Posts Tagged ‘cancer risk factors’

6 Ways to Reduce your Risk of Cancer in the New Year

Walter J. Curran Jr., MD

It’s that time of year when we resolve to start fresh and break old habits, but did you know that some of the most common New Year’s resolutions could also help reduce your risk of cancer? Nearly 1.7 million Americans will be diagnosed with cancer in 2014 and many cases could be prevented by taking steps to decrease risk.

Here are six ways to cut your chances of developing cancer:

  1. Stop smoking or never start: cigarette smoking is the major cause of lung cancer and many other cancers. Doctors recommend you stay away from all tobacco products and byproducts, including second hand smoke. Winship Cancer Institute is offering a step-by-step program developed by the American Lung Association to help you quit. To register, click here.
  2. Watch what you eat and drink: obesity is increasingly proven to be a major risk factor for certain cancers. Eat more fruits, vegetables and whole grains. Limit red and processed meat consumption. Cut down on alcohol consumption; experts recommend no more than two drinks per day for men and one drink per day for women.
  3. Get physical: an active lifestyle is critical for your overall health and well-being, but studies show regular exercise can reduce the risk of a variety of cancers.
  4. Practice sun safety: protect yourself from the harmful effects of ultraviolet radiation by wearing sunscreen with SPF 30 or higher. Tanning beds and sunlamps are also associated with increased risk of skin cancer, so stay away.
  5. Get screened: early detection of certain cancers can make a difference in treatment and recovery. Women at average risk for breast cancer should have a clinical breast exam and mammogram every year starting at age 40. Cervical cancer screening is now recommended every five years for women at average risk between the ages of 30 and 65. Men and women 50 and older should begin screening for colorectal cancer with a colonoscopy or other early detection method approved by a physician.
  6. Know your family history: some cancers run in families, but before you ask for genetic testing, it’s important to know that most cancers are not linked to genes inherited from our parents. Your doctor can help you determine the right course of action.

When it comes to your health, being proactive about reducing cancer risk will help you not just in the New Year but for the rest of your life. What are some ways that you’ve resolved to get healthy this year?

By Walter J. Curran, Jr., MD, executive director, Winship Cancer Institute

About Dr. Walter Curran
Walter J. Curran, Jr. was appointed Executive Director of the Winship Cancer Institute of Emory University in September 2009. He joined Emory in January 2008, as the Lawrence W. Davis Professor and Chair of Radiation Oncology and Chief Medical Officer of the Winship Cancer Institute.

Dr. Curran, who is a Georgia Cancer Coalition Distinguished Cancer Scholar, has been a principal investigator on several National Cancer Institute (NCI) grants and is considered an international expert in the management of patients with locally advanced lung cancer and malignant brain tumors. He has led several landmark clinical and translational trials in both areas and is responsible for defining a universally adopted staging system for patients with malignant glioma. He serves as the Founding Secretary/Treasurer of the Coalition of Cancer Cooperative Groups and a Board Member of the Georgia Center for Oncology Research and Education (Ga CORE). Dr. Curran is the only individual currently serving as director of an NCI-designated cancer center and as group chairman of an NCI-supported cancer cooperative group, the Radiation Therapy Oncology Group.

Dr. Curran is a Fellow in the American College of Radiology and has been awarded honorary memberships in the European Society of Therapeutic Radiology and Oncology and the Canadian Association of Radiation Oncology. In 2006, he was named the leading radiation oncologist/cancer researcher in a peer survey by the journal Medical Imaging. Under Dr. Curran’s leadership Emory’s Radiation Oncology Department has been recently selected as a “Top Five Radiation Therapy Centers to Watch in 2009” by Imaging Technology News. Dr. Curran ranked among the top 10 principal investigators in terms of overall NCI funding in 2010 and among the top 20 principal investigators in overall NIH funding in 2010.

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Lung Cancer: Not Just a Disease of Smokers

Cigarette smoking is the main risk factor for most patients who develop lung cancer; however, some patients who are diagnosed with lung cancer have never smoked a cigarette. Physicians today are seeing more non-smokers and light smokers with lung cancer. Why do these people get lung cancer?

We now understand that exposure to secondhand smoke can cause lung cancer, in fact, even passive exposure to tobacco smoke increases your risk for developing lung cancer. Secondhand smoke is responsible for 3,000 lung cancer related deaths a year in the United States, and there’s a 20 to 30% increased risk of developing lung cancer for nonsmokers living with a smoker. This is why so many cities have passed laws to limit smoking in restaurants, bars and clubs. Many workplaces are also becoming tobacco-free to protect the health of their employees.

