Cancer Awareness 2019

A SPECIAL PUBLICATION OF THE BOZEMAN DAILY CHRONICLE

Cancer Awareness To increase awareness, provide information and share stories of hope and support during Cancer Awareness Month.

Cancer Awareness: Let’s Talk About It For so long, cancer has been taboo. It was something you couldn’t talk about at the dinner table, Cancer Support Community executive director Becky Franks said.

The fear, and even guilt, that comes with a cancer diagnosis can make it difficult and uncomfortable to talk about, and even the word “cancer” comes with a whole host of connotations and baggage.

The truth is, though, that about one third of all people in the U.S. will develop cancer in their lifetime, according to the American Cancer Society. Not everyone will die of the disease. In fact, new technology is emerging all the time that can better help slow, prevent and treat cancer. Still, that number means almost everyone is touched by it — either developing it themselves or knowing someone who will. And even though the stigma surrounding cancer has been lessened in recent years, some old attitudes still remain. It’s something we need to talk about, and not just in terms of prevention, which Franks said is much easier.

“The thing that’s never talked about is that it’s scary,” she said. “Those are the hard parts.”

There were 5,920 new cases of cancer in Montana in 2019 alone, ACS reported.

Within that number, female breast cancer came in at No. 1 for the most common type, and lung and bronchus came second. October is breast cancer awareness month, and the goal of this publication is to shed light on it as well as all forms of cancer and some of the resources available in our state and community. Breast Cancer Awareness Month helps promote conversation, Franks said, and it can help people feel like they’re not so alone.

PHOTO CREDIT: CONSTANCE MARTIN

“I think it gives a commonality to the disease and helps people actually talk about it,” she said.

Hospital cancer center growing in patients, services With the high emotional and financial cost that can come with traveling for care, many patients prefer to stay closer to home. That’s why it has been a priority for Bozeman Health to expand its cancer center services, said Dr. Justin Thomas.

“People can live in their homes, live with their families, sleep in their own beds,” he said.

Right now, there are more services offered for those with cancer in Bozeman than ever before, Thomas said. In the past, patients with cancer would have to travel to a larger city like Seattle or Denver as the disease progressed.

There are still treatments that require travel for Southwest Montana residents, but many can stay at home for cancer care in advanced stages, he said. The hospital

has focused on expanding its resources and filling in some of the gaps Montana has had overall.

Among other things, Bozeman Health has added to hematology oncologists, or doctors who specialize in blood cancers, to its team. The cancer center also recently hired a new patient navigator, Polly Knuchel, who will receive all referrals to the center, helping connect patients to the right providers and making sure they have all the required tests done.

The cancer center has also started doing telehealth for its patients that live out of town, so they don’t have to drive in, said Jo May, manager of oncology and radiation oncology.

As the cancer center has steadily added services over the years, the number of

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patients it serves has also increased. From 2017 to 2018, it saw about 100 more patients than it did the year before, which translates to about 20 percent growth, May said.

This is partly due to overall growth in Bozeman’s population, but it also has to do with the center reaching out to more rural communities around Bozeman and being able to do telehealth. The center also has more people doing well and needing more services as they recover, Thomas said.

The cancer center also hopes to add more specialists and services in coming years, like a gastroenterologist.

“There are more and more cancer survivors,” Knuchel said. “People are living for years and years and the need is great.”

Detection and Prevention There’s no guaranteed way to prevent cancer, and even healthy individuals can get it. There are ways to prevent it, however, through lifestyle choices like exercising, eating nutritious food and avoiding smoking.

To help educate people on what they can do to detect and prevent cancer, the American Cancer Society has put together the following list to address the major types of cancers, preventative measures, screenings and research on each type.

Bladder Risk Factors: Smokers are at least 3 times as likely to get bladder cancer as nonsmokers.

Smoking causes about half of the bladder cancers in both men and women. Certain industrial chemicals have been linked with bladder cancer.

