December 2016 & January 2017
Cancer Stakeholder Florida Department of Health, Comprehensive Cancer Control Program
PROGRAM SPOTLIGHT:
All Women Are At Risk for Cervical Cancer JANUARY IS CERVICAL CANCER AWARENESS MONTH ervical cancer occurs most often in women over age 30. According to the Centers for Disease Control and Prevention (CDC), approximately 12,000 women in the United States are diagnosed with cervical cancer each year. In Florida, there were 914 new cases and 345 deaths from cervical cancer in 2013 (Florida Cancer Data System). Most cases of cervical cancer occur in women who have never received a Pap test screening or who have not been screened in the past five years. The CDC recommends talking to your doctor about when a Pap test is most appropriate for you. Tests for cancer-causing strains of human papilloma virus (HPV) support early diagnosis of cervical cancer. When found early, it is highly treatable and associated with long survival and good quality of life. Since the HPV vaccine was introduced in 2006, CDC reports that the rates of HPV strains related to genital warts and some cancers have decreased 56 percent among American teen girls. Nearly all cervical cancers are caused by HPV. The two or three dose HPV vaccination series can help prevent multiple cancers, including cervical cancer and cancer of the mouth and throat. The Advisory Committee for Immunization Practices recommends
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vaccinating boys and girls, ages 11 to 12 years old. The HPV vaccine may be given starting at 9 years of age and through the age of 26 for those who did not get any or all of the shots when they were younger. The new Gardasil HPV 9 vaccine offers protection from more types of HPV. Those males and females who have completed a HPV vaccination series do not need vaccination with the new vaccine. HPV 9 may be used to complete a series started with one of the other HPV vaccines. According to the CDC, to reduce risk or prevent cervical cancer: Get the HPV vaccine Women between 21 and 65 years old should see their doctor regularly for a Pap test Do not smoke Limit the number of sexual partners
Parents and young adults are encouraged to visit this site at Diseases and the Vaccines that Prevent Them to learn more about vaccinepreventable diseases and recommendations. Medical providers are encouraged to visit the CDC’s Preteen and Teen Vaccines website which includes useful information and patient handouts: HPV Vaccine is Cancer Prevention For more information on cervical cancer go to www.cdc.gov/cancer.
The Florida Breast and Cervical Cancer Early Detection Program offers free or low cost Pap tests to women who are: Ages 50-64; and low income; and have no health insurance. To learn more about HPV vaccination series or Pap testing call your local county health department or visit the Florida Department of Health’s website.
December 2016 & January 2017 Cancer Stakeholder
State Update
There’s More about Tobacco Use & Cancer A new 2016 report from the CDC1 shows the enormous burden of cancer caused by tobacco use in the United States. While tobacco-related cancer death rates have declined since the 1990s, too many preventable tobaccorelated cancer cases and deaths are still occurring. According to the report, cigarette smoking causes three in ten of all cancer deaths. Tobacco use is a risk factor for at least 12 different types of cancers. Florida recently celebrated the momentous progress made in tobacco control over the past 10 years. In 2006, Floridians voted overwhelmingly in support of a state constitutional amendment to fund a tobacco education and use prevention program, now known as Tobacco Free Florida. The program has resulted in a significant decrease in smoking rates among both adults and teens in the state, leading to billions of dollars and countless lives saved.