Other environmental exposures besides tobacco smoke have been associated with lung cancer including chemicals used in some workplaces, such as asbestos, tar and soot and heavy metals like chromium, nickel and arsenic. There has also been an association with radon gas and lung cancer, especially in people exposed to high levels of radon, such as uranium miners. People who have been exposed to large doses of radiation, like atomic bomb survivors in Japan, also have a higher risk of lung cancer. It is still unclear how much of a factor air pollution plays in developing lung cancer.

Family history can also impact chances of being diagnosed with lung cancer. There is almost a two fold increased risk of lung cancer in a person with a family history and this risk is even higher if more than two relatives in a family have lung cancer. We still have not identified a particular gene that is passed on in these families that makes them more prone to lung cancer; however, at Winship Cancer Institute of Emory University, genetic testing is now given to every patient diagnosed with lung cancer to identify specific mutations in tumor tissue that may inform treatment decisions.

Research has identified genetic mutations in lung cancers from people who have never smoked or are/were light smokers. These mutations are not inherited, rather they originate in the lung tissue and create lung cancer. Interestingly enough, mutations in the epidermal growth factor (EGFR) and ALK genes have been found more frequently in lung cancer patients who never smoked. These patients can be treated with drugs that target these specific mutations.

Researchers at the Winship Cancer Institute are also involved in more extensive genetic testing of tumors to find other mutations that could explain why non-smokers develop lung cancer. Understanding more about these genetic changes and other factors will help us be able to treat all lung cancer, particularly those in non-smokers, with better, more personalized treatments.

About Dr. Pillai:

Dr. Rathi PillaiRathi Pillai, MD, is an Assistant Professor in the Division of Hematology and Medical Oncology. She joined the faculty after graduating from Emory University’s Hematology/Oncology fellowship program in 2013, where she served as chief fellow from 2012-2013. Dr. Pillai earned her medical degree from the University of Texas at Southwestern Medical School and completed her residency in internal medicine at Emory University. She is a member of the American Society of Clinical Oncology, American Association for Cancer Research, Eastern Cooperative Oncology Group, International Association for the Study of Lung Cancer, and the American College of Physicians. Dr. Pillai’s research interests are in novel therapies in lung cancer, including PD-1 targeted agents, and phase I drug development.

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On November 15 – Commit to Quit

Great American Smokeout - Quit Smoking November 15You’ve heard the health tips a million times: exercise regularly, eat a healthy, balanced diet, and limit alcohol consumption. And the most frequently recommended tip to improve overall health and prevent disease? Don’t smoke.

Tobacco use continues to hold the top seat as the single greatest preventable cause of disease and premature death in America. It’s evidence like that which prompts Emory Healthcare, the Winship Cancer Institute of Emory University, and the American Cancer Society to take action towards improving awareness around the importance of quitting smoking for the 45 million Americans who still smoke cigarettes and the 15 million Americans who smoke cigars or pipes.

Each year, the American Cancer Society hosts its Great American Smokeout event to create a way to encourage current smokers to set a date, as a group, to quit. This year’s Great American Smokeout takes place on November 15, 2012, and we want to encourage those members of our community who smoke or use tobacco products to take an important step in owning their health by joining others who will choose to make November 15 their quit date.

Quitting is not easy and there’s no single approach that works for everyone, but there is help. If you are trying to quit smoking, know that you have the support of the Emory community and hundreds of individuals like you who have been through it. Carla Berg, PhD, assistant professor at Emory’s Rollins School of Public Health and an expert on smoking behaviors, says most people make multiple attempts to quit before being successful, “but every time you try, you’re one step closer to actually quitting. And if you quit by age 30, research shows you’ll have the same life expectancy as someone who’s never smoked.”

And no matter what your age, your health improves every day you’re not smoking. It’s never too late to quit.

When it comes to tobacco-use, there are no hypotheticals. Smoking cigarettes causes cancer, heart disease, lung disease and stroke. As an academic medical center, we are constantly searching for treatments and cures for disease, and we are just as passionately committed to disease prevention. To that end, Emory has implemented our own tobacco-free policy to promote and support the health of our patients, families, staff and community. As of September 1, 2012, the Emory family—including the Winship Cancer Institute of Emory University and Emory Healthcare—is a tobacco-free organization.

We ask that on November 15, 2012, you join us. We ask that you commit to quitting; commit to your health; commit to a better life.

If you have suggestions to share with our readers that have helped you or a loved one quit, please share them in the comments below. For more information and support resources related to quitting and the Great American Smokeout, visit the American Cancer Society’s website.

