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

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0

100

200

300

400

500

White, NonHispanic

White,Hispanic

Black AmericanIndian

Asian/PacificIslander

Cancer Rate by Race/Ethnicity, Arizona, 2005-2009

Male Female

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Age when Diagnosed with Cancer(Arizona Native Americans, 2005-2009)

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HIGH PREVENTION POTENTIAL

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

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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

How do plasma cells become “evil”?

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)

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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

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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