Assessing your cancer risk

True.  You may not think of your routine dental visit as a cancer screening test, but, in part, it is.  Dentists and dental hygienists examine your mouth, tongue and surrounding tissue much more closely than you do and are most often the people who find pre-cancerous or cancerous lesions in early stages of growth.

The facts:

• Oral cancers are diagnosed in more than 34,000 people a year in the United States.
• Risk factors include tobacco and alcohol use and HPV infection.
• Oral cancers are often preceded by pre-cancerous changes, which may appear as red or white patches or spots.

Learn more about the importance of routine dental visits in oral cancer screening on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

False.  Most screening tests can detect pre-cancerous lesions, which can then be removed to prevent cancer from developing. If cancer is found, a screening test may find it at an early stage, typically making it easier to treat.  Cancer screening tests are designed for specific cancers, but there aren’t good tests for every type of cancer, so prevention and risk reduction are still important. 

The facts:

• A screening test must be safe.
• The results must be reliable and useful.
• The benefits of screening must outweigh any risk related to further testing and treatment. 

Learn more about cancer screening tests and the recommended tests for you on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True.  A recent study in the Archives of Dermatology reports that hair stylists examine their clients'  scalp, neck and face for suspicious lesions while giving them a new do.  Some hair professionals even report having had some training in skin cancer detection in school.  These professionals look at this area of the skin – an area you cannot see well – from a unique vantage point.  So, the next time you’re getting those locks tamed, thank your hair stylist for helping you with your routine skin exams.

Learn more about skin cancer risk on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True.  Diethylstilbestrol (DES) was given to pregnant women from 1938-1971 because it was believed to prevent miscarriages and promote “healthy pregnancies.”  Not only did the drug not prevent problems, it caused health issues for the women taking it as well as for children born of these pregnancies.

The facts:

• Women who took DES are at increased risk for breast cancer.
• Daughters of these pregnancies are at risk for developing a rare form of vaginal or cervical cancer called clear cell adenocarcinoma.
• Additional health concerns for these daughters include infertility, miscarriage and an abnormally shaped uterus.

Learn more about DES exposure and cancer risk on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

False.  Hookah smoking burns flavored tobacco using a water pipe. The smoke is inhaled through a long hose. Some claim that the actual amount of tobacco smoked is low and that the water acts as a filter, but these claims are false.

The facts:

• Hookah tobacco contains the same carcinogens and chemicals that cigarette tobacco does.
• A one-hour hookah smoking session exposes a smoker to 100 to 200 times the amount of smoke from a single cigarette.
• Hookah smoking delivers the same amount of nicotine as a cigarette, so it may be equally addictive.

Learn more about hookah and other exotic smoking practices and their cancer risk on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True.  A healthy diet, regular physical activity and a healthy weight have been linked to a lower risk of developing cancer. These three components make up the “cancer prevention triangle.” They are strongly interrelated, and working to improve one can often lead to improvements in another.    

Certain foods have been found to have cancer-causing properties. These foods include charred meats, pickled and salt cured foods, red and processed meats, and white and processed grains.   

Learn more about diet and cancer risk on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True. Breast cancer in men accounts for about 1 percent of all breast cancers and about 0.2 percent of all cancers in men. There will be about 2,190 new cases of male breast cancer in 2012, compared with 229,000 cases in women.

The facts:

• Risk factors for male breast cancer include Klinefelter's syndrome, being of Jewish decent, mumps orchitis, a family history of male or female breast cancer, and family cancer syndromes (BRCA1 & 2 gene abnormalities account for 40 percent of cases).
•  The most common symptom is a mass in the breast. Other symptoms include nipple discharge (particularly if bloody), nipple retraction and skin ulceration.
•  Mammograms are difficult to perform, particularly on thin men, so a biopsy should be done on any suspicious lump. 

Learn more about breast cancer risk on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

False.  Every year, 70,000 people between the ages of 15 and 39 (young adults) are diagnosed with cancer.  Unfortunately, despite the many advances in cancer care, survival rates in this group have not changed in 30 years. 

The facts:

• A cancer diagnosis is eight times more common in young adults than in kids younger than 15.
• This age group has the highest uninsured or underinsured rates of any age group in the United States, which may lead to delayed diagnosis and health care.
• Health-care providers see young adults as being at low risk for cancer and may not consider this diagnosis. Symptoms may be attributed to stress or fatigue related to school, work or family obligations.

Get the facts about cancer in young adults on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

False. A number of recent studies have not shown any relationship between a person’s cancer risk and a person’s sugar consumption. 

