PREVENTION: An Eye Towards Prevention

 

LifeCheq nurse Kim Hagedorn examines a mole on Aramco employee Najwa Hajjar-Artigue's back during an off-site cancer screening visit.

 

 

One way to achieve M. D. Anderson's mission of eradicating cancer is to prevent the disease in the first place.

 

Through public and patient education about healthy lifestyle behaviors, cancer screenings and research, health professionals are empowering individuals with knowledge about cancer prevention.

 

"Adopting healthy lifestyle habits - such as avoiding tobacco, limiting sun exposure and alcohol consumption, eating plenty of fruits and vegetables, exercising regularly and knowing your family's history - continues to be an important message we want to convey to people," says Dr. Bernard Levin, vice president for cancer prevention. "Such behavior change can help to prevent 65-85 percent of all cancers."

 

Last year alone, more than 10,000 people were armed with valuable disease prevention information through various health fairs, community forums and lectures sponsored by M. D. Anderson's LifeCheq program. Another 408 people completed the program's CheqUp Health Risk Assessment.

 

In addition to educating people about healthy habits, "we are paving the road to cancer prevention by directly applying new concepts to patient care through screening and early detection," says Dr. Levin, holder of the Betty B. Marcus Chair in Cancer Prevention.

 

During the past year, specialized clinics within the Cancer Prevention Center began providing prevention care and education to those who have not been diagnosed with cancer, but who may be concerned about their risk of getting the disease, according to Dr. Therese Bevers, medical director of the Cancer Prevention Center.

 

At the Breast Evaluation Clinic, women who have not been diagnosed with breast cancer can come for a mammogram and breast examination. The Skin Evaluation Clinic and Ovarian Evaluation Clinic offer similar services for anyone concerned about having these cancers.

 

The importance of services offered at the prevention center is demonstrated by the number of people who were found to have early-stage cancer. Roughly five percent of the center's 6,000 patients were diagnosed and referred to M. D. Anderson's multidisciplinary care centers for treatment during the year.

 

"Because of these screening examinations, these patients were able to receive treatment early in the disease process, greatly increasing the chance of successful treatment," Dr. Bevers says.

 

While comprehensive examinations and services are offered at the prevention center, several off-site screenings were provided to individuals in the community. The Mobile Mammography Van made it possible for more than 3,700 women to receive mammograms; 19 women were diagnosed with breast cancer. In addition, prostate screening examinations were made available to 212 men through community screening programs.

 

Since several cancers run in families, genetic testing has become another potential weapon in the prevention of cancer. During the past year, 126 people who were concerned about their risk of developing cancer sought genetic testing and counseling services.

 

With increased understanding of the mechanisms involved in the function of tumor cells, scientists within the Division of Cancer Prevention and throughout the institution continue to discover the important role nutrition and other lifestyle behaviors play in cancer development. Several studies and programs addressing these areas were launched this past fiscal year.

 

They include:

 

· Diet and Prostate Cancer. Dr. Margaret R. Spitz, chair of the Department of Epidemiology, and her colleagues are studying intake of specific nutrients in the diet that may help to slow the growth of prostate cancer. "We need to understand what dietary and genetic factors determine which men with prostate cancer will develop clinically aggressive disease," she says.

 

· "Compaņeras Saņas," or "Healthy Friends." Begun this year, the research project is examining whether increases in dietary fiber can reduce breast cancer risk in Hispanic women ages 50 or more.

 

According to the study's principal investigator Dr. Lovell A. Jones, there is evidence that a high-fiber diet helps reduce estrogen levels in women. Studies have shown that women with lower levels of this hormone have a reduced risk of breast cancer.

 

"In the study, we're not trying to ascertain whether or not these women eventually get breast cancer," says Dr. Jones, professor and head of the Breast Cancer Nutrition Research Group. "Instead, we're interested in whether changes in their diet will reduce the amount of estrogen in their system, which is an important risk factor in breast cancer."

 

· Urban Boy Scout Nutrition Program. A new nutrition education program targeting urban minority youths in the Greater Houston Boy Scouts aims to increase young boys' consumption of fruit and vegetables, which have been linked to a decreased risk of several cancers, says Dr. Tom Baranowski, professor of behavioral science.

 

To help children incorporate more of these foods in their diet, dietitians provide fun learning activities at Scout meetings, including role playing and taste testings of simple fruit and vegetable recipes. Comic books, take-home education sheets and healthy recipes encourage family discussion and dietary change. Those completing the program earn a Scout "5-A-Day" badge.

 

· Smoking Cessation. Dr. Paul Cinciripini, associate professor of behavioral science and director of the Tobacco Research and Treatment Program, and his colleagues are involved in several continuing research projects examining the best methods for smoking cessation and relapse prevention.

 

According to Dr. Cinciripini, preliminary data from the past year indicate that combining a formal smoking cessation program with antidepressant medication and the nicotine patch provide the best opportunity for quitting smoking.

 

In addition to these nutrition and behavioral-based programs, scientists also pursued other important areas of research during the past year, including chemoprevention (see page 18) and genetic susceptibility to cancer (see page 19).

 

"As we continue our research with patients, we also know the importance of educating the public about the reality of cancer prevention, namely that good health habits today may ward off cancer tomorrow," Dr. Levin says.

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