Ann Jones NHS South Cheshire CCG

1. Ann JonesNHS South Cheshire CCG Saving Lives Together

2. What’s behind the campaign nationally? • NHS Cancer Strategy/5 Year Forward View • Saving lives through early diagnosis • Helping people to live better, longer with and beyond cancer • Improving services alongside value for money • What is ‘Action on Cancer’ all about? https://www.england.nhs.uk/wp-content/uploads/2016/05/cancer-strategy.pdf What are we doing locally? • Out and about, involving local people in many ways • Raising awareness, getting people talking and acting early • Cancer Strategy lists 8 specific actions to achieve by 2020 • Improved health education about what we can each do • Fewer people diagnosed with preventable cancers • More people surviving after diagnosis • More people having a positive experience of care & support • More people enjoying a better long-term quality of life

3. Let’s Talk about Cancer • What does cancer mean?

4. Unpleasant Treatments Talking about cancer is embarrassing I’m still me, I still want everyone to treat me like they did before I got cancer, I haven’t changed • Talking about Cancer .. • Can be painful and traumatic Pain There is nothing I can do about cancer Why? Hospital Family grief Fear • Its not fair on my family and friends to feel my burden “Cancer is the best song we have ever written. Every time I hear it I have to try to hold back the tears” Hair Loss How Long have I got? Cancer is a dirty word DEATH

5. Incidenceof Cancer isIncreasing An estimated rise of 2% per year - that’s 742 per every 100,000 people by 2035 In 2014, there were 360,700 new diagnoses within the UK (CRUK)that’s 980 cases diagnosed every day. During 2015 in England alone there were 299,923 (ONS) Source: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html

6. Some local cancer facts Source: CRUK; http://www.cancerresearchuk.org/cancer-info/cancerstats/local-cancer-statistics/?location-name-1=NHS%20Vale%20Royal%20CCG&location-1=02D&location-name-2=NHS%20South%20Cheshire%20CCG&location-2=01R

8. Good News Source: CRUK; http://www.cancerresearchuk.org/cancer-info/cancerstats/local-cancer-statistics/?location-name-

9. How it starts • Healthy cells become damaged • DNA doesn’t copy correctly • Abnormal cells multiply • What is Cancer?

10. How it grows • What is Cancer? Damaged cells begin to form tumours Tumours break through normal cells.

11. Stage 1 small and contained Stage 2 larger but still within original tissue Stage 3 growing into surrounding tissue areas and lymph nodes • What is cancer? -Stages 1 2 3 4 • Stage 4 spreading from original source into other organs (secondary or metastatic) • Source: Read more at http://www.cancerresearchuk.org/about-cancer/what-is-cancer/stages-of-cancer#xCqJps5AZq9SPPMj.99

12. Signs & symptoms of cancer • - most common • Persistent heartburn or indigestion • Unexplained vaginal bleeding • Croaky voice or hoarseness • Mouth or tongue ulcer that won’t heal • Jaundice • New mole or changes to a mole • Changes in bowel habits (eglooser poo) • Blood in your pee or poo • Persistent cough Breathlessness • Unexplained weight loss • Heavy night sweats • Coughing up blood • Unusual lump or pain anywhere • Unusual breast changes • Unexplained pain or ache • Post-menopause vaginal bleeding • Problems peeing Difficulty swallowing • Prolonged tiredness, no energy • Persistent bloating • Sore that won’t heal

14. Breast / Prostate/ Lung/ Colorectal (bowel and rectum) • Types of Cancer – Most common http://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence/common-cancers

15. Exposure to Radon Gas or harmful chemicals • Mesothelioma – asbestos related • 8 out of 10 smoking • Older people • COPD (emphysema) • Types of Cancer - Lung • Common lung cancer symptoms • A cough that doesn’t go away after 3 weeksor a noticeable change in your persistent cough • Coughing up blood • Breathlessness which you can’t explain • Loss of weight for no obvious reason • Unexplained tiredness, lack of energy for some time • Hoarse voice; Persistent chest infections • Chest and/or shoulder pains without explanation

16. Breast Cancer is the most common cancer in the UK affecting 1 in 8 women in the UK • Types of Cancer - Breast • Rare in males • Females over 55 more at risk • Genetic links • Hereditary gene • Recurrence Common breast cancer symptoms • Lumps or thickened skin within the breast area or swellings under the armpit • Changes to size, shape or feel of the breast • Dimpling of the breast skin • Nipple changes shape or becomes inverted • Unusual or bloody discharge from the nipple • Unusual rashes around the nipple or surrounding area Source: https://www.breastcancercare.org.uk/about-us/media/press-pack-breast-cancer-awareness-month/facts-statistics

