seven "Super Foods" that are recommended for inclusion in any diet being consumed with cancer-prevention in mind. Here's the list, condensed from WebMD:

GARLIC

The same sulfur compounds causing garlic's distinctive odor may also stop cancer-causing substances from forming in your body, speed DNA repair, and kill cancer cells. It also battles bacteria, including H. pylori (connected to some ulcers and stomach cancer), and it reduces the risk of colon cancer. To get the most benefit, peel and chop the cloves and let them sit 15 to 20 minutes before cooking to activate enzymes and release the sulfur-containing compounds that have the most protective effect. Experts say that using garlic supplements does not show the same benefits that the whole cloves do.

BROCCOLI

Many cruciferous vegetables such as cabbage, kale, and cauliflower contain phytochemicals called glucosinolates, which produce protective enzymes that are released when you chew the raw veggie, rupturing the cell walls. Your body also produces those enzymes in the intestines, and they are activated when the raw (or gently cooked) veggies are digested. 

Broccoli and its cousins are most protective against cancers of the mouth, esophagus, and stomach, but research is also being conducted on sulforaphane, another chemical found in cruciferous vegetables that might reduce cancer risk by detoxifying harmful substances (such as smoke and other environmental pollutants) in the body and act as an antimicrobial agent by attacking the bacterium H. pylori.

TOMATOES

The red coloring that makes it easy to spot a ripe specimen also makes them a potential weapon against prostate cancer. That red hue comes from a phytochemical called lycopene, a powerful antioxidant, which is most concentrated in tomatoes. Several ongoing studies suggest that a lycopene-rich diet is connected to a reduced risk of prostate cancer. In laboratory tests, lycopene has stopped other types of cancer cells from growing, including breast, lung, and endometrial (the lining of the uterus). Researchers speculate that lycopene protects cells from damage that could lead to cancer by boosting the immune system and interfering with abnormal cell growth. 

To get the most benefit, eat cooked or processed tomatoes, including tomato juice and pizza sauce. Processing makes the cancer-fighting compounds more available to your body because heat breaks down the plant's cell walls. If you just aren't a fan of tomatoes, you can get a reduced amount of its benefits from lycopene in watermelon, pink grapefruit, or red bell peppers.

STRAWBERRIES

Berries of all kinds have been getting a lot of attention lately. Research points to possible protection against heart disease and memory decline as well as cancer. In a recent study, berry extracts slowed the growth of cancer cells; specifically, strawberry and black raspberry extracts had the greatest impact on colon cancer cells. Strawberries are rich in antioxidants such as vitamin C and ellagic acid. 

 

In laboratory tests, ellagic acid seems to have anticancer properties that rev up enzymes, which destroy cancer-causing substances and slow the growth of tumors. They also contain flavonoids, which suppress an enzyme that damages DNA and has been linked to lung cancer. Other types of berries, all rich in flavonoids, that are worth adding to your grocery basket include raspberries, blackberries, blueberries, and cranberries. Blueberries are packed with anthocyanins, which reduce inflammation and are one of the most powerful antioxidants. Some consider berries and cruciferous vegetables the most powerful protective foods available to consumers.

CARROTS

One of the easiest vegetables eat, carrots are packed with disease-fighting nutrients. They contain beta-carotene, an antioxidant scientists believe may protect cell membranes from toxin damage and slow the growth of cancer cells. Carrots also deliver other vitamins and phytochemicals that might guard against cancers of the mouth, esophagus, and stomach. Some studies suggest carrots protect against cervical cancer, perhaps because they supply antioxidants that could battle HPV (human papilloma virus), the major cause of cervical cancer. Plus, carrots contain falcarinol, a natural pesticide, which has been found to reduce the risk of developing cancerous tumors in lab tests. 

 

Unlike some foods that lose their potency when cooked, carrots (and tomatoes, spinach, mushrooms, asparagus, cabbage, and peppers) experience an increase in their antioxidant levels when exposed to heat.

