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UNITED NATIONS OFFICE AT NAIROBI
JOINT MEDICAL SERVICE
WORLD CANCER DAY – We Can/I Can.
My role in cancer prevention and screening
What is cancer?
Cancer is a disease that starts in our cells. Our bodies are made up of millions of cells, grouped
together to form tissues and organs such as muscles and bones, the lungs and the liver. Genes
inside each cell order it to grow, work, reproduce and die. Normally, our cells obey these orders
and we remain healthy. But sometimes the instructions get mixed up, causing the cells to form
lumps or tumors, or spread through the bloodstream and lymphatic system to other parts of
the body.
Tumors can be either benign (non-cancerous) or malignant (cancerous). Benign tumor cells stay
in one place in the body and are not usually life-threatening.
Malignant tumor cells are able to invade nearby tissues and spread to other parts of the body.
Cancer cells that spread to other parts of the body are called metastases.
Cancers are named after the part of the body where they start. For example, cancer that starts
in the bladder but spreads to the lung is called bladder cancer with lung metastases.
A. What is a risk factor to cancer?
Cancer risk refers to a person’s chance of developing cancer. A risk factor is any substance or
condition that increases the risk of developing cancer.
There are very few cancers that have a single, known cause. Most cancers seem to be the result
of a complex mix of many risk factors. These risk factors may play different roles in starting
cancer and helping it grow. Some risk factors include heredity (genetics), lifestyle choices and
exposure to cancer-causing substances (carcinogens) in the environment.
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in general, the more often and the longer the exposure to a risk factor, the greater
the chance that cancer will develop
It can take many years for cancer to develop after exposure to a risk factor.
Cancer usually develops after exposure to many risk factors over time. People may
be exposed to several risk factors in the course of their daily lives.
Some people have a higher risk of developing cancer because of certain risk factors.
Even if a person has one or more risk factors, it is impossible to know exactly how
many these factors may contribute to developing cancer later in life.
People at low risk may get cancer, while people at high risk may not get cancer.
Low risk does not mean that a person will not get cancer. It means that there is less
chance of getting cancer.
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JOINT MEDICAL SERVICE
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High risk means that the chances of getting cancer may be greater, but it does not
mean that cancer will develop. It isn’t always clear why one person gets cancer and
another doesn’t.
B. How do you reduce your risk?
Risk reduction (or prevention) means taking action to lower the risk of developing cancer.
There are things you can do to lower your overall chance of developing certain types of cancer
and stay well.
At least one-third of all cancer cases are preventable. Prevention offers the most cost-effective
long-term strategy for the control of cancer.
This includes:
1. Healthy Choices
Whatever age or stage you’re at in life, it’s never too late to start living well. Things like being
active, healthy eating, drinking alcohol less, not smoking, limiting your exposure to synthetic
hormones or harmful chemicals – all help to reduce your risk forcancer. Even the smallest
change can make a big difference.
Physical activity
Regular physical activity can help you maintain a healthier body weight and moderate
hormones in your body – key factors that help reduce the risk of breast cancer. But being active
doesn’t mean you have to go hard at the gym. It could be a brisk daily walk, playing with the
kids, cleaning your house, or getting a workout as you garden. Find something you enjoy doing
or always wanted to try.
Take the first step
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incorporate activity into things you already do, like taking the stairs instead of the
elevator
Set a goal. write it down
go for a walk at lunch
exercise with a friend
try to work up to 30 minutes of physical activity a day for 5 days a week
Healthy eating
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JOINT MEDICAL SERVICE
Taking a balanced approach to what you eat is a big step toward a healthier body weight – one
of the most important defenses against breast cancer, especially after menopause. An easy way
to start eating better is to fill your plate with colour. Variety in colour means variety in food!
Though you may hear stories about “cancer-fighting” foods, it’s hard to say how much influence
any one food has on cancer risk. By eating lots of different foods, we’re more likely to get the
range of nutrients our bodies need to be healthy.
Eat well
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include fresh fruit or vegetables at every meal
Limit meat, dairy products and processed meat.
limit fried, processed and salty foods
avoid saturated and trans fats
eat smaller portions of calorie-rich foods
Eating plenty of fiber can help you maintain a healthy body weight, which reduces your
risk of cancer. Research shows that a diet high in fiber protects against colorectal
cancer.
limit salt and salty food
limit sugar
Antioxidants
Antioxidants are chemical substances in many foods. Antioxidants protect the body's cells and
tissues from free radicals which are made when our bodies use oxygen.