The industries carrying highest risks include the makers of rubber, leather, textiles, and paint products as well as printing companies.

Preventative Measures: There is some evidence that drinking a lot of fluids—mainly water—might lower a person’s risk of bladder cancer.

Screenings and Early Detection: One way to test for bladder cancer is to check for blood in the urine during a urinalysis. Blood in the urine is usually caused by benign (non-cancerous) conditions, but it also can be the first sign of bladder cancer.

Brain Risk Factors: The best known environmental risk factor for brain tumors is radiation exposure, most often from radiation therapy to treat some other condition. Cell phones are also a topic of much debate. There have been concerns that the phones, whose antennae are built-in and therefore are placed close to the head when being used, might somehow raise the risk of brain tumors.

Preventative Measures: The risk of many cancers in adults can be reduced with certain lifestyle changes (such as staying at a healthy weight or quitting smoking). Other than radiation exposure, there are no known lifestyle-related or environmental causes of brain and spinal cord tumors, so at this time there is no known way to protect against most of these tumors.

infection with any of the high-risk types, about two-thirds of all cervical cancers are caused by HPV 16 and 18.Women who smoke are about twice as likely as non-smokers to get cervical cancer. Tobacco by-products have been found in the cervical mucus of women who smoke.

Preventative Measures: A well-proven way to prevent cervical cancer is to have testing to find pre-cancers before they can turn into invasive cancer. The Pap test and the HPV test are used for this. If a pre-cancer is found it can be treated, stopping cervical cancer before it really starts.

Most invasive cervical cancers are found in women who have not had regular Pap tests.

Screenings and Early Detection: The Pap test is a procedure used to collect cells from the cervix so that they can be looked at under a microscope to find cancer and pre-cancer. These cells can also be used for HPV testing. A Pap test can be done during a pelvic exam.

Colorectal Risk Factors: Younger adults can develop colorectal cancer, but the chances increase markedly after age 50: About 90 percent of people diagnosed with colorectal cancer are at least 50 years old. As many as 20 percent of people who develop colorectal cancer have other family members who have been affected by this disease.

Preventative Measures: A diet that is high in red meats and processed meats can increase colorectal cancer risk.

Screenings and Early Detection: At this time there are no widely recommended tests to screen for brain and spinal cord tumors. Tumors in any part of the brain may cause pressure inside the skull leading to symptoms like headaches, nausea, vomiting, blurred vision, balance problems, seizures or drowsiness.

Screenings and Early Detection: From the time the first abnormal cells start to grow into polyps, it usually takes about 10 to 15 years for them to develop into colorectal cancer. Regular screening can, in many cases, prevent colorectal cancer altogether. This is because most polyps can be found and removed before they have the chance to turn into cancer. Screening can also result in detecting colorectal cancer early, when it is highly curable. People should begin regular screening at age 50.

Breast Cancer

Kidney

Risk Factors: Simply being a woman is the main risk factor for developing breast cancer. This disease is about 100 times more common among women than men. Men have less of the female hormones estrogen and progesterone, which can promote breast cancer cell growth. About 10% of breast cancer cases are thought to be hereditary.

Studies have found that women using oral contraceptives have a slightly greater risk of breast cancer than women who have never used them.

Risk Factors: The risk of kidney cancer is higher in people with high blood pressure. Some studies have suggested that certain medicines used to treat high blood pressure may raise the risk of kidney cancer, but it is hard to tell if it’s the condition or the medicine that may be the cause of the increased risk.

Preventative Measures: A diet that is rich in vegetables, fruit, poultry, fish and low-fat dairy products has also been linked with a lower risk of breast cancer in some studies. Alcohol also increases the risk of breast cancer.

