Activities

What is Cancer Activity: Radio Show

Directions: The teacher has a copy of the radio script and reads the radio announcer words. Print a copy of the script and cut apart the caller questions and the expert answer. Class participants are given a caller question or an expert answer. The caller reads their question when the radio announcer asks for that caller number. The expert responds to that caller’s question by reading their information on the paper. The teacher/radio announcer can add additional information if needed to help answer the caller’s question. There are 8 callers and 8 experts.

Radio Announcer: Welcome to Wellness Ways Radio show. Thank you to everyone out there in radio land for tuning in to our talk show. Today we will be talking about cancer basics. We have several callers on the line and a group of experts to help us answer their questions. Let’s start with caller number 1.

Caller number 1: Thank you so much for talking about such an important subject today. Cancer can be so hard to talk about. I am a bit confused…Is cancer more than one disease?

Radio Announcer: That is a very good question. Let’s see if we have an answer to go with that question…Is cancer more than one disease?

Expert (Is cancer more than one disease?): Cancer is not just one disease. Cancer is a word used to describe more than 100 different diseases.

Radio Announcer: Thank you to our expert. Do I have caller number 2 out there in radio land?

Caller number 2: Good day and thank you for inviting me to ask my question. What exactly is cancer?

Radio Announcer: Is there an expert to answer our caller’s question What is cancer? 

Expert (What is cancer?): Cancer is a word for a group of diseases in which abnormal cells divide without control or order. Cancer happens when cells keep growing and making new cells without dying.  Cancer cells rob nutrients from nearby tissues and destroy normal cells or push them out of the way. Normally the cells which make up your body, die after a certain amount of time once they get worn out and have done their job. Healthy new cells replace them, ready to take over to get the jobs done. 

Radio Announcer: Caller number two, did that answer your question? (Wait for caller number 2 to respond. If they are still confused perhaps add more information or restate the answer.) Thank you to our local expert. That was a lot of good biology information. Ok we are ready for Caller number 3.

Caller number 3: Oh I’m glad it is my turn. The lines have been busy and I wasn’t sure I would get through. I’m wondering how a cancer diagnosis is made?

Radio Announcer: That seems like very helpful information to know. How is a cancer diagnosis made? I hope there is an expert in radio land to help answer your question.

Expert (How is a cancer diagnosis made?): Cancer can only be definitely diagnosed by looking at cells or tissue under a microscope. A specially trained doctor called a pathologist looks at the cells. Cancer cells look different in size and shape than normal cells. Normal cells look uniform, with similar sizes and orderly organization. Cancer cells look less orderly and have different sizes and shapes. 

Radio Announcer: That is good to know. So you cannot tell if a person has cancer just by looking at them or by looking at an x-ray. It sounds like the only way to know for sure is to have a biopsy and for a doctor to look at cells or tissue under a microscope. We have time for just a few more questions. Let’s see do we have caller number 4.

Caller number 4: My Auntie went to the doctor and they told her she has a tumor. Does that mean she has cancer?

Radio Announcer: Oh great question. I can see where that might be confusing. Let’s hope we have an expert to help us understand just what tumor means.

Expert (Does having a tumor mean that you have cancer?): The word tumor means an abnormal growth of cells or tissue. This uncontrolled cell growth occurs in solid tissue, such as an organ, muscle, or bone. Tumors can be benign (not cancer) or malignant (cancer). So having a tumor doesn’t mean you have cancer. You need to learn if that tumor is benign or malignant.

Radio Announcer: Oh I can see where that is confusing for folks. It will be good to learn what kind of tumor it is. But it sounds like just having a tumor doesn’t mean that you have cancer. Thank you for sharing that helpful information. Let’s see, do we have caller number 5.

Caller number 5: I’m really enjoying today’s show, so much helpful information! How do you know what type of cancer it is?

Radio Announcer: Thank you for listening to the show and calling in. Everyone’s questions really help us to learn so much from our experts! And now let’s go to our knowledgeable expert to help answer your question. How do you know what type of cancer it is?

Expert (How do you know what type of cancer it is?): Cancer can occur anywhere in the body. When a pathologist looks at the cells or tissue under the microscope they can tell where those cancer cells came from. Cancer is named after the body part where it first started to grow. This is also called the Primary Site or the Primary Tumor Site. For example cancer can start in a solid organ such as the lungs and is called lung cancer. Cancer can also start in your blood or bone marrow and those cancers are called leukemia, lymphoma or myeloma. 