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But there is still much work to be done. Approximately half of all Floridians who continue to smoke are expected to die from a tobacco-related disease. Quitting smoking can significantly decrease the risk. This month, many Floridians and their loved ones will resolve to quit tobacco in the New Year. While quitting is not easy, finding help is. Tobacco Free Florida’s Quit Your Way program offers free tools and services, which have already helped more than 159,000 Floridians quit. Tobacco users in the state can pick the tools and services that are right for them and get the support they need to make 2017 the year they become tobacco free. Learn more at tobaccofreeflorida.com/ quityourway. 1. Henley SJ, Thomas CC, Sharapova SR, et al. Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality — United States, 2004–2013. MMWR Morb Mortal Wkly Rep 2016;65:1212–1218. DOI: http://dx.doi.org/10.15585/mmwr.mm6544 a3
The Cancer Control and Research Advisory Council (CCRAB) established by the Florida Legislature in 1979, under section 1004.435, Florida Statute, convened on October 14, 2016 to discuss efforts to control cancer in the state. The council, tasked with developing a state cancer control and research plan (Florida Cancer Plan), unveiled a new dashboard for tracking progress made on achieving goals from the Florida Cancer Plan. The dashboard includes 5 measures for addressing goals related to cancer data, 20 measures for addressing goals related to cancer prevention, 15 measures for addressing goals related to improving patient outcomes, 9 measures for addressing goals related to cancer survivorship, and 22 measures addressing goals related to cancer care. Cancer stakeholders can view progress made and notes on objectives and strategies developed at www.ccrab.org. To engage in local efforts to address the Florida Cancer Plan, stakeholders can contact their regional collaborative coordinator (see Regional Cancer Control Collaboratives section on page 7. Regional collaboratives convene local cancer control partners to develop and implement strategic objectives and strategies to address the Florida Cancer Plan. New 2016 to 2018 objectives have been crafted and more opportunities are available to network and reduce the cancer burden.
December 2016 & January 2017 Cancer Stakeholder
Plans Are Essential
Cancer Survivor Tips ince the release of the Institute of Medicine’s report From Cancer Patient to Cancer Survivor: Lost in Transition in 2005, cancer patients are more aware of the role and importance of having a survivorship care plan and a follow up plan. Survivorship care plans assist in watching for health changes after treatment, monitoring for a reoccurrence, managing follow-up care and maintaining a comprehensive health record that includes: Pathology reports on diagnosis and type of cancer Surgical reports Chemotherapy and radiotherapy treatment regiments Contact information on each doctor and the center that is providing care Psychosocial, nutritional and other supportive services
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A follow-up care plan outlines what a cancer patient needs to do to stay healthy. The plan should include information on possible late and long-term effects of treatment, any referral information, and recommendations for future medical tests or cancer screenings. After treatment, patients need to see their doctors for follow-up. Almost any cancer treatment may have side effects for patients. A patient should ensure all appointments are kept and doctors are informed about any problems or side effects, pain or physical problems. Ending treatment can be both exciting and can cause anxiety, but remember that the risk of a cancer recurrence differs among people. Survivorship care and follow-up care plans are essential for doctors to provide optimum care for cancer patients. A treatment plan is essential in maintaining an honest dialogue between a patient and the health care team. For more information on care after treatment visit the National Cancer Institute’s website.
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December 2016 & January 2017 Cancer Stakeholder
Educate Patients about Liver Cancer Prevention Healthiest Weight Florida encourages health care providers and professionals to educate their patients about the prevention of liver cancer.
s with most cancers, liver cancer development is highly dependent on healthy lifestyle behaviors including healthy eating, physical activity and alcohol consumption. One of the major risk factors for liver cancer is long-term heavy alcohol intake. Obesity, diabetes and hepatitis are also risk factors for developing liver cancer. In addition, Asian/Pacific Islander and Hispanic men have a higher chance of developing liver cancer than other racial and ethnic groups.1,2 The liver breaks down and stores nutrients absorbed from the intestine and filters all blood in the body to remove toxins and chemical waste from alcohol, drug and medication use.1 Since all blood in the body must be filtered by the liver, it is highly accessible to cancer cells present in the bloodstream. The liver comprises many dierent types of cells which can lead to the formation of several types of cancerous and non-cancerous tumors. Most liver cancer is metastatic, meaning that it spreads from other cancerous organs in the body. Some
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Healthiest Weight Florida is a public-private collaboration bringing together agencies, institutions, organizations and communities to help Floridians make more informed choices about active lifestyles and healthy eating.
