Prevention Works - April 2017

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Issue: Apr 2017

Dialogue is coming to town







The state of cancer prevention Q&A with Dr. Kathleen M. Schmeler The time to regulate (p.6)

Broadway star Marissa Jaret Winokur wants you to Think About the Link® Q&A with Dr. Karen Sfanos








The nutrition mistakes you're probably making

Rural health care



Video game marathon at the forefront of cancer prevention worldwide STOP CANCER BEFORE IT STARTS!™ p.





Dear Readers, We are proud to announce singer-songwriter Alejandro Escovedo and Broadway star Marissa Jaret Winokur as the national spokespeople for Think About the Link®, an education campaign about the link between certain viruses and cancer. You can read their stories on Page 4. We are grateful to them for sharing their stories and speaking out so the next generation can prevent virallyinduced cancers. In this issue, we’re also bringing you expert voices in the field of cancer prevention and early detection. Read on to hear from Dr. Ernest Hawk, head of cancer prevention and population sciences at MD Anderson Cancer Center; Dr. Kathleen Schmeler, who is working to help reduce cervical cancer incidence and increase screening rates in underserved communities; and Dr. Karen Sfanos, who received her first-ever grant from the Foundation in 2008. Prevention is possible, but we can’t do it alone. Add your voice to the chorus, and share your story with us so we can Stop Cancer Before It Starts!®

Carolyn Aldigé President & Founder

“We now know that your zip code matters more than your genetic code in driving health outcomes. Factors such as access to healthy foods, safe places for physical activity, a living wage, education, good housing and safe air and water all have a powerful impact on your health.”


Dialogue is coming to town

The annual Dialogue for Action® conference on cancer screening and prevention is shaking things up with a new location and new technology to make this year’s conference the most exciting one yet. The 19th annual Dialogue will be held at the Hilton McLean Tysons Corner in McLean, Virginia. Its close proximity to two airports will make travel easy for conference attendees joining us from around the world, and guests can reach the heart of Washington, DC in just 30 minutes. If you want to check out what else is new for Dialogue 2017—there’s an app for that! Download the conference app from Guidebook to maximize your conference experience. You can use the app to connect with other attendees before or during the event, see the latest speakers as they are added to the conference agenda and personalize your experience with a custom calendar. Though there are many changes being made to Dialogue this year, you can still expect the excellent caliber of speakers, Cancer Prevention Laurels winners and networking connections that you have come to know and appreciate.

To register, visit Speaker Highlight: Garth Graham, M.D., MPH Limited access to affordable and quality health care keeps people in underserved communities across the country from getting the check-ups, screenings and treatments they need. Garth Graham, MD, MPH, president of the Aetna Foundation, will deliver the keynote address on health disparities and health equity. “We now know that your zip code matters more than your genetic code in driving health

outcomes. Factors such as access to healthy foods, safe places for physical activity, a living wage, education, good housing and safe air and water all have a powerful impact on your health.”




Broadway star Marissa Jaret Winokur and Singer-songwriter Alejandro Escovedo want you to Think About the Link ®

At age 27, Marissa Jaret Winokur was about to embark on the time of her life. Though she didn’t know it at the time, she would soon be cast in the lead role as Tracy Turnblad in Broadway’s “Hairspray,” for which she would later win a Tony award. But before she got the big news about her big break, Winokur was given news of a different sort—she was diagnosed with cervical cancer. More than 12,000 women in the U.S. are diagnosed with invasive cervical cancer each year. Winokur’s cancer, like more than 90 percent of cervical cancer cases, was caused by the human papillomavirus (HPV). Though she was lucky her cancer was detected with a routine Pap test, women today have more options available to prevent cervical cancer. The Centers for Disease Control and Prevention (CDC) recommend the HPV vaccine for all girls and boys ages 11-12. (HPV not only causes most cervical cancers, but is also linked to at least five other types of cancer, which is why it is recommended for boys as well as girls.) In addition to the vaccine, the Prevent Cancer Foundation® recommends women begin regular cervical cancer screenings at age 21 with a Pap test every three years. Women ages 35-65 should have a Pap test combined with an HPV test every five years, or a Pap test every three years. Winokur’s cancer was detected after an abnormal Pap test. Just days after her diagnosis, Winokur had to have part of her cervix removed, and later, she had a hysterectomy. She is now cancer-free. “When I was young, the HPV vaccine wasn’t available, and neither was the HPV test,” Winokur said. “Girls and young women today can protect themselves from cancer, but they have to know about their options. That's why I tell everyone to think about the link between HPV and cancer, and to speak with your doctor about getting vaccinated and screened so you don't have to go through what I did.”