Radio Announcer: That is helpful to know that cancer is always called after where it first started to grow. This seems like very good information to know to help with cancer treatment. Caller number 6 – thank you for waiting so patiently.

Caller number 6: Oh I’m so glad we didn’t run out of time yet. My family member had cancer that started in the breast so I guess that is called breast cancer and then it spread to their bones. Do they now have breast cancer and bone cancer? 

Radio Announcer: Do we have an expert to answer that important question?

Expert (My family member had cancer that started in the breast so I guess that is called breast cancer and then it spread to their bones. Do they now have breast cancer and bone cancer?): It sounds like the person has breast cancer that has spread or metastasized to their bones. The spread of cancer from one part of the body to another is called metastasis. The treatment is based upon where the cancer first started to grow.

Radio Announcer: Excellent job in answering that question. My Dad had prostate cancer that spread or metastasized to his bones and his wife thought that he had both prostate cancer and bone cancer. When the doctor explained it to her it helped her to understand that he really had prostate cancer with metastasis to his bones and he didn’t also have bone cancer.  I’m glad you shared this information because this can be confusing for people. Unfortunately, we are almost out of time for today. It has been great to visit with folks.  Do we have caller number 7?

Caller number 7: Oh thank you for having time for my call. It has been a great radio show. I always look forward to learning so much on Wellness Ways. I’ve learned a lot about cancer but Is there anything people can do to help prevent cancer?

Radio Announcer: That is a great question for all our listeners out there in radio land to help keep us healthy. What ideas does our expert have on ways to prevent cancer?

Expert (Is there anything you can do to prevent cancer?): There are several wellness choices people can make to live healthy and decrease their cancer risk. Being physically active, eating healthy foods, staying tobacco free are all good choices. Having recommended screening tests help to find cancer early before it has time to spread. It is usually easier to treat cancer when it is found early. 

Radio Announcer: Oh wait I have a flashing light to answer one final question to wrap up today’s radio show. Lucky caller number 8.

Caller Number 8: If I want to learn more about cancer, where should I reach out for information? 

Radio Announcer: Super good question. It is often hard to know where to find more information. And if you’re like me I’m always thinking of more questions than answers.

Expert (If I want to learn more about cancer, where should I reach out for information?): That is a great question. People often go to the internet and there is a lot of misinformation out there. Besides, it is very overwhelming to find so much information on the internet, which often tells you different things, and it could cause more anxiety.  It is often hard to tell which website is credible and which one is not. So I would recommend starting with your health care provider, and look up information on ACS or NCI. 

Radio Announcer: Thank you for the resources. Those are 2 good resources to know about: the American Cancer Society or ACS and the National Cancer Institute or NCI. I have a few more questions that I’d like to look up. Thank you very much for all of our callers and experts for helping us to learn about cancer basics today. Until next time this is Wellness Ways Radio signing off. 

Crossword puzzle download.

Cancer Diagnosis and Treatment Role Play Activity: 

Grandma’s Cancer Doctor Visit Part 2

Directions: Print a copy of the script for each class participant. The teacher asks for 5 volunteers to each read a role. There are 5 roles in this activity: nurse, doctor, patient (grandma), patient’s daughter, and patient’s grandson. After all characters have been selected, the teacher introduces each character and who is reading that part. Readers only need to read their words and not their character’s name. If people stumble over their words, that is OK. Talking with people is not usually rehearsed and in life we may stumble over our words and with what we are trying to say. The readers are bringing life to the characters on the page.

Listeners also have a very important part. It is a gift to really listen by being present to peoples’ story. This is an opportunity to practice listening skills. 

Post reading conversation questions: The following are possible questions to start a conversation after reading “Grandma’s Cancer Doctor Visit Part 2.” Thank people for reading and listening. How was it for you to be a reader or a listener? Was there any part of the story that really connected with you? After reading this story are there any things you are wondering about? Any parts that are confusing? 

Grandma’s Cancer Doctor Visit Part 2

Doctor: Now we have a basic understanding of what cancer is, let’s talk about your cancer diagnosis and treatment plan. Fortunately, your cancer was found early before it had time to spread because you have been really good about having a mammogram regularly.

Grandma: Thank goodness. I almost skipped this year’s mammogram but I am so glad I didn’t. I’ve had normal mammograms year after year and thought I should be fine without it this year. But my daughter told me not to skip it. 

