Cancer 101

1. Cancer 101 Santee Health Fair June 10, 2009

2. Northern Plains Cancer Coalition • Implementing a Cancer Plan with partnership and collaboration • Listen to community needs • Seek resources together • Assist community leaders to implement projects • Flexible for cultural relevance

3. Example Projects • Screening projects • Caregiver workshops • Community grants • Cancer Data Improvement

4. Acknowledgements These slides are adapted from curriculums developed by several agencies including: • “Cancer 101” by Northwest Portland Area Indian Health Board/Cancer Information Service • Screening Curriculum by Walking Forward Program • “Get on the Path..” by Native American Cancer Research

5. Audience Response System (ARS) The Keypads

6. Turning Point Keypads These are NOT calculators and need to be returned to the faculty at the end of the session please

7. Audience Response System (ARS) – keypads 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)

8. Audience Response System (ARS) – keypads 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

9. Audience Response System (ARS) – keypads 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

10. Demographic items(TP)

11. Please Choose the Answer that Best Describes Your Gender. Male Female Don’t want to answer 13 of 52 gender2

12. About How Old are You? 81 and older 65-80 50-64 41-49 31-40 21-30 13-20 Under 12 Don’t want to answer 13 of 52 brthyr5

13. What is Your Primary Race or Ethnicity? American Indian / Alaska Native (AIAN) Pacific Islander Asian African-American Non-Hispanic white (Caucasian) Hispanic / Latino / Chicano Don’t know / Don’t want to answer 13 of 52 Race-ethn3

14. How Much Schooling have You Completed? 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 0 of 52 Educ3

15. Which of the Following Bests Describes You? Community leader Community member Student Teacher / Faculty Researcher / Scientists Healthcare provider (MD, RN, etc.) Outreach recruiter Cancer patient, survivor Other Don’t know / Don’t want to answer 13 of 52 Role2

16. Pre-Education Knowledge

17. 12 of 52 What is true about benign tumors? • They are probably cancerous • They will not spread to other parts of the body • They are difficult to treat • They are difficult to detect at early cancer stages • Don’t Know/Not Sure

18. 13 of 52 At what age should Native women who are at “normal” risk for breast cancer get their first mammogram? • 15 years of age • 25 years of age • 40 years of age • 50 years of age • Don’t know / not sure

19. 13 of 52 How do most colon cancers begin? • Bad Diet • Lack of Exercise • Inherited from Mother or Father • Polyp • Don’t know / Not sure

20. 12 of 52 Which of the following is true about Pap Tests? • All girls/women should begin Pap Tests at age 16 • Getting a Pap Tests can help prevent you from getting cervical cancer • Elder women no longer need to get Pap Tests after they have gone through menopause • Women should get a Pap Test once every 5 years • Girls who have had the HPV Vaccine no longer need to get a Pap Test • Don’t know/Not Sure

21. 13 of 52 What is the name for the test that screens for Prostate cancer? • PSA • FOBT • Mammogram • Colposcopy • PCS

22. The Cancer Journey

23. A Cancer Journey Sarah Allman (Oglala Lakota) “I didn't have anything [symptoms], except I had bladder infections, so I went in for that. Then [the doctor] said I should have a [Pap test]. I didn't have anything though [based on what the doctor could see]… and in a few days my doctor called and said I had to come in for a visit. Then I went into the hospital and had my surgery [for cancer of the cervix]. [That was in 1970]

24. A Cancer Journey Sarah Allman (Oglala Lakota) [Before I had cancer, I didn't know anything about cancer] Nothing. I just …thought it was a killer, you know. I was always so scared of that word "cancer".... I'm not even scared of that word anymore. I'm just thankful for having twenty-four years of cancer free... No, I just go on, doing my chores. And just have faith in God.”