The facts: 

• Every cell in our body uses sugar for fuel.  It breaks down easily, providing energy quickly. However, our cells cannot tell whether the glucose in the bloodstream is from a jellybean or from brown rice, as each sugar molecule looks the same to our cells.
• Cancer cells are our own cells that have mutated, and they do use the same fuel source that our healthy cells use.
• Cancer cells do typically use up more fuel than regular cells, but they, too, cannot distinguish the source of sugar molecules in the bloodstream.
• This may sound scary, but a number of recent reviews have come out in the last couple of years that do not show any relationship between a person’s cancer risk and a person’s sugar consumption.
• Of the studies that have shown any indication that sugar consumption and carbohydrate intake may influence cancer risk, the increased risk was small.  

Learn more about the truth behind sugar and cancer on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True.  Many diseases increase a person’s risk of developing one type of cancer or another. For instance, hepatitis B and C increase the risk of developing liver cancer, GERD (gastro-esophageal reflux) increases the risk of esophageal cancer, and inflammatory bowel disease increases the risk of cancer in the area of the GI tract that is affected.

This is by no means an exhaustive list.  As with any new diagnosis, it is in your best interest to get educated about the disease and associated risks. Talk with your health-care provider, search the Internet, and talk to others with the disease.   

Learn more about potential risks related to your own health history on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

False.  Casual sun exposure is enough to make enough vitamin D.  On the flip side, too much time in the sun is one driving force behind the rising skin cancer rates in this country. 

The facts:

• Our bodies can make vitamin D with as little as 5 to 15 minutes in the sun, two to three times a week.
• Our bodies will “stockpile” vitamin D for use in winter months, so you need not bare your arms and legs to the sun in winter months.
• Too much sun leads to skin damage and cancer, so any more time in the sun and you should be using sunscreen with an SPF of 15 or higher).

Learn more about sun exposure and cancer risk on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True.  Heavy alcohol users who quit drinking are taking an important step to reducing their cancer risk.

The facts about quitting drinking:

• Heavy drinkers have a 10 to 15 times higher risk of developing cancers of the head and neck, esophagus, liver, breast, colon and rectum.
• The risk for alcohol-related cancers is reduced over time.
• After 15 to 20 years of being alcohol free, your risk of developing esophageal or head and neck cancers is almost equal to that of someone who never drank.

Learn more about alcohol use and cancer risk on OncoLink®, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

False. Smokeless tobacco includes dip, chew, spit, oral and spitless tobacco and dry and moist snuff. Many people may not realize that it is just as addictive as cigarette smoking. 

The facts:

• One can of snuff contains the same amount of nicotine as four packs of cigarettes, and dipping eight to 10 times a day introduces as much nicotine into the body as smoking 30 to 40 cigarettes.
• Oral tobacco contains at least 28 chemicals known to cause cancer (carcinogens).
• People who use smokeless tobacco have a higher risk of cancers of the mouth, throat (pharynx), esophagus (swallowing tube from the throat to the stomach), stomach, and pancreas.

 Learn more about smokeless tobacco and cancer risk on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True.  Ten percent to 15 percent of lung cancers diagnosed in people who have never smoked are attributed to secondhand smoke.

The facts:

• Secondhand smoke exposure has also been associated with increased risk for cancers of the mouth, throat, voice box, pancreas, bladder, kidney and cervix, and to childhood leukemia.
• Smoke-free workplaces, restaurants and bars have helped reduce unwanted exposure to secondhand smoke, but many people are still exposed in their homes.
• The EPA has tools for community groups and individuals starting educational programs promoting smoke-free homes or just creating a smoke-free environment in their own home. 

Learn more on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True (in most cases).  The incidence of anal cancer has been increasing over the last 30 to 40 years, likely related to the prevalence of the human papilloma virus (HPV), which is the cause of 80 percent to 90 percent of anal cancer cases.

The facts:

• HPV infects an estimated 75 percent of sexually active females and males.
• Many people jump to the conclusion that anal cancer caused by HPV would have to be transmitted through anal sex, which is not the case. HPV is spread by skin-to-skin contact, not necessarily penetration.
• Men who have sex with men are at highest risk and should talk with their health-care providers about this risk and possible screening.

Learn more about sexual practices and cancer risk in men and women on OncoLink.  Learn more about HPV, the associated risks and prevention tips, discussed in this webchat. Find out more about your cancer risk by completing OncoLink’s What’s My Risk? assessment.

False.  Even though you can’t “undo” your smoking history, the good news is that the risk of having lung cancer and other smoking-related illnesses decreases after you stop smoking and continues to decrease as more tobacco-free time passes. 

