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Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Senior Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.

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Cancer can develop at any age, and that’s why the experts at Renown are ready to help you stay ahead of breast cancer, especially if you're in your 20s or 30s. We're talking about early detection, signs to be aware of, and why being proactive is a big deal. Studies show there has been an increase in breast cancer in younger women. Although breast cancer is rare in women under 40, when it occurs, it tends to be aggressive. The tricky part? Many young women don't think it can happen to them, so they don't check for the signs as often as they should. Reviewed by Dr. Colleen O'Kelly-Priddy, MD, FACS, breast surgical oncologist at Renown Women's Health. Early Signs and Symptoms New or Different Lump in the Breast: A lump is probably the most well-known symptom. Breast cancer is usually painless and firm, but it can also be soft. If you find a new lump, don't panic, but don't ignore it either. Changes in Breast Size or Shape: Have you noticed that one breast looks a little different? Whether it's swelling, shrinking, bulging, dimpling, or seems off, it's worth mentioning to your doctor. Skin Changes: If the skin on your breast starts to thicken or turn red, it's time to pay attention. If your skin starts looking like an orange peel (thickened, with prominent pores), that warrants evaluation. Nipple Discharge: Spontaneous drainage coming from your nipple that isn't breast milk—especially if it's clear or bloody—should be checked out. Nipple Changes: If your nipple starts to invert, flatten, or look different, call your doctor. Breast Pain: Continuous pain in your breast or nipple that isn't linked to your menstrual cycle is another symptom to note. However, breast pain is very common and is only rarely a sign of cancer, so don’t panic. Swelling or Lumps in the Armpit: When it spreads, breast cancer usually first goes to the lymph nodes in the armpit, so swelling or lumps under your arm should be on your radar.

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Cancer affects millions of lives worldwide. Though medical advancement has done a great deal to increase the human lifespan, proper nutrition has also been proven to help in the prevention of cancer. As researchers continue their hunt for a cure, there is a lot of information out there to support the argument that nutrition is an essential component in disease prevention and management. Nutrition Services: To learn more, call us at 775-982-4000 Linking Diet and Cancer Risk Evidence shows that our diets impact our vulnerability to cancer – and our ability to fight it. The American Cancer Society states that at least 18% of all cancers in the United States are related to excess body weight, physical inactivity, alcohol consumption, and/or poor nutrition. (American Cancer Society Guideline for Diet and Physical Activity | American Cancer Society). Sure, genetics can contribute, but research continues to support the belief that following a healthy diet can reduce the likelihood of developing cancer in the first place. Renown Health’s Jessica Blauenstein, MS, RDN, LDN, CSO, Registered Dietitian and Board-Certified Specialist in Oncology Nutrition confirms the importance of a nutritious diet consisting of: Fruits and Vegetables: Eating a variety of fruits and vegetables provides large amounts of vitamins, minerals and antioxidants. Nutrient-rich, they help in fighting off oxidative stress and inflammation, both of which are factors for developing cancer. Whole Grains: A diet rich in grains such as brown rice, quinoa and oats, contains substantial amounts of fiber that helps in digestion. A few studies have shown that whole grains might offer some protection against colorectal cancer. Lean Proteins: Reducing the amount of red and processed meats in the diet by substituting lean proteins, such as poultry, fish, beans and lentils may lower the risk of developing cancer. Red and processed meats have been associated with colorectal and other cancers when consumed in large amounts. Healthy Fats: Begin focusing on healthy fats from foods like avocados, nuts, seeds and olive oil. These fats are anti-inflammatory, which may play a beneficial role in disease prevention. Avoidance of Sugar and Processed Foods: Sugar and foods high in processed ingredients have been linked to an increased risk of obesity, type 2 diabetes and some cancers. It's important to limit the intake of sugary drinks, candy and snacks in the battle against cancer. A Role of Nutrition in Cancer Recovery Nutrition becomes even more critical for individuals who receive treatment and are in recovery. Treatments such as chemotherapy, radiation therapy and surgery can take a lot out of a body, affecting appetite, digestion and nutrient absorption. Proper nutrition during and after treatment can help: Support Immune Function: A good, balanced diet will provide the essential nutrients that support a resilient immune system, which is important in fighting off infections and supporting overall health during cancer treatment. Maintain Strength and Energy Levels: Proper caloric intake, protein and micronutrients prevent muscle wasting and fatigue, allowing patients to sustain their strength and energy. Address Side Effects: Certain foods and diets can help reduce or alleviate some common side effects associated with cancer treatment, including nausea, vomiting and mucositis. Eating small, frequent meals, maintaining good hydration, and avoiding spicy or acidic foods can all ease treatment-related discomfort associated with the GI tract. Facilitate Healing and Recovery: Nutrient-rich foods promote healing and the repair of tissues that may be damaged after surgery or other medical interventions. Foods high in proteins, vitamins and minerals play a significant role in repairing and replacing damaged tissues and cells. Correct Nutritional Deficiencies: Cancer and its treatment cause vitamin D, vitamin B12 and iron deficiencies in the diet. Nutrition therapy through a registered dietitian or nutritionist can identify those deficiencies and help manage them through dietary changes or supplementary means. Related information: Nourishing Your Loved One Through Cancer Treatment

