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Cancer Among Native Americans in
Arizona and New Mexico
Data Provided by
Arizona Cancer Registry at the
Arizona Department of Health Services
and the
New Mexico Cancer Council
©2012 MFMER | slide-2
Cancer Rate by Race/Ethnicity, Arizona, 2005-2009
Age-adjusted incidene rate per 100,000
500
Male
Female
400
300
200
100
0
White, Non
Hispanic
White,
Hispanic
Black
American
Indian
Asian/Pacific
Islander
©2012 MFMER | slide-4
Age when Diagnosed with Cancer
(Arizona Native Americans, 2005-2009)
©2012 MFMER | slide-5
HIGH PREVENTION POTENTIAL
©2012 MFMER | slide-6
Yearly average count of new cancers among
Arizona Native Americans
Cancer Sites
Breast
Male
Female
1
58
Prostate
56
Colorectal
30
25
Kidney/Renal Pelvis
30
14
Corpus Uteri
27
Lung and Bronchus
11
11
Stomach
14
6
8
11
Other sites combined
48
33
Liver and Intrahepatic Bile Duct
12
6
Thyroid
4
12
Leukemia
9
7
Non-Hodgkin Lymphoma
Ovary
14
Gallbladder and Other Biliary
5
9
Pancreas
6
7
Oral Cavity
7
4
Cervix Uteri
11
Myeloma
5
5
Brain and Other Nervous System
6
4
Source: ACR, 2005-2009
©2012 MFMER | slide-11
©2012 MFMER | slide-12
CONCLUSIONS
• AIAN elders increasing proportion of the
population
• Cancer screening will be an important aspect of
maintaining health as people age
• Looking at the “whole person” remains the most
important determinant for good care
©2012 MFMER | slide-13
Introduction to Myeloma:
Diagnosis, Treatment, Risk Factors
and Prevalence
Scottsdale, Arizona
Rochester, Minnesota
Jacksonville, Florida
Alan Bryce, MD
Staff Oncologist, Mayo Clinic Arizona
Multiple Myeloma - Introduction
• Myeloma is a cancer of the Plasma Cells
• They grow out of control in the bone marrow (at least
10% and as high as nearly 100%)
• This results in many problems including:
• Low hemoglobin (anemia) and platelets
• Elevated abnormal immunoglobulins (proteins)
• Bone pain and fractures
• Infections (partly due to low normal
immunoglobulins)
• Kidney problems
• Other complications…
Spectrum of Myeloma
Normal
plasma
cell
MGUS
Monoclonal
gammopathy
of unknown
significance
Asymptomatic
Myeloma
Active
Myeloma
Aggressive
Myeloma
How do plasma cells become “evil”?
Multiple Myeloma – Causes?
• The cause of myeloma is still unknown
• Some have suggested:
• Radiation- Nuclear Bomb Survivors
• Chemicals (benzenes), herbicides and
insecticides- The “Myeloma Belt”
• Genetics or even viruses
• Familial Myeloma – still rare
• However, nothing is conclusive, and it is likely a
combination of many factors…
Multiple Myeloma
• Unfortunately, MM is not a curable disease (yet!!)
• Historically most people did not live for much more
than 2 years…
• However, the average survival is now at least 8 years
• This has been a result of three key
developments:
1. Early Detection
2. Autologous Stem Cell Transplant
3. Novel Drugs (thalidomide, bortezomib,
lenalidomide)
Age-adjusted incidence rate per
100,000 population
Myeloma rate in Arizona among race groups,
1995-2009
12
10
10.8
Male
8
Female
7.1
6
4
2
5.1
6.9
5.6
4.8
3.1
3.7
2.6
1.2
0
White, Non
Hispanic
White,
Hispanic
Black
American
Indian
Asian/Pacific
Islander
Race/Ethnic Group
©2012 MFMER | slide-20
Common Symptoms
•
•
•
•
•
•
•
Not all patients will have all of these symptoms
Fatigue
Lack of Appetite
Infection
Bone Pain
Kidney Failure
Confusion, dehydration, and constipation (high calcium)
Myeloma Treatment
• Principles of therapy
• 1. Stop the production of the abnormal plasma cells
(chemo)
• 2. Strengthen the bone and prevent fractures
• 3. Increase the hemoglobin count and reduce fatigue
• 4. Reduce risk of infections
• 5. Promote well being and quality of life
Conclusions
• New Treatments for myeloma have improved
survival
• Myeloma is usually preceded by many years of
MGUS
• Screening and early detection can allow therapy
to begin before organ damage develops
• Bone Marrow transplant and Clinical Trials
should be considered when appropriate
©2012 MFMER | slide-23