SPINACH

Maybe you've heard that lutein, an antioxidant, is good for your eyes. Early results of research shows it might also play a role in guarding against cancer. Spinach is rich in lutein and zeaxanthin, carotenoids that remove unstable molecules called free radicals from your body before they damage it. They're found in spinach and other dark green leafy vegetables, and some studies show they could protect against cancer of the mouth, esophagus, and stomach. 

An NIH/AARP study of more than 490,000 people found that those who ate more spinach were less likely to develop esophageal cancer. Some studies suggest the carotenoids in spinach and other foods reduce the risk of ovarian, endometrial, lung, and colorectal cancer, too. Throw in folate and fiber, which researchers think might trim the risk of certain cancers, and you've got nutritional powerhouse in every dark green leaf. Folate helps your body produce new cells and repair DNA, and is especially important for women of childbearing age because it can prevent neural tube defects in a developing fetus. 

You'll get the most lutein from raw or lightly cooked spinach. Enjoy it in a salad, steamed, or sautéed with garlic and olive oil, or stirred into soups. For a change (but reduced benefit), substitute kale, collard greens, Swiss chard, or romaine lettuce.

WHOLE GRAINS

You may have noticed that a lot of foods - even sugary kids' cereals and frozen pizzas - are adding whole-grain components to their ingredients. It's a result of revised federal nutrition guidelines that recommend half of all the grains you eat -- rice, cereal, and even chips -- should be whole grains, not processed. Whole grains deliver plenty of fiber, which has been suspected to reduce the risk of colon cancer. 

Experts are not yet sure how the fiber/cancer connection works, but whole grains also contain other substances that might battle cancer, including lignans, which act as antioxidants, and saponins, which could keep cancer cells from multiplying. Look for bread labeled "100% whole wheat" rather than simply "wheat bread," which likely contains refined grains. For even more lignans, choose a whole wheat bread sprinkled with flax or sesame seeds.

So, now you know WHAT to eat, but do you know how much of these foods makes up a serving? Here's an article that can help. Habits can be tough to break, and family-members' preferences can also present a challenge when trying to add some Super Foods to your diet. Use these tips to make changes to your family's meals in small steps. Remember, small steps may be necessary at first, but they still start you off in the right direction.

The Best Defense is a Good Offense

The Arkansas Department of Health recently published their annual report, Cancer Facts & Figures 2011. It states that cancer remains the 2nd leading cause of death in Arkansas and the United States. The overall estimated cost of cancer in the U.S. in 2010 was $263.8 billion, with the highest costs being assocated with breast, colorectal, lymphoma, lung and prostate cancer. The American Cancer Society (ACS) predicts about 577,190 people will die of cancer in the U.S. this year. That averages out to approximately 1,500 each day. What are you doing to reduce your risk?

Cancers caused by environmental exposures are modifiable and can be prevented. The American Cancer Society estimates that in this country in 2010 approximately 171,000 cancer deaths were related to tobacco use and one-third of the 569,490 deaths were related to obesity and physical inactivity. Deaths from cancers caused by infectious agents, such as Hepatitis B, human immunodeficiency virus (HIV), human papillomavirus (HPV), and Helicobacter pylori (H. pylori) etc. could have been prevented through behavioral changes, vaccinations and antibiotics.

February is National Cancer Prevention Month, so in our weekly posts we'll be taking a closer look at a few specific ways to prevent cancer in yourself and your loved-ones. To get us started, here's a list created by the Mayo Clinic: 

1. Don't Use Tobacco 

Tobacco use is the single greatest avoidable risk factor for cancer mortality worldwide, causing an estimated 22% of cancer deaths per year. Smoking has been linked to various types of cancer — including cancer of the lung, bladder, cervix and kidney — and chewing tobacco has been linked to cancer of the oral cavity and pancreas. Exposure to secondhand smoke may also increase your risk of lung cancer.

Avoiding tobacco — or deciding to stop using it — is one of the most important health decisions you can make. If you are being treated for cancer and need help quitting tobacco, our Certified Tobacco Treatment Specialist, Casey Shelor, can help you find a plan that works best for you. Contact her by email or at 479-361-5847 for a confidential appointment.