1. American Cancer Society (2016). What is Liver Cancer? Retrieved from http://www.cancer.org/cancer/livercance r/detailedguide/liver-cancer-what-isliver-cancer 2. Centers for Disease Control and Prevention (2016). Division of Cancer Prevention and Control. Liver Cancer. Retrieved from https://www.cdc.gov/ cancer/liver/ 3. American Cancer Society (2016). Signs and Symptoms of Liver Cancer. Retrieved from http://www.cancer.org/cancer/ livercancer/detailedguide/liver-cancersigns-symptoms 4. American Cancer Society (2016). Key Statistics About Liver Cancer. Retrieved from http://www.cancer.org/cancer/ livercancer/detailedguide/liver-cancerwhat-is-key-statistics
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liver tumors can make hormones that aect organs other than the liver. These hormones may cause symptoms which can induce nausea, constipation, weakness, low blood sugar levels which can cause fatigue or fainting, breast enlargement and/or shrinkage of the testicles in men, or high cholesterol levels.3 Primary liver cancer starts directly in the liver as a result of alcohol abuse, hepatitis, or obesity. Signs and symptoms of liver cancer often do not show up until the later stages of the disease, making liver cancer hard to diagnose early. Some of the most common symptoms of liver cancer are unexplained weight loss, nausea or vomiting, and yellowing of the skin and eyes (jaundice). Throughout the U.S., liver cancer cases have more than tripled since 1980.4 Healthiest Weight Florida encourages Floridians to engage in healthy lifestyle behaviors such as healthy eating, active living and limited alcohol consumption in order to help prevent liver cancer and other types of cancer from developing.
December 2016 & January 2017 Cancer Stakeholder
Cancer In the News General Cancer Related Articles
Black Raspberries, Exercise, the Microbiome: Research Conference Highlights—AICR, Dec. 1, 2016
Daily, Nov. 17, 2016
Large-scale cancer gene profiling is feasible but faces barriers—Science Daily, Nov. 17,
State of the Science on Melanoma Prevention and Screening—CDC, Dec. 1,
Estimating survival in patients with lung cancer, brain metastases—Science Daily,
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Nov. 17, 2016
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White wine may raise melanoma risk—
Developing a Cost Data Collection Tool for Cancer Registry Planning—Centers for
MNT, Dec. 3, 2016
Breast Lump Removal: What to Expect, Recovery—MNT, Nov. 17, 2016
Disease Control and Prevention (CDC), Nov. 16, 2016
Access to Care Related Articles
Stereotactic Breast Biopsy: What Happens, Results, and Outlook—MNT, Nov. 17, 2016
Prevention Related Articles
Lung Cancer: What Everyone Should Know About Screening Options—American Lung
Association, Nov. 1, 2016
New information on how brain cancer spreads—Science Daily, Nov. 17, 2016
How a common virus triggers blood cancer—Science Daily, Nov. 10, 2016
Sponge on a string test could replace endoscopies—Science Daily, Nov. 10, 2016
E-cigarettes “just as harmful as tobacco” for oral health—Medical News Today (MNT),
Drug combination therapy for estrogenreceptor–positive breast cancer passes critical step for worldwide approval—
135,000 alcohol-related cancer deaths predicted by 2035—Science Daily, Nov. 17,
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Nov. 17, 2016 Chronic sleep disruption linked to liver cancer—MNT, Nov. 23, 2016
Science Daily, Nov. 17, 2016
Cell of origin in childhood brain tumors affects susceptibility to therapy—Science
Cough virus kills liver cancer cells and hepatitis virus—MNT, Nov. 17, 2016 Glowing tumors help surgeons cut out brain cancer with precision—Science Daily,
Nov. 17, 2016 Advanced Prostate Cancer: Symptoms, Treatment, and Outlook—MNT, Nov. 18,
Scientists advance a novel urine test to predict high-risk cervical cancer—Science
2016
Prevent Food Waste! Don’t Toss Those Cancer-Fighting Veggie Parts—American
Daily, Nov. 17, 2016
Institute for Cancer Research (AICR), Nov. 25, 2016
Can Frankincense Treat Cancer? Get the Facts—MNT, Nov. 28, 2016
Survivorship Related Articles
Apricot Seeds: Cancer Treatment or Danger to Health?—MNT, Nov. 27, 2016