25. 13 of 52 Do you know someone who has been diagnosed with cancer? • Yes • No • Don’t want to answer

26. 13 of 52 In your opinion, how much of a health problem is cancer in your community? • Very big problem • Somewhat of a problem • A little problem • Not a problem at all • Don’t know/Don’t want to answer

27. Yesterday and TodayNative American Cancer Myths and Facts

28. Cancer Yesterday and Today • Why do you think cancer was less common among our ancestors than it is today? • Cancer was very rare among our ancestors, even those who lived to very old ages • Today, cancer is the 2nd leading cause of death for Native Americans

29. Cancer Yesterday and Today • Like our ancestors, we need to • Practice healthy habits like having daily physical activity • Eat more home-cooked and traditional foods, rather than “fast foods” from drive-through restaurants. • Have regular health checkups • Have regular screenings that look for cancer

30. Native American Cancer Facts • Many cancers are more common among Native Americans living in the Northern Plains than other parts of the country • Native Americans living in the Northern Plains are less likely to survive cancer than non-Natives in the same region

31. 12 of 52 How afraid of cancer are people in your community? • Not at all • A little • Somewhat • A lot

32. Native American Cancer “Myths” Myth: There is nothing I can do about getting cancer. • Reality: Many common types of cancer are preventable. • Lead healthy lifestyles (diet and exercise) • Stop commercial tobacco use • Reduce alcohol use • Get screening tests that can remove pre-cancerous cells (Cervical and Colon cancer) • Vaccination for Cervical Cancer

33. Native American Cancer “Myths” Myth: Cancer is usually fatal. • Reality: Many cancers are curable if detected early. • Colon Cancer example • 91% of patients with localized cancer are alive 5 years after diagnosis. • BUT-only 37% of patients are diagnosed at this early stage. Thank you Claudia Christensen, FNP, ANMC

34. Native American Cancer “Myths” Myth: You only need to have health screenings if you are having symptoms. • Reality: Since symptoms are often silent, it is important to have regular screenings. • Breast, Colon, Cervical, Prostate • Know your body!

35. QUESTION: Why don’t some people like to talk about cancer? • Some Native Americans think if they talked about it, they are “inviting” the disease into their body • The word, “cancer” has too many bad feelings and beliefs • Sometimes we just don’t know how to talk about it

36. QUESTION: Why is it “Hard” for some to talk about Cancer? • Embarrassed • Ashamed • Afraid • Shy (male/female cancers) • Uneasy with providers (male/female)

37. What is “cancer”?

38. What Is Cancer? • The term “cancer” refers to more than 100 different diseases that begin in the cells

39. What is a “cell”? • Cells are the body’s basic unit of life • All humans start out from 2 cells combining • One from the mother is the “egg” • One from the father is the “sperm”

40. What Is Cancer? • Cancer develops when cells become damaged and grow and form more cells without order or control. • Under normal circumstances, new cell growth and old cell death are kept in balance. • In cancer, this balance is disrupted.

41. Benign versus Malignant Tumors Malignant (cancer) cells invade neighboring tissues, enter blood vessels, and metastasize to different sites Benign (not cancer) tumor cells grow only locally and cannot spread by invasion or metastasis

42. Cancer Screening and Prevention

43. 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).

44. Cancer Screening andEarly Detection • Awareness of body changes may help detect early signs of cancer • Examples of changes to note: - Breast tissue - Testicular tissue

46. Cancer Screening and Prevention • Medical screening tests are effective tools of early detection of cancer • Some of the most common types of cancer have specific tests that aid in detecting cancer

47. Cancer Screening and Prevention Screening tests for common types of cancer: • Breast – Mammogram, Clinical Breast Exam • Cervix - Pap Test • Colon - Fecal Occult Blood Test (FOBT), Colonoscopy, Flexible Sigmoidoscopy • Prostate – Prostate Specific Antigen (PSA) and Digital Rectal Examination (DRE) Source for screening guidelines for this module: American Cancer Society. http://www.cancer.org/docroot/ped/content/ped_2_3x_acs_cancer_detection_guidelines_36.asp

48. Breast Cancer Screening

49. The Mammogram • A mammogram is an x-ray picture of the breast. It can find breast cancer that is too small for you or your provider to feel. • Studies show that if you are in your 40’s or older, having a mammogram every 1 to 2 years could save your life.

50. Why do I Need a Mammogram Every 1-2 years? • As you get older, your chances of getting breast cancer get higher. • Cancer can show up at any time -- so one mammogram is not enough. • Decide on a plan with your provider and follow it for the rest of your life.