Screenings and Early Detection: Women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health. Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic health exam by a health professional, at least every three years. Breast selfexam (BSE) is an option for women starting in their 20s. Women at high risk for breast cancer based on certain factors should get an MRI and a mammogram every year. A mammogram is an x-ray of the breast. A diagnostic mammogram is used to diagnose breast disease in women who have breast symptoms or an abnormal result on a screening mammogram. Screening mammograms are used to look for breast disease in women who are asymptomatic; that is, they appear to have no breast problems.

Cervical Risk Factors: The most important risk factor for cervical cancer is infection by the human papilloma virus (HPV). HPV is a group of more than 150 related viruses. Doctors believe that a woman must be infected with HPV in order to develop cervical cancer. Although this can mean

Preventative Measures: In many cases, the cause of kidney cancer is not known. In some other cases, even when the cause is known it may not be preventable. Cigarette smoking is responsible for a large percentage of cases, so stopping smoking may lower your risk.

Screenings and Early Detection: A routine urinalysis may find small amounts of blood in the urine of some people with early kidney cancer. But many things other than kidney cancer cause blood in the urine. Some people with kidney cancer do not have blood in their urine until the cancer is quite large. Imaging tests can often find small kidney cancers. Often, kidney cancers are found incidentally during imaging tests for some other illness such as gallbladder disease.

Liver Risk Factors: Alcohol abuse is a leading cause of cirrhosis in the United States, which in turn is linked with an increased risk of liver cancer.

Worldwide, the most significant risk factor for liver cancer is chronic infection with hepatitis B virus and hepatitis C virus. These viruses can spread from person to person through sharing contaminated needles and through unprotected sex.

screening tests thought to be helpful for screening in the general population.

Lung Risk Factors: Smoking is by far the leading risk factor for lung cancer. At least 80 percent of lung cancer deaths are thought to result from smoking.

If you don’t smoke, breathing in the smoke of others can increase your risk of developing lung cancer by almost 30%. Secondhand smoke is thought to cause more than 7,000 deaths from lung cancer each year.

Preventative Measures: The best way to reduce your risk of lung cancer is not to smoke and to avoid breathing in other people’s smoke.

Screenings and Early Detection: Usually symptoms of lung cancer do not appear until the disease is already in an advanced, non-curable stage. CT scans of the chest provide more detailed pictures than chest x-rays and are better at finding small abnormalities in the lungs.

Ovarian Risk Factors: Women who have been pregnant and carried it to term before age 26 have a lower risk of ovarian cancer than women who have not.

The risk goes down with each full-term pregnancy.

Women who have their first full-term pregnancy after age 35 or who never carried a pregnancy to term have a higher risk of ovarian cancer.

Preventative Measures: Using oral contraceptives decreases the risk of developing ovarian cancer, especially among women who use them for several years. Women who used oral contraceptives for five or more years have about a 50 percent lower risk of developing ovarian cancer compared with women who never used oral contraceptives. Women considering taking these drugs for any reason should first discuss the possible risks and benefits with their doctor.

Screenings and Early Detection: There has been a lot of research to develop a screening test for ovarian cancer, but there hasn’t been much success so far. The two tests used most often to screen for ovarian cancer are trans-vaginal ultrasound and the CA-125 blood test.

Pancreatic Risk Factors: Smoking is the most important avoidable risk factor for pancreatic cancer. It is responsible for 30 percent of pancreatic cancers.

Preventative Measures: The cause of many pancreatic cancers is not known, so there is no sure way to prevent it. Eat a healthy diet, with an emphasis on plant foods. Choose whole-grain breads, pastas and cereals instead of refined grains, and eat fish, poultry or beans instead of processed and red meat.

Screenings and Early Detection: Pancreatic cancer is hard to find early. The pancreas is deep inside the body, so early tumors can’t be seen or felt by health care providers during routine physical exams. Patients usually have no symptoms until the cancer has already spread to other organs.

At this time, no major professional groups recommend routine screening for pancreatic cancer in people who are at average risk. This is because no screening test has been shown to lower the risk of dying from this cancer.

