Episode 18: Cancer Prevention and Screening

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welcome back to cancer uncovered. This is Christine wen with the live strong cancer institutes at UT Austin’s Dell medical school hook ’em horns. It’s a new year. This episode is being launched in January of 2022. And we’re pumped about all of the cool things we get to do in 2022. And we’re pumped to have you along with.

We have an amazing episode for you. First, we’re going to dive into our moment of cancer awareness. January is cervical cancer awareness month, and I have the pleasure of meeting one of our newest oncologists at the cancer institutes, Dr. Valerie Galvin Turner, who took a few moments to give me some information about cervical cancer.

I am Valerie Galpin Turner. I am a genetic logic oncologist here at UT health Austin. Cervical cancer is a cancer that arises from the uterine cervix. The uterus is the reproductive organ, um, that is housed in a female body. It is where primarily. Fetus or embryo starts to form when a person is pregnant, the lower part of the uterus or the lower three to four centimeters of the uterus is known as the cervix.

So it’s not a separate part of the uterus. It is actually, um, the same organ, but the lower part is a set of cells that can behave differently than the upper part. And that’s why it’s identified separately from the uterine body. Um, but cervical cancer can affect anyone. Um, from 20 years old to 80 years old, um, it just depends on the patient population that lives in the area.

So cervical cancer is one of the only cancers where the causative agent is known over 95% of cervical cancers are caused by the HPV virus. Many people have the HPV virus, not everyone will get cervical cancer, but the primary cause of cervical cancer is one of the HPV viruses. There are many different strains of HPV virus.

Um, that being said. One of the ways to prevent cervical cancer is to get vaccinated against the HPV virus. And you can do that starting at age nine, or you can do that up to age 45. So if you haven’t been vaccinated for HPV yet, I highly encourage you to do so. Um, for those patients who are looking to get information on screening or trying to figure out where to get screened, or you can talk to your doctor, you can ask your primary care doctor, your pediatrician.

You can talk to student wellness to find out where’s a place where you can get HPV screening or a pap smear screening. Um, planned parenthood is another good resource to help you find providers who can help you with cervical cancer screening. In the U S there’s going to be about 12,000 new cases of cervical cancer diagnosed annually with about 4,000 deaths anticipated each year.

So the goal here is going to be prevention. If you haven’t gotten that vaccine, there’s never a bad time to get it. Oh, the other thing that’s really important is that the vaccine is encouraged for both males and females. And really quick, let me just ask you this. How did you end up doing this type of.

That is not a quick question, but the shortest to answer that question, um, I’m first-generation um, my family, my, both of my parents were born in Mexico and they were migrant workers. Um, so I’m first generation Mexican American and in my culture, at least in my family, women’s health was very, very taboo subject.

You just didn’t didn’t talk about women’s health. You know, I, I learned in fifth grade from the, you know, student nurse that, you know, I was going to have a period and you know, that kind of a thing just horrified me, like, why, why didn’t nobody tell me why is all this stuff going to happen to girls? And nothing happens to boys.

And, and it was almost, you know, the, all of this, you know, taboo topic about women and their bodies and the changes that happened. It made me even more interested about it. It was, it was like the forbidden fruit. The more you couldn’t talk about it, the more I wanted to learn about it. And so it was, I had to learn more about it.

I would sit in my, in my tiny little library in my town and I would ride my bike there almost, you know, every other day, because I didn’t want to check out a book because if my mom or somebody were to tell my mom that my name was in the library card, you know, on that book about. Health, you know, what, what would they tell her I would get in so much trouble.

And so it was just going to be destined the stars that I’d had to go into women’s health and OB GYN, and then later gynecologic oncology. So it’s just something I’m very passionate about. I’m very passionate about, um, women’s health and, um, women’s cancers and, and especially, uh, passion about making sure that underserved and underrepresented patients, um, get taken care of.

All right. And a salary. Well, I will let you go and I will let your family get back into your house. Um, and once you have the rest of your afternoon, thank you. Perfect. Well, this was fun if you ever need anything else. Thank you so much to Valerie for taking the time to share this information with me at the expense of kicking your son and husband out of the house to do so.

