n orthwest p ortland a rea i ndian h ealth b oard indian leadership for indian health tribal cancer...

Northwest Portland Area Indian Health Board

Indian Leadership for Indian Health

Tribal Cancer Control Tribal Cancer Control Education Education

Eric VinsonNorthwest Tribal Comprehensive Cancer Program

May 4, 2010Risky Business Training

Supported by CDC Grant #1 U58 DP000786-3

Organizational Chart

Northwest Portland Area Indian Health Board04/18/23 2

Northwest Diabetes Project NTCCP& W H PP

National Diabetes Project

N T C C P & W T D PK e rr i L o p e z,

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N o r th w e st T rib a l E p id e m o lo g y C e n terV ic to r ia W arre n -M e a rs,

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N P A IH BJ o e F in kb o n n e r,

E x e cu tiv e D ire c tor

N o r th w e st P or tla n d A r e a In d ia n H e a lth B o a rdE x e c utiv e C o m m itte e M em b e rs

July 1998Northwest Portland Area Indian Health Board Delegates resolved to form the Northwest Tribal Cancer Coalition and the Northwest Tribal Cancer Control Project

Northwest Tribal Cancer Control Project (NTCCP)


To envision and work toward cancer-free tribal communities

by taking an integrated and coordinated approach to cancer

control

NTCCP Mission


An integrated and coordinated approach towards preventing and

controlling cancer in tribal communities

To reduce cancer incidence, mortality, and morbidity among American Indians and Alaskan Natives (AI/AN) in Northwest tribal communities

NTCCP 20 Year Plan


• Facilitate a process for Northwest tribes to promote cancer risk reduction strategies.

• Provide information on the most current early detection, screening and treatment practices through education and resource materials.

• Provide education regarding quality of life for cancer patients, their families and caregivers.

• Coordinate and collaborate with local and national cancer organizations and individuals.

• Improve Indian-specific cancer control data.

NTCCP Goals


• Cancer among American Indians and Alaskan Natives

• What is Cancer?• Screening and Early Detection• Risk Factors and Risk Reduction• Diagnosis and Treatment• Support for Patients and

Caregivers

Cancer 101:6 Lessons to help Us Understand Cancer


• The term “cancer” refers to more than 100 different diseases that begin in the cells, the body’s basic unit of life.

• Cancer develops when cells grow and form more cells without order or control.

• Under normal circumstances, new cell growth and old cell death are kept in balance.

• In cancer, this balance is disrupted.

What Is Cancer?


Normal vs Cancerous Cells


Cancer among American Indians And Alaskan Natives

Goal: Understand the growing health concern of cancer among AI/AN.

Ca 101 Learning Module 1


Lifestyles : Traditional and Western

• Dietary changes

• Decrease in exercise

• Personal vs. traditional use of tobacco

Cancer Background


AI/AN have the lowest five-year survival rate for all cancer sites combined of any racial group in

the U.S.

Cancer Survival Rates


Contributing factors:• Late detection• Treatment compliance• Concurrent disease• Access to care• Barriers to care

Cancer Survival Rates


• Reduce barriers to care

• Increase participation in screening and early detection services

• Chance for survival is better if cancer is found early.

Improving Survival Rates


Risk Factors and Risk ReductionScreening and Early Detection

Goals: Understand breast and cervical cancer risk

factors and how to reduce risks associated with cancer.

Understand breast and cervical cancer screening and early detection and why it is important.

Breast and Cervical Cancer 101 Adapted from Modules 3&4


Am I at risk for breast cancer?


Research has shown that these factors increase your risk:

• Gender (Female) • HRT

• Age •Alcohol

• Family History •Personal history

• Genetic alternations •Diet

• Benign breast disease •Obesity

• Early Menstruation •Radiation

• Not Having Children •Aging

• Regular exercise• Breastfeeding during pregnancy• Maintain a healthy diet• Maintain a healthy weight• Limit alcohol consumption• Consult with your clinician

regarding menopausal hormone use

Can I do anything to reduce my risk for breast cancer?


• A lump or thickening in or near the breast or underarm

• A change in the size or shape of the breast• Nipple discharge or tenderness, or the

nipple pulled back (inverted) into the breast

• Ridges or pitting of the breast (the skin looks like the skin of an orange

• A change in the way the skin of the breast, areola, or nipple looks or feels

What are the symptoms of Breast Cancer?


• Breast Self Exam (BSE): DO NOT substitute BSE for regularly

scheduled mammograms and clinical breast exams.

• Clinical Breast Exam (CBE): Performed by a healthcare professional.

• Mammogram: A special kind of x-ray image of the breasts. Women in their 40’s and older should have a

mammogram regularly, every 1 to 2 years

Screening for Breast Cancer


You are at risk if you…• Are a women• Sexually active before age 16• Many sexual partners• No regular Pap tests • Weakened immune system• Over age 40• Smoke cigarettes

Am I at risk for Cervical Cancer?


