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Native Cancer 101 Module 10 “Prevention and Early Cancer Diagnosis (Screening)” Sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605].

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  1. Native Cancer 101 Module 10 “Prevention and Early Cancer Diagnosis (Screening)” Sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  2. Curricula based on excerpts from “Get on the Path to Health”Breast, Cervix, Colon, Lung, and ProstateNative American Cancer Research Corporation 3022 South Nova Road Pine, CO 80470-7830 Phone: 303-838-9359; 1-800-537-8295 http://www.NatAmCancer.org Presented by: Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  3. Please turn off your cell phones or switch them to “vibrate” mode Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  4. Audience Response System (ARS) The Keypads Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  5. Turning Point Keypads Lanyard that goes around your neck These are NOT calculators and need to be returned to the faculty at the end of the session please Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  6. We want to ask a few questions that will let us know a bit about you We will be using keypads to gather the information You press the number on the keypad that best describes your answer (use “0” for “10” on the keypad) No identifying information will be collected (this is why there is no consent form) Audience Response System (ARS) – keypads Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  7. This is how we vote on different items and issues Although the keypads are “anonymous” (we don’t know who uses which keypad); but we would like you to use the same one throughout the workshop You do not need to “point” the keypad (like a TV remote control) You will see a counter on the screen that shows how many people have “voted” on any item Audience Response System (ARS) – keypads Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  8. A top bar appears and the upper right-hand box needs to be “green” before you vote. You can change your vote up until the final vote has been collected and the slide advances A summary of bar graphs appears on the screen after the votes are completed for most items so that everyone can see the total tallies The summary bar graph will not appear for pre-workshop knowledge items or workshop satisfaction Audience Response System (ARS) – keypads Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  9. Demographic 5 items(TP) Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  10. Male Female Don’t want to answer Please Choose the Answer that Best Describes Your Gender. Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605] gender2

  11. 81 and older 65-80 50-64 41-49 31-40 21-30 13-20 Under 12 Don’t want to answer About How Old are You? Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605] brthyr5

  12. What is Your Primary Race? American Indian / Alaska Native (AIAN) Pacific Islander Asian African-American Non-Hispanic white (Caucasian) Other Don’t know / Don’t want to answer

  13. Are you Hispanic, Latino or Chicano? • Yes • No • Don’t Know / Not sure • Don’t want to answer

  14. Elementary (kindergarten through grade 6 / grade school) 7th , 8th , or 9th grade (middle school) 10, 11, or 12th grade (no degree) High school graduate / GED Technical school /apprentice training Some college (no degree) College AA degree College BA, BS degree Masters’ degree Doctorate or more How Much Schooling have You Completed? Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605] Educ3

  15. Pre-workshop Health Knowledge9 items

  16. WIRB approved –What is the primary risk factor for breast cancer? • Being younger than 50 years of age • Being a woman • Having only one child • Having a family member with breast cancer • Don’t know / not sure

  17. WIRB approved –Which statement is true about inherited forms of breast cancer? • They cause 5-10% of all breast cancers • They only occur in older women • The only factors involved are diet and lifestyle habits • The cancer risk is not passed from a parent to a child • Don’t know/not sure

  18. WIRB-ApprovedWhen should females start having Pap tests? • Within 3 years of her first sexual intercourse • Beginning at age 25 • After she has her first child • Before she receives her first HPV vaccine • Don’t know / Not sure

  19. WIRB-ApprovedWhich is TRUE about HPV? • The HPV vaccine only works in females • Most women (90%) have no symptoms when they are infected with HPV • Women who only have sex with one partner are not at any risk for HPV infection • Women who have given birth and want no more children are not at risk for developing HPV infections • Don’t know / Not sure

  20. WIRB approved:Which colon screening test is probably the most accurate? • Fecal Occult Blood Test (FOBT) • Flexible sigmoidoscopy • Colonoscopy • They are equally accurate • Don’t know / not sure

