Coalition Updates / Events
Free Seminars: Caring People- CEUs available
Here is a FYI for social workers and certified case managers to earn 2.0 free CEU’s by attending two seminars, one focusing on senior adults and the other on anxiety and stress reduction, presented on Thursday, December 8th and held at Senior Source, located in The Shops at Riverside Mall, 310 Riverside Square Mall, Hackensack, NJ 07601.
Please review promotional flyer and feel free to network to your contacts who are social workers or certified case managers.
To RSVP, contact Jenny Pourakis, LCSW, Home Care Consultant, Caring People, at firstname.lastname@example.org or 201-421-7371.
Special thanks to the Community Networking Association of Bergen County for providing (networking) this information.
Live Well Cancer Survivor Program
As per grant requirements of our Bergen-Hudson Chronic Disease Coalition, one of the initiatives that we are undertaking is Cancer Survivorship. We are in the process of amassing information on resources available to cancer survivors and their caregivers.
As an FYI, the Wyckoff Family YMCA is offering The Live Well Cancer Survivor Program, an 8-week group program designed for cancer survivors include fitness, nutrition, yoga, and resources to support a healthy and strong lifestyle to Live Well! The 8 sessions, sponsored by the Wyckoff Y Cares Fund, are held on Tuesdays at 2:00 pm. For this program, members of the Wyckoff YMCA and non-members are welcome at no charge.
In addition, the Wyckoff YMCA is also offering Cancer Survivor One-On-One Training, an individualized exercise program designed for cancer survivors who have recently become de-conditioned from their treatment. The program includes one fitness assessment/consultation and eight 30-minute sessions. Focus is on improving muscle strength, flexibility, endurance, and quality of life. For this program, there is no charge for a full member of the Wyckoff YMCA and there is a fee of $160.00 for basic and non-members.
Both programs will be held in the Wyckoff YMCA’s Fitness Center located in Bergen County at 691 Wyckoff Avenue, Wyckoff, NJ.
Most importantly, a physician’s clearance is required for participation in these programs.
For more information, please contact RonD@wyckoffymca.org and/or visit http://wyckoffymca.org/programs-services/fitness-wellness/wellness-services/.
This Thursday, November 17th is The Great American Smokeout
The American Cancer Society marks the Great American Smokeout on the third Thursday of November (the Thursday before Thanksgiving) each year by encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. The 41st annual Great American Smokeout will be held this coming Thursday, November 17, 2016. By quitting –even for one day—smokers will be taking an important step towards a healthier life-one that can help lead to reducing the risk of chronic diseases linked to tobacco use.
The idea for the Great American Smokeout grew out of a 1971 event in Randolph, Massachusetts in which Arthur P. Mullaney asked people to give up cigarettes for a day and donate the money that would have spent on cigarettes to a high school scholarship fund. In 1974, Lynn R. Smith, editor of the Monticello Times in Minnesota, spearheaded the state’s first D-Day, or Don’t Smoke Day. The idea caught on, and on November 18, 1976, the California Division of the American Cancer Society succeeded in getting nearly one million smokers to quit for the day. That California event marked the first Great American Smokeout, which went nationwide in 1977.
According to the Center for Disease Control (CDC), in the more than 50 years since the Surgeon General's first report on smoking and health, cigarette smoking among U.S. adults has been reduced by approximately half. However, since 1964, an estimated 20 million persons have died because of smoking, which remains the leading preventable cause of disease, disability, and death in the United States. About two out of three adult smokers want to quit smoking cigarettes, and approximately half of smokers made a quit attempt in the preceding year. However, in 2015, an estimated 15.1% of U.S. adults (approximately 36.5 million persons) were current cigarette smokers.