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One of the most crucial aspects of maintaining health and wellness is staying proactive about regular cancer screenings. Early cancer detection significantly increases the chances of successful treatment and survival. The multidisciplinary care team at the William N. Pennington Cancer Institute at Renown Health provides compassionate care and support to the community for early detection and diagnoses. This comprehensive guide outlines the various cancer screenings available for breast, colorectal, lung, cervical, prostate and skin cancer. Breast Cancer Screening Who Should Get Screened? Mammograms are recommended starting age 40 for those considered at average risk for breast cancer. Women with a family history or other risk factors should discuss appropriate screening options with their healthcare provider. Women under 40 with a family history should discuss risk factors with a healthcare provider. Screening Methods Mammogram: This provides an X-ray of the breast and can detect tumors that are not yet palpable. Breast MRI: This type of scan is recommended for women at high risk for breast cancer due to genetic factors or family history. Screening Breast Ultrasound: This scan can help in identifying masses in denser breast tissue that might not be visible on mammogram. It is recommended in addition to a mammogram for patients at a higher risk for breast cancer. What to Expect During a mammogram, the breast is compressed between two plates to capture X-ray images. Some pressure or discomfort may be felt, but the procedure is brief and critical for early detection. Colorectal Cancer Screening Who Should Get Screened? Adults aged 45 to 75 should undergo regular colorectal screenings. Some adults under 45 may need to be screened earlier depending on family history or other genetic risks. Those over 75 should consult with their healthcare provider to determine if continued screening is necessary. Screening Methods Colonoscopy: This procedure uses a flexible tube with a camera to examine the entire colon. Fecal Immunochemical Test (FIT): A non-invasive test that detects hidden blood in the stool. CT Colonography (Virtual Colonoscopy): Uses Computed tomography (CT) imaging to provide detailed views of the colon. What to Expect A colonoscopy can detect changes or abnormalities in the large intestine (colon) and rectum. Screening is usually advised every ten years, but if you are at risk, screening may be recommended every 3 to 5 years after your initial colonoscopy. Colonoscopy preparation includes bowel cleansing the day before and sedation during the procedure. FIT is a simple at-home test requiring no special preparation. Lung Cancer Screening Who Should Get Screened? Adults aged 50 to 80 with a significant smoking history (20 pack years or more) and who currently smoke or have quit within the past 15 years. Screening Methods Low-dose Computed Tomography (LDCT): A CT scan with low radiation doses to create detailed images of the lungs. What to Expect LDCT is a non-invasive scan that requires you to hold your breath for a few seconds. Cervical Cancer Screening Who Should Get Screened? Women aged 21 to 65 should undergo regular screenings. Women aged 21 to 29 should have a Pap test every three years. Women aged 30 to 65 should have a Pap test and HPV test every five years, or a Pap test alone every three years. Screening Methods Pap Test (sometimes called a Pap Smear): Collects cells from the cervix to detect precancers. HPV Test: Identifies high-risk human papillomavirus (HPV) types that can cause cervical cancer. What to Expect The Pap test involves collecting cells from the cervix using a small brush. Some discomfort may be felt, but the procedure is brief and crucial for early detection. Prostate Cancer Screening Who Should Get Screened? Men aged 50 and older should discuss screening options with their healthcare provider. Men at higher risk (African American men and those with a family history of prostate cancer or are a BRCA2 gene carrier) should begin discussing screenings  at age 40. Screening Methods Prostate-Specific Antigen (PSA) Test: Measures PSA levels in the blood. Digital Rectal Exam (DRE): A physical examination where the provider feels the prostate through the rectum to detect abnormalities. What to Expect The PSA test is a simple blood test. The DRE may cause slight discomfort but is quick and essential for early detection. Skin Cancer Screening Who Should Get Screened? Anyone with a suspicious lesion or abnormal area on their skin. Individuals with more than 50 moles or dysplastic moles. Those with a personal history of melanoma or history of other skin cancers. Those who have more than one member of immediate family with a history of cancers (melanoma, breast cancer, pancreatic cancer) or a family member who was diagnosed with melanoma before they were 50 years old. Positive gene testing for BRACA2, Lynch syndrome genes (MLH1, MSH2, MSH6, PMS2 or EPCAM). Screening Methods Skin Exam: A visual examination by your provider to check for unusual moles, birthmarks, or other skin changes. Biopsy: Removal of a small sample of skin for testing if an abnormal area is identified. What to Expect A skin exam is non-invasive and visual. A biopsy involves minor discomfort and local anesthesia if needed. Expert Advice Although the cadence of these skin screenings may or may not be annual, as one's age increases, the risk of many cancers rises. Everyone benefits from attentive sun protection, including avoiding direct sun between 10 a.m. and 4 p.m. by seeking shade and wearing hats, clothing and sunscreen. When purchasing sunscreen, look for SPF 50, UVA/UVB broad spectrum. Questions to Discuss with Your Healthcare Provider What is my risk level for different types of cancer? Which screening tests do you recommend for me and why? What are the potential risks and benefits of each test? How often should I get screened? What steps to follow if a test result is abnormal? Importance of Cancer Screenings Regular cancer screenings are vital for maintaining your health and catching cancer early, when it is most treatable. Renown Health is dedicated to guiding you through the process and providing the highest quality of care. Consult with your healthcare provider to determine the appropriate screenings for your specific needs and to take proactive steps toward a healthier future.