Free radicals can damage cells, which may lead to cancer. Antioxidants are thought to help
protect cells by removing free radicals before they cause damage.
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Certain vitamins and minerals found in many foods, especially vegetables and fruit, act
as antioxidants. Vitamin c, vitamin e, beta carotene and selenium are antioxidants. It is
best to choose foods with these vitamins and minerals, rather than take vitamin and
mineral supplements (pills). Researchers say that it may not be only the vitamins and
minerals that help protect against cancer but the special forms of these vitamins or
minerals in foods or their combination with other substances in foods.
Phytochemicals are natural compounds found in plants. All vegetables and fruit and
many grains contain phytochemicals. They give vegetables and fruit their colour. Some
phytochemicals act like antioxidants
Chemicals in food
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By being aware of what you eat, how it was grown, and how far it's travelled, you can help
reduce your exposure to harmful chemicals and your breast cancer risk.
Go greener in what you eat!
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try to choose fully organic or local, pesticide-free food - or grow your own
learn which fruits and vegetables have the most pesticide residue and why it's better to
go organic if you can
look for hormone-free meat
remove skins on fruits and vegetables to remove pesticides
Drinking alcohol
By not drinking alcohol, you're helping to lower your risk for several cancers, including breast
cancer
Smoking
By not smoking you give your body so many health benefits – including a lower risk of heart
disease, stroke, lung cancer, and other cancers including breast cancer. Stay smoke free and try
to avoid second-hand smoke.
Chemicals in the home
Many of the everyday products we use to keep our bodies and homes clean contain low levels
of chemicals that may be harmful to our health. Research shows that some chemicals may
increase the risk for breast cancer by altering our biological processes, disrupting our
hormones, causing early puberty cell changes, or affecting breast development.
Keep it simple
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Stress
avoid personal care products with formaldehyde, phthalates, parabens, alkyl phenols,
fragrance or partum, and placental extracts
Read labels. Don’t rely on claims that a product is "natural" or "green."
switch to non-toxic and pesticide-free household and garden products
use fewer or simpler products or consider making your own
UNITED NATIONS OFFICE AT NAIROBI
JOINT MEDICAL SERVICE
Stress can cause people to turn to unhealthy behaviors, such as overeating, smoking and heavy
drinking, which may increase cancer risk.
Sunlight and vitamin D
Experts suggest that taking vitamin d supplements and spending short periods of time in the
sun are the best ways to get enough vitamin D.
2. Vaccines
Vaccines (shots)(http://www.cdc.gov/cancer/dcpc/prevention/vaccination.htm) also help lower
cancer risk. The human papillomavirus (HPV) vaccine helps prevent most cervical cancers and
several other kinds of cancer, and the hepatitis b vaccine can help lower liver cancer risk.
3. Screening
Screening is done to healthy individuals to help find cancer before you even have the
symptoms. They’re part of your regular medical care.
Simple screening tests look for particular changes and early signs of cancer before it has
developed or before any symptoms emerge.
Only a few cancers can be prevented or diagnosed early to make treatment successful
Breast cancer
Cervical cancer
Lung cancer
Melanoma
Colorectal cancer
Prostate cancer
Screening is based on gender and age.
Screening for prostate cancer
 Digital Rectal Exam:
A doctor inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate
and feel for lumps or abnormalities.
 Prostate Specific Antigen (PSA) test
psa measures the level of psa in the blood. PSA is a substance made by the prostate. The levels
of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be
elevated in other conditions that affect the prostate.
UNITED NATIONS OFFICE AT NAIROBI
JOINT MEDICAL SERVICE
As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present.
But many factors, such as age and race, can affect PSA levels. Some prostate glands make more
PSA than others.
Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA
test results.
Screening for breast cancer
Whatever your age, you should know what is normal for your breasts and tell your doctor if you
notice any changes.
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Mammography
It is a low dose x ray. It is the most reliable method of finding breast cancer.
You will be asked to remove your top in private.
When you are ready the radiographer will take at least two x-rays of
each breast.
The x-ray machine will firmly press each breast to get the best x-ray. The pressing may be
uncomfortable but any discomfort usually only lasts around 10 seconds.
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Clinical Breast Exam
This is done by a doctor /nurse where a physical examination of your breasts is done to check
for signs of cancer.
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Breast Self-Exam
A breast self-exam is when you check your own breasts for lumps, changes in size or shape of
the breast, or any other changes in the breasts or underarm (armpit). This is done every month
same timing preferably a few days after your menstrual period or the day you begin hormone
replacement therapy each month.
