Cancer Awarenessfor Pharmacy Staff

Joanne Coy

Sheffield City Council

July 2013

Our session at a glance

• Aims and Objectives • Purpose of the session• Facts and figures• Cancer risk factors• Importance of early diagnosis• Local awareness of key symptoms• Symptoms• Lung cancer and current publicity campaign• Screening programmes• How you can use this knowledge

Aims and Objectives

To provide key messages about cancer to pharmacy staff:•Know local numbers of new cases and deaths from cancer•Understanding of the most common risks •Know the most common symptoms of cancer•Awareness of the importance of cancer screening programmes•Awareness of the importance of your role in promoting cancer awareness and early treatment.

What is Cancer?

• Cancer is a disease that occurs when the cells of the body multiply in an uncontrolled manner, creating a a cluster of cells called a tumour.– usually the tumour takes the form of a lump

• Cancer is not a single disease with a single type of treatment. There are more than 200 different kinds of cancer, each with its own name and treatment

• Early diagnosis can often make a difference to how easily cancer is managed/treated and the chance of making of good recovery.

Cancer cases in Sheffield

How many people are diagnosed with cancer every year in Sheffield?

a)1800

b)2700

c)3050

b) 2700 (Source: NCIN, 2011)

The most common cancers in Sheffield

Each year in Sheffield there are about:

• 400 new cases of lung cancer

• 380 of breast cancer in women

• 300 of bowel cancer– also known as colorectal cancer or

colon cancer or rectal cancer

• 280 of prostate cancer in men

The 20 Most Common Causes of Cancer Death, UK, 2010

Source: CRUK http://www.cancerresearchuk.org/cancer-info/cancerstats/mortality/

cancerdeaths/

Top 3 causes of death from cancer in Sheffield

Rank Men number of cancer deaths

per year

Women number of cancer deaths

per year

1 lung cancer185 deaths

lung cancer147 deaths

2 prostate cancer82 deaths

breast cancer107 deaths

3 bowel cancer72 deaths

bowel cancer50 deaths

Cancer and Age• cancer is mainly a disease of older

people

• three out of five cancers (60%) are diagnosed in people aged 65 and over – obviously 2 out of 5 (40%) are found in people

aged under 65

• more than a third (36%) are diagnosed in the elderly (aged 75 and over).

Cancer prevention

• Your age and your family history (genetics) are important influences on your chance of getting cancer

• But 4 out of every 10 cancers are due to lifestyle and are therefore preventable

How to reduce your chance of developing cancer• Smoking: don’t smoke• Diet: eat a balanced diet with plenty of fruit and vegetables• Weight: don’t be overweight or obese• Take exercise: e.g. walking• Alcohol: don’t drink above recommended limits• Be Sun Smart: avoid sun burn by covering up and wearing

suncream

The Good News

• many people feel that having cancer will automatically lead to death

• but many types of cancer today are successfully treated– the quality of cancer care in England has

increased enormously in recent years

• increasing numbers of people in the UK are surviving cancer and leading a normal life

The Not So Good News • Survival rates for many forms of cancer

are worse in Britain than in some other parts of Europe and the rest of the world

• Many people are dying of cancer whose lives could have been saved

• Others are having much more extensive and unpleasant treatment than might have been the case

Why are our Survival Rates not as good as the best?

• Many people don’t know enough about the key symptoms and signs of cancer

• Many people are so worried about cancer that they put off going to the doctor for as long as possible

• Thus, by the time it is diagnosed, cancer is often very advanced – may need very extensive treatment– may not be treatable at all

Survey of Sheffield people’s knowledge about cancer in 2009

• 1 in 5 men and 1 in 7 women could not name any cancer warning signs

• most warning signs were recognised by only a small proportion of people

• only 1 in 17 people knew that a cough/hoarseness is a possible sign of cancer

Cancer Awareness Measureunprompted awareness in

Sheffield

Don’t Know:27% Male

15% Female

Cancer Awareness Measure Sheffield Data: How soon would you visit your GP?

Why would Sheffield people delay seeking treatment?

• 1 in 3 would be worried about wasting the GP’s time.

• 1 in 3 said they would delay because of difficulties in making an appointment

• 1 in 3 said they would delay because they would be worried about what the doctor might find

• 1 in 6 would be too embarrassed to report symptoms to their GP.

What are the key symptoms that might be cancer?

• An unusual lump or swelling anywhere on your body• A change in the size, shape or colour of a mole• A sore that does not heal after several weeks• Mouth/tongue ulcer lasting more than 3 weeks• Cough/croaky voice lasting more than 3 weeks• Persistent difficulty swallowing or indigestion• Problems passing urine• Blood in urine• Blood in bowel motions• A change to more frequent and loose bowel motions 4-6 weeks• Unexplained weight loss/heavy night sweats• Unexplained pain /ache that lasts longer than 4 weeks

Know Your Body and What is Normal for You

• If you start to get new symptoms/signs that aren’t going away (e.g. 3 weeks or more), then make an appointment with your GP to get them checked

• If it turns out not to be serious, you’ve got peace of mind

• If it is serious, by getting treatment early you have the best chance of making a good recovery

Lung Cancer Facts• 2nd most common in UK - 38,000+ a year

• 400 new cases per year in Sheffield

• Globally is the most common cancer• 9 out of 10 cases diagnosed are smokers • But also: former, passive and non-smokers• No effective screening test • IF FOUND EARLY CAN OFTEN BE TREATED• British survival rates poor compared with the

best in Europe

Lung Cancer Risk Factors

• Smoking – by far the biggest risk

• Radon gas exposure

• Industrial exposure (arsenic, diesel, herbicides)

• Air Pollution (particulates from diesel traffic fumes)

• Family History

Lung Cancer

Symptoms • New and persistent cough for more than 3 weeks• Blood flecks in Phlegm• Recently started feeling breathless

• New chest or shoulder pain longer than 3 weeks• Unexplained loss of weight /appetite• Fatigue• Chest infection that doesn’t get better after antibiotics• Hoarseness/loss of voice but no sore throat.