Stopping smoking is associated with the following health benefits:
There is no one right way to quit smoking. Quitting tobacco is a lot like losing weight—it takes a strong commitment over a long period of time. Tobacco users may wish there was a magic bullet—a pill or method that would make quitting painless and easy, but, unfortunately, there’s nothing like that on the market. Nicotine substitutes can help reduce withdrawal symptoms, but they are most effective when used as part of a plan that addresses both the physical and psychological components of quitting tobacco.
commemorates the American Cancer Society’s Great American Smokeout, an initiative where smokers are afforded the opportunity to develop a plan to quit and/or decide to go “cold turkey” and stop smoking for the day or hopefully longer. The Bergen-Hudson Chronic Disease Coalition, administered by the Bergen County Department of Health Services, would like to encourage smokers to participate in the 39th Great American Smokeout on Thursday, November 19th and make a commitment to quit smoking cigarettes, cigars, pipes, the use of smokeless tobacco products and electronic smoking devices. By quitting, even for one day, smokers will be taking an important step towards a healthier life—
The Great American Smokeout is a golden opportunity for individuals to encourage a smoker to participate in this initiative and support their efforts to be tobacco-free. The American Cancer Society recommends that a nonsmoker make a commitment to “adopt” a family member, friend, co-worker who smokes to assist them through those difficult times when they crave tobacco. When trying to quit smoking, support can make all the difference.
Here are some suggestions to plan to assist or adopt a smoker to get through the day, or any day without cigarettes:
Most former smokers quit without using one of the treatments that scientific research has shown can work. However, the following treatments are proven to be effective for smokers who want help to quit:
Studies show that only 3% to 5% of smokers are able to quit without any assistance. For smokers who made a commitment to quit but are having difficulty quitting on their own, they can take advantage of New Jersey Quitline, a FREE telephone counseling service supported by the New Jersey Department of Health. Quitline counseling can more than double a smoker’s chances of quitting and research shows that Quitline users have about a 60% better chance of staying smoke-free than those who try to quit on their own. NJ Quitline is staffed by multilingual quit coaches who have prior counseling experience.
Smokers who need quitting assistance in the form of free telephone counseling on the Great American Smokeout or other days during the year can contact New Jersey Quitline at 1-866-NJ-STOPS or 1-866-657-8677 seven days a week. NJ Quitline registration and counseling is available Monday through Friday from 8:00 am to 9:00 pm and 9:00 am to 5:00 pm on Saturday and Sundays. After hours an individual has access to voice mail and quit tips. To register, smokers can contact NJ Quitline directly toll-free at 866-657-8677 or visit www.njquitline.org. For additional tobacco cessation information, smokers can contact Mom’s Quit Connection at their toll-free number of 888-545-5191.
For more information on tobacco control and The Great American Smokeout, visit www.cancer.org/smokeout. Additional information and support for quitting smoking is available by telephone at 800-QUIT-NOW (800-784-8669). CDC's Tips From Former Smokers campaign offers additional quit resources at http://www.cdc.gov/tips.
People who stop smoking greatly reduce their risk for chronic disease and early death. Although the health benefits are greater for people who stop at earlier ages, there are benefits at any age and smokers are never too old to quit. Smoking kills more people than alcohol, AIDS, car accidents, illegal drugs, murders and suicides COMBINED! Encourage smokers to participate in the Great American Smokeout and support their commitment to quit smoking cigarettes, cigars, pipes, the use of smokeless tobacco products and electronic smoking devices.
On November 24th (Thanksgiving Day), if you are able to assist and support someone successfully to be tobacco-free either on the Great American Smokeout or at another time during the year, it is truly a special reason to give thanks!
The Bergen-Hudson Chronic Disease Coalition is funded through a grant from the New Jersey Department of Health Office of Cancer Control and Prevention (OCCP). For more information on Comprehensive Cancer Control in New Jersey, please visit: www.njcancer.gov.
November is National Diabetes Month
National Diabetes Month is observed every November to draw attention to diabetes and its effects on millions of Americans. Diabetes remains the 7th leading cause of death in the United States killing more Americans every year than AIDS and breast cancer combined.
