Cancer Prevention

1. Cancer Prevention You Can Make a Difference in Your Own Health Prevention Department January 2011

2. Discussion Outline • What is cancer? • Myths about cancer prevention • What is prevention? • Importance of prevention in cancer control • Cancer and other chronic diseases • Cancer risk factors • Cancer prevention recommendations • What can I do as an individual? • Early warning signs of cancer 1

3. What do you think about when you hear the word “cancer”? 2

4. What is Cancer? 3

5. Where do you think cancer occurs most commonly in men and women? Men Women 4

6. Cancer Statistics • In Canada in 2010: • an estimated 173,800 new cases of cancer • an estimated 76,200 deaths from cancer • In Saskatchewan in 2007: • 8,447 new cancer cases were diagnosed (includes non-melanoma skin cancers) • 2,236 people died of cancer

7. Cancer Projections • Globally by 2020: • more than 16 million new cancer cases • over 10 million cancer deaths per year • In Canada over the next 30 years: • ~ 6 million Canadians will develop cancer • ~ 3 million Canadians will die from cancer

8. What are some of the myths about cancer or cancer control that you have heard? For example, myths that you have heard from your family, friends, co-workers, community members, etc. 7

9. Myths About Cancer Control • Everything causes cancer… • We are sitting ducks just waiting for cancer to happen… • There is nothing we can do about it… • Finding a cure is our only hope… 8

10. … the function of protecting and developing health must rank even above that of restoring it when impaired … (Hippocrates, born in 460 BC) 9

11. What is Prevention? • Approaches to prevention: • Primary • Secondary • Tertiary 10

12. No matter what advances there may be in high-technology medicine, any major reduction in deaths and disability from cancer will come from prevention, not from cure. (The Cancer Atlas, ACS, 2006) 11

13. Cancer Control • Prevention, screening, surveillance, treatment, supportive care and research • Prevention is an essential component of all cancer control plans • Prevention has the potential to have the greatest impact on the health, social and economic burden of cancer

14. Human behaviours or lifestyles such as, smoking, poor diet, tanning, and sexual activity play a significant role in the development of cancer. Do you believe this to be true or false? Why? True

15. Research Shows … • 85% of lung cancer cases are a result of smoking • Smoking is responsible for 30% of all cancer deaths • 20 – 25% of all cancers are linked to food, nutrition, physical activity, and obesity

16. Convincing Evidence Compelling association of  risk: • Tobacco misuse – lung, pancreatic, kidney, esophageal cancers • Obesity – colorectal, breast, pancreatic, kidney, esophageal, endometrial cancers • Physical inactivity – colorectal cancer • Alcohol consumption – colorectal, breast, esophageal cancers World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective. Washington DC: AICR; 2007. 15

21. Cancer Remains a Disease Where Human Behavior Plays a Significant Role • The Harvard Report on Cancer Prevention estimated that 50-75% of cancer mortality in the US was related to human behaviors including: • tobacco misuse • lack of physical activity • overuse of alcohol • diet • overexposure to sunlight • sexual activity • Modification of these exposures and behaviors is the focus of cancer prevention and control Colditz G, DeJong W, Hunter D, Trichopoulos D, Willet W. Harvard report on cancer prevention. Volume 1: Causes of human cancer. Cancer Causes & Control1996 Nov; 7 Suppl 1:S3-S58. 20

22. Environmental factors such as, geographical location and dietary patterns play a significant role in the development of cancer. Do you believe this to be true or false? Why? True

23. Environmental Factors 22

24. Cost-Effectiveness • SunSmart – Australia •  rates of melanoma & non-melanoma skin cancers •  use of hats and sunscreens •  in sunburn and people’s desire for a tan • $2.32 net savings for every dollar spent • California Tobacco Control Program • $86 billion saved in health care costs from 1989 to 2004 • 50 times the rate of return on the expense of the program at $1.8 billion in 2004 dollars

25. Role of Prevention is Crucial • Current healthcare spending is not sustainable... • Prevention is cost-effective… • At least 50% of cancers are due to preventable factors and only ~10% are due to heredity… • Modifiable risk factors…such as smoking, poor diet, inactivity, and obesity have the greatest bearing… also sun/ultraviolet radiation exposure and occupational and environmental carcinogens • Requires a new approach / new way of thinking… 24

26. Cancer & Other Chronic Diseases

27. Risk Factors • Non-modifiable risk factors • Age, gender, ethnicity, genetics • Modifiable risk factors • Change at the individual level • Change at the population level