  21. WIRB approved:Which is TRUE about early warning signs of colon cancer? • Orange rind texture of skin on the stomach means the cancer is advanced • The belly button protrudes is one of the earliest common symptoms • Hot feeling in the lower stomach area is the most common symptom • Most people have no symptoms • Don’t know/Not sure

  22. WIRB ApprovedWhat percentage of lung cancer is caused by habitual cigarette smoking? 30% 50% 70% 90% Don’t know / Don’t want to answer 0 / 175

  23. WIRB Approved Habitual cigarette smoking causes what percentage of all types of cancer? 30% 50% 70% 90% Don’t know / Don’t want to answer 0 / 175

  24. Which is TRUE about prostate cancer? • Prostate cancer is more common among AIs living in the Southwest than among those who live elsewhere. • Prostate cancer has usually spread to other parts of the body by the time of diagnosis. • People who are 50 and older need to be screened even if they have no symptoms. • Prostate cancer is significantly more common among women than among men. • Don’t know / Not sure

  25. “Get on the Path to Health” Early Detection and Cancer Screenings for: • Breast • Cervix • Colon • Lung • Prostate Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  26. Objectives: • Identify at least 2 factors that increase your risks for developing cancers • Identify benefits of taking part in early detection screening services • Identify at least 2 ways to sign up for screening. Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  27. Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605] Indian Health Service, Regional Differences in Indian Health, 2002-2003. Data from 1999-2001

  28. Breast Health Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  29. The shield in these slides represents your protection against things that may make you more susceptible to cancer (i.e., cancer risks) The larger the holes and the more number of holes in the shield, the less likely it is to protect you from cancer or other health problems Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  30. Breast Cancer risks that “damage” her shield of protection include: • Being a woman • Growing older • Personal history of breast cancer • Personal history of another type of cancer • Hereditary risk (e.g., BRCA1, BRCA2) • Family history • Sedentary life style • Over recommended body weight by 15-20 pounds (high fat / calorie diet) • Drinking equivalent to more than 7 alcoholic drinks in a week • No birth children • No breast feeding longer than 1 year • Tobacco use (store-bought) Being female is the “biggest” risk! Only 5-10% of all breast cancers are inherited Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  31. How Can I Help Myself? 1. By age 18, do monthlyBreast Self-Exams, so you can become familiar with your own breasts. • Have your health provider perform a Clinical Breast Exam during your annual checkup. • Have your annualmammogramif you have symptoms or high risk, or at least when you are 40 years old Clinical Breast Exam Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  32. “Know your lumps” • Need to get lumps checked by a healthcare provider • Cannot diagnose yourself • Even if diagnosed with cancer, you do not know if it is cyst, fibrous tissue or fatty tumor, cancer tumor • Cannot let fear paralyze you … take action! Breast Self-Exam Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  33. “Know your body” Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  34. How Can I Get A Mammogram? • Your doctor may recommend that you have one • You can also ask your doctor to send you for a mammogram if you have symptoms • Local health department or programs Mammogram Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  35. Cervix Health Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  36. Cervix Cancer risks that “damage” her shield of protection include: • Early Age At First Intercourse (16 Years Old Or Younger) • More Than 5 Different Sexual Partners In Your Whole Life • Having Sex With Partners Who Have Had Many Sexual Partners • Sexually Transmitted Diseases (HPV -Human Papilloma Virus) Which May Also Cause Genital Warts • Herpes Virus • HIV Infection • Exposure To Cigarette Smoke (Smoking And Second Hand Smoke) • Giving Birth To More Than 4 Children • Long Term Use Of Oral Contraceptives • Diets Low In Carotene, Vitamins C And E

