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Lessons learned at the Health Forum

Posted: October 27, 2013 - 12:07am

Well, there’s good news and bad news. Bad news first: in Alaska, cancer ranks as the leading cause of death — for two decades running, now. The good news: regular screenings can lead to early detection, not only increasing survival rates but rendering certain types of cancer almost entirely preventable.

These are merely two tidbits I took away from the Cancer Connection’s Community Health Forum, a surprisingly informative cancer-related public health seminar last Saturday afternoon at Centennial Hall.

Cancer Connection strives to offer a comfortable environment — “with good food” — where people can learn more about the importance of good health and cancer prevention, Cancer Connection president Nicole Hallingstad explained to me via email.

“Our speakers are selected to cover a range of topics, and we hope it stays interesting each year,” she said. After offering separate men’s and women’s seminars for years, this year, the organization realized the whole community would benefit from coming together in one big forum.

“It’s important to keep the conversation going about the disease — in all its forms, to be able to say the word ‘cancer’ without feeling like it’s taboo, or worse: a death sentence,” she said.

Plus, how often would I get a free hour with two doctors, and a meal catered by Abby’s Kitchen?

And so, while I don’t usually spend my weekends attending health education seminars, this particular Saturday I thought ‘why not live a little?’ and join several hundred other Juneauites — a predominately middle-aged crowd, skewing decidedly female — for a healthy, “risk-reducing, no-cost lunch” (as event literature phrased it), two keynote presenters and a Q&A about cancer prevention, a topic starting to hit closer to home for me and my age cohort.

Obviously, cancer can be a serious subject. To keep the mood light, Cancer Connection enlisted local musician George Kuhar to open the forum with “Everybody Must Get Screened,” a spirited play on the Bob Dylan classic “Rainy Day Women #12 & 35.” Of course that made me wonder whether Dylan, himself, goes in for screenings (he’s 72; he really should).

As anyone who’s ever hosted a public event in Juneau knows, if you want to people to show up, you’ve got to serve free food. No frozen hors d’oeuvres or pre-packaged cheese platters at Cancer Connection’s Community Health Forum, however. We’re talking fresh “Superfood” salad with pomegranate vinaigrette, multigrain bread, and blueberry gingerbread with fresh lemon drizzle — all the recipes printed out and served alongside the meal. I’ve got to say, public health never tasted so good.

After the requisite food allergen warnings — the salad had tree nuts in it — Hallingstad, acting as MC, thanked everyone for coming, then jokingly thanked everyone “for bringing the men.”

Laughter fading, she yielded the podium to the keynote speakers Dr. Catherine Peimann, MD, of Southeast Medical Clinic and Dr. Robert Urata, MD of Valley Medical Care. The two gave presentations answering questions I’ve coincidentally been pondering myself lately: when should I get screened and why?

For the next three-quarters of an hour, the doctors covered the four cancers most common to Juneau: breast, colorectal, prostate and lung.

“The U.S. officially declared war on cancer back in the 1950s, which makes it the longest running war in the country’s history,” Dr. Peimann said. “And while screening certainly helps fight that war, prevention comes before screening. Don’t smoke, get plenty of exercise, eat a healthy diet. Stuff like that makes a real difference — all around.”

Some highlights from her portion of the presentation: accessibility to mammograms can be an issue for at least a third of Alaska, but portable mammography machines are bridging that gap; regular colonoscopies can keep you entirely free of colorectal cancer (which two of my great-grandfathers died of before reaching 60) and when it comes to discussing colorectal cancer, Canadians are much less squeamish than we are.

“Despite their effectiveness, putting the word out about colonoscopies can be tricky,” said Dr. Peimann, referencing Canadian public service advertising campaigns with slogans such as “Don’t Die of Embarrassment” and the slightly more to-the-point “Get Your Butt Checked.”

Not to be outdone in the comedy department, Dr. Urata followed with an apology about his “low-tech” presentation — text slides only, no graphics — but offered instead to demonstrate a prostate examination on a volunteer from the audience.

“Darn it,” he said before launching into his discussion of prostate and lung cancer. “I forgot my gloves.”

According to Dr. Urata, prostate cancer ranks among the most common types of cancer not just in Alaska, but everywhere. However, thanks to early detection techniques, it is one of the most successfully treatable. And more good news: doctors are moving away from digital rectal screening in favor of the far less invasive PSA (prostate-specific antigen) blood test.

As for lung cancer, my biggest takeaway was no screening for those at average risk, but for those at high risk (smoking at least 30 packs a year), yearly low-dose CT scan screening should begin at age 55 and last until 74, even for those who quit smoking up to 15 years prior. That’s pretty intense. Although, I’m 38, which means I can still take it up and then quit as long as I do it in the next two years.

Nah, I should probably find a more productive hobby. Like chewing gum. Or attending community health forums.

Visit the Cancer Connection website at www.cancerconnectionak.org for information about future events, as well as full listings of all programs and resources for those newly diagnosed with cancer, including travel assistance, various support and counseling services, a fun run, yoga for breast cancer survivors and even a Cancer Connection apartment in Seattle for Southeast Alaska patients to rent during treatment and follow-up. The site also provides a link for donations — dollars or Alaska Airlines mileage.

Screening guidelines (from the American Cancer Society, www.cancer.org)

Breast cancer

• Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health

• Clinical breast exam (CBE) about every 3 years for women in their 20s and 30s and every year for women 40 and over

• Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.

Colorectal cancer and polyps

Beginning at age 50, both men and women should follow one of these testing schedules:

Tests that find polyps and cancer

• Flexible sigmoidoscopy every 5 years*, or

• Colonoscopy every 10 years, or

• Double-contrast barium enema every 5 years*, or

• CT colonography (virtual colonoscopy) every 5 years*

Tests that primarily find cancer

• Yearly fecal occult blood test (gFOBT)*,**, or

• Yearly fecal immunochemical test (FIT) every year*,**, or

• Stool DNA test (sDNA)***

* If the test is positive, a colonoscopy should be done.

** The multiple stool take-home test should be used. One test done by the doctor in the office is not adequate for testing. A colonoscopy should be done if the test is positive.

Lung cancer

The American Cancer Society does not recommend tests to screen for lung cancer in people who are at average risk of this disease. However, the ACS does recommend screening if you meet all of the following criteria:

• 55 to 74 years of age

• In fairly good health

• Have at least a 30 pack-year smoking history AND are eithers till smoking or have quit smoking within the last 15 years

Prostate cancer

The ACS recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer.

Starting at age 50, men should talk to a doctor about the pros and cons of testing so they can decide if testing is the right choice for them.

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