Screening for colon cancer
Regular screening, beginning at age 50, is the key to preventing colorectal cancer, but screening
can be done earlier if your doctor determines that you are at risk.
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High-sensitivity fecal occult blood test (fobt), which checks for hidden blood in three
consecutive stool samples; should be done every year as advised by your doctor.
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JOINT MEDICAL SERVICE
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flexible sigmoidoscopy, where physicians use a flexible, lighted tube (sigmoidoscope) to
look at the interior walls of the rectum and part of the colon; should be done every five
years with fobt every three years.
Colonoscopy, where physicians use a flexible, lighted tube (colonoscope) to look at the
interior walls of the rectum and the entire colon; should be done every 10 years or
earlier as determined by the doctor. During this procedure, samples of tissue may be
collected for closer examination, or polyps may be removed. Colonoscopies can be used
as screening tests or as follow-up diagnostic tools when the results of another screening
test are positive.
Screening for cervical cancer
If you’ve ever been sexually active, you should start having regular pap tests by the time you’re
21. You’ll need a pap test every 1 to 3 years, depending on your previous test results. Even if
you have stopped having sex, you should continue to have a pap test. If you’ve had a
hysterectomy, you may still need a pap test, but talk to your doctor about whether this is
necessary.
The most important risk factor for developing cervical cancer is infection of the cervix with
human papillomavirus (HPV). hpv is spread mainly through sexual contact (including sexual
intercourse, genital skin-to-skin contact and oral sex), and the virus can appear years after you
have been exposed to it. Using a condom during sex may decrease the chance that you will pick
up HPV, but a condom can only provide partial protection as it doesn’t cover the entire genital
area.
Even if you’ve had the HPV vaccine, regular pap tests are still needed. The HPV vaccine doesn’t
protect against all types of HPV.
C. Why should you find cancer early?
When cancer is found early, it’s often easier to treat. don’t ignore any changes to how your
body feels. Tell your doctor about them. The sooner you report signs to your doctor, the sooner
a problem can be dealt with
D. When do you see your doctor?
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Regular checkups are important because healthcare professionals like doctors are trained to
spot the early warning signs of cancer. But even if you’ve recently seen your doctor for a
checkup, it’s important to report any of these changes as soon as possible:
a new or unusual lump or swelling in the breast, testicles or any other part of the body
any sore which does not heal anywhere on your body or in your mouth
UNITED NATIONS OFFICE AT NAIROBI
JOINT MEDICAL SERVICE
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obvious change in the shape, size or colour of a mole or wart
a nagging cough, hoarseness or a croaky voice
difficulty swallowing
blood in the urine, stool or phlegm
unusual bleeding or discharge of any sort from the nipple or vagina
any change in bladder habits, such as pain or difficulty urinating
any change in bowel habits (constipation or diarrhea) that last more than a few weeks
persistent indigestion
unexplained weight loss, fever or fatigue
unexplained aches and pains
any new growth on the skin, or patches of skin that bleed, itch or become red
Having any of these signs doesn’t always mean that you have cancer. They may be due to some
other medical problem, or they may not be serious at all. Only your doctor can tell for sure.
E. What is the role of Joint Medical Service (JMS) in Cancer Screening?
JMS in partnership with CIGNA and Allianz insurance supports cancer screening for UN staffs
and their dependants. This is achieved and facilitated during the periodic examination where
the JMS team determines if the staff needs cancer screening tests depending on gender and
age. The required request forms are filled and the staff members are also requested to take the
forms to their spouse depending on their eligibility.
F. Cancer Support Group
Cancer support groups are people with cancer and, sometimes, family and friends, meeting
regularly to talk about common issues and provide emotional support.
Cancer support groups provide an opportunity for people affected by cancer to meet for
discussions in an emotionally supportive environment.
Having cancer is often one of the most stressful experiences in a person's life. However,
support groups help many people cope with the emotional aspects of cancer by providing a
safe place to share their feelings and challenges and learn from others who are facing similar
situations.
If you are interested contact JMS ([email protected], cc [email protected]
and [email protected])
UNITED NATIONS OFFICE AT NAIROBI
JOINT MEDICAL SERVICE
If you are not interested in joining a support group or find that support groups are not helpful
for you, consider these other sources of support:
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Talk with a friend.
Get individual counseling or psychotherapy.
Ask a doctor or nurse specific questions.
Participate in activities that you enjoy and that allow you to connect with friends or
family.
Adapted from: Union for International Cancer Control (UICC) and Canadian Cancer Center