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Insulin allows blood sugar (glucose) to enter cells, where it can be used for energy. There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant, which can put the pregnancy and baby at risk and lead to type 2 diabetes later). With type 1 diabetes, the body can't make insulin, so it needs to be taken every day. Type 1 diabetes is less common than type 2 diabetes; about 5% of the people who have diabetes have type 1. Currently, no one knows how to prevent type 1 diabetes. Most people with diabetes—9 out of 10—have type 2 diabetes. Type 2 diabetes develops most often in middle-aged and older adults but can appear in young people. With type 2 diabetes, the body doesn't use insulin well and is unable to keep blood sugar at normal levels. Diabetes is a leading cause of kidney failure, blindness and amputations of toes, feet, or legs, and a major cause of heart disease and stroke.
Diabetes is growing at an epidemic rate in the United States. According to the Center for Disease Control (CDC), more than 29 million people in the United States have diabetes, but 1 out of 4 of them don't know they have it. At least 1 out of 3 people will develop diabetes in their lifetime. Risk of death for adults with diabetes is 50% higher than for adults without diabetes. In New Jersey approximately 904,861 people, or 12% of the adult population (nearly 1 in 11 people) have diabetes. Of these, an estimated 235,000 have diabetes but don’t know it, greatly increasing their health risk. Every year an estimated 43,000 people in New Jersey are diagnosed with diabetes.
The risk factors for Type 2 diabetes include being overweight, being 45 years or older, having a parent, brother, or sister with type 2 diabetes, being physically active less than 3 times a week, and ever having gestational diabetes or giving birth to a baby who weighed more than 9 pounds. Race and ethnicity also matter: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk for type 2 diabetes. Individuals who have any of the risk factors, should consult with their doctor if they should be tested for diabetes. The sooner it is detected, the sooner the individual can start making healthy changes that will benefit them now and in the future.
The symptoms of diabetes are typical. However, some people with type 2 diabetes have symptoms so mild that they go unnoticed. Common symptoms of diabetes include urinating often, feeling very thirsty, feeling very hungry - even though you are eating, extreme fatigue, blurry vision, cuts/bruises that are slow to heal, weight loss - even though you are eating more (type 1), tingling, pain, or numbness in the hands/feet (type 2.)
Diabetes complications and related conditions include the following:
There are no clear symptoms of prediabetes, and individuals may have it and not know it. Some individuals with prediabetes may have some of the symptoms of diabetes or even problems from diabetes already. Individuals usually find out that they have prediabetes when being tested for diabetes. Results indicating prediabetes are: an A1C of 5.7% – 6.4%. The A1C is a test that measures a person's average blood glucose level over the past 2 to 3 months. Diabetes is diagnosed at an A1C of greater than or equal to 6.5%; fasting blood glucose of 100 – 125 mg/dl (this test checks fasting blood glucose levels.) Fasting means after not having anything to eat or drink (except water) for at least 8 hours before the test. This test is usually done first thing in the morning, before breakfast. Diabetes is diagnosed at fasting blood glucose of greater than or equal to 126 mg/dl milligrams per deciliter; and an Oral Glucose Tolerance Test (OGTT) 2 hour blood glucose of 140 mg/dl – 199 mg/dl. The OGTT is a two-hour test that checks your blood glucose levels before and 2 hours after you drink a special sweet drink. It tells the doctor how your body processes glucose. Diabetes is diagnosed at 2 hour blood glucose of greater than or equal to 200 mg/dl. Individuals who have prediabetes, should be checked for type 2 diabetes every one to two years.
According to the American Diabetes Association, research shows that an individual can lower their risk for type 2 diabetes by 58% by losing 7% of their body weight (15 pounds if an individual weighs 200 pounds) and if an individual can’t get to their ideal body weight, losing even 10 to 15 pounds can make a huge difference; ), and exercising moderately (such as brisk walking) 30 minutes a day, five days a week. Tobacco use cessation is also important to avoid complications that could damage blood vessels.