Daughter: Thanks mom. I’m so glad you made that appointment and had your mammogram. Even if you were not sure that you wanted to this year. 

Nurse: Yes, early detection is so important. Having recommended screening tests can make a huge difference in treatment outcomes. You had so many scans, tests, and procedures because the radiologist saw an area on your mammogram that was of concern. 

Grandson: Yes, grandma has had lots of different tests done. We are all eager to hear what you learned. 

Grandma: My family is here to support me. What are my test results? 

Doctor: Ok, so you just had the needle biopsy to get some tissue sample from the lump in your breast, right? I have your pathology report here. I am sorry to tell you that your tumor was malignant, which means cancerous. But the good news is, it has not spread to any other parts of your body according to the CT and MRI results.  

Daughter: That’s a huge relief! Now, what’s next? Does she need chemo? 

Doctor: Actually, since her cancer was found early, I think we can treat it with surgery and radiation only. We will order a test called ‘Oncotype’. The surgeon will send a sample of the cancerous tumor to the lab. They will analyze it to see if your mom will need chemo or not. We are hopeful that she won’t need chemo. 

Grandson: If a surgeon can cut out all the cancer, why would grandma still need radiation? 

Doctor: That's a great question. A cancerous tumor is visible and the surgeon can cut it out. But sometimes cancer cells could be very sneaky, trying to spread and grow in nearby tissues. Cancer cells are so tiny, and of course, we cannot see them with our own eyes. Even with a CT scan or MRI, those ‘micro invasions’ cannot be detected. That's why we often use radiation treatment to kill off those hidden cancer cells around the spot where the cancerous tumor was growing. Does it make sense?" 

Grandson: I see. Yes, it does. Thanks for explaining. 

Daughter: I’ve heard people use the words clean margins. What does that mean?

Doctor: Great question. ‘Clean margin’ or ‘clear margin’ means no cancer cells are found within the outer edge of the malignant tumor that was removed. When margins are clear, usually no additional surgery is needed. When the cancer cells are seen right at the edge of the removed tumor, more surgery might be necessary. If cancer cells are close to the edge of the tissue, but not right at the edge, the doctor might call it a ‘close margin’.  If it’s a close margin than the doctor might recommend going back to surgery or adding an additional dose of radiation. 

Daughter: Thanks for helping me to understand that.

Grandson: Ok, so it sounds like grandma might need radiation treatment after her surgery. Is grandma going to lose her hair from radiation? I think that’s one of her biggest worries…

Doctor: Actually, radiation would not cause your grandma to lose her hair. 

Daughter: Really? I thought the cancer treatment causes hair loss? 

Doctor: Chemo usually does. Chemotherapy is a systemic treatment, which means as soon as the cancer fighting medicines enter a person’s body, it goes all over their body looking for cancer cells to damage and kill. Unfortunately, they can damage any fast-growing cells…do you remember cancer cells are fast-growing cells?

Grandson: Yes, cancer cells don’t follow rules and they just keep dividing and growing without dying off like regular cells do. 

Doctor: Exactly! Hair and blood are also fast-growing cells, so unfortunately chemo meds also affect them. That's why people receiving chemo may have hair loss, anemia, and a poor immune system. But the difference between cancer cells and healthy cells, like hair and blood, is their DNA structure. Cancer cells cannot repair themselves from the damage because of their unhealthy DNA structure, but healthy cells can. So even if people receiving chemo experience hair loss and a poor immune system, those problems are usually temporary. 

Grandma: That’s great to hear that I won’t be losing my hair. But are you also saying that radiation won't cause a poor immune system? 

Doctor: You are going to be receiving radiation to your breast area. So no, you won't experience a poor immune system from radiation. See, radiation is different from chemotherapy. Chemotherapy is a systemic treatment, which affects all over your body. Radiation is a local treatment. Radiation therapy only affects the area which is radiated. Unless you are receiving radiation to your head for brain cancer, you won't lose hair. Unless you are receiving radiation to a large portion of your bones, like your spine, you won't experience anemia or a poor immune system. Because the blood is made in bone marrow. 

Grandma: I never knew that. I thought everyone going through cancer treatment loses hair and has a poor immune system. 

Nurse: Those are pretty common misconceptions. I also want to add, there are a lot of new treatments coming nowadays. People diagnosed and treated for cancer are living well with great quality of life. Even patients with metastasis.

Grandson: What does metastasis mean again? That’s such a big word.