• Human papillomavirus (HPV) Very common virus – over 100 types! About 15 types cause cervical cancer Other types cause warts, but not cancer

• Other factors may work with HPV to increase your risk of developing cervical cancer: Use of birth control pills more than 5 years Having 7 or more children Smoking cigarettes

What causes Cervical Cancer?


Pap Test (or Pap Smear)

• Performed in a doctor’s office or clinic during a pelvic exam

• Looks at cervical cells• Is used to detect cancer or

changes that may lead to cancer• Can show non-cancerous

conditions

Prevention and Early Detection


Doctors generally recommend that women:

• Should begin having Pap tests 3 years after they begin having sexual intercourse or when they turn 21

• Should have a Pap test at least once every 3 years

• Who have had a total hysterectomy do not need to have cervical cancer screening, except if they had cervical cancer

How often should women have Pap tests?


What are the three recommended screenings for

Breast Cancer?

• Breast Self-Exam (BSE)• Clinical Breast Exam (CBE)• Mammography or Mammogram

Questions


Support for Patients and Caregivers

Goal: Understand the psychological and social issues that affect cancer patients and their caregivers.

Cancer 101 Learning Module 6


Common emotions after diagnosis:

Denial AngerStress AnxietyDepression

Coping with feelings


Do:• Treat me like you always have• Be there for me • Share emotions with me• Help my family• Ask if I’d like to talk• Listen

Support for the Patient


• Remember now more than ever before, people are surviving after a Cancer diagnosis.

Support for the Patient


Caregiving can be made less stressful by:

• Setting realistic limits• Offer periodic breaks• Support groups• Use community and volunteer

resources

Support for the Caregiver


Facing a cancer diagnosis and surviving

cancer treatment may be the greatest

challenge a person will face in their lifetime.

The Path to Recovery


• How we become well again:• Attain and maintain balance• Find a sense of purpose• Keep physical & emotional

defenses strong• Share stories of survival

Path to Recovery


What are some ways to support caregivers?

• Set realistic limits• Offer periodic breaks• Support groups• Use community and volunteer

resources

Question


Cancer Control in Northwest Tribal CommunitiesPreventionScreening & Early DetectionTreatmentSurvivorship

• Rehabilitation • Palliation

Tribal Cancer Action Planning


Women’s Health Example

Cancer Prevention through Education and Outreach


Objective Strategy Evaluation

Increase the awareness of women aged 40 and older about the importance of annual mammograms.

Develop a community awareness campaignPlan a “women’s health day” to distribute information about breast healthPlan an activity in connection with Breast Cancer Awareness Month (October)

Record activities of awareness campaign·Record number of persons served at community health dayMeasure awareness of importance of screeningSurvey community for change in level of awareness of importance of screening

Planning to achieve a specific objective.

Includes:• Who will conduct each component of the

activity• When actions are to be carried out• What resources need to be allocated• What outcomes are anticipated• What evaluation is needed to determine

success

Tribal Action Plans


Sample Tribal Action Plan

Activity: Cancer Mural Walk

Action Steps Accountability Schedule ResourcesFeedback

Mechanism

Primary Others Start Complete DollarsTime (hrs)

Register to Use Park Jensen Thayer, WA BCCP

May 7, 2007

May 7, 2007

$25 0.3

Get Tables for Park ONCS ACS

Wagon Rental Jensen Thayer, WA BCCP

$195 0.3

T-Shirts Pat Ike/ONCS WA BCCP $600 8

Cancer Pins/Tape Measures Jensen Thayer, WA BCCP

$50 0.60

Juice Ellen Doublerunner/ONCS

Yakama Juice $108 0.60

Mural Walk Posters Ellen Doublerunner/ONCS

Yakama Legends Casino

$200 8

Mural Walk Maps Jensen Thayer, WA BCCP

Mural Society .15

Cancer Literature Yakama Navigator ACS .30

Total $1,188 18.25 Sign-In Sheets

Yakama ONCS Mural Walk/Ride 2005

• Use partnerships to extend resources and delivery

• Partner with providers and other clinical staff

• Consult with other tribal programs• Partner with state programs for

services and training• Use advisors to provide clinical

guidance and test new ideas

Successful Strategies for Developing Partnerships


Partners

Foundations and Non-Profits

American Indian and Alaska Native Organizations

State and Federal Organizations

June 14 – July 1, 2010• Summer Research Training Institute For

American Indian and Alaska Native Heath Professionals

Upcoming Activities


Northwest Tribal Comprehensive Cancer Program

Kerri Lopez (Tolowa), Project DirectorEric Vinson (Cherokee), Project CoordinatorTom Becker, MD, PhD, Medical Epidemiologist

Northwest Tribal Registry ProjectMegan Hoopes, MPH, Project Director

Phone: 503-416-3301Email: [email protected]

Contact Information


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