There isn't a cure yet for diabetes, but a healthy lifestyle can really reduce its impact on an individual’s life. Research has shown that diabetes self-management education and support improves diabetes outcomes, including helping to reduce A1C levels; reducing the onset or advancement of diabetes complications; improving lifestyle behaviors, such as eating a more healthful diet and exercising more frequently; and decreasing diabetes-related distress and depression. What an individual does every day can make the difference in the management of this chronic disease.
According to the American Diabetes Association, every 23 seconds someone in the United States is diagnosed with diabetes. Individuals who find that they’re at high risk for diabetes should speak with their health care provider. Take this opportunity during National Diabetes Month to raise awareness about diabetes risk factors, the importance of its early detection and encourage people to make healthy changes to prevent and/or delay the complications of this chronic disease.
For more information on diabetes, visit the websites of the American Diabetes Association at www.diabetes.org, the Center for Disease Control (CDC) at www.cdc.gov/diabetes/ or The Diabetes Foundation at www.diabetesfoundationinc.org/
The Bergen County Chronic Disease Coalition is funded through a grant from the New Jersey Department of Health’s Office of Cancer Control and Prevention (OCCP). For more information on Comprehensive Cancer Control in New Jersey, please visit: www.njcancer.gov.
Stupid Cancer- Ugly Christmas Sweater Fundraiser
Stupid Cancer is a non-profit organization that empowers young adults under the age of 40 who are affected by cancer through innovative and award-winning programs and services. Stupid Cancer is the nation's largest support community for this underserved population and serve as a bullhorn for the young adult cancer movement.
With the approaching holidays a traditional time for gift-giving, the organization would like your financial support through the purchase of their 2016 edition of their Ugly Christmas Sweater.
The sweater can be purchased for a limited time only, and the deadline for pre-ordering is midnight (ET) on Dec. 4, 2016
Since all proceeds go to support the young adult cancer movement, please read below on how you can support them with your purchase.
To learn more about the Stupid Cancer organization, visit www.stupidcancer.org.
Enright Melanoma Foundation
The Enright Melanoma Foundation, a coalition member, is a non-profit organization whose mission is to raise sun safety awareness and to help prevent melanoma through education and early detection. They are a prevention focused doctor-led organization.
With Thanksgiving less than two weeks away, the Foundation would like to extend their thanks to those who have provided support, participated in their initiatives and donated to their mission during the year. The Foundation welcomes donations of any size to help them fund their mission of melanoma and skin cancer prevention and requests that you consider making a donation in honor or in memory of someone you love. The foundation is a registered 501 (c)(3) organization allowing you to deduct the contributions you make.
In the spirit of Thanksgiving, this is a golden opportunity, if you choose, to support the Foundation.
For more information on the work of The Enright Melanoma Foundation and skin cancer (particularly their online Apply, Cover & Enjoy sun safety certification program, please visit www.enrightmelanomafoundation.org or call (908) 464-0277.
Special thanks to Janet L. Horowitz, Enright’s Executive Director, for providing this information.
Spirituality and Survivorship
Brooke Laster, LCSW, OSW-C, ACHP-SW, Oncology Social Worker, The Valley Hospital’s Blumenthal Cancer Center, Paramus, would like to announce that their next workshop in their Survivorship Series – “Spirituality and Survivorship” will be held on Tuesday, December 6, 2016, from 6 - 7:30 p.m. The free workshop will take place in the second floor conference room at The Valley Hospital's Daniel & Gloria Blumenthal Cancer Center — Luckow Pavilion located at One Valley Health Plaza, Paramus, NJ.
Mason Jenkins, Board Certified Chaplain with a Masters of Divinity from Union Theological Seminary and chaplain at Valley Hospital for the last six years, will discuss ways to promote spiritual and emotional well-being through human relationships, mindfulness practice, and fostering gratitude. As hospital chaplain, Mason works with patients from all back-grounds and stages of illness to help them access sources of strength, hope, meaning, and courage.
To register please call or email: Suzanne Kaufman, LSW at: 201-634-5422 or email@example.com
Cancer patients who are in treatment and post treatment are encouraged to attend, as well as health care professionals and interested individuals.