28. What do you see?

29. According to Canada’s Food Guide, what is the recommended number of servings of fruits and vegetables daily for females age 19 to 50 years? • 4 servings • 5 to 6 servings • 7 to 8 servings • 8 to 10 servings • I don’t know

30. Food and Nutrition

31. What are some good alternatives to meat that will help you get enough protein in your diet? • Fish • Beans • Eggs • Peanut butter • All of the above

32. Food and Nutrition

33. “You don’t have to cook fancy or complicated masterpieces; just good food from fresh ingredients.” Julia Child, chef, author and teacher (1912-2004) 32

34. What do you see?

35. Canada’s Physical Activity Guide recommends that adults add physical activity into their daily life by including how many minutes of moderate physical activity every day (e.g., walking, biking, yard work)? • 30 minutes • 30 to 60 minutes • 60 minutes • I don’t know

36. Physical Activity

37. Maintain a Healthy Body Weight

38. What do you see?

39. Tobacco Reduction/Cessation • Tobacco misuse and exposure to tobacco smoke increase cancer risk • Tobacco misuse is a behaviour which can be modified to reduce cancer risk • Canadian Cancer Society Smoker’s Helpline • 1-877-513-5333 • www.smokershelpline.ca • PACT (Partnership to Assist with the Cessation of Tobacco) & TAR (Tobacco Addiction Recovery) • www.makeapact.ca

40. Health Benefits of Quitting Tobacco • Within 1 minute – body begins to cleanse itself of tobacco poisons • Within 8 hours – carbon monoxide levels in the body decrease, oxygen levels in the blood increase • Within 48 hours – sense of smell and taste improve • Within 2 weeks to 3 months – lungs work better making it easier to breathe

41. Health Benefits of Quitting Tobacco • Within 6 months – coughing, sinus congestion, tiredness and shortness of breath improve • After 1 year – risk of a smoking related heart attack is reduced by half • Within 10 years – overall risk of an ex-smoker dying from lung cancer is cut in half • Within 15 years – risk of dying from a heart attack is equal to a person who has never smoked

42. Consuming alcohol increases one’s risk for: • Breast cancer • Colorectal cancer • Liver cancer • Mouth, pharynx, larynx and esophageal cancers • All of the above

43. Limit Alcohol Consumption

44. What do you see?

45. Who is at risk for developing skin cancer? • People with fair-skin • People with dark skin • People with blond or red hair • People with lighter eye colour (blue, green, grey) • Everyone

46. Practice Sun Safety • Seek shade or create your own (umbrellas, trees, canopies, portable tents) • Wear protective clothing; dark, loose and closely woven fabrics to cover your arms and legs • Wear a wide-brimmed hat to shade your face, ears and neck • Wear a broad-spectrum (UVA & UVB) sunscreen with a sun protection factor (SPF) of at least 15 • Wear sunglasses with even shading, medium to dark lenses, and UVA & UVB protection • Remember sun protection when planning vacations to sunny places • Avoid tanning beds; especially youth under the age of 18

47. In Canada, what percentage of all cancers are thought to be linked to infectious agents (e.g., bacteria or viruses such as HPV – human papillomavirus)? • 2 per cent • 7 per cent • 15 per cent • I don’t know

48. Infectious Agents • Human Papillomavirus (HPV) • HPV 16, 18, 33, 39 → Anal, rectal, vaginal and cervical cancers • HPV 5, 18, 17 → Skin cancer • Hepatitis – HBV and HCV • Liver cancer, especially hepatocellular carcinoma • Helicobacter pylori • Stomach cancer • Herpes – Epstein-Barr Virus • Hodgkin’s disease; Non-Hodgkin’s lymphoma • Retrovirus • HTLV-1→ Adult T-cell leukemia/lymphoma • HTLV-2→ Hairy cell leukemia

49. Occupational Exposure • Most common types of occupational cancer: • Lung, bladder and cancer of the mesothelioma (lines the lungs and peritoneum) • Excessive exposure to sunlight is responsible for a higher incidence of skin cancer in farmers and other outdoor workers • CAREX Canada – www.carexcanada.ca

50. Environmental Exposure • Environmental tobacco smoke • Vermiculite insulation • Contains asbestos • Arsenic contaminated drinking water • Arsenic found in the bedrock • Lead contaminated food, drinking water, air, soil, dust and various consumer products • CAREX Canada – www.carexcanada.ca