Cancer Awareness
for Pharmacy Staff
Joanne Coy
Sheffield City Council
July 2013
Our session at a glance
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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/cancerinfo/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 cancer
185 deaths
lung cancer
147 deaths
2
prostate cancer
82 deaths
breast cancer
107 deaths
3
bowel cancer
72 deaths
bowel cancer
50 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
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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 Measure
unprompted 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?
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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
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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
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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/cancerinfo/spotcancerearly/naedi/beclearoncanc
er/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 2hour 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 4600
www.cavcare.org.uk
Age UK Sheffield’s Macmillan Cancer Support
Service
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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/eat
las.aspx