The workshop is sponsored by The Valley Health System and Mount Sinai Comprehensive Cancer Care. Special thanks to Brooke Laster for providing this important information.
The Us TOO Prostate Cancer Support Group of Hackensack
Will be meeting next Wednesday, November 16, 2016 from 10:00 a.m. to 12:00 noon at the John Theurer Cancer Center, Hackensack University Medical Center, 92 Second St., Hackensack, NJ. Parking is free in the garage across from the Cancer Center.
Dr. Henry Tsai, ProCure, will deliver a presentation on "Proton Beam Therapy".
The refreshments that will be served are courtesy of Abb Vie Endocrinology Inc.
Please network this information to those affected by prostate cancer, including spouses and caregivers.
Movie Night: VAXXED
The Cancer Awareness Research Exchange group, facilitated by Harvey Kunz, will be meeting this Thursday, November 10, 2016 at the United Methodist Church, 100 Dayton St., Ridgewood. The CARE group stresses nutritional education, not only cancer treatment. CARE is a non-profit support organization formed to help people maintain optimum health, make intelligent decisions about their lifestyle, be aware of the latest progress in all medical fields, and share experiences and concern with those in similar circumstances.
The CARE Group meets the second Thursday of each month in the “East End Conference Room, adjacent to the church parking lot. The meeting begins at 7:00 pm with a short update on health news and evaluation of new treatments, followed by the featured speaker (or other special event) ending with questions/answers or the opportunity to network from 9:00 to 9:30 pm. Most speakers welcome personal one-on-one questions as time allows.
At this meeting, the theme is Movie Night where the controversial movie on immunizations titled “VAXXED” will be shown.
The fee for the meeting is $10.00. However in the past, Harvey indicated that this fee would be waived for members of the coalition.
The Coalition is committed to networking information regarding programs and services of its members. Please review this information with an open mind and consider attending a meeting to examine alternative treatments to better health.
Diabetes Foundation Open House
In recognition of November designated as National Diabetes Month, coalition member Diabetes Foundation, Inc., office located in Paramus, NJ, has provided an FYI on some of the free activities they will be conducting in Northern New Jersey (some in Bergen and Hudson County.)
I would like to call to your attention that on Tuesday, November 8th, the Diabetes Foundation will be sponsoring an open house from 11:00 am to 2:00 pm at their office a13 Sunflower Avenue, Suite 1010, Paramus, NJ. Activities include diabetes Information; Blood Sugar, Blood Pressure, Cholesterol, & Body Fat Screenings with Horizon NJ Health & Ridgewood YMCA; Dietitian & Certified Diabetes Educator Consultations.
Attached is a promotional flyer and please network to your contacts who may be at risk for pre-diabetes and diabetes and spread the word about the activities conducted during November.
With 1 out of 10 New Jersey residents already living with diabetes, here is an excellent opportunity on this Election Day to learn more about diabetes and the wonderful services the Diabetes Foundation provides. Vote for good health!
Special thanks to Marla Klein, Bergen County Department of Health Services for providing this information.
Pies for Prevention
Thanksgiving will be here before you know it! Besides this holiday being a great time to pause and give thanks for all that we have, it also focuses on the food that we will share with our family and friends. Here is a FYI of their Pies for Prevention Initiative where you are afforded the opportunity to purchase different kinds of pies, perfect for Thanksgiving! The proceeds from this sale goes to some of Sharsheret’s wonderful programs.
Sharsheret, Hebrew for “chain”, is a national not-for-profit organization supporting young women and their families, of all Jewish backgrounds, facing breast cancer at every stage—before, during, and after diagnosis. Their mission is to offer a community of support to women diagnosed with breast cancer or at increased genetic risk, by fostering culturally-relevant individualized connections with networks of peers, health professionals, and related resources. They also provide educational resources, offer specialized support to those facing ovarian cancer or at high risk of developing cancer, and create programs for women and families to improve their quality of life. All Sharsheret’s programs are open to all women and men.
Please visit http://www.sharsheret.org/pies-for-prevention for more details.
