Cancer Prevention Works fall 2023

DARE

IMAGINE

Page 2 CEO’s Corner, Foundation news

Page 3 Global grant project expands quality lung cancer screening in Poland

Page 4 5 myths about lung cancer

Page 6 What does your breast density mean and how does it play a role in cancer risk?

Page 8 You never forget your first time: getting a mammogram

Page 10 Prevent Cancer Foundation supports the Reducing Hereditary Cancer Act

CEO’S CORNER DEAR READERS,

Fall brings more than just cooler temperatures and beautiful foliage. It also ushers in two cancer awareness months that remind us to stay on track with routine cancer screenings and to continue participating in healthy lifestyle choices to reduce our risk.

In recognition of Breast Cancer Awareness Month this October, we are sharing stories that we hope will encourage everyone of average risk to schedule their routine mammogram screenings beginning at age 40. I just got my annual mammogram and needed a follow-up diagnostic mammogram for a closer look. After being inspired by many of your stories, I brought a friend with me for the follow-up, and we went out to lunch after. It seemed silly at first, but it made the whole experience so much easier.

And although lesser known than its October counterpart, Lung Cancer Awareness Month—which occurs every November—is the perfect time to learn about factors that can contribute to the disease and ways to reduce your risk. Addressing the stigma surrounding lung cancer is equally important. Anyone with lungs can get lung cancer—educating ourselves and changing the way we discuss the disease will lead to better outcomes.

We hope you enjoy this issue, and I encourage you to take something you learn and share it with your loved ones, empowering them to stay ahead of cancer through prevention and early detection.

JODY HOYOS CEO

JORDANIAN ROYALTY GRACES 29TH PREVENT CANCER FOUNDATION ANNUAL GALA

Marking nearly three decades of honoring nations committed to fighting cancer, this year’s Prevent Cancer Foundation Gala, themed Pillar of Wonder, transported guests to the nation of Jordan, raising more than $2 million for cancer prevention and early detection. Her Royal Highness Princess Ghida Talal of Jordan and Her Excellency, Ambassador Dina Kawar, both were in attendance with nearly 1,000 guests to celebrate. The event was held on September 27 at the National Building Museum in Washington, D.C. Funds from the Gala will support the Foundation’s programs, including research grants, fellowships and community grants and the Foundation’s public education campaigns.

Her Royal Highness, Princess Ghida Talal of Jordan

GLOBAL GRANT PROJECT EXPANDS QUALITY LUNG CANCER SCREENING IN POLAND

Lung cancer is the world’s number one cancer killer, which has encouraged countries around the world to launch national lung cancer screening services with the goal of detecting and treating at earlier and more curable stages. In Poland, where deaths from lung cancer are the second highest in the European Union, health officials are focused on expanding access to quality computed tomography (CT) screening for high-risk populations nationally. One of the most promising breakthroughs in reducing lung cancer mortality has been the implementation of low-dose CT lung cancer screening for those at high risk.

In support of this aim, the Prevent Cancer Foundation awarded a grant to develop and design a low-cost, cloud-based system for obtaining and monitoring the quality of the CT images during lung cancer screening. The project team deployed their novel CT calibration phantom (test object) at multiple CT lung cancer screening sites in Poland with the purpose of improving the quality of lung cancer screening.

Results have indicated a promising future. After using the phantoms and software for over two years, Dr. Joanna Bidzińska, national lung cancer screening program coordinator for the northern macroregion of Poland at the Medical University of Gdańsk, concluded:

“Constant quality assurance and monitoring is indispensable in lung cancer screening on the level of the acquisition protocols, scans quality and beyond. The phantom use should be included in future interventions.”

These innovations have the potential to rapidly optimize lung cancer screening imaging—making them more effective at catching more cancers in their earliest stages—across Poland and around the world.

For more information on the Prevent Cancer Foundation’s global grants program and to learn what other work is being done around the world to prevent cancer or detect it early, visit preventcancer.org/global.

5 MYTHS ABOUT LUNG CANCER

In 2021, the U.S. Preventive Services Task Force (USPSTF) lowered the eligible screening age and smoking criteria for lung cancer, effectively expanding screening access to millions more smokers and former smokers. Yet, screening rates in the U.S. are low, with less than 5% of those who are eligible being screened annually.

We know that when cancer is detected early, it increases your chance of survival. Early detection may also require less extensive treatment or more treatment options.