2. Eat a Healthy Diet 

Although making healthy selections at the grocery store and at mealtime can't guarantee cancer prevention, a diet heavy in fats and processed foods has been linked to several types of cancer. Consider these guidelines:

• Eat plenty of fruits and vegetables. Base your diet on fruits, vegetables and other foods from plant sources — such as whole grains and beans.
• Limit fat. Eat lighter and leaner by choosing fewer high-fat foods, particularly those from animal sources. High-fat diets tend to be higher in calories and may increase the risk of overweight or obesity — which can, in turn, increase cancer risk.
• If you choose to drink alcohol, do so only in moderation. The risk of various types of cancer — including cancer of the breast, colon, lung, kidney and liver — increases with the amount of alcohol you drink and the length of time you've been drinking regularly. 
  

3. Maintain a Healthy Weight & Include Physical Activity in Your Daily Routine

Maintaining a healthy weight may lower the risk of various types of cancer, including cancer of the breast, prostate, lung, colon and kidney. Physical activity counts, too. In addition to helping you control your weight, physical activity on its own may lower the risk of breast cancer and colon cancer. As a general goal, include at least 30 minutes of physical activity in your daily routine — and if you can do more, even better. Try a fitness class, rediscover a favorite sport or meet a friend for daily brisk walks.

4. Protect Yourself from the Sun

Skin cancer is one of the most common kinds of cancer — and one of the most preventable. Try these tips:

• Avoid midday sun. Stay out of the sun between 10 a.m. and 4 p.m., when the sun's rays are strongest.
• Stay in the shade. When you're outdoors, stay in the shade as much as possible. Sunglasses and a broad-rimmed hat help, too.
• Cover exposed areas. Wear tightly woven, loosefitting clothing that covers as much of your skin as possible. Opt for bright or dark colors, which reflect more ultraviolet radiation than pastels or bleached cotton.
• Don't skimp on sunscreen. Use generous amounts of sunscreen when you're outdoors, and reapply often.
• Avoid tanning beds and sunlamps. These are just as damaging as natural sunlight.

5. Get Immunized
Cancer prevention includes protection from certain viral infections. Talk to your doctor about immunization against:

• Hepatitis B. Hepatitis B can increase the risk of developing liver cancer. The hepatitis B vaccine is routinely given to infants. It's also recommended for certain high-risk adults — such as adults who are sexually active but not in a mutually monogamous relationship, men who have sex with men, and health care or public safety workers who might be exposed to infected blood or body fluids.
• Human papillomavirus (HPV). HPV is a sexually transmitted virus that can lead to cervical cancer. The HPV vaccine is available to both men and women age 26 or younger who didn't have the vaccine as an adolescent.(We covered this subject in detail in our recent post about HPV vaccines.)   

6. Avoid Risky Behaviors

Another effective cancer prevention tactic is to avoid risky behaviors that can lead to infections that, in turn, may increase the risk of cancer. For example:

• Practice safe sex. Limit your number of sexual partners, and use a condom when you do have sex. The more sexual partners you have in your lifetime, the more likely you are to contract a sexually transmitted infection — such as HIV or HPV. People who have HIV or AIDS have a higher risk of cancer of the anus, cervix, lung and immune system. HPV is most often associated with cervical cancer, but it may also increase the risk of cancer of the anus, penis, throat, vulva and vagina.
• Don't share needles. Sharing needles with an infected drug user can lead to HIV, as well as hepatitis B and hepatitis C — which can increase the risk of liver cancer. If you're concerned about drug abuse or addiction, seek professional help.

7. Take Early Detection Seriously

Regular self-exams and professional screening for various types of cancers — such as cancer of the skin, colon, prostate, cervix and breast — can increase your chances of discovering cancer early, when treatment is most likely to be successful. Ask your doctor about the best cancer screening schedule for you.

If you have any questions about these tips, you can contact one of our Certified Health Education Specialists at 479-361-5847.