Alejandro Escovedo had an unlikely path to fame. Though he comes from a musical family— brothers Coke and Pete played with Santana and niece Sheila E. is a well-known pop star— he did not begin playing music until his early twenties, when he worked on a film about a band that couldn’t play. His music has defied genre, with influences from garage rock, country, punk and traditional Mexican music. His fans know him as a rocker and a musician, but Escovedo now has another moniker to his name: hepatitis C survivor. Escovedo was diagnosed with hepatitis C in 1996, and his illness intensified—and was brought into the spotlight—when he collapsed on-stage in 2003. At the time of his diagnosis, Escovedo was unaware that hepatitis C is one of the leading causes of liver cancer. By the time of his collapse, he had advanced cirrhosis of the liver, as well as tumors in his abdomen and varices in his esophagus. He has said, “Getting sick was like taking a walk on a beautiful sunny day, and suddenly a piano falls on you from out of nowhere.” Today, Escovedo is cured of hepatitis C and feeling well. Now he wants you to have the information he didn’t have: that hepatitis C is linked to cancer, and if you are at risk you need to get screened for this virus before it leads to cancer. “Many people are unaware of the link between hepatitis C and cancer,” Escovedo said. “I am proud to join with the Prevent Cancer Foundation to tell you to take charge of your health and think about the link between viruses and cancer.”




Q&A with Dr. Karen Sfanos

The Prevent Cancer Foundation® makes it a priority to invest in early-career scientists ready to tackle high-risk, high-reward research. We sat down with Karen Sfanos, M.S., Ph.D. a researcher and associate professor at Johns Hopkins University, who received her first-ever grant from the Prevent Cancer Foundation® in 2008. We wanted to find out what she’s been up to and how that first grant has impacted her research.

Q: Can you briefly describe your current research?

My current research is largely focused on the influence of the microbiome (the collection of microorganisms that live on and inside us) on the prostate cancer disease spectrum. This includes studies on the influence of the urinary microbiome and pathogenic microorganisms on prostate cancer initiation, as well as the influence of potentially beneficial microorganisms (such as the ones that reside in the gut) on prostate cancer development and treatment responses.

Q: What is the potential future impact of your work?

What we ultimately hope to achieve with our studies is to determine whether the microbiome can serve as a modifiable risk factor to prevent prostate cancer development. In other words, can we determine and detect harmful combinations of microorganisms in the gut or in the urinary tract that predispose to cancer development, and then develop strategies to modify the microbiome to lower disease risk.

Q: What has the support of the Prevent Cancer Foundation®

meant for your research?

The postdoctoral fellowship award that I received from the Prevent Cancer Foundation was the first grant I ever received. I really credit the Prevent Cancer Foundation with providing the crucial support that I needed early on in establishing myself as a researcher and landing my initial faculty position. My current research program is built entirely on the work that I performed early on during my fellowship.


The time to regulate

Last year, the Food and Drug Administration (FDA) finalized a rule to regulate all tobacco products, including e-cigarettes, cigars and hookah. (The FDA has regulated cigarettes, smokeless and roll-your-own tobacco since 2009.) The new provisions, enacted August 8, 2016, were aimed at restricting youth access to these products. As retailers and manufacturers work to meet these new regulations, here are a few dates you should be aware of. September 8, 2017: Manufacturers and retailers must stop distributing products with modified risk claims like “mild” or “light.” February 8, 2018: Manufacturers must submit ingredient listings to the FDA (right now, only the manufacturers know what is in their products). This deadline was extended from August 8, 2017. May 10, 2018: Manufacturers must include required warning statements on packages and advertisements. Tobacco use is linked to at least 12 types of cancer, including bladder, breast, cervical, colorectal, liver, lung, oral and prostate cancers. The FDA has taken a critical first step in regulating tobacco products in order to prevent these cancer cases and Stop Cancer Before It Starts!® For more information on tobacco use and cancer, visit To see the complete timeline for regulations on pipe, cigar and vape shops, or to learn more about the FDA’s new tobacco regulations,