Prostate Risk Factors: Prostate cancer is very rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About 60 percent of cases of prostate cancer are found in men over the age of 65.

Preventative Measures: This may be prevented by not sharing needles and by using safer sex practices.

Preventative Measures: Studies have found that men who get regular physical activity have a slightly lower risk of prostate cancer. Vigorous activity may have a greater effect, especially on the risk of advanced prostate cancer.

Screenings and Early Detection: Screening for liver cancer is not recommended for people who are not at increased risk. At this time there are no

Screenings and Early Detection: Prostate cancer can often be found early by testing the amount of prostate-specific antigen (PSA) in a man’s blood.

Skin Risk Factors: Exposure to ultraviolet (UV) rays is a major risk factor for most melanomas. Sunlight is the main source of UV rays. Tanning lamps and beds are also sources of UV rays. While UV rays make up only a very small portion of the sun’s rays, they are the main cause of the damaging effects of the sun on the skin. UV rays damage the DNA of skin cells. Skin cancers begin when this damage affects the DNA of genes that control skin cell growth.

Preventative Measures: Use sunscreens and lip balms on areas of skin exposed to the sun, especially when the sunlight is strong. Use sunscreen even on hazy days or days with light or broken cloud cover because UV rays still come through.

Tanning lamps give out UVA and usually UVB rays as well, both of which can cause long-term skin damage and can contribute to skin cancer. Tanning bed use has been linked with an increased risk of melanoma, especially if it is started before the age of 30.

Screenings and Early Detection: It’s important to check your own skin, preferably once a month.

You should know the pattern of moles, blemishes, freckles and other marks on your skin so that you’ll notice any new moles or changes in existing moles. Any suspicious areas or unusual moles should be seen by your primary doctor or by a dermatologist, a doctor who specializes in skin problems.

Stomach Risk Factors: Stomach cancers are more likely to develop in people who have had part of their stomach removed to treat non-cancerous diseases such as ulcers. This might be because the stomach makes less acid, which allows more nitrite-producing bacteria to be present. These cancers typically develop many years after the surgery.

Preventative Measures: The dramatic decline of stomach cancer in the past several decades is thought to be a result of people reducing many of the known dietary risk factors. This includes greater use of refrigeration for food storage rather than preserving foods by salting, pickling and smoking. To help reduce your risk, avoid a diet that is high in smoked and pickled foods and salted meats and fish.

Screenings and Early Detection: Studies in the United States have not found that routine screening in people at average risk for stomach cancer is useful, because this disease is not that common. On the other hand, people with certain stomach cancer risk factors may benefit from screening. Unfortunately, earlystage stomach cancer rarely causes symptoms.

New Research: Research has clearly shown that differences in diet are an important factor in explaining variations in stomach cancer risk around the world. Recent research in countries with relatively low stomach cancer risk has provided some insight into risk factors.

Testicular Risk Factors: One of the main risk factors for testicular cancer is a condition called cryptorchidism, or undescended testicle(s). This means that one or both testicles fail to move from the abdomen into the scrotum before birth. Males with cryptorchidism are several times more likely to get testicular cancer than those with normally descended testicles.

Preventative Measures: Many men with testicular cancer have no known risk factors. Some of the known risk factors, such as undescended testicles, white race and a family history of the disease, can’t be changed. For these reasons, it is not possible now to prevent most cases of this disease.

Experts recommend correcting cryptorchidism in boys for a number of reasons (such as preserving fertility and body image).

Screenings and Early Detection: Most of the time a lump on the testicle is the first sign, or the testicle might be swollen or larger than normal. But some testicular cancers may not cause symptoms until after they have reached an advanced stage.

The ACS advises men to be aware of testicular cancer and to see a doctor right away if they find a lump in a testicle. Some doctors recommend that all men examine their testicles monthly after puberty.

Kids with Cancer Each year, about 40 kids in Montana are diagnosed with cancer, and providing resources for those kids to process the huge traumatic events happening in their lives is vitally important, Franks said.