Lung cancer symptom awareness campaign 2013

• July to mid-August 2013 Be Clear on Cancer

• Focus on 3-week cough

• See website: http://www.cancerresearchuk.org/cancer-info/spotcancerearly/naedi/beclearoncancer/lung/

• Adverts on radio/TV and leaflets

Sheffield event for the Lung cancer campaign 2013

• We will also be running local events– giving out leaflets at shopping centres– talks to local groups

• Can we run an event at or near your pharmacy?

• Other suggestions??

Cancer Screening Programmes

• Testing large and seemingly healthy population groups for signs of cancer

• Can detect abnormal cell changes at an early stage, sometimes even before cancer has developed

• Current programmes: Bowel, Breast, and Cervical

• Different intervals/age groups/gender

No screening test is 100% effective

• Body Awareness is still important!

• Still need to be on the lookout for symptoms and signs of cancer– Know your body and what is normal for you

• See your GP if new and persistent symptoms or signs appear– even if you have been screened

Cancer Screening Programmes and Age Ranges

• Cervical: women aged 25-64

• Breast: women aged 50-70 – women over 70 can opt in– Telephone breast screening unit at the

Hallamshire Hospital

• Bowel: men & women aged 60-74 – People over 74 can opt inolder people can opt

in)

Cancer Screening saves lives

• But uptake for cervical and breast cancer screening programmes is declining in Sheffield

• Cervical uptake has fallen sharply among young women aged 25-34

• Encourage people to take part in cancer screening

Bowel Cancer Screening• New screening programme, began in 2008

in Sheffield

• Currently targets men and women aged 60-74

• People who’ve lost the screening kit can telephone for a replacement

• Helpline 0800 707 60 60

• Older people can opt into the programme by telephoning the helpline

Process of Bowel Cancer Screening

• Home testing kit posted every 2 years for home completion & return by post– If kit is lost, can phone 0800 707 60 60 for a

replacement kit

• Abnormal results (i.e. blood in poo or stool) are followed up by specialist nurse.

• Bowel cancer screening programme aims to prevent bowel cancer developing, by detecting pre-cancerous changes in the bowel

Curing Bowel Cancer

• Bowel cancer is one of the most treatable forms of cancer, if caught early

• 9 out of 10 people with bowel cancer who seek treatment at an early stage will survive for at least 5 years

• Look out for symptoms lasting more than 3 weeks– especially change in bowel habit to looser, more

frequent motions• Take part in the bowel cancer screening

programme

We can save lives by increasing the early detection of cancer

• 10,000 lives could be saved in England each year if survival rates matched the best in Europe (Department of Health, 2011).

• 5,000 lives saved if survival rates were at the European average

Key Messages

• Be aware of the early warning signs for Cancer

• Encourage and help people to speak to their GP

• Encourage people to take part in cancer screening programmes

• Spread the good news - If caught early enough, many types of cancer can be cured.

Practical Action

• Display leaflets and posters in your shop to encourage symptom awareness and importance of getting problems checked by GP

• Signpost people to their GP in response to specific symptoms

Examples of signposting to GP• Heartburn/Reflux/acid - for over 40’s

– pharmacist to check if this is a new symptom. If yes, signpost to GP

• Cough medicine – check if smoker and if having recurrent chest

infections. If yes, signpost to GP

• Urinary tract infection symptom – for over 50’s – signpost to GP.

• Does your pharmacy do this?

Other ways you can help

• Learn more about cancer by taking part in Sheffield City Council’s free 2-hour basic cancer awareness course

• We can visit your practice to deliver training or run “drop in’s” for clients

• Contact Joanne Coy on:– 0779 403 2523 – or email Joanne.Coy@sheffield.gcsx.gov.uk

Sheffield organisations for people with cancer & their relatives, carers, or friends

• Weston Park Cancer Information & Support Centre, 23 Northumberland road, Sheffield, S10 2TX. Tel: 226 5391 or www.cancersupportcentre.co.uk

• The Cavendish Centre 27 Wilkinson Street Sheffield S10 2GB

tel 0114 278 4600www.cavcare.org.uk

Age UK Sheffield’s Macmillan Cancer Support Service

• contact Age UK Sheffield on 0114 2502850 or email debbie.price@ageuksheffield.org.uk

Further information about Cancer

• General Information on types of cancer, symptoms, treatment: Cancer Research UK http://cancerresearchuk.org/

• National Cancer Intelligence Network. Statistics/Trends

https://ncin.org.uk/analyses

• NHS Screening Programmes • http://www.cancerscreening.nhs.uk

Cancer Information (continued)

• Cancer Backup – advice and information• http://www.cancerbackup.org.uk

• BBC Health Website• http://www.bbc.co.uk/health

/conditions/cancer

• Sun Smart website• http://www.sunsmart.org.uk/index

References

Department of Health (2011) Improving Outcomes: a Strategy for Cancer, January 2011

Sheffield and North Trent Cancer Network data are available from the National Cancer Intelligence Network’s (NCIN) Cancer e-atlas, available from: http://www.ncin.org/cancer_information_tools/eatlas.aspx