We’re thankful for them as well. Next month, February is national cancer prevention month. And in order to best prepare, we invited our colleague, Kayla mom, with the American cancer society to talk to us about ways to prevent or stop cancer in our lives and in the lives of our family, friends. And. In this episode, you’ll hear Kayla mentioned that she works in cancer control and according to the American cancer society, cancer control focuses on reducing the number of people who get cancer, have complications from it and die from it.

It uses approaches that have been tested through research to control the number of cancer cases, as well as the effects of cancer. Cancer control programs, work to find and use the most effective ways to prevent cancer. Reduce the risk of cancer. Find cancer earlier, improve cancer treatments, help more people survive cancer and improve the quality of life for people who have cancer.

The goal of cancer control is to reduce the cancer burden. That means preventing cancer and decreasing how cancer impacts a community family. And individual. Let’s dive in and meet Kayla. Well, hello everyone. My name is Kayla mom. Sullied say I am the senior manager for cancer control, strategic partnerships.

And so I work in the cancer control department at American cancer society, and we work really closely with hospitals. Cancer treatment facilities, primary care providers, safety net clinics, health plans, um, to help increase the number of patients who are completing cancer screenings and to provide resources and services to cancer patients and their care.

Kayla. Can you talk to us a little bit about the American cancer society? Yeah, definitely. So like I was mentioning our cancer control department works really closely with patients around services and resources for while they’re going through treatment as well as services for their caregivers. And then we also work a lot.

Patients on prevention and you know, what can we do to help ensure that patients don’t have a cancer diagnosis or that we can catch it really early, but there are a lot of other different departments within American cancer society. And so we do a lot of research, so different types of cancer research, some of that’s around treatment, some of it’s around prevention, some of it may be around health equity or different.

Like that. And so research is a big arm of American cancer society as well. And we also have our income department. So as a nonprofit, we really rely on our community and support from community members and companies and organizations to help us fight our mission. And we want to, you know, end cancer. We would love to put us all out of a job and that would definitely be the end goal.

And we really appreciate the support that we get. Because without that support, we couldn’t do the work that we do. How did you end up here with ACS? How did you get here? Yeah, I definitely never thought about ACS when I was kind of along my career path. Um, I was working in the oncology field and, um, kind of found out about some volunteer opportunities with American cancer society.

So I kind of got involved just as a volunteer and I always knew no matter what I ended up doing in life, I wanted to help other people. That’s always been. It’s important to me. And once I started volunteering with ACS and learning more about the mission and the work that we do, I just really am so passionate about our work and, uh, opportunity opens up and I, you know, jumped in and applied and I’m really excited to say, I’ll be celebrating 10 years with American cancer society in may.

So it’s been a great. Um, opportunity for me in career. And like I said, I think the biggest thing for me is I feel like I’m helping people every day. I’m doing something to make a difference. And that’s what I love so much. That is awesome. Thank you so much for sharing that. And congratulations on 10 years, that’s fantastic.

The reason that I really wanted to bring you on to be a part of our education podcast, because it was because I’ve heard you speak a lot in other forums about your work around prevention and screening. And I think for this audience, I wanted to talk about screening and sort of put that out in the open as something that is on their radar, something they could potentially share with friends and family is it doesn’t directly apply to them.

Probably applies to somebody they know, and they love and their community or their family. Kayla, if you could define cancer screening and then maybe give us some information about that. What, what should our student listeners know about screening? Yeah, absolutely. I’m so excited to talk about this topic because I think it’s so important and a lot of people don’t realize that we can actually.

Some cancer by screening and the more we can get this information out and the more we can help encourage people to complete those screenings, the fewer cancers we’re going to see diagnosed in the more people will see surviving their diagnosis and living. So, you know, like probably most people on this call, I have seen friends and family who have battled a cancer diagnosis and, you know, I really want to help and make sure that if there’s something we can do to prevent.

For somebody that we are doing that screaming basically as a test to find cancer or some other type of disease in people who do not have any symptoms or we call that asymptomatic. And that’s, what’s really the key and important here is that you don’t have symptoms when we’re screening. Truly just because you’re of age and it’s time to start doing this.

So screenings are part of routine healthcare, just like checking your blood pressure or going to the dentist. And, uh, it’s important because a lot of times we hear from patients. I don’t have any symptoms. I feel fine right now. I don’t need to go get a screening, but again, actually this is the perfect time for screening, because once you do have symptoms, it’s no longer a screening.