“When you’re 65 and get cancer, it’s a whole different thing than when you’re four and get cancer,” she said.

The emotional toll it takes on kids and their families is huge, and groups like CSC and Eagle Mount work to provide resources and community support groups for kids experiencing cancer or impacted by it.

The understanding and feelings of each kid and each family is different, Franks said. There’s no one way that everyone feels. But one thing that’s for sure is that it changes kids’ lives forever.

“What I can tell you is that, with kids,

the long-term effects of cancer go on their whole life,” Franks said.

To help kids cope with the dramatic shift in their lives and plans, groups like CSC and Eagle Mount offer summer camps and support groups throughout the year, aiming to bring some sense of fun, support, normalcy and safety in a time that is often challenging and difficult.

Beyond that, there are also financial resources for families across the state.

Kids with cancer are often sent out of state for certain treatments, and the cost of travel, lodging and treatment adds up. Among other organizations, there’s Bozeman 3 in town, and the Payden Memorial Foundation in Livingston.

Further information and resources can be found through the Montana Cancer Coalition at mtcancercoalition.org.

How To Talk To the Kids There’s no one right thing to say when telling kids that a family member has cancer.

Every kid, every parent and every family is different, Franks said, and the way parents should talk to their kids about cancer depends on the family’s communication style and kids’ ages.

“The hard part is just knowing and understanding what your kid is capable of understanding,” she said.

One thing that is certain is kids will make up information in an abyss, she said, and what they’re imagining is often worse than reality. So it’s important to explain what’s happening soon after diagnosis, and for kids around five years old and older, you can use pretty clear language.

If parents are unsure of how to approach the conversation, they can go to Cancer Support Community and talk over the situation with someone who can provide advice and support, Franks said.

If a child is older, maybe in their teen years, they will likely be comforted by the science and want to know more.

For younger children, it can be helpful to explain it more simply, helping them understand that the sickness lasts a long time and doesn’t go away like a cold does.

It’s important to encourage kids to let themselves feel whatever feelings they have, Franks said, and for them to express those feelings, even ones that are uncomfortable. It also often helpful to notify teachers of the family member’s diagnosis, as they may notice changes in behavior at school.

One of the things Franks said CSC often does is in her kids support groups is have them build what they think cancer looks like with clay. It usually ends up being a blob of colors, but she said it’s the process that’s valuable.

Though every situation is different, she said it’s OK to use the “cancer” word. It’s important to help them understand that they didn’t cause it and can’t catch it.

Often, family members and caregivers feel helpless. For young and adult children alike, it can be helpful to engage them and let them help somehow, even if that just means helping keep the house cleaner, Franks said.

Normalcy and routine is also important.

“Kids will look up with tears in their eyes and say, ‘You mean I can sit on Grandma’s lap?’” she said.

“Asking ‘What can I do for mom?’ and ‘What can I do for grandma is incredibly helpful,” she said.

We are working with Becky Franks and the Cancer Support Community in promoting healthier eating inside our store. We had a booth built specifically for this and Monday thru Friday it is manned by MSU students 4 PM to 6 PM that are part of the nutrition program.

For the month of October we are doing a “Round-up” for Cancer Support Community.

Next time you are in make sure to participate!

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Another way to find prostate cancer is the digital rectal exam (DRE).

Another important issue is that even if screening detects a cancer, doctors often can’t tell if the cancer is truly dangerous. Finding and treating all prostate cancers early might seem as if it would always be a good thing. Some prostate cancers grow so slowly that they would probably never cause problems. Because of an elevated PSA level, some men may be diagnosed with a prostate cancer that they would have never even known about at all.

10 Tips for Caregivers 1. FIND YOUR SUPPORT COMMUNITY—CSC offers a cancer caregivers support group. Members often find they can share valuable information and find ways to cope by sharing similar experiences with other caregivers. You not only learn how to support your loved one better, but you learn how to support yourself.