Anxiety and Depression Medicine Use Among Cancer Survivors—CDC, Nov. 2,
Targeting breast cancer metabolism to fight the disease—Science Daily, Nov. 28, 2016
Stop smoking! Quitting at any age reduces the risk of death after 70—Science Daily,
Nov. 30, 2016
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Young cancer survivors have twice the risk of suicide—Science Daily, Nov. 30, 2016
Immunology treatments providing hope for late-stage melanoma patients—Science
Daily, Nov. 15, 2016
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December 2016 & January 2017 Cancer Stakeholder
Funding Opportunities
Tools & Resources CancerCare presents the following free Connect® Education Workshops (all are from 1:30–2:30 p.m. ET): All sessions are free and preregistration is required. Jan. 11: Advances in the Treatment of Waldenstrom’s Macroglobulinemia (WM) Jan. 18: Living with Chronic Myelogenous Leukemia (CML) Jan. 26: Update from the 2016 American Society of Hematology (ASH) Annual Meeting Feb. 1: What Are Biosimilars? Understanding Their Role in Cancer Treatment: Current and Future Perspectives Feb. 2: Treatment Update on Mantle Cell
Lymphoma Feb. 6: Advances in the Treatment of Gastric Cancer Feb. 26: Update on Thyroid Cancer
Participate by listening to these workshops on the telephone or via live streaming through the Internet. For more information or to register online, visit CancerCare online or call 1-800-813HOPE (4673). Listen to past Connect Education Workshops as podcasts through CancerCare's website. The National Comprehensive Cancer Network’s (NCCN) Continuing Education Program seeks to improve patient outcomes in oncology by educating clinicians on the application of evidence-based medicine. Their accredited educational activities are designed for oncologists (in both community and academic settings), nurses, pharmacists, case managers, and other health care professionals involved in the care of patients with cancer. Dec. 21: NCCN 2016 Congress Series™: Immunotherapies in Cancer-Management of Toxicities Related to Immunotherapies
Sessions are approved for AMA PRA Category 1 Credit(s)™ as identified.
Sharsheret is hosting an educational opportunity for healthcare professionals. The session is free and pre-registration is required. Dec. 20: BRCA Genetic Testing: Understanding the Physical, Emotional, and Financial Challenges, 8:00–9:00 p.m. ET
The Patient Advocate Foundation hosts patient empowerment webinar series to build patients’ skills and increase access to health care. Jan. 19: Fertility Preservation for Cancer Patients, 12:00–1:00 p.m. ET Cancer and Careers is hosting an educational series for health care professionals (all are from: 1:00–2:00 p.m. ET unless otherwise noted) that covers practical and legal issues concerning balancing work and cancer. All sessions are free and pre-registration is required. One continuing education credit will be provided free of charge to eligible oncology nurses and social workers upon approval from listed agencies. Jan. 11: Managing Long-Term Stress Feb. 8: Managing Finances March 8: Job Search June 7: Career Change Sept. 13: Disclosure, Privacy & Online Brand Oct. 11: Working Through Treatment
The CDC provides funding to the American Cancer Society to coordinate collaboration among immunization and cancer experts to promote and implement HPV vaccination. The National HPV Vaccination Roundtable will bring together these stakeholders with the purpose of providing education, outreach, and training to the public and to health care providers. The CDC’s Immunization Services Division hosted a NetConference on Oct. 26, 2016 where Dr. Lauri Markowitz of the Division of Viral Diseases discussed recent HPV vaccine recommendation changes. To view the presentation, titled Recommendations for HPV Vaccination: 2016 Update, click here. The American Academy of Pediatrics developed an HPV Champion Toolkit to assist primary care practices in improving HPV vaccination rates. The toolkit includes quality improvement resources, HPV vaccine educational materials, sample public communication posts and printable resources. To view the toolkit click here.