Community Network Association of Bergen County
The third meeting of the Community Networking Association of Bergen County will be held on Tuesday, November 15th at the Woodcrest Health Care Center, 800 River Road, New Milford, NJ from 10:00 am to 12:00 noon. The CAN’s mission is to bring together professionals from a variety of backgrounds to discuss and create awareness of their available services/programs that would assist county residents in need and build relationships through networking.
For individuals who either live or work in Bergen/Hudson County, here is an opportunity to network with your peers on available services and resources to benefit and serve county residents in their respective communities.
Please RSVP CNA of Bergen@gmail.com
Your presence will afford you the opportunity to connect with other professionals and help reach their goal of bridging resources to build stronger and healthier communities. I had the opportunity to attend both meetings and many networking connections were made.
Individuals based in Hudson County who would like more information on the Community Networking Resource Association of Hudson County can send via email to firstname.lastname@example.org
You are welcome to join and become part of Bergen County’s (and Hudson County’s) community network.
FREE “Cancer: Thriving & Surviving” Workshop Beginning Thursday, November 10th at the Ridgewood YMCA
As per grant requirements of our Bergen-Hudson Chronic Disease Coalition, one of the initiatives that we are undertaking is Cancer Survivorship. To address this initiative, we are collaborating with the Ridgewood YMCA, to sponsor a free workshop for cancer survivors titled “Cancer: Thriving and Surviving” with the first session beginning Thursday, November 10 from 12:00 to 2:30 pm at the Ridgewood YMCA, 112 Oak Street, Ridgewood, NJ. Since it is being held during hours usually reserved for lunch, lunch will be provided.
This two and a half hour workshop, developed by Stanford University, is facilitated by two trained peer leaders and presented once a week for six weeks on the following dates: November 10, 17, December 1, 8, 15 and 22nd.
Subjects covered include: 1) techniques to deal with problems such as frustration, fatigue, pain, isolation, poor sleep and living with uncertainty, 2) appropriate exercise for regaining and maintaining flexibility, and endurance, 3) making decisions about treatment and complementary therapies, 4) communicating effectively with family, friends, and health professionals, 5) nutrition, 6) setting priorities, and 7) relationships.
Each participant in the workshop receives a copy of the companion book, Living a Healthy Life With Chronic Conditions, 4th Edition, and a relaxation CD, Relaxation for Mind and Body.
Classes are highly participative, where mutual support and success build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.
The program is designed to enhance regular treatment and gives participants the skills to coordinate all the things needed to manage their health, as well as to help them keep active in their lives and relationships.
In order for this workshop to be conducted, a minimum of 10 to a maximum of 20 cancer survivors and/or caregivers must be registered. We are asking you to promote this program, obviously to those contacts you work with or provide assistance, family members, friends, neighbors and/or members of your church community who may be cancer survivors who would truly benefit from this workshop.
For registration, please contact Carol Livingstone, Ridgewood YMCA, 201.444.5600 x330 or email@example.com WWW.RIDGEWOODYMCA.ORG
Attached is a promotional flyer and we thank you for networking and promoting this excellent workshop geared to cancer survivors.
Open Enrollment for 2017 Starts TODAY (November 1) for the Health Insurance Marketplace
Starting November 1, you can log in to HealthCare.gov and enroll in a 2017 health plan.
Enroll by December 15, 2016 and your coverage can start January 1, 2017. You can preview plans and prices before you buy starting shortly before November 1.
En Español at https://www.cuidadodesalud.gov/es/
Special thanks to Gloria Andrade, Teaneck Department of Health, for providing this information.
Today is the last day of National Breast Cancer Awareness Month.
The focus of this initiative, held in October, is to increase public awareness about the importance of early detection of breast cancer and screening. Women are encouraged to talk to their healthcare provider about their risk for breast cancer, especially if a close family member has had breast or ovarian cancer. Men need to know that breast cancer is not limited to only women. Even though their lifetime risk of getting breast cancer is about 1 in 1,000, men who notice any breast changes should see their healthcare professional as well. Even though the initiative is nearly over until next year, the importance of early awareness continues every day of each month throughout the year.