To help reverse current lung cancer trends, we’re debunking the top five myths about lung cancer.

Myth #1: I’m a smoker but it’s too late—there’s no point in quitting now

While many factors can contribute to lung cancer risk, about 80%–90% of lung cancer deaths are related to cigarette smoking. Quitting smoking has near-immediate benefits and reduces your risk of getting cancer or other smoking-related diseases. According to a study published in Annals of Internal Medicine, quitting smoking even after a lung cancer diagnosis can help people live longer or delay a cancer recurrence or worsening of the disease. In other words, it’s never too late to quit. For help quitting, call 1-800-QUIT-NOW.

Myth #2: A lung cancer screening happens when a health care provider holds a stethoscope to your chest and listens to your breathing

When your doctor checks your breathing with a stethoscope, they are listening for wheezing or fluid in the lungs—but they can’t detect lung cancer that way.

Actual lung cancer screening is done through a specialized computed X-ray, also known as a CT scan, to detect cancerous growths inside a person’s lungs. This is formally referred to as a low-dose computerized tomography (LDCT) scan and is a quick, noninvasive procedure.

There is definitive evidence that screening long-time smokers with LDCT significantly reduces lung cancer deaths. If you’re a heavy smoker or former heavy smoker, get screened for lung cancer. The USPSTF recommends lung cancer screening for current or former smokers between 50 and 80 years old who have a 20 pack-year history* of smoking and still smoke or have quit smoking within the past 15 years.

1. De Groot PM, Wu CC, Carter BW, Munden RF. The epidemiology of lung cancer. Transl Lung Cancer

health care provider if these symptoms occur:

• A cough that does not go away

• Coughing up blood

• Constant chest pain

• Repeated pneumonia or bronchitis

• Weight loss and loss of appetite

• Hoarseness lasting a long time

• Wheezing or shortness of breath

• Feeling very tired all the time

Myth #4: You can only get lung cancer if you smoke or use tobacco

Perhaps the biggest myth surrounding lung cancer is that smoking is the only cause of lung cancer. People who have never smoked can also be diagnosed with the disease—10%-20% of lung cancers are found in nonsmokers, according to the Centers for Disease Control and Prevention (CDC). You may be at increased risk for lung cancer if you have had heavy exposure to secondhand smoke, were exposed to indoor or outdoor air pollution, have had a job with exposure to radiation, were exposed to toxic substances (such as arsenic, radon or asbestos) or have a personal or family history of lung cancer.

These factors may not make you eligible for screening, but you can talk to your health care provider and stay vigilant for any signs or symptoms of disease.

Myth #5: Aside from not smoking, there’s nothing I can do to reduce my risk of lung cancer

There are many steps you can take to reduce your risk of lung cancer. Avoid secondhand smoke and instead of relying on vitamin supplements such as beta-carotene, which has been linked to increased risk of lung cancer, increase your intake of fresh fruits and vegetables to get the vitamins and nutrients you need and lower your risk for all cancers.

It’s also important to make your home and community smoke-free and to check the radon levels in your home. Exposure to radon is the second leading cause of lung cancer. Radon is an odorless, radioactive gas that can enter homes and buildings through the ground. Despite its risks, radon-testing is uncommon. Sadly, many people only learn what radon is only after they have been diagnosed with lung cancer.

*A ‘pack-year history’ is an estimate of how much a person has smoked over time. The number of packs of cigarettes smoked every day is multiplied by the number of years a person has smoked that amount. Example: a person who smoked 1 pack a day for 20 years has a history of 1 x 20 = 20 pack years.

WHAT DOES YOUR BREAST DENSITY MEAN

and how does it play a role in cancer risk?

Breast density. You may have heard about it on the news or saw the words on your recent mammogram report. But do you know what it is and why it’s important?

Updated U.S. Food and Drug Administration (FDA) regulations say that beginning next year, health care providers must include breast density data when notifying patients of their mammogram results.

Since greater breast tissue density has been linked with a higher risk for breast cancer, understanding your breast density can help you and your provider develop a personalized plan to achieve better outcomes.

What is breast density?

Breast density describes the ratio of the breast’s three main types of tissue: fibrous connective (that gives support), glandular (that makes milk), and fat. Breast density is a term that describes the amount of each of these tissues compared to one another. Dense breast tissue has higher amounts of fibrous connective and glandular tissue (also called fibroglandular tissue) compared to fat.