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Breast Cancer – Understanding Risk Factors & Preventing Recurrence

Joan Giblin, Winship Cancer Institute

Joan Giblin, Survivorship Program Director, Winship Cancer Institute

Author: Joan Giblin, NP, Director of Survivorship, Winship Cancer Institute of Emory University.

Substantial research conducted over the last few decades demonstrates that being overweight at the time of a breast cancer diagnosis may result in less favorable outcomes. This information—coupled with the fact that many women are indeed overweight at the time of their breast cancer diagnosis and additional weight gain during treatment is frequently reported—means that for a woman diagnosed with breast cancer, achieving or maintaining a desirable weight may be one of the most important lifestyle pursuits they can make in the interest of their overall health and wellness.

Much of the research around breast cancer has supported the theory that excess weight at the time of diagnosis can lead to a worse prognosis. Recently, analyses conducted on a group of nonsmoking breast cancer survivors corroborated these findings. According to the study’s findings, women who increased their body mass index (BMI) by 0.5 to 2 units were found to have a 40% greater chance of breast cancer recurrence, and those who gained more than 2 BMI units had a 53% greater chance of recurrence. Data suggests that being overweight or obese adversely influences not only cancer-specific outcomes, but also overall health and quality of life. As a result, weight management is now considered a priority standard of care for overweight women diagnosed with early stage breast cancer.

Research around breast cancer also suggests that the weight gain experienced by women who have undergone chemotherapy or hormone treatments seems to be the result of increased tissue mass, with no change or a decrease in lean body mass. This unfavorable shift in body composition suggests that steps should be taken to not only curb weight gain during treatment, but also to preserve or rebuild muscle mass. Moderate physical activity (especially resistance training) during and after breast cancer treatment may help survivors maintain lean muscle mass while avoiding the accumulation of excess body fat.

Additional research is currently under way to evaluate the effects of dietary patterns on cancer-specific outcomes, as well as overall health. One observational study found that dietary pattern was important for overall survival among breast cancer patients, with those who ate a Western diet having poorer overall survival and those who ate a dietary pattern characterized by high amounts of fruits, vegetables, and whole grains having better survival rates overall. Furthermore, this theory is supported by data on breast cancer survivors participating in the Nurses’ Health Study. Participants were followed for nearly 10 years post-diagnosis, and study findings suggest that those who consume a healthy diet, with higher intakes of fruits, vegetables, and whole grains and lower intakes of added sugar, refined grains, and animal products, may not have had significantly lower rates of recurrence or cancer-specific mortality.

A topic of controversy as it relates to breast cancer risk and prognosis is alcohol consumption. Alcohol is an unusual factor, as it presents both risks and benefits to those with breast cancer. In the general population, clear and consistent evidence links moderate alcohol intake (1-2 drinks per day) with a lower risk of cardiovascular disease. For breast cancer survivors, however, the decision to drink alcoholic beverages at moderate levels is complex because they must consider their levels of risk for recurrent or second primary breast cancer as well as cardiovascular disease. See our post on the relationship between alcohol and breast cancer for more information.

It is important to remember that lifestyle, nutrition and physical activity recommendations to reduce the risks of a second primary breast cancer and heart disease are especially important for breast cancer survivors. Diet for those at high risk for breast cancer or with a breast cancer diagnosis should emphasize vegetables and fruits, have low amounts of saturated fats, and include sufficient dietary fiber. Most importantly, breast cancer patients and survivors should strive to achieve and maintain a healthy weight through eating a well-balanced diet and regular exercise. In addition, regular physical activity should be maintained regardless of any weight-related concerns.

Table 1. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention and Cancer Survivorship.
Achieve and maintain a healthy weight.
• If overweight or obese, limit consumption of high-calorie foods and beverages and increase physical activity to promote weight loss. Engage in regular physical activity.
Engage in regular physical activity.
• Avoid inactivity and return to normal daily activities as soon as possible following diagnosis.
• Aim to exercise at least 150 minutes per week.
• Include strength training exercises at least 2 days per week.
Achieve a dietary pattern that is high in vegetables, fruits, and whole grains.
• Follow the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention.

 

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An Intro to Colorectal Cancer Part I: Risk Factors, Symptoms & Diagnosis

Colorectal Cancer Awareness MonthMarch is colorectal cancer month, and an article in the New York Times highlights the important role colonoscopies have played in reducing deaths from colorectal cancer. The study included patients tracked over 20 years after receiving a colonoscopy, which lead to the detection and removal of precancerous polyps, known as adenomatous polyps. Findings from the study show that the combination of a colonoscopy and polyp(s) removal lowered the colorectal death rate by 53 percent. While not all polyps turn into cancer, evidence shows that early detection and intervention are keys to survival. In the spirit of helping raise awareness around Colon Cancer and the importance of colonoscopies as a diagnostic and preventive tool, below you’ll find some helpful resources and important information about colorectal cancer.