Breast cancer is the most common cancer among women in the United States, other than skin cancer. About 1 in 8 women born today in the US will get breast cancer at some point during their lifetime. On average, every 2 minutes a woman is diagnosed with breast cancer and 1 woman will die of breast cancer every 13 minutes. The American Cancer Society estimates that, 246,660 new cases of invasive breast cancers will be diagnosed among women (2,600 new cases in men) in the US in 2016. Deaths from breast cancer have declined over time, but remains the second leading cause of cancer death among women overall and the leading cause of cancer death among Hispanic women
Breast cancer occurs when cells in the breast divide and grow without their normal control. Tumors in the breast tend to grow slowly. By the time a lump is large enough to feel, it may have been growing for as long as 10 years. (Some tumors are aggressive and grow much faster.) Between 50-75 percent of breast cancers begin in the milk ducts (tubes that carry milk to the nipples), about 10-15 percent begin in the lobules (glands that produce milk) and a few begin in other breast tissues (connective tissue consisting of fibrous and fatty tissue that surrounds and holds everything together.)
When abnormal cells grow inside the milk ducts, but have not spread to nearby tissue or beyond, this is called ductal carcinoma in situ. The term "in situ" means "in place." With DCIS, the abnormal cells are still inside the ducts. DCIS is a non-invasive breast cancer or a “pre-invasive breast carcinoma.” Although ductal carcinoma in situ is non-invasive, without treatment, it can develop into invasive breast cancer. Invasive breast cancer occurs when abnormal cells from inside the milk ducts or lobules break out into nearby breast tissue. Cancer cells can travel from the breast to other parts of the body through the blood stream or the lymphatic system. They may travel early in the process when a tumor is small or later when a tumor is large. The lymph nodes in the underarm area (axillary lymph nodes) are the first place breast cancer is likely to spread. In advanced stages, breast cancer cells may spread to other parts of the body such as the liver, lungs, bones and brain (a process called metastasis). There, the breast cancer cells may again begin to divide too quickly and make new tumors. This is called metastatic breast cancer.
The most common symptom of breast cancer is a lump or mass in the breast, which is often painless. Less common symptoms include other persistent changes to the breast, such as thickening, swelling, distortion, tenderness, skin irritation, redness, scaliness, nipple abnormalities, or spontaneous discharge. Breast pain is more likely to be caused by benign conditions and is not a common symptom of breast cancer.
Some women will get breast cancer even without any other risk factors that they know of. Having a risk factor does not mean a women will get the disease, and not all risk factors have the same effect. Most women have some risk factors, but most women do not get breast cancer. Modifiable factors associated with increased breast cancer risk include weight gain after the age of 18 and/or being overweight or obese (for postmenopausal breast cancer), use of menopausal hormone therapy (combined estrogen and progestin), physical inactivity, and alcohol consumption. In addition, recent research indicates that long-term, heavy smoking may also increase breast cancer risk, particularly among women who start smoking before their first pregnancy. The International Agency for Research on Cancer has concluded that shift work, particularly at night (i.e., that disrupts sleep patterns), may be associated with an increased risk of breast cancer.
Non-modifiable factors associated with increased breast cancer risk include older age; a personal or family history of breast or ovarian cancer; inherited mutations (genetic alterations) in BRCA1, BRCA2, or other breast cancer susceptibility genes; certain benign breast conditions (such as atypical hyperplasia); a history of ductal or lobular carcinoma in situ; high-dose radiation to the chest at a young age (e.g., for cancer treatment); high breast tissue density (the amount of glandular tissue relative to fatty tissue measured on a mammogram); high bone mineral density (evaluated during screening for osteoporosis); and type 2 diabetes (independent of obesity). Reproductive factors that increase risk include a long menstrual history (menstrual periods that start early and/or end later in life), recent use of oral contraceptives, never having children, having one’s first child after age 30, and high natural levels of sex hormones.