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© Arthon Meekodong via Canva.com Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.

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While there used to be three basic treatment options for cancer -- surgery, radiation and chemotherapy, or a combination of the three -- there's a fourth option: clinical trials. Here, a Renown patient shares her successful battle with ovarian cancer, aided by a clinical trial. Shari Flamm's battle with ovarian cancer began in 2011. She was experiencing prolonged bleeding, irregular thyroid levels and anemia and was scheduled to undergo a hysterectomy. Before the surgery, her gynecologist ran routine tests to check for cancer as a precautionary measure. All tests were negative for cancer, expect her CA 125 test. A CA 125 test measures the amount of the protein CA 125 (cancer antigen 125) in the blood. In some cases, a CA 125 test may be used to look for early signs of ovarian cancer in women with a very high risk of the disease. In most laboratories, the normal level is 0 to 35 units/ml. Flamm's CA 125 level was 121. As Flamm can attest, early diagnosis played a key role in her battle with ovarian cancer. September is Gynecologic Cancer and Ovarian Cancer Awareness Month – an important time to learn the signs, symptoms and risk factors of this type of cancer so your doctor can diagnosis the disease as early as possible. Ovarian Cancer: Round One Despite the elevated CA 125 results, her doctor recommended they move forward with the hysterectomy. But when surgery began, doctors discovered a mass. She had stage 4 cancer. The procedure was halted, the mass was biopsied and she was immediately seen by Dr. Peter Lim of the The Center of Hope. Following diagnosis, Flamm underwent surgery with Dr. Lim to remove the cancer, which had spread to part of diaphragm, spleen, colon and other organs. Three months after surgery, Flamm had recovered enough to start six rounds of chemotherapy in her hometown of Carson City. She continued working at a doctor's office during her treatment, and was grateful for Dr. Lim’s ability to co-manage her care so she could stay close to work and family. “To me, chemo was the scariest part because I didn’t like feeling sick,” Flamm says. Thankfully, her body responded well to the treatments and she was back to the things she loved. “I stated working out at the gym, even if it was only for 10 minutes,” she says. She also stayed positive by spending time with her grandchildren, attending a San Jose Sharks hockey game, going for walks and enjoying concerts. Ovarian Cancer: Round Two In November 2014, Flamm had a cancer check-up. That’s when doctors discovered three cancerous tumors. For this round, Flamm choose another treatment option -- clinical trials at Renown Institute for Cancer. Clinical trials are the studies that test whether drugs work, and inform doctors' decisions about how to treat their patients. Flamm participated in a clinical trial that featured oral-targeted therapy stronger than IV chemotherapy. The hope was for the drug to shrink her tumors, however the result was stabilization -- meaning the lumps weren’t growing or spreading. The best part of the clinical trial, Flamm says, was the constant monitoring. Between the CT scans every six weeks, a heart scan every three months and monthly doctor visits, she was confident that if the cancer started growing or spreading, her healthcare team would catch it right away. For Flamm, the benefits of the clinical trial included less hair loss, less fatigue and more time to focus on what’s important in her life -- her family. “I decided I wasn’t going to be that sick grandma on the couch with cancer,” Flamm says. After taking the oral medication for one year, Flamm developed a rash and discontinued treatment due to discomfort. Clinical Trials, Setbacks and Survival In June 2016, two of the three tumors began to grow and had to be surgically removed. Despite the setback, Flamm was determined to maintain a positive outlook. "You have to stay positive because cancer feeds off anger, depression and stress," Flamm says. Flamm was released to go home with clear margins, meaning the tumors were removed and are surrounded by a rim of normal tissue that does not have cancerous cells. Flamm says her outlook on life has changed drastically since her first cancer diagnosis. “Your whole mentality changes when cancer disturbs your life," Flann says. "The things that weren’t important, are now ever so important. I’m a lot calmer now,” Flamm says.