17. Prostate cancer is the most common cancer in men • 1 in 4 black men • Over 330,000 live with it • Genetic and hereditary links • 1 in 8 men UK • 470,000 every year • Over 50 • Types of Cancer - Prostate Common prostate cancer symptoms • Difficulty passing pee or holding back • Peeing more frequently, especially at night • Weak/interrupted flow of pee • Painful burning sensation • Difficulty having an erection • Painful ejaculation • Blood in pee or semen • Frequent stiffness in the lower back, hips or upper thighs Source: Prostate cancer UK,; Prostate Cancer Foundation

18. Types of Cancer - Bowel Bowel cancer is cancer of the colon or rectum • 40,000 new cases annually • 1 in 20 people • Over 50s more common • 43% of cases, aged 75+ • Common bowel cancer symptoms • Blood in poo • Change to normal bowel habits • GP finds lump in your tummy (abdomen), or your back passage on examination • Straining feeling in back passage • Weight loss • Pains in tummy or rectum

19. Over 200types…..5main groups: • Carcinomas: skin & tissues covering body & internal organs • Types of Cancer – groups • Primary cancers are usually named after the part of the body where the cancer originates • Brain Tumours: and central nervous system • Lymphomas: immune system • Sarcomas: bone, cartilage, fat, muscle or blood vessels • Leukaemias: blood and bone marrow related

20. Some secondary cancers are detected before the primary cancer. Tests will be carried out to find the source, but this isn’t always possible • Primary Cancer / Secondary Cancer A cancer that spreads to other parts of the body but originates from a primary cancer • A secondary cancer is also called a metastasis. • It is usually named after the primary cancer

21. Stacking the odds in your favour… • In the last 5 years, more than 750,000 cancers in the UK could have been prevented

22. What’s in a Cigarette?

23. Smoking can cause at least 14 Cancers

25. Being Overweight/Obesity linked at least 13 cancers Overweight and obesity causes around 22,800 cancer cases in the UK every year – the next biggest cause after smoking Source CRUK

27. Unhealthy Diets can increase the risk of 6 Cancers

29. Being Physically Inactive could cause at least 3 Types of Cancers

30. Tips for Getting Active • Find your local walking for health scheme • Try to fit walking into your daily routine • Break up sitting time by getting up regularly and walking round the office • Have fun in a local green space with your family and friends • Check out your local swimming pool or leisure centre for a new activity • Footballer in the past? Walking football is fun! • Think about an activity you enjoyed in the past and consider re-starting

31. Check skin regularly, include hard to see places (getting someone you trust to look) • Any change to a mole or skin area should be investigated • Sunbeds and UV lamps can also cause skin cancer • Around 13,500 diagnosed each year (UK) • 5th most common cancer UK (4 x higher 1970s) • Fastest growing cancer in Central Cheshire – up by 167% since 2001 • 2nd most common cancer in the under 50s

32. What is so important about early diagnosis?

33. FACTORS AFFECTING EARLIER DIAGNOSIS Primary care delays Lack of primary care access to diagnostic investigations Poor communication between primary and secondary care Barriers to secondary care referral Lack of clarity around cancer screening Public Education re Prevention Patient delay Not being aware of early signs and symptoms

34. Screening • National screening programmes Breast screening test - Mammography Women 47 to 73 every 3 years Invitation through GP surgery Women 73+ can request screening via GP Cervical screening test – Smear test Women 25 to 64 in England Every 3 years up to 49, then every 5 years to 64 Invitation through GP surgery Bowel screening test – new FIT test (Faecal immunochemical test) Men & women 60 to 74 Every 2 years by Postal testing kits – just 1 sample needed for this new test Age 55 – one off invitation for bowel scope (programme being gradually rolled out over our area) If someone wants a replacement kit, they can just call the Bowel Screening Service 0800 707 6060

35. Our Key Messages

36. What positivelycould YOU do next? • Start by thinking of yourself • Share the key Action on Cancer campaign messages • Help to raise awareness in your local community • Encourage people with symptoms or concerns to visit GP • If you know someone who’s been invited to screening for bowel, breast or cervical cancer, encourage them to do it • Just TALKand encourage friends & family to TALK! Hmmm. How can I reduce my cancer risk? @AoCCheshire