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Human Resources and Services Administration released a Health Care Service Area Competition (SAC) opportunity to provide comprehensive primary health care services to an underserved area or population. Priority populations include lowincome persons, public housing residents and homeless or migrant farmworkers. Click here to apply. Closing date 1/10/17. Department of Health and Human Services released a FOA to scale and spread existing clinical decision support as well as disseminate and implement findings from Patient-Centered Outcomes Research into Clinical Practice. Click here to apply. Closing dates 1/25/17, 5/25/17. Agency for Healthcare Research and Quality released a FOA for research projects to develop, test and evaluate measures of shared decision making for research in clinical settings. Click here to apply. Closing dates 2/5/17, 6/5/17, 10/5/17. National Institutes of Health released FOAs for a variety of cancer related research projects: New Informatics Tools and Methods to Enhance U.S. Cancer Surveillance and Research is a FOA to support tools and methods to facilitate data extraction from medical records, approaches for integration of registry and medical data and approaches for ongoing reporting to registry data flow. Click here to apply. Closing dates 4/14/17, 11/30/17.
December 2016 & January 2017 Cancer Stakeholder
About the Cancer Stakeholder
Events Cancer Survivorship Symposium: Advancing Care and Research in San Diego, Ca. on Jan. 27–28, 2017. CHEST GAIN: Regional Non-Small Cell Lung Cancer Summits in Tampa, Fla. on Jan. 14, 2017 and Atlanta, Ga. on Feb. 11, 2017. Blood Cancer Conference 2017 in Fort Lauderdale, Fla. on Jan. 28, 2017.
Collaboratives R
egional Cancer Control Collaboratives exist across the state and work to bring public and private partners together to reduce the burden of cancer. For information about what your regional collaborative in your area is doing, visit their websites listed below.
> Northwest Florida Cancer Control Collaborative
22nd Annual Multidisciplinary Symposium on Breast Disease in Amelia Island, Fla. on Feb. 9–12, 2017.
> Northeast Florida Cancer Control
NCCN 2017 Congress Series™: Breast Cancer with Updates from 2016 San Antonio Breast Cancer Symposium in Chicago, Ill. on February 10, 2017.
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Families USA Health Action 2017 Conference in Washington, D.C. on Feb. 16–18, 2017.
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NCCN 2017 Nursing Program and NCCN Academy for Excellence & Leadership in Oncology™ School of Pharmaceutical & Biotech Business in Orlando, Fla. on March 22, 2017.
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NCCN 22nd Annual Conference: Improving the Quality, Effectiveness, and Efficiency of Cancer Care™ in Orlando, Fla. on March 23–25, 2017.
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Collaborative Facebook: NEFCCC North Central Florida Cancer Control Collaborative East Central Florida Cancer Control Collaborative Southeast Florida Cancer Control Collaborative Facebook: SoFla Fighting Cancer Southwest Florida Cancer Control Collaborative The Southeast American Indian Council (SEAIC) focuses on needs assessments, preventive education and quality of life for American Indians. Membership is open to anyone of American Indian heritage. Email Dewey Painter or call him at (904) 2080857 for an application or for more information.
To be added to the contact list for any of these collaboratives, send an email request to Cancer@flhealth.gov.
The Cancer Stakeholder is an e-newsletter, which includes the DOH cancer updates, cancer tools and resources, funding opportunities, events, research, and other information about cancer. The opinions expressed in the Cancer Stakeholder do not necessarily reflect the views of the Department or its staff. Please direct questions, comments and suggestions to the Comprehensive Cancer Control Program at cancer@flhealth.gov. If you would like to be removed from this distribution list, please send an email with “Unsubscribe” written in the subject line to cancer@flhealth.gov. Please type in the body of the email the county where you reside. Please understand that unsubscribing from the Cancer Stakeholder will unsubscribe you from receiving future emails related to the Comprehensive Cancer Control Program, the Regional Cancer Control Collaboratives and the associated local and statewide cancer activities. This electronic newsletter was funded by Cooperative Agreement U58/DP003872 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. For any questions or concerns regarding this newsletter or to include your information in a future issue: Sam.Mooneyhan@ flhealth.gov (850) 245-4444, ext. 3857.
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