Early detection saves lives and increases treatment options. Breast cancer screening can help find breast cancer early, when the chances of survival are highest. Screening is important for all women. Women at higher risk may need breast cancer screening earlier and more often than women at average risk. Screening is not recommended for most men. However, some men at higher risk (inherited gene mutation or a strong family history of breast cancer) should get screened.
At this time, the best way to find breast cancer is with a mammogram. Mammography is a low-dose x-ray procedure used to detect breast cancer at an early stage. Numerous studies have shown that early detection with mammography helps save lives and increases treatment options. However, like any screening tool, mammography is not perfect. For example, it can miss cancers, particularly those in women with very dense breasts, and also detects cancers that would never have caused harm, resulting in some over diagnoses. Most (95%) of the 10% of women who have an abnormal mammogram do not have cancer. For women at average risk of breast cancer, recently updated American Cancer Society screening guidelines recommend that those 40 to 44 years of age have the choice for annual mammography; those 45 to 54 have annual mammography; and those 55 years of age and older have biennial or annual mammography, continuing as long as their overall health is good and life expectancy is 10 or more years. For some women at high risk of breast cancer, annual screening using magnetic resonance imaging (MRI) in addition to mammography is recommended, typically starting at age 30. According to the United States Preventive Task Force, the decision to start screening mammography in women prior to age 50 years should be an individual one. They recommend that women should consult with their health care provider for informed decision-making on screening ages 40-49 and every 2 years ages 50-74. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years.
Other examinations include a clinical breast exam, an examination by a doctor or nurse, who uses his or her hands to feel for lumps or other changes. Women can conduct breast self-awareness, or visual inspection of their breasts since six of the eight warning signs of breast cancer are visual and cannot be felt if women conduct breast self-exam or BSE. By conducting routine breast self-awareness, women will begin to become familiar what is normal for them regarding how their breasts look and feel and can help them notice symptoms such as lumps, pain, or changes in size that may be of concern. These could include changes found during a breast self-exam. Most importantly, women or men should report any changes that they notice to their doctor or health care provider.
According to the American Cancer Society, the 5, 10, and 15-year relative survival rates for breast cancer are 89%, 83%, and 78%, respectively. Most cases (61%) are diagnosed at a localized stage (no spread to lymph nodes, nearby structures, or other locations outside the breast), for which the 5-year survival is 99%. Survival rates have increased over time for both white and black women, although they remain 11 percentage points lower, in absolute terms, for blacks.
In addition to early detection and screening, women may reduce their risk by making healthy lifestyle choices—maintaining a healthy weight, add exercise into their routine, limit alcohol intake, limit postmenopausal hormone use and breastfeed, if possible.
The New Jersey Cancer Education and Early Detection Screening Program (NJCEED) is part of the New Jersey Department of Health. NJCEED provides comprehensive screening services for breast, prostate, cervical, and colorectal cancer. The services include education, outreach, early detection, case management, screening, tracking, and follow-up. Persons eligible for these services must be at or below 250% of the Federal Poverty Level and be uninsured or under-insured.
For more information about the Bergen and Hudson CEED Programs respectively and eligibility, please contact the following: Bergen CEED-Bergen County Department of Health Services at /index.aspx?nid=359, 201-634-2660; and Hudson CEED-Hoboken Family Planning at 201-963-0300, http://hobfamplan.net/abouthfp.html.
For more information on breast cancer and screening visit the website of the Center for Disease Control (CDC) at www.cdc.gov/cancer/breast or the American Cancer Society at www.cancer.org.
As we close out National Breast Cancer Awareness Month for 2016, women who have breast cancer risk factors should consult with their health care provider throughout the year to discuss ways they can lower their risk and screening recommendations.
The Bergen-Hudson Chronic Disease Coalition is funded through a grant from the New Jersey Department of Health Office of Cancer Control and Prevention (OCCP). For more information on Comprehensive Cancer Control in New Jersey, please visit: www.njcancer.gov