The state of cancer prevention

A conversation with Dr. Ernest Hawk, vice president of the division of cancer prevention and population science at MD Anderson …on what you can do to reduce your cancer risk Avoid tobacco, the single most preventable cause of death and of cancer in our population. That’s easier said than done. For those who smoke, it’s an addiction, not a habit. More than just knowing what to do, most people need assistance in helping to quit. (Editor’s Note: For help quitting, call 1-800-QuitNow to be connected with a trained quit coach in your area.) The second most important way to reduce risk is to maintain a normal weight across the lifespan. We’re learning that being overweight and obese contributes to the risk of 6 or 8 different types of cancer, and that list is constantly growing. Being physically active is a key component of weight control and physical inactivity in itself can increase cancer risk. …on HPV and cancer One of the landmark achievements of the last 20 years is the genesis of cervical cancer in transforming our knowledge of how cancer develops, in developing an effective strategy for cervical cancer and HPV testing, and in the development of a vaccine that can prevent HPV-related cancers. But vaccination rates are low, and our data suggests two major reasons. 1) There is a lack of public understanding of the relationship between HPV and cancer. 2) There is a lack of provider recommendation. Providers are not suggesting vaccination as an important part of routine preventive health care, or are not presenting the recommendation in the same way as other vaccines. …on the need to focus on prevention There are far too few organizations like the Prevent Cancer Foundation that prioritize prevention and early detection. We need to value health and wellness and prevention as much as we now do treatment. Our kids are taking us in that direction, but that has not been a traditional premise in our country. Prevention is not easily prioritized in and of itself unless each of us pays attention to it and the potential that it holds.

Q&A with Dr. Kathleen M. Schmeler

In the United States, cervical cancer is becoming less common thanks to increased vaccination rates, improved screening rates and better treatment. But incidence and death rates remain high among women in underserved areas across the country. We talked to MD Anderson’s Kathleen M. Schmeler, M.D., about the Project ECHO program that trains community health providers to better educate, screen and treat women along the Texas-Mexico border.

Q: Dr. Schmeler, tell us about Project ECHO.

Through videoconferencing and hands-on training, teams of specialists co-manage patients with community primary care clinicians working in rural and underserved populations. This approach has enabled these communitybased clinicians to develop the skills, confidence and knowledge to treat patients with common, complex diseases in their own communities, thereby reducing travel costs, wait times and avoidable complications.

Q: What makes this project so effective in the Rio Grande Valley (RGV) of South Texas?

The cervical cancer incidence and mortality rates in this region are approximately 30 percent higher than the rest of Texas. These populations are less likely to receive cervical cancer screening due to economic, social, educational and geographical barriers. There is also a shortage of locally-available trained providers to screen and manage patients. Project ECHO brings the knowledge and resources of specialists and large institutions to medically underserved communities.

Q: Has this program been as effective in other underserved areas?

We are currently using Project ECHO in many settings, including Houston, Zambia and Mozambique in Africa, and 12 countries in Latin America. It is a bit complicated with multiple time zones and different languages, but we are able to make it work!

Cervical cancer is a preventable disease, but remains one of the leading cancer killers worldwide—in fact, it is THE leading cancer killer of women in Central and South America and sub-Saharan Africa. Talk to your doctor about the HPV vaccination and screening so you can Stop Cancer Before It Starts!®



Rural health care

For those in less populated areas, access to health care remains a challenge If you’re a city-dweller, you may not realize that access to health care is not equal across the country. Often, those in rural areas face obstacles in paying for and even getting to treatment and preventive care. The Affordable Care Act has made a significant impact on rural health care. With Medicaid expansion, there has been an increase in the number of people insured—and able to pay for care—in rural areas, providing a boost to rural clinics and hospitals. Subsidies for coverage have further expanded the number of people with insurance, and regulations such as guaranteed insurance, even with pre-existing conditions, have helped people in rural and urban areas. But one of the largest programs supporting rural hospitals, called “340B,” is now at risk. This program, which was expanded by the Affordable Care Act, provides discounted drugs to hospitals that are “critical access” or “sole access” hospitals. These hospitals serve rurals communities and are at least 35 miles from the next closest hospital. They often serve low-income population, and have much higher overhead since they also serve fewer people. Without programs that make drugs more affordable and provide higher reimbursements through Medicare, these hospitals would close. At the Prevent Cancer Foundation®, we support programs such as 340B to protect rural health care. We are committed to making sure all people have access to preventive services and screening programs at medical facilities in their communities. To join us in protecting access to health care for those in rural areas, visit



The nutrition mistakes you're probably making An unhealthy weight has been linked to increased risk for many different cancers—and research suggests obesity could overtake smoking as the leading cause of cancer by 2030. But we have the power to do something before it’s too late. March is National Nutrition Month and we’re sharing the most common nutrition mistakes you may be making.