The facts:

• The risk of lung cancer decreases over time, though it can never return to that of a never-smoker.
• The risk also continues to decrease for the 12 other types of cancer that smoking can cause.
• Quitting smoking leads to health benefits that start right away and continue over many years. This is true even for people who already have a smoking-related disease.

Learn more about quitting smoking and cancer risk on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True.  That being said, there are no studies following people over time to see exactly how many scans or tests result in increased cancer risk.

The facts:

• Experts use a detailed calculation to translate how many tests increase risk, but even this isn’t foolproof. 
• The amount of radiation received in one of these tests can vary from machine to machine – even in the same hospital – based on the particular doctor’s protocol or if repeat pictures are needed.

Weigh the pros and cons with your doctor - Is the test needed? Will it change the treatment plan? - and make an informed decision about each test.  Learn more about radiation from radiology tests on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

False.  Studies have found that exercise can reduce the risk of cancers of the breast, colon, prostate and endometrium (uterus). 

The facts:

• Experts feel that somewhere between 30 and 60 minutes a day of moderate to vigorous activity is needed to impact cancer risk.  A moderate activity is the equivalent of a brisk walk, whereas vigorous activities increase heart and breathing rates. 
• As you can imagine, healthy weight, physical activity and a good diet are inter-related and one can often lead to another.  This trio is a “triangle” of cancer prevention and is thought to be the second most important cancer prevention strategy – after not smoking.

Learn more about exercise and cancer risk on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

False. Brown-skinned people, including black, Asian, Latino and Native Americans, often have a false sense of security when it comes to skin cancer risk.  Although it is true that darker-skinned individuals have a lower risk of skin cancer, they are not immune.

The facts:

• Melanomas in darker-skinned individuals tend to occur in areas that are not exposed to sun, such as the buttocks, genitals and bottom of the feet, and under the fingernails or toenails.
•  They are also more likely to die of the disease than fair skinned individuals, due to later diagnosis and treatment.

Learn more about skin cancer risk on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True.  A diet high in red meat - or, worse yet, processed foods such as hot dogs, sausage, bologna and lunchmeat - increases not just cancer risk but also the risk of heart disease and early death.  This doesn’t mean you can never enjoy a juicy burger. Moderation is key to reducing risk.

The facts:

•  A diet high in red and processed meat is strongly linked to colon and rectal cancers and may be related to endometrial and pancreatic cancers.
• Limit red meat to one to two servings a week for optimal health. Remember, a serving is about 4 ounces, or the size of a deck of cards. 

Learn more about diet and cancer risk on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True. Most people are aware that smoking is the No. 1 cause of lung cancer. However, you may not know that the second leading cause of lung cancer - radon - may be lurking, undetected, in your basement.   

The facts:

• Radon is a naturally occurring odorless, colorless radioactive gas that results from the decay of rock and soil components.
• Radon moves up from the ground into homes, where it becomes trapped and accumulates, exposing inhabitants to its cancer-causing potential. 
• The amount of radon found in a basement depends on the ground below, the home’s foundation and the ventilation of the space.  For this reason, two houses next  door to each other can have different radon levels. 

You should have your basement tested and, if the levels are high, invest in a mitigation system - an investment that could be life-saving. Learn more about radon, radon testing and mitigation on OncoLink, a cancer information website developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True. While the overall number of cases of head and neck cancer has been decreasing in recent years - consistent with the decrease in tobacco use in this country - cases in young (40- 50-year old) nonsmokers have been on the rise, particularly those of the tonsils and base of the tongue. Why? Human papilloma virus or HPV, a common sexually transmitted disease.

The facts:  

·        HPV infects an estimated 75 percent of sexually active females and males.  

·        Although many people are aware that HPV can cause cervical cancer, they may not be aware of the link between HPV and other cancers, such as cancers of the tongue, throat and tonsils. Media coverage of these cancers falls short of discussing the “touchy” subject of oral sex, one means of HPV transmission.  

·        Experts believe that changes in sexual behaviors (oral sex with more partners and at earlier ages) may be driving this rise in cancers in younger people.  

·        The risk is present in both sexes engaging in oral sex with men or with women. HPV does not discriminate.

Learn more about sexual practices and cancer risk in men and women on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. You can hear more about HPV, the associated risks and prevention tips on this webchat. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True. While most smokers are aware of some of the health problems that smoking causes, such as lung cancer and heart disease, they may not be aware of the 12 other types of cancer that smoking can cause.