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Head, neck and oral cancers account for just 3 percent of all cancer in the U.S. and can be hard to diagnose. Dr. Abhinand Peddada, radiation oncologist with the Renown Institute for Cancer, explains. While you likely don’t frequently hear about head, neck and oral cancers — they are significantly less common than many kinds of cancer — they can be extremely dangerous. One of the primary reasons: some symptoms mimic the common cold, making them difficult to detect without a medical professional. We asked Abhinand Peddada, M.D., radiation oncologist with the Renown Institute for Cancer, to break down the symptoms and lifestyle risks of these rare cancers. First off, what are some of the signs and symptoms of head, neck and oral cancers? Symptoms can vary based on where the cancer is. For example, throat cancer may show up as a persistent sore throat, while sinus cancer may present as soreness or pressure in the sinuses that doesn’t get better. Some other symptoms to watch may include: Swelling in the throat Painless swelling in the neck Red or white patches in the throat Hoarseness Bloody noses or blood in the mucus or saliva A new and unexplained lump or bump anywhere on the face, neck, mouth or throat Difficulty breathing Difficulty swallowing, chewing or moving the muscles in your face, neck, mouth or throat Bad breath, even with good oral hygiene Loose teeth Dentures or retainers that no longer fit Double vision Who is most at risk for head, neck and oral cancers? Both men and women can develop head, neck and oral cancers, but men are at almost twice the risk of women. People over the age of 40 are also at a higher risk, and these cancers tend to be more common in African Americans. Tobacco use — including cigarettes, cigars, pipes and chewing tobacco — is another risk factor. Tobacco is linked to 85 percent of head and neck cancers. Exposure to fumes and chemicals can increase your risk as well. We’re also seeing more HPV-related head and neck cancers in the U.S., so patients with HPV may want to watch more closely for symptoms. What about screening and prevention? Your dentist already looks for signs and symptoms at your regular dental checkups. Additionally, if you have one of these risk factors and are experiencing signs and symptoms, it’s a good idea to check with your doctor about possible screenings. To help prevent these types of cancers, try to minimize your controllable risk factors. This means quitting tobacco, watching your alcohol consumption and taking care of your oral hygiene by brushing and flossing regularly. We also recommend the HPV vaccination for both boys and girls starting at age 11. By vaccinating at an earlier age, one is less likely to develop oral HPV. What do diagnosis and treatment look like for these cancers? At Renown Institute for Cancer we offer the most advanced diagnostic testing available including fiberoptic photos, CT and PET scans, as well as MRIs. Together, you and your care team will decide which treatment best fits your needs. For these types of cancers, treatment options include radiation, chemotherapy and surgery. Renown Institute for Cancer | 775-982-4000 At the Renown Health Institute for Cancer, our experienced team provides the support and care to maintain the highest quality of life and then achieve the best possible outcome, all in one location that’s close to home. Our dedicated team, clinical expertise and advanced treatment options allow us to tailor care to each patient. Learn about: Our Team Cancers We Treat Screening and Prevention Treatment Options Find a Cancer Doctor

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