2. LOOK FOR INFORMATION—CSC has a library with information on all types of cancers, wellness and nutrition and survivor stories. “Caregiving is easier when you understand what a person with cancer is experiencing,” said a CSC handout on tips for caregivers. It’s important to know about relapses, treatments and side effects. Knowledge is power.

3. EMBRACE YOUR NEW NORMAL—It’s important to recognize that you cannot do everything. Sometimes daily chores will be pushed aside in order for you to make time for hospital visits or for you to care for your loved one. CSC recommended identifying the parts of your life that you can still control and prioritize them.

4. TAKE BREAKS FOR YOURSELF—Too often, according to Franks, caregivers get worn out. “There is this belief that you definitely have to not take care of yourself, because you should be taking care of the person with cancer.”

However, taking time for yourself is not selfish. Self-care is important, whether that means maintaining and exercise routine, taking a bath, writing in a journal or a whole host of other activities.

5. REMAIN INVOLVED—Strength comes from the support of others. Don’t shut out other family members, friends or community members. People will help you and your involvement with others will give you a way to reduce stress.

6. PLAN FOR THE FUTURE—Be practical. Things like financial and legal issues are necessary to address. These plans may not be needed, but no one knows what the future holds.

7. LEARN TO ACCEPT HELP—Friends, neighbors and family can help, and don’t be shy about asking for help. You can delegate responsibilities. You do not have to be the only caregiver for your loved one.

8. STAY HEALTHY—If your own health starts to slip, who will be your loved one’s caregiver? Eat well, get a good night’s rest and exercise.

9. FIND WAYS TO RELAX—CSC offers many programs and activities that can help you relax. Perhaps attending a yoga class with your loved one will offer you a way to relieve some stress while also spending quality time with people who support you. Finding a stress reliever is important and can come in many forms. Cooking classes and art programs are offered at CSC, so don’t be afraid to ask about any interests you have that you want to explore through CSC. 10. SET LIMITS—You don’t have to be the only caregiver, and if there is something you are uncomfortable with doing—due to time constraints, your own personal health or other reasons—then let your loved one know.

Boundaries are healthy and important.

Though caring for a person with cancer can be extremely difficult, there are also moments that are comforting and rewarding. For each of the one in three people in the U.S. who develop cancer in their lifetime, there is at least one person acting as a caregiver for them.

A caregiver is anyone who provides physical, financial, spiritual or logistical support for someone with cancer. Often, there are a team of caregivers acting in different roles to support a person who has cancer, and it’s a team effort. As a main caregiver, it’s important to help everyone on this team express concerns, opinions, and emotions, ensuring that the person with cancer has a central role in all decisions and discussions, if possible.

Caregivers often don’t realize how important their role is and how deeply cancer impacts them. They can also feel alone or isolated if they are the main caregiver, and it can be difficult to find their own community of support as they adjust to their new role.

Being the main caregiver takes a lot of strength and emotional energy, and it can all be exhausting. It’s important that caregivers check in and make sure they’re also taking care of their own needs. For this reason, CSC provides resources for caregivers as well, and it has also laid out a series of tips for helping caregivers cope with their new role taking care of loved ones.

Empowered by Knowledge Strengthened by Action Sustained by Community cancersupportmontana.org 406.582.1600 102 S. 11th Ave Bozeman, MT 59715

“At bosom buddies, I discovered my second family where our commonality is cancer, we speak the same language and our experiences are mutual.

Through their support, I have found hope, empowerment and courage.

I am not alone.“ “I would not have known what to ask my healthcare team without the support of Cancer Support Community. It made a lot of difference in advocating for my own care.”

For more information visit CancerSupportMontana.org Our Bosom Buddies Support Group meets at Cancer Support Community the first & third Tuesday of the month from 5:30-7pm. *Prior to joining a Support Group, an orientation meeting with CSC’s Program Director, Amber Reilly, is required.

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