It’s not all about calories

Reducing your calorie intake is an outdated weight loss method because not all calories are equal. Studies have shown that filling your diet with single ingredient whole foods and eating the right balance of protein, fats and carbs, have a more positive effect on your health than eating fewer calories.

Don’t be afraid of fat

Cutting all fat from your diet will not give you the results you’re looking for. Our bodies need fat to absorb important vitamins, monounsaturated fats and Omega-3 fats to improve brain and cardiovascular function. Healthful sources of fat include avocados, nuts, salmon and olive oil.

Getting tricked by “healthy foods”

A good rule of thumb if a product is labeled “healthy,” it probably isn’t. Food companies put misleading labels on their products to boost sales. Most of these foods have been stripped of their nutrients and replaced with sugar, additives and preservatives. Always read nutrition labels!

Fruit juice is not the same as whole fruit

Most fruit juices are fruit-flavored sugar water. Even 100 percent fruit juices are packed with as much sugar as a can of cola and are missing the fiber and other vitamins that make whole fruit healthy.




Video game marathon at the forefront of cancer prevention worldwide

Just six years ago, a few friends organized a small video gaming marathon and raised more than $53,000 for the Prevent Cancer FoundationÂŽ. Since then, Awesome Games Done Quick (AGDQ) has grown into one of the most popular events in the gaming world and has raised millions of dollars to support cancer prevention and early detection internationally. Each January, viewers from around the world tune in to watch the rockstars of speedrunning play popular video games 24-hours-a-day for one week (a speedrun is a play-through of a video game with the intention of beating it as fast as possible). In January 2017, the gaming community outdid itself by raising a record-breaking $2.2 million from 33,673 donors in 87 countries. In order to reach this awesome new level of funds raised, the dedicated players, attendees and viewers of AGDQ partnered with other businesses to enhance the event experience and increase donations.

Twitch is one of the biggest social video platforms in the gaming world, a channel for millions of visitors to stream videos and interact with other users every day. Twitch streamed the AGDQ marathon online and helped promote it to millions of gamers in their community. TheYetee, a t-shirt retailer, creates a custom AGDQ design every year. All proceeds from the t-shirt sales go to the Foundation. Pinball Joe has attended the past two marathons, bringing eight pinball machines for attendees to play in between runs. He also raffles off a brand new pinball machine to one lucky winner, with proceeds benefitting the Foundation. Since AGDQ viewers and donors hail from around the world, the Foundation has prioritized funding programs to support cancer prevention and early detection on a global scale. With the dedication of AGDQ and their partners, the Foundation has been able to make a big impact worldwide through international community grants, technical transfer fellowships and more.

It all started with a group of friends eager to play the games they love for a good cause. To learn more about setting up your own event to benefit the Prevent Cancer FoundationÂŽ, visit




HELP US FIND IT! Contact Maggie Klee

UPCOMING EVENTS AND NEWS April 19-21: Dialogue for Action® & Laurels Awards Luncheon October 2-3: Quantitative Imaging Workshop November 5: Prevent Cancer 5k Walk /Run and Health Fair

News from 2017

TO SUBSCRIBE, CONTACT: Prevent Cancer Foundation 1600 Duke Street, Suite 500, Alexandria, VA 22314 Toll-Free: (800) 227-2732 Main: (703) 836-4412 Email: Visit: Cancer PreventionWorks is published by the Prevent Cancer Foundation, a 501(c)3 nonprofit organization dedicated to the prevention and early detection of cancer. All contributions are tax deductible to the fullest extent allowed by law. The Prevent Cancer Foundation is a member of the Combined Federal Campaign (#11074).

1600 Duke Street, Suite 500, Alexandria, VA 22314

Politics and prevention

Dialogue is coming to town

Singer-songwriter Alejandro Escovedo wants you to Think About the LinkÂŽ

Q&A with Dr. Karen Sfanos

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