It’s a diagnostic. And it doesn’t mean that cancer is going to be found. There’s a lot of reasons why you may have some sort of symptom. Um, and so that’s another misconception too, but it’s just there to find out what’s going on in, in a screening sense. It’s there to say, look, let’s, if something is going to be going on, let’s catch it before it’s causing a problem.

And when there’s something that we can do about. So again, most people don’t realize we can actually prevent some cancers through screenings. The way that this is possible is we’re finding cancers in like this pre cancer stage four. So you think about colorectal cancer, that’s a polyp, it’s a precancer stage and we can actually remove that pallette before it turns into cancer.

So we’ve prevented a cancer onset in that situation. So we remove those precancerous from the patient and able to save their life and save them from that diagnosis of, you know, you have cancer. So it’s not only important because we can prevent cancer, but it’s also important because we can catch cancer early when it’s easier to treat.

And there’s the best chance for a cure. I can tell you just kind of high level what some of these screenings are that we are encouraging patients to go get. So colorectal cancer screening should start at the age of 45 and that’s for everybody. Who’s just at a normal risk. If you have family history, you need to start screening earlier than that.

Talk to your doctor. Um, and a lot of people don’t realize that there’s a lot of different types of tests for colorectal cancer. So the best thing to do is go talk to your doctor if you’re 45 or, you know, someone who’s 45, encouraged them to go find out what is the best screening method for that. Breast cancer screening should start at the age of 45 as well.

And then patients who are 40 to 44 should have that option to start screening. If they would like to cervical cancer screening should start at the age of 25. And lung cancer screening is recommended for people who have a 20 pack year history or more of smoking history. Who smoke now or who have quit in the past 15 years and are between the age 50 and 80.

So that one’s a little bit more complicated and definitely for any of these screenings, you know, talking to your healthcare provider, um, is the best way to go. They can help get the, get you sent to the proper place to complete those screenings. If your, um, provider doesn’t do them directly. That is great information.

And I know, I know there are our listeners saying, wow, I am not even close to 25. I’m not even close to 45. So, but I think this is again, really important because you know, somebody that’s 25, you probably know someone that’s 45 or older. And so I think this is just something important that you could share with a friend or a neighbor or a family member.

Absolutely. Absolutely. And it’s hard to think about that in the moment in life gets in the way, and there’s always barriers or things that come up and you’re like, oh, I can put that off or let me reschedule that. But you’re absolutely right. Thinking about, well, what if I didn’t do the screening? And then I did end up with a cancer.

Or scare cancer scare. It’s definitely way better to go through that screening than to go through cancer treatment. And it’s also, you know, financially a lot more feasible to go through screening then treatment as well. And it’s not just the burden on yourself when you have a cancer diagnosis. The whole family is affected by a cancer diagnosis.

And, you know, there’s a lot of heartache with that, a lot of challenges and we can again prevent it or catch it early when it’s more treatable or easier to treat and you know, more likely to have that cure. It’s definitely. Yes, those are really excellent points. It’s a, it, you know, it’s less of a financial burden.

It’s less of a burden on your family. Those are really, really important points. So thank you for that, Kayla. I know one other thing is we hear a lot like, oh, you know, I’m, I’m taking care of my family or, you know, a lot of times we hear that from women too, you know, they’re so busy, just making sure everybody else is taken care of, but what would happen if they were not able to take care of everybody else because they are going through cancer.

So, you know, it’s not, not thinking of your family by going to get screening. It’s actually doing your family a favor as well, because you are thinking of yourself and your overall health, um, and prioritizing yourself. It’s important that everybody prioritizes and self a little bit in some ways, Absolutely talk about, you know, self care is such a buzz word, right?

But like, this is the ultimate in self care, the take care of yourself. Right. And put your health first. So you can, so you can go take care of your loved ones and be a part of your family. So super important kind of in that same vein, then one thing I did want to make sure that we talked about and that I discussed with you during this time is barriers to screening.

Right? So we talked a little bit about. A few reasons why people might not get screened. So they don’t feel like they have time or they feel fine. But could we talk about some of the other things that may be other issues or challenges that maybe you’ve seen through your work? Why do people not get screened?