The facts:

• Smoking causes 85 percent of lung cancer cases in the United States.
• Smoking is a primary cause of cancers of the oral (mouth) and nasal (nose) cavity, sinuses, pharynx (throat), larynx (voice box), esophagus (tube from the throat to the stomach), stomach, pancreas, liver, bladder, kidney, and cervix, and acute myeloid leukemia.
• More than 7,000 different chemicals have been found in tobacco and tobacco smoke; among them are more than 60 known carcinogens.

Learn more about smoking and cancer risk, the benefits of quitting and resources to get started on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True (for some cancers). “Chemoprevention” is the term used to describe the use of a medication, supplement or food to prevent or delay the development of cancer. Although there are many false claims on the Internet about magic pills to prevent cancer, there are medications that are effective chemoprevention agents for several cancers.

The facts:

• Breast cancer prevention is the most studied, with two approved medications for chemoprevention: tamoxifen and raloxifene.
• Several medications have shown success in preventing prostate cancer.
• Studies have shown that regularly taking aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) reduces the risk of developing colorectal polyps and cancer.

Learn more about chemoprevention on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True. Studies most strongly associate being overweight or obese with a higher risk of breast (postmenopausal women), colorectal, endometrial, esophagus and renal cell cancers. This is likely caused by excess fat raising hormone levels in the body.

The facts:

•    Experts estimate that 14 percent of cancer deaths in men and 20 percent of cancer deaths in women are caused by obesity.
•    Losing weight can help. In a sample of U.S. bariatric (weight loss) surgery patients, cancer death rates were 38 percent lower than people who were obese and did not undergo surgery.

Learn more about weight and cancer risk and tips for weight loss on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

True. Many people are aware that heavy alcohol use can cause health problems, but many are not aware that alcohol can increase your risk of developing several types of cancer, including cancers of the mouth, throat (pharynx), voice box (larynx), esophagus (swallowing tube), liver, breast (in women), colon and rectum.

The facts:

• Heavy drinkers have a 10 to 15 times higher risk of developing these cancers than those who do not drink. 
• However, the overall risk increases after just one drink a day for women or two for men. (A drink is defined as 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80 proof liquor.) 
• Higher breast cancer risk has been associated with just a few drinks a week, so the risk is not limited to heavy drinking.
  

Learn more about alcohol and cancer risk on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

False. Popular culture has made us believe that having a tan makes us look healthy and more attractive. Unfortunately, the ultraviolet light exposure required to get this “healthy glow” is killing us. Many people turn to tanning booths to get a quick tan.

The facts:

• Cases of melanoma, the most deadly form of skin cancer, are on the rise. Particularly in women ages 20 to 40 – those most likely to use tanning beds.
• The tanning industry has been found to be providing false information to patrons, suggesting that the link between skin cancer and tanning is a myth and in some cases suggesting that indoor tanning is beneficial.
• The truth is that those who use tanning salons are 75 percent more likely to develop melanoma than those who do not.

Parents need to get informed and educate their kids about these dangers, as it is this group that the industry targets in their advertising. Learn the facts about tanning on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.

• Only 15 percent to 20 percent of cancers occur in someone with a family history. Most cases are not related to family history.  For example, 80 percent of people diagnosed with colorectal cancer have no family history of the disease at all.
• On top of this is the issue of what you don’t know.  For many years, discussion of cancer was considered taboo.  Family members may have had cancer and it was not discussed - or was referred to as “stomach problems” or other benign conditions so that people wouldn’t know of the diagnosis. 
• It is important to have family conversations about health history and share this information with one another.  

False. Many people perceive cigar smoking as safer than cigarettes  because most cigar smokers do not inhale while smoking. The truth is, cigars have higher levels of carcinogens and nicotine.

The facts:

• Cigars are particularly dangerous due to the process of aging and fermenting the tobacco, which creates carcinogenic compounds (such as tar, carbon monoxide and ammonia) in cigar smoke in much higher levels than found in cigarette smoke. One large cigar can contain as much tobacco as an entire pack of cigarettes.
• The amount of nicotine is higher in a cigar (1 to 2 milligrams in a cigarette versus up to 400 milligrams in a single cigar). Since this nicotine is quickly absorbed in the saliva, the addiction to cigars is just as strong as to cigarettes.
• Smokers' saliva contains the chemicals from the tobacco smoke, exposing the mouth, lips, tongue and throat to these carcinogens. Although lung cancer rates are lower in cigar smokers, cancers of the mouth, nose and throat are more often seen in this group.

Learn more about the cancer risk associated with cigars on OncoLink, a cancer information Web site developed by experts at the University of Pennsylvania's Abramson Cancer Center. Find out more about your overall cancer risk by completing OncoLink’s What’s My Risk? assessment.