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April 9, 2008 > Cancer Control Month: Prevention and Early Detection Are Key To Controlling Cancer

Cancer Control Month: Prevention and Early Detection Are Key To Controlling Cancer

While cancer treatments have improved dramatically over the past couple of decades, the American Cancer Society notes that cancer is still the second leading cause of death in the United States. Studies show that the lifetime risk of developing cancer remains high, with half of all men and one third of all women in the U.S. at risk of developing cancer during their lifetimes.

"Cancer develops when cells in the body begin to grow out of control," says Dr. Vandana Sharma, an oncologist at Washington Hospital. "Normal body cells grow, divide and die in an orderly way, but cancer cells continue to reproduce new abnormal cells that replace normal tissues in the body."

Each year, April is designated as Cancer Control Month to highlight advances in cancer treatment and encourage people to follow established guidelines for cancer screenings and take control of various risk factors for cancer.

"Different types of cancer can grow at different rates and respond to different treatments, and the treatments are improving all the time," Dr. Sharma says. "The key to controlling cancer, though, is to take preventive measures to reduce your risk factors and to catch cancers in the early stages when treatment can be most effective."

A risk factor is anything that increases your chances of getting cancer. Some risk factors can be changed, but others cannot.

"Cancer is primarily a disease of aging, and you really can't do anything about getting older," Dr. Sharma explains. "You also cannot control your sex or your family's medical history, both of which can affect your susceptibility to certain types of cancer. What you can try to control is your exposure to various carcinogens in the environment, such as certain chemicals and radiation. You also can control lifestyle choices such as smoking, alcohol use, improper diet, physical inactivity and sun exposure.

"In the case of cervical cancer, it's also important to avoid exposure to the sexually transmitted human papilloma virus (HPV), since it has been linked to cervical cancer," she adds. "It is now recommended that all women, from age 9 to age 26 receive the new vaccine - Gardasil - that prevents infection against the two types of HPV responsible for most cervical cancer cases, as well as against two types of HPV that cause genital warts."

Dr. Sharma recommends that all people follow the American Cancer Society's guidelines for cancer screenings outlined below. "People who are at increased risk for certain cancers may need to follow a different screening schedule, such as starting at an earlier age or being screened more often," she notes. "People with symptoms that could be related to cancer - including changes to a mole that can indicate skin cancer - should see their doctor right away."

Breast Cancer
* Yearly mammograms for women, starting at age 40.

* Clinical breast exam by a physician about every three years for women in their 20s and 30s, and every year for women 40 and over.

* Regular breast self-exams for women beginning in their 20s.

* Women at high risk (greater than 20 percent lifetime risk) should get an MRI and a mammogram every year.

* Women at moderately increased risk (above 15 percent lifetime risk) should ask their doctors about the benefits and limitations of adding MRS screening to their yearly mammogram.

Colon and Rectal Cancer
* Beginning at age 50, both men and women at average risk for colorectal cancer should have a flexible sigmoidoscopy screening every 5 years or a colonoscopy every 10 years.

* If a flexible sigmoidoscopy produces positive test results, it should be followed up with a complete colonoscopy.

* People should be screened earlier and/or more often if they have:
-- a personal history of colorectal cancer or polyps
-- a personal history of chronic inflammatory bowel disease
-- a strong family history of colorectal cancer or polyps
-- a known family history of hereditary colorectal cancer syndromes

Cervical Cancer
* All women should begin cervical cancer screening about three years after they begin having vaginal intercourse, but no later than age 21.

* Screening should be done every year with the regular Pap test or every two years using the newer liquid-based Pap test.

* Beginning at age 30, women who have had three normal Pap tests results in a row may get screened every two to three years.

* Another option for women over 30 is to get screened every three years with the conventional or liquid-based Pap test, plus the HPV DNA test.

* Women over 30 who have certain risk factors such as DES exposure before birth, HIV infection or a weakened immune system should continue to be screened annually.

* Women aged 70 or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical screenings. Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue to be screened as long as they are in good health.

* Women who've had a total hysterectomy may choose to stop having cervical screening, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who had a hysterectomy without removal of the cervix should continue to follow the guidelines above.

Endometrial (Uterine) Cancer
* At the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer and should be strongly encouraged to report any unexpected bleeding or spotting to their doctors.

* For women with - or at high risk for - hereditary non-polyposis colon cancer (HNPCC), annual screening should be offered for endometrial cancer with endometrial biopsy, beginning at age 35.

Prostate Cancer
* Both the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE) should be offered annually, beginning at age 50.

* Men at high risk (African-American men and men with a strong family history) should begin testing at age 45.

* Men at even higher risk, due to multiple first-degree relatives affected at an early age, could begin testing at age 40.

Washington Hospital offers support groups and educational programs to help members of the community better understand and cope with cancer. To see a full list of support groups and classes, call (800) 963-7070 for a free copy of the hospital's Health & Wellness Catalog or visit, click on "The Community," and select "Community Seminars & Health Classes."

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