Is it normal?

Having dense breasts is completely normal and is quite common—almost half of all women ages 40 and over are found to have dense breasts on a mammogram. Breast density can change over time, and although breast density can increase during menopause through the use of hormone replacement therapy, more typically, breast density decreases as women age along with decreases in estrogen levels and increases in body weight.

Women who are pregnant or breastfeeding tend to have greater breast density (due to increased estrogen), and those with lower body weight tend to have denser breasts, as they have less fatty tissue throughout their body.

How can you tell if you have dense breasts?

Breast density cannot be determined by how your breasts feel or look, but can be seen on a mammogram, which is an X-ray of the breast. Both 2D and 3D (tomosynthesis) mammograms show dense areas of the breast as white, while areas that are less dense (or more fatty) appear dark.

Why does it matter if I have dense breasts?

Dense breasts can make it harder for the radiologist reading your mammogram to see breast cancer. This is because most often, breast cancer appears white on a mammogram. If breast cancer occurs in an area of dense breast tissue, which also appears white on a mammogram, the radiologist may miss it.

For reasons that are not well known, people with dense breasts have a higher risk of developing breast cancer as compared to those with less dense breasts. And that risk increases as the amount of dense breast tissue increases.

How can I learn how dense my breasts are?

In addition to cancer detection, mammograms also help determine whether the breast density category is:

A. Mostly fatty: almost entirely fat with little fibroglandular tissue

B. Scattered fibroglandular densities: mostly fat with scattered fibroglandular tissue

C. Heterogeneously dense: many areas of fibroglandular tissue, which may obscure small masses

D. Extremely dense: large amounts of fibroglandular tissue

The category of breast density is included in the report the radiologist sends to the health care provider who ordered the mammogram and they can share that information with you.

Some states require the facility where you had the test performed to notify you of your breast density—and thanks to updated FDA regulations issued in March 2023, this will be a national requirement by the end of 2024.

How can I change my breast density?

In most cases, you can’t do much to change your breast density. Weight loss (or gain) can impact your breast density as it may change the amount of fatty tissue in your breast, but the amount of fibroglandular tissue will largely stay the same.

What should I do if I have dense breasts?

Depending on the density of your breasts and your personal risk of breast cancer, your provider might recommend additional testing, such as breast magnetic resonance imaging (MRI) or breast ultrasound, to confirm cancer was not missed on the mammogram. It is important to remember: these tests do not replace mammography but help increase the chance of finding early-stage breast cancers in dense breasts. This is important because Early Detection = Better Outcomes.

YOU NEVER FORGET YOUR FIRST TIME:

Getting a Mammogram

By Cassie Smith

When I called the radiology center listed on my mammogram order first-thing one Monday morning, I expected to be put on hold, allowing me time to take a few sips of coffee. (With a 9-month-old, I cherish the days I can drink my coffee when it’s still hot!) But lo and behold, an actual person picked up the phone, ready to set up my appointment. Not only that, but she also offered me an appointment within the next two weeks, and at a time convenient to me.

Boom. Appointment made and my coffee was still warm.

For women of average risk for breast cancer, the Prevent Cancer Foundation supports the recommendation to begin annual mammograms at age 40. I recently celebrated my 36th birthday, but since my mom was diagnosed with breast cancer in her early 40s, my doctor had previously recommended I schedule my first mammogram once I was no longer breastfeeding my daughter.

I brought this up at my annual check-up this summer, and the doctor promptly gave me an order for a 3D mammogram. Thanks to my job at the Prevent Cancer Foundation, I knew a 3D mammogram could provide a more comprehensive look at my breasts compared to a 2D mammogram, so I was grateful my doctor recommended this.*

When I made my appointment, the receptionist shared a few helpful tips: don’t wear deodorant, lotion or perfume the day of your appointment; and wear a two-piece outfit. The day of my appointment, I felt as prepared as I could be, which eased some of the nervousness I typically get ahead of any medical appointment.

I checked in with the receptionist and joined the others in the waiting room. Soon, I was taken back to a dressing room and instructed by the radiology technician to undress my top half and put on a robe. At this point, I imagined I was getting ready for a spa day, which helped me relax a bit.

