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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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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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Up to half of all men and one-third of all women will face a cancer diagnosis in their lifetime, according to the Nevada Cancer Coalition. Chances are, you or someone you care about has been affected by cancer and has witnessed the ultimate fight for life. More than likely, your loved one’s cancer journey involved radiation therapy – and in fact, more than half of cancer diagnoses are treated in whole or in part with radiation. At first glance, this treatment plan can sound scary to any person. With a cancer care journey, it takes a village, and at Renown Health, we have top-notch leaders of the village roads that lead to radiation.  Meet our Radiation Oncology team at the William N. Pennington Cancer Institute. From intake to inpatient, this department of passionate physicians, radiation therapists, registered nurses, medical assistants, intake coordinators, schedulers and more are here to help every patient dealing with the intimidating diagnosis of cancer. Any patient that needs radiation as a part of their treatment is in the best of hands with this team, who will stop at nothing to ensure each patient under their care knows that they have a village Fighting the Good Fight right alongside them.  Teamwork in Tackling Tumors One of the most common forms of cancer treatment, radiation therapy uses high-energy X-rays to minimize cancerous cells. But with Renown’s Radiation Oncology department, the impressive cancer care doesn’t stop there – this team leverages advanced technology right at their fingertips. In fact, our cancer institute has the most state-of-the-art radiation therapy system of its kind – the ultra-precise Varian TrueBeam radiation therapy system – and is the very first program holding American College of Radiology accreditation in the entire region.  Given the advanced nature of their jobs and the high standard of care their patients expect them to uphold, it’s no question that the days-in-the-life of each team member is complex and can continually change every day.  “There are many moving parts in radiation oncology on any given day,” said Sandra Bailey, Manager of Radiation Oncology Services. “The radiation oncologists consult newly diagnosed patients, follow up with previously treated patients and oversee daily treatments for patients actively receiving treatments. Nurses and medical assistants move around the clinic to support the physicians with patients and provide education and other supportive care.”  The physics and dosimetry teams work diligently alongside the physicians to design the most beneficial treatment plan for each patient. Once a patient begins their treatments, the radiation therapists administer the daily treatments with the utmost precision. Intake coordinators, schedulers and patient access representatives make surethe patients have their insurance authorization and are processed through the system appropriately. Like any well-oiled machine, each part is necessary for the other to function at peak performance to ensure our patients receive the quality care they deserve and expect. Like many other clinical departments at Renown, teamwork coupled with education is crucial to best serve radiation therapy patients. Our nurses on this team are experts at exactly that, serving as a reminder of the transformative power of care in the face of a daunting disease.  “Radiation oncology is a unique world,” said Kristen Reed, Registered Nurse. “We have many different team members that play a role in how we function as a department. We all work together in some aspect to provide care for our patients. As a nurse, I provide patient education to all my patients before starting treatment to go over potential side effects and expectations on their treatment. Daily, we see new patients and follow-ups, plan simulations to start patients for radiation treatments and provide radiation treatments, among many other daily tasks.”  The unique role of our radiation therapists, the team members who are on the frontlines of giving radiation treatments, helps this department stand out from the rest with their tireless dedication to fighting against cancer with compassion and expertise. Not only are they armed with technology, but they are also armed with hands that deliver healing rays of radiation.  “As a radiation therapist, our daily tasks can vary pretty widely,” said Casey Johnson, Radiation Therapist. “We rotate between three radiation treatment machines called linear accelerators – one of which we use for stereotactic radiosurgery, a minimally invasive form of surgical intervention. We also staff the CT simulation room where we construct all the patients' treatment devices and perform their ‘mapping’ scan. We then coordinate with the dosimetrists and physicians to determine the specifics of the patients’ course of treatment. The most important parts of our job are patient care and education. Even though our job is very technical and requires tremendous attention to detail, the critical part is remembering that our average workday could be a monumental day for a new patient.”  “Our day-in-the-life in Radiation Oncology is centered around patient care,” added Haley Longfield, Radiation Therapist. “Although we do not spend a ton of time with our patients, we see them every day. We are able to build a wonderful rapport with our patients that is top-notch. We set up the room with their treatment devices, get them set up appropriately and administer their radiation treatment. On average, our patients are here for about 15 minutes.”  The bottom line: our Radiation Oncology team’s unified commitment to both excellence and innovation promises a brighter future for those battling cancer. No one is ever alone in their fight, and this team makes sure of that, no matter what.  Radiating Excellence in Cancer Care The Pennington Cancer Institute boasts a stellar reputation in our community for offering best-in-class, evidence-based care and cutting-edge research, improving outcomes for patients battling cancer. This fact is what inspired many Radiation Oncology team members to take their talents to this department in the first place.   “I chose to work at the Cancer Institute because I believe we offer the best patient care experience, along with the most advanced radiation treatments in the area,” said Casey Johnson.  "I am a fifth generation Reno resident, and I am part of this community through and through,” added Haley Longfield. “I always knew that I wanted to work here.” The success of our cancer institute starts with our people – and many members of the Radiation Oncology team witnessed this firsthand upon their arrival in this department. “I was initially inspired to move across the country to work in the Cancer Institute by the vision of the senior leaders and the future growth plans for the entire institute; once I arrived, I quickly realized what a great team I am now leading,” said Sandra Bailey. “The compassion and care the Radiation Oncology team provides our patients is second to none. Medical errors are rare in our department, and this can be attributed to not only the processes in place to prevent them, but everyone working together to deliver radiation treatments safely. Each day I witness a patient relationship being nurtured and developed. I am truly honored to be part of this team.”  Inspired by Renown's integral role in the northern Nevada community, several team members were drawn to this department because of the opportunity to make a meaningful impact on patients' lives in a quiet healing environment.  “As a student nurse, I had clinical and practicum on the cancer nursing unit here at Renown; I noticed the quiet, healing environment and a patient population enduring some of life’s most challenging hurdles,” said Rachel Bales, Registered Nurse. “It is in these moments that you can really make a difference as a nurse. After pursuing critical care as a new grad and working in Interventional Radiology with cancer patients, I knew that I had to find my way back to oncology. I applied to Radiation Oncology, and I am working towards my third year in this department. I have always known that I enjoy helping others, and the fulfillment that comes from working with this patient population is unmatched.”  “Renown is a huge part of the community in northern Nevada, and I knew while I was in nursing school that I wanted to have a career here,” added Kristen Reed. “I ended up joining the Cancer Institute about two years ago. My patients are a huge part of why I stay. We really get to know these patients and their families well, especially because they come in from Monday through Friday for up to six weeks for treatments. Building connections and being able to support these patients during a difficult time in their life makes my job fulfilling.”  From the initial consultation to the administration of therapy, the staff's commitment to personalized care remains strong. Patients and their families develop profound connections with these team members as they navigate through the challenges of treatment.  “We have knowledgeable and caring staff that help guide our patients through treatment,” said Kristen Reed. “This starts on the day of their consultation and continues even after completion of treatment. The patients and families get to know the staff through their treatment, and having a familiar face can be reassuring to them. We also take time every week to see how they are doing physically and mentally while undergoing treatment and we give them a chance to check in with their doctor. Taking this time helps reassure patients and allows them to ask questions, and in turn, reduce some anxiety and worry.”

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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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