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Cancer Among Native Americans in Arizona and New Mexico
Data Provided by Arizona Cancer Registry at the
Arizona Department of Health Servicesand the
New Mexico Cancer Council
©2012 MFMER | slide-4
0
100
200
300
400
500
White, NonHispanic
White,Hispanic
Black AmericanIndian
Asian/PacificIslander
Cancer Rate by Race/Ethnicity, Arizona, 2005-2009
Male Female
Yearly average count of new cancers among Arizona Native Americans
Cancer Sites Male Female
Breast 1 58
Prostate 56
Colorectal 30 25
Kidney/Renal Pelvis 30 14
Corpus Uteri 27
Lung and Bronchus 11 11
Stomach 14 6
Non-Hodgkin Lymphoma 8 11
Other sites combined 48 33
Liver and Intrahepatic Bile Duct 12 6
Thyroid 4 12
Leukemia 9 7
Ovary 14
Gallbladder and Other Biliary 5 9
Pancreas 6 7
Oral Cavity 7 4
Cervix Uteri 11
Myeloma 5 5
Brain and Other Nervous System 6 4
Source: ACR, 2005-2009
©2012 MFMER | slide-13
CONCLUSIONS
• AIAN elders increasing proportion of the population
• Cancer screening will be an important aspect of maintaining health as people age
• Looking at the “whole person” remains the most important determinant for good care
Introduction to Myeloma:Diagnosis, Treatment, Risk Factors
and Prevalence
Scottsdale, ArizonaScottsdale, Arizona Rochester, MinnesotaRochester, Minnesota Jacksonville, FloridaJacksonville, Florida
Alan Bryce, MDStaff Oncologist, Mayo Clinic Arizona
Multiple Myeloma - Introduction
• Myeloma is a cancer of the Plasma Cells• They grow out of control in the bone marrow (at least
10% and as high as nearly 100%)• This results in many problems including:
• Low hemoglobin (anemia) and platelets• Elevated abnormal immunoglobulins (proteins)• Bone pain and fractures• Infections (partly due to low normal
immunoglobulins)• Kidney problems• Other complications…
Spectrum of Myeloma
Normal plasma
cell
Asymp-tomatic
Myeloma
Aggressive Myeloma
Active Myeloma
Monoclonal gammopathy of unknownsignificance
MGUS
Multiple Myeloma – Causes?
• The cause of myeloma is still unknown
• Some have suggested:• Radiation- Nuclear Bomb Survivors• Chemicals (benzenes), herbicides and
insecticides- The “Myeloma Belt”• Genetics or even viruses
• Familial Myeloma – still rare
• However, nothing is conclusive, and it is likely a combination of many factors…
Multiple Myeloma
• Unfortunately, MM is not a curable disease (yet!!)
• Historically most people did not live for much more than 2 years…
• However, the average survival is now at least 8 years• This has been a result of three key
developments:1. Early Detection 2. Autologous Stem Cell Transplant3. Novel Drugs (thalidomide, bortezomib,
lenalidomide)
©2012 MFMER | slide-20
5.1 4.8
10.8
6.9
2.63.1
3.7
7.1
5.6
1.20
2
4
6
8
10
12
White, NonHispanic
White,Hispanic
Black AmericanIndian
Asian/PacificIslander
Race/Ethnic Group
Male
Female
Myeloma rate in Arizona among race groups, 1995-2009
Common Symptoms
• Not all patients will have all of these symptoms
• Fatigue
• Lack of Appetite
• Infection
• Bone Pain
• Kidney Failure
• Confusion, dehydration, and constipation (high calcium)
Myeloma Treatment
• Principles of therapy
• 1. Stop the production of the abnormal plasma cells (chemo)
• 2. Strengthen the bone and prevent fractures
• 3. Increase the hemoglobin count and reduce fatigue
• 4. Reduce risk of infections
• 5. Promote well being and quality of life
©2012 MFMER | slide-23
Conclusions
• New Treatments for myeloma have improved survival
• Myeloma is usually preceded by many years of MGUS
• Screening and early detection can allow therapy to begin before organ damage develops
• Bone Marrow transplant and Clinical Trials should be considered when appropriate