I snapped a couple of quick selfies in the privacy of the dressing room to share on social media and met the technician on the other side of the curtain. (I’m not just a Millennial who documents everything—sharing on social is a powerful way to encourage your friends to get their screenings!) She offered me a hair tie to pull back my hair so it didn’t get tugged by the machine—a tip I’m glad to have for next year’s mammogram.

The word I hear most often when people describe a mammogram is “uncomfortable.” It was not painful to me, but I was asked to stand in some interesting positions. I’d say it’s like the most awkward photo shoot you’ll probably ever do, right down to the instructions from the mammographer.

Tilt your head this way.”

“Place your arm here.”

“Turn your feet toward the corner.”

“Say cheese.”

Okay, she didn’t say that last one, but you get what I mean.

The whole process took less than 15 minutes, and while I still needed to wait for my results, I left the appointment feeling empowered, as I imagine many women feel when they are proactive about their health.

A few days later, I received an email that my results were negative with a note from my doctor that I should plan to schedule another mammogram next year. I’m setting my reminder now so I don’t miss it!

Have you had your mammogram? To learn what routine cancer screenings you may need, visit preventcancer.org/screenings. And don’t forget—the powerful stories we share can encourage others to take charge of their health! Share your first time on social media and tag @preventcancer with #MyFirstTime.

*Both 2D and 3D mammograms are appropriate screening options. 3D mammograms may offer screening advantages for some, such as those with dense breasts. Talk with your health care provider about which screening method is right for you.

PREVENT CANCER FOUNDATION SUPPORTS THE REDUCING HEREDITARY CANCER ACT

The Prevent Cancer Foundation is proud to support the Reducing Hereditary Cancer Act, (H.R. 1526 / S.765). This bipartisan, bicameral legislation aims to modify current Medicare statutes to enable coverage of potentially lifesaving genetic counseling, genetic testing, cancer screening and risk-reducing interventions.

Under existing Medicare law, only people with “signs, symptoms, complaints, or personal histories of disease” get coverage of medical services. For routine cancer screenings currently covered under Medicare (like mammograms and PSA tests), Congress had to pass specific legislation giving Medicare the authority to cover these services. Legislation also gives Medicare the

authority to cover more frequent screenings for people at high-risk for certain cancers, such as colon cancer. Unfortunately, many guideline-recommended screenings and risk-reduction measures for people at increased risk of cancer are not covered under Medicare.

The Reducing Hereditary Cancer Act will remedy this Medicare coverage gap, ensuring that Medicare patients have access to guideline-recommended, evidence-based screening and preventive services. Ultimately, this will save lives and money by preventing or detecting cancers early for those who are at high-risk due to a hereditary predisposition. It will also reduce health disparities by addressing a lack of coverage as a barrier to appropriate care.

Use the QR code to learn more about this important legislation. For resources on knowing your family health history, visit preventcancer.org/know-your-family-history

Would you like to support the Prevent Cancer Foundation, but aren’t sure how? Making a difference doesn’t have to be a huge undertaking. You can turn everyday events and activities into fundraisers. Instead of receiving birthday gifts, ask your friends and family for donations to the Prevent Cancer Foundation, or get together with your friends to host a video game marathon to fundraise for the Foundation.

Hosting an event for friends and family—either in person or online—is a great (and fun) way to support the mission of the Foundation. Our new fundraising toolkit shows you, step-by-step, how to turn nearly any event into a fundraiser to help prevent, detect and beat cancer.

The kit includes information from start to finish, beginning with how to organize your fundraiser online to thanking your donors at the end of the event. You’ll even find templates for social media posts, donor outreach and more.

The toolkit also has instructions for how to livestream a fundraiser. Whether you’re planning to host a speedrunning tournament or an online concert, the toolkit can help, with tips on creating a schedule, planning prizes and incentives and more.

To get started, visit preventcancer.org/fundraise and take the first step toward creating your own fundraiser. If you have specific questions or need additional support, please reach out to Amanda Wallach at amanda.wallach@preventcancer.org.

FUNDRAISING IS AS EASY AS 1-2-3 Learn how to fundraise your way today!

TO SUBSCRIBE, CONTACT: PREVENT CANCER FOUNDATION®

333 John Carlyle St., Ste. 635, Alexandria, VA 22314

Toll-Free: (800) 227-2732

Main: (703) 836-4412

Email: pcf@preventcancer.org

Visit: preventcancer.org