Yeah, absolutely. Um, you know, a lot of times. They didn’t know that they needed to get screened. Um, you know, maybe they went and saw their provider, but they had another issue that they were really focused on with their provider. So cancer screening maybe wasn’t brought up or they just didn’t know that it was time.

So knowledge is, is really important. And that’s why I’m excited about this today because we’re empowering a lot of people with great knowledge that can go in. Spread that knowledge amongst their friends and family and help everybody understand. So, you know, again, people just aren’t aware of the importance of screening or that it’s again, part of the recommended routine healthcare.

Um, so it’s really important to get regular screenings, even if you’re feeling fine. You know, it’s also important to note that cancer screening tests can catch some changes that may or may not be cancer. So most of the time, these screenings are not going to come back with a cancer diagnosis. They’re going to come back with the all clear, you’re good to go until your next screening.

Um, and that’s important to keep in mind, but sometimes they do come back with some sort of change or, you know, hopefully not cancer, but if it is finding that the hope is that we did find it early. Oftentimes people are also nervous about. And it’s important to let people know it’s okay to have questions about medical procedures and cancer screenings.

It’s okay to be concerned about possible findings or even just seeing a doctor, but knowing the current state of your health can make it easier to take care of any issues that potentially are there, and it can also help lengthen or save your life. So we really encourage everyone to. Talk to their healthcare provider asks their questions.

And again, remember that most of the time, these test results are normal. Some other barriers, um, you know, besides knowledge are just some cultural barriers, economic barriers, maybe location, lifestyle, and responsibility. So, you know, we do see in some cultures that people only go to the doctor when they really are sick.

And the idea of going for a screening when they’re healthy, just seems so foreign and you know, why would I go and look for something that’s not there. But again, we know that screening is for the asymptomatic. So just helping people to understand. And, and know that message can be really beneficial. It’s also important to note that most screenings are covered by insurance or are available at no cost.

So there might be costs for some followup appointments or additional testing if needed. But most of the time, these test results are normal. So you won’t need that additional follow-up. And most of the time insurance can, does cover it. So if you don’t have insurance or if you’re, for some reason, insurance is not covering.

Good to check with your local hospital health department, your safety net clinic, like a federally qualified health center. Uh, we call those FQHC. There are lots of resources out there to help patients get screened. And so, you know, we really encourage you to talk to those people that can, can help with that.

Um, you know, and, you know, finding that time to take off of work and childcare, transportation goes back to, you know, prioritizing yourself and, you know, making sure that. I find that time there are resources to get screened and off work hours, some screenings that’s not possible just because of timing or how long the procedure may take.

But again, it’s important to prioritize yourself sometimes and make sure that you are able to take care of those things that are needed. So, you know, talking to your healthcare provider, If there is a challenge, like getting to the screening, right. Or if you’re not sure about how to handle work or childcare, your physician will likely have some resources that they can talk to you about.

But do you have any, any other thoughts on resources that people could check out if they’re concerned about. You know, financial burdens or childcare or getting a ride. Yeah. Again, you know, checking with your local hospital district or health department safety net clinics. They’re going to know of those resources to help with some of these barriers to screening.

And again, you know, there’s things called like mobile Memorial. So they bring the mammography bus out to a location. So maybe that bus is going to come close to you. So you don’t have to take the whole afternoon off. You can just leave on your lunch hour or something like that. So again, those places will have a lot of those resources.

You can also talk to American cancer society and you can call our national cancer information center. That number is 1 802 2 7 2 3 4 5. That’s fantastic. Thank you for letting us know about that specific resource with ACS as well. And that’s something that all, um, I can share at the end of this conversation too.

I wanted to talk with you Kayla, about prevention. I was curious about your suggestions for what students can do now for themselves to prevent cancer from being a part of their lives. And while we can’t always prevent cancer, there are some things we do know can help in the prevention of cancer. So I wanted to get your take on that.

Yeah, absolutely. So we talked about like actually going and getting screenings, and that is geared a little bit more towards once you get a little bit older, but there’s lots of things that everybody can be doing all the time to help lower their risks of a cancer diagnosis. So the first thing is the HPV vaccination.

So a lot of people don’t realize, but this vaccine actually provides. Six different types of cancer, and it can be given as young as nine American cancer society recommends that that vaccination is given between nine and 12. It is a two dose series. If you get it before the age of 15, after the age of 15, it is a three dose series and you can get it all the way up to the age of 23.