Colorectal Cancer Statistics

According to the American Cancer Society, “excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States.” That means in 2012, estimates for the number of colorectal cancer cases that will be diagnosed in the United States are:

  • 103,170 new cases of colon cancer
  • 40,290 new cases of rectal cancer

But, if detected early enough, colorectal cancer is curable. So, how is colorectal cancer detected?

Colorectal Cancer Diagnosis

According to the Winship Cancer Institute of Emory University, “colorectal cancer usually starts in the innermost layer of the lining and slowly progresses through the other layers.”  There are several ways of diagnosing colorectal cancer, but the most popular method is a colonoscopy. A colonoscopy is a special type of cancer screening because it allows doctors to screen and intervene at the same time.

During a colonoscopy, the doctor will use a colonoscope, which is a flexible, lighted tube with a small video camera on the end. They use this instrument to look at the entire length of the colon and rectum. If the doctor finds abnormalities such as polyps or growths, he or she can remove them right away while patients are under sedation. Special instruments can be passed through the colonoscope to remove the suspicious looking areas before they have the chance to turn into cancer.

Colon Cancer Web Chat

According to Roberd Bostick, MD, MPH and a professor in the Department of Epidemiology at Emory University’s Rollins School of Public Health, “most of the time, a colonoscopy is the most effective means for diagnosing [colorectal cancer].Certainly, if a person were to have symptoms that would be suggestive of colon cancer, then those symptoms might precipitate them wanting to have a diagnostic test, like a colonoscopy.”

For a full list of symptoms and risk factors of colorectal cancer, please see below. Watch the full video discussion with Roberd Bostick, MD, MPH. Also, bring your additional questions to Dr. Bassel El-Reyes and Dr. Roberd Bostick’s colon cancer chat on March 20th (UPDATE – CHAT TRANSCRIPT).

Colorectal Cancer Symptoms

If you are experiencing any of these symptoms, contact your doctor to be properly diagnosed and treated. It’s important to note that these symptoms may not necessarily be a result of colorectal cancer. Other health problems can produce similar symptoms, which is why it is important to contact your physician if you are experiencing any of the symptoms listed below:

  • Change in bowel habits:
    • Diarrhea or constipation
    • Feeling that your bowel does not empty completely
    • Finding blood (either bright red or very dark) in your stool
    • Finding your stools are narrower than usual
  • Frequent gas pains or cramps, or feeling full or bloated
  • Loss of weight for no apparent reason
  • Feeling very tired all the time
  • Nausea or vomiting

Colorectal Cancer Risk Factors

The main risk factors for colorectal cancer are uncontrollable. They are heredity, family history and personal medical history. Other risk factors include:

  • Presence of an inflammatory bowel disease (i.e. Crohn’s disease, ulcerative colitis, etc.)
  • Diabetes
  • Other controllable factors
    • Obesity
    • Red meat consumption
    • Processed meat consumption
    • Smoking
    • Alcohol consumption

Remember, early detection is the key to providing the best chance for a cure. It is important to contact your physician if you are experiencing symptoms or are at risk for colorectal cancer.  If your physician feels it’s appropriate, a screening test, such as a colonoscopy, will most likely be recommended to rule out the possibility of cancer.

With all this information, what can you do to stay healthy? Take action and make sure you are getting regularly screened! While a colonoscopy is bound to not be the most pleasant experience, it could potentially save your life by detecting colorectal cancer early when the disease is easier to cure.  If you are interested in learning more about colorectal cancer, make sure to check out the chat transcript the colorectal cancer chat.

Contact us for more information about our colorectal cancer treatment programs: 404-778-1900 or request an appointment online.

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Cervical Cancer & HPV 101 – Part I

Cervical Cancer & HPV MD ChatJanuary is Cervical Health Awareness Month. To help raise awareness around cervical health and cervical cancer, this is the first of a two-part blog post series on the topic. Before we dig deeper into cervical cancer types and risk factors, here a few cervical health-related statistics you should be aware of:

  • Cervical cancer was previously the leading cancer-related cause of death for women in the U.S. In the last 40 years, however, the number of deaths from cervical cancer has dropped. According to the National Institute of Health (NIH) & CDC, the decline is largely “the result of many women getting regular Pap tests, which can find cervical precancer before it turns into cancer.”
  • Approximately 10,800 new cases of HPV-related cervical cancer are diagnosed in the U.S. each year.
  • Greater than 70% of all cervical cancers (carcinomas) were squamous cell type, and nearly 20% were adenocarcinomas, between 1998-2003.

