Building Healthy Communities through Medical-Religious Partnerships

6. Cancer

6 Cancer There are more than one hundred types of cancer, all characterized by the uncontrolled growth and spread of abnormal cells. The most common types that can lead to death are prostate, breast, lung, and colon cancer, each of which typically begins as a discrete localized tumor (or mass) in the affected organ. Skin cancers are also common, particularly among older patients, but less frequently lead to death if identified and treated early. Some less common cancers of the bloodstream, such as lymphoma or leukemia, involve the body more generally at the time of presentation. Initially, most organ and skin cancers are localized, with cancer cells confined to their original site. Later, cancer cells may spread or metastasize to other sites. Treatment is more successful when cancer is localized; once cancer cells have spread, treatment is more difficult and less effective. More than 1,400,000 new cases of cancer are diagnosed and approximately 550,000 deaths from cancer occur each year in the United States, making it the second leading cause of death in our country. The incidence and mortality rates for cancer are generally higher for African Americans than for non-Hispanic whites, reflecting differences in genetics, environmental exposure related to socioeconomic status, and ongoing health care disparity . Paralleling these differences, the five-year survival rate for cancer in African Americans is significantly lower than for non-Hispanic whites, due in large part to diagnosis occurring later in the disease process. 62 suggested topics for congregational programs The Risks of Ignoring Information on Cancer Fear and fatalism often interfere with people’s obtaining accurate information about cancer and the appropriate tests and treatment options. Many individuals are so fearful of cancer that they do not want to know much about it or participate in screenings that might detect it. Often their fear is combined with a fatalistic view of cancer: they believe that there is little they can do to prevent it and that there are virtually no effective treatments . People need help in overcoming their fear and sense of hopelessness about cancer. In recent years, screening for cancer has become more precise, and early detection has reduced some cancer death rates. People need to know not only that there are steps they can take to reduce their risk of developing cancer but also that other steps can result in early detection and cure. What Can Be Done to Prevent Cancer? It is important that cancer be detected and treated as early as possible. Generally, the earlier the treatment begins, the better the chance of curing or controlling the cancer. The overall survival rate for many cancers would increase significantly if more people participated in early detection programs . A combination of regular self-exams and screenings provides the best means of detecting cancer early enough to allow for effective treatment . Unfortunately, too many people ignore or are not informed of the recommendations about regular self-exams and screenings. At present, the American Cancer Society recommends the following screening tests: • Colon cancer screening: Adults 50 years of age and older should have annual stool testing for occult blood, and either a colonoscopy every 10 years, a flexible sigmoidoscopy every five years, or a double-contrast barium enema every five years. • Breast cancer screening: Women should have an annual mammogram starting at 40 years of age and scheduled annual breast exams augmented by frequent self-breast exams. • Cervical cancer screening: Women should have pelvic examinations and PAP smears starting three years after their first sexual encoun- cancer 63 ter or at 21 years of age. Women 70 years of age or older with more than three normal PAP tests in a row and no abnormal PAP test results in the last 10 years may choose to stop having cervical cancer screening. • Prostate cancer screening: Men over 50 years of age should consider annual digital-rectal examination and PSA screening. For each of these screening recommendations, high-risk persons should begin screening at an earlier age. Some people fail to participate in regular screenings for cancer because of their fear of the pain or indignities associated with the screenings. Therefore , accurate information about the nature of the screenings and the definite benefits of early detection needs to be provided. Special efforts are needed to increase the number of African Americans and Hispanics who participate in early detection programs. Historically, lower rates of participation among minority groups have resulted...