Um, older than 26, it is possible, but we do recommend talking to your provider about that and making that decision. So that is a really great way to prevent cancers, a simple vaccine that you go in. And again, it prevents six different types of cancer. Some other things that you can do is around diet and physical activity.

So about one in five cancers diagnosed in the U S are linked to excess body weight, lack of physical activity, drinking alcohol and, or a poor diet. 16% of cancer deaths are related to these same factors. So some of those cancers could be prevented. So American cancer society recommends to get to and stay at a healthy weight, adopt a physically active lifestyle, follow healthy eating patterns and avoid alcohol.

And a lot of people think like, okay, physically active. I have to go and run miles and all of this, but it’s not about that. It’s just about, you know, instead of sitting down on the couch, go out and work in your garden or go for a walk around the block, it is recommended to get about 150 to 300 minutes of moderate exercise.

Or 75 to 150 minutes of vigorous exercise per week. And teens mean one hour of moderate or vigorous activity per day. So that can all help you, you know, eating a variety of colorful vegetables, whole grains foods high in nutrients can help lower your risk. Also sensor safety is very important. So most skin cancer is caused by repeated and unprotected skin exposure to ultraviolet radiation.

So American cancer society has the slogans, slip, slop, slap, and wrap to help, uh, remember, uh, what you can do to protect yourself from UV radiation. So you slip on a shirt, you slop on some sunscreen, slap on a hat and wrap on sunglasses, um, and definitely stay away from those tanning beds. And I think that the other really big thing that people can do is avoid tobacco products, um, and also avoid being around people when they are using tobacco.

Including e-cigarettes. So it’s really important to know that all tobacco products, including e-cigarettes can cause health problems each year using tobacco causes about one out of five deaths in the United States. That’s a lot of death. And in fact, smoking cigarettes kills more Americans than alcohol car.

HIV guns and illegal drugs combined. So tobacco smoke, uh, it contains more than 7,000 chemicals and compounds. Hundreds are toxic and at least 69 cause cancer. So if you or a friend or a family member uses e-cigarettes or other tobacco. Talk to a doctor about quitting call somebody, there is a lots of resources out there to help you quit.

And this is probably one of those things that can really help lower that risk of a cancer onset. I just wanted to make a quick point about COVID-19 and the pandemic, and it has definitely impacted screening across the board. And we know early on in the pandemic, a lot of screenings were put on hold. And, you know, we were told not to leave and don’t go anywhere and it’s taken the screenings have not picked up as fast as we maybe hoped that they would.

And not only that, but when they were put on hold there. Lots and lots of people who were supposed to be getting their screenings that didn’t go and do them. So screaming, um, has resumed and it is safe to return to regular screening the facilities that offer screenings have safety precautions in place, and it’s best to schedule your test as soon as you can.

So definitely keep that in mind. And if you know of somebody who maybe put something off during the pandemic, encourage them to get back out there and get that, um, screening scheduled. And, uh, don’t let this pandemic hold you back. It goes beyond screening, just your normal well visits and adolescent vaccines.

I mean, we have seen a huge decline in just those recommended vaccines that adolescents go get. So all of that type of healthcare is very important. So make sure again, prioritize. If anyone has questions or wants to know how to get involved with American cancer society, please reach out. And, um, we would love to talk with you all good luck with everything.

And there’s lots of people out here cheering you all on in, in here to help support. So don’t be afraid to reach out to others as well. So thank you. Thank you to Kayla for your time and expertise. As Kayla mentioned to the American cancer society is available to everyone 24 hours a day. Seven days a week as a place to find resources and more information, you can reach them at 1 802 2 7 2 3 4 5.

Or by visiting cancer.org, you can find out more about the live strong cancer institutes at Dell med dot. E D U if you have questions regarding this episode, previous episodes, or have an idea for an upcoming episode, we want to hear from you. Please email us at live strong cancer institutes at Dell med dot U, Texas dot E D.

You can also follow us through our chair, Dr. Gail Eckhart on Twitter at S Gale at cart at cart is spelled E C K H a R D T. This is Kristin when for cancer uncovered. Thank you for listening and learning with us. .