Cervical Cancer Types

Squamous cell carcinoma and adenocarcinoma are the two types of cervical cancer. Each type is distinguished based on its appearance under a microscope. Both squamous cell and adenocarcinoma begin in the cells that line hollow organs, but squamous cells have a thin, flat appearance while adenocarcinomas involve cells with secretory functions. As is noted in the statistic above, the squamous cell carcinoma type of cervical cancer is far more common and currently makes up approximately 90% of cervical carcinoma cases. Both types have similar risk factors, prognoses, and treatments.

Cervical Cancer Risk Factors

HPV

According to the CDC, “almost all cervical cancers are caused by the human papillomavirus (HPV),” which is why it is so important that parents and young women understand their options for getting vaccinated to protect themselves from typically symptomless HPV. Emory Healthcare will be hosting an online chat on the topic of cervical cancer and HPV. The chat will cover everything from cervical cancer prevention and diagnosis to treatment options, along with information on the relationship between HPV and cervical cancer.

Smoking

As is the case the with all cancers, smoking increases your risk. Take steps to quit smoking today.

Birth Control

Having given birth to three or more children or having been on birth control pills for over 5 years can increase your risk for cervical cancer.

In our next post on cervical cancer, we’ll cover its connection to the HPV virus, including more information on the HPV vaccine and its effectiveness and the relationship between various HPV strains and cervical cancer. In the meantime, if you have questions on the topic of cervical cancer, or something you want to see covered in our next post, let us know in the comments section below!

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Intro to Pancreatic Cancer Part I: Stats, Types, & Risk Factors

Pancreatic Cancer Awareness Month

November is Pancreatic Cancer Awareness Month. Before we dig a bit deeper into pancreatic cancer in this two-part blog post, below are some important stats you should be aware of. According to the National Cancer Institute (NCI) and American Cancer Society:

  • pancreatic cancer is the 4th leading cause of cancer-related death in both men and women in the U.S.
  • 1.41% of men and women born today will be diagnosed with cancer of the pancreas at some time during their lifetime
  • the median age for diagnosis of pancreatic cancer was 72 years old (based on data from ‘04-’08)
  • the median age of death as a result of pancreatic cancer was 73 years old (based on data from ‘04-’08)
  • 0.53% of men will develop cancer of the pancreas between their 50th and 70th birthdays compared to 0.39% for women
  • About 44,030 people (22,050 men and 21,980 women) will be diagnosed with pancreatic cancer.

Pancreatic Cancer Types

According to the Winship Cancer Institute of Emory University, “A pancreatic cancer type is based on the location of the tumor’s origin within the pancreas. More than 95 percent of pancreatic cancers are adenocarcinomas of the exocrine pancreas. Tumors of the endocrine pancreas are much less common and most are benign.”

  • Acinar Cell Cancers: Acinar cell cancers are tumors that form on the ends of the pancreatic ducts.
  • Adenocarcinoma: An adenocarcinoma is a cancer that begins in the cells that line certain internal organs and have secretory properties. In the pancreas, this is a cancer of the exocrine cells that line the pancreatic ducts.
  • Cystic Tumors: Cystic tumors derive their name from the presence of fluid filled sacs within the pancreas. The fluid is produced by the lining of abnormal tissues or tumors. These tumors may lead to cancer in some patients; however, most cystic tumors of the pancreas are benign.
  • Sarcomas: Sarcomas are tumors that form in the connective tissue that bonds pancreatic cells together and are rare.

Pancreatic Cancer Risk Factors

  • Age:  Nearly 90% of those with pancreatic cancer are older than 55 years and over 70% are older than 65.
  • Gender: Pancreatic cancer incidence rates are higher among men than women, but it is possible that this can be attributed to higher tobacco use incidence rates among men.
  • Weight: According to the NCI, “In a pooled analysis of clinical data,  higher body mass index was associated with an increased risk of developing pancreatic cancer, independent of other risk factors.”
  • Cigarette Smoking: According to the American Cancer Society, pancreatic cancer risk is 2-3x higher for smokers than non-smokers. About 20% to 30% of exocrine pancreatic cancer cases are thought to be caused by cigarette smoking.

Next week, we’ll follow up with more information on pancreatic cancer, including steps you can take to lower your risk (prevention), symptoms of cancer of the pancreas, and how pancreatic cancer is diagnosed and treated.

In the meantime, if you have questions about pancreatic cancer, please leave them for us in the comments below. All comment responses will be provided by physicians of Emory Healthcare and/or the Winship Cancer Institute of Emory University.