  37. How Can I Help Myself? Avoid HPV Infection! • 100 types of human papillomavirus (HPV) • Only about 12 types cause cancer of the cervix • HPV16 and HPV18 found in most cervix tumors • Both of the current HPV vaccines include HPV types 16 and 18 • Most women have no noticeable symptoms • Some women get genital warts • Most may not even know they have it Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  38. How Can I Help Myself? Avoid HPV Infection! • Limit number of sexual partners • Most people will get HPV if they have more than 5 sexual partners in their lifetime • Sexual partners are likely to share the same HPV type - both partners need to be treated. (Men also at risk for other cancers; can get vaccine) • Use condoms • HPV may be present on skin not covered by a condom = transmission is possible. Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  39. How Can I Help Myself?HPV (Human Papillomavirus) • The HPV vaccine is likely to eliminate most Cancer of the Cervix, but it is not a cure-all • Talk with you provider about whether or not the HPV vaccine is appropriate for you • Females still need to practice good behaviors that help prevent Cancer of the Cervix Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  40. How Can I Help Myself? • Get a Pap test every year or as often as your provider suggests • If you have a sexually transmitted disease (STD), get treatment • Do not use manufactured tobacco habitually and reduce your exposure to second hand smoke Excerpt from Get on the Path for Health, Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  41. QUESTION: What are Pap Tests? • The Pap Test can tell if you have abnormal cells or cancer of the cervix early, while it is still easy to cure • The test is done during a pelvic examination by a trained provider in a health clinic or medical screening van Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  42. Who Needs To Get A Pap Test? • All women once they are 18 years old • All women who are having sex, regardless of age (may need it earlier than age 18) • Young girls who were molested / raped Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  43. Who Needs To Get A Pap Test? • Women need to continue having an annual test throughout life. • Unless you have had 3 “normal” Pap tests in a row within the most recent 5-year period • Your provider may recommend that you have a Pap test every 3 years Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  44. Who Needs To Get A Pap Test? • Many American Indian women quit having Pap Tests after their childbearing years • But women beyond their childbearing years need Pap Tests too, including women who have gone through the change of life (menopause). Dominga Rosetta Santo Domingo Pueblo Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  45. Colon Health Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  46. Who Develops Colon Cancer? • Anyone can develop colon cancer • Cancer knows no prejudice • It is found in all racial groups • Both men and women develop colon cancer • But, your chances of developing cancer increase as you grow older • Cancer develops over time: • It is a result of a complex mix of factors related to: • Lifestyle (daily behaviors) • Environment • Heredity/genetics Called “risk factors” Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  47. Colon Cancer risks that “damage” the shield of protection include: • Personal history of polyps in colon • Growing older • Personal history of colon cancer • Personal history of another type of cancer • Alaska Native / No. or So. Plains • Hereditary risk (e.g., HNPCC, FAP) • Family history • Personal history of colon problems • Sedentary life style • Habitual tobacco use • Diabetes • Diet (low fiber/ folic acid) • Over recommended body weight by 15-20 pounds (high fat / calorie diet) • Drinking equivalent to more than 7 (F) / 14 (M) alcoholic drinks in a week • For post-menopausal women, not taking hormonal replacement therapy

  48. Polyps (paul-lips) • Most polyps are “benign” • Some polyps are pre-cancerous and may gradually develop into cancer • Others never become cancer • Polyps may be very small (tiny dot) to fairly large (size of a walnut) • Polyps can be surgically removed to help prevent problems • Having polyps may be the most common risk factor for CRC Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

  49. QUESTION: How is colorectal cancer diagnosed? • Fecal occult blood testing (FOBT) annually • Flexible sigmoidoscopy (flex sig) every 5 years • Double contrast barium enema with flex sig every 5 years • Colonoscopy every 10 years • Stool DNA (likely to have FDA approval by 2014) Excerpts from Get on the Path for Health curricula from Native American Cancer Research 1-800-537-8295; http://www.NatAmCancer.org; sponsored by Mayo Clinic’s Spirit of Eagles Communities Network Program 2 [NCI1U54CA153605]

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