Daughter: I was actually reading up on that. It’s an interesting word because ‘meta’ means beyond and ‘stasis’ means to stop. Metastasis means that the cancer has spread from one part of the body to another part.

Nurse: That’s a great explanation. Even with people who have a cancer that has metastasized or spread to another part of the body I see quite a lot of them succeed in controlling their cancer with ongoing treatment. People continue to live well - enjoying life, working, and being active in their community. A cure or no evidence of disease is the ultimate goal for your grandma’s cancer treatment. Although good cancer control or stable disease could be achievable for many people who have stage 4 cancer.

Doctor: That’s a great point. Each patient’s treatment goal is different, just like each person has a unique treatment plan. In your case, your cancer was found early, and we should definitely aim for a cure. But even in more challenging cases, people should know that cancer is not a death sentence. 

Grandma: That is so encouraging. I came in here today all scared. Now I know what to expect. I feel like I can finally breathe. 

Grandson: Big breath grandma! 

Daughter: I think we are all breathing a bit easier after you explained everything and answered our questions. 

Nurse: I’m sure not knowing what is going to happen was the hardest part of the cancer diagnosis. Now you know what to expect, and it seems like you have great family support. 

Grandma: It is a lot to take in. 

Nurse: But please remember, you are always welcome to ask questions. We will introduce all of you to one of our cancer navigators before you leave. Cancer navigators are a team of nurses and social workers who are trained to help people diagnosed with cancer and their family members during their cancer treatment journey. You are going to be seen by a medical oncologist, surgeon, radiation oncologist, while keeping your primary doctor informed. Cancer navigators will make sure the important information won’t get missed between so many different doctor’s offices. They can also offer useful resources to improve your treatment outcomes. 

Daughter: That's super helpful, I was already thinking how I can keep track of which doctor is in charge of what, and who should we be asking questions to. It's nice to know there is someone who can help us in connecting us with the right resources.  

Doctor: Great. Thanks for coming in today. We will see you at the next appointment. The nurse will introduce you to the cancer navigator now. 

Cancer and Environment Role Play 

Directions: Print a copy of the script for each class participant. The teacher asks for 4 volunteers to each read a role. There are 4 roles in this activity: Sam, Mary, Luci, and Bob. After all characters have been selected, the teacher introduces each character and who is reading that part. Readers only need to read their words and not their character’s name. If people stumble over their words, that is OK. Talking with people is not usually rehearsed and in life we may stumble over our words and with what we are trying to say. The readers are bringing life to the characters on the page.

Listeners also have a very important part. It is a gift to really listen by being present to peoples’ story. This is an opportunity to practice listening skills. 

Post reading conversation questions: The following are possible questions to start a conversation after reading “Cancer and Environment Role Play.” Thank people for reading and listening. How was it for you to be a reader or a listener? Was there any part of the story that really connected with you? After reading this story are there any things you are wondering about? Any parts that are confusing? 

Narration: The goal of this case study is to help Sam understand what caused his cancer diagnosis. The names and case specifics are not real. Sam, his wife Mary, daughter Luci, and friend Bob are meeting for a cup of coffee. Sam was recently diagnosed with cancer and is wanting to understand what caused his cancer. By asking many different questions, participants can begin to understand the complexities of cancer risk and what causes cancer. 

Sam: I’m really wanting to learn what caused my cancer. Do you have any ideas?

Mary (Sam’s wife): Hi Bob, Thanks for joining us for coffee. Figuring out what causes a person’s cancer or increases a person’s cancer risk can be complicated.

Luci (Sam’s daughter): I think there are usually lots of different reasons. But over the years scientists have learned a lot about what increases a person’s risk for developing cancer. 

Sam: Well, maybe together we can sort out some of the clues as to what contributed to my cancer. It’s good to be curious and ask questions.

Bob (friend): What type of cancer were you diagnosed with? I heard that cancer is a word used to describe over 100 different kinds of diseases and that depending upon what type of cancer it is there might be different causes.

Mary (Sam’s wife): That’s a really good point. My friend was diagnosed with cervical cancer and they told her that most cervical cancers were caused by the human papilloma virus or HPV. I guess that’s why the vaccine for kids is so important for prevention. Before that I never really thought about cancer being caused by a virus. 

Luci (Sam’s daughter): That’s helpful information. I’ll be sure to check with the Community Health Aide about getting the kids vaccinated. I’m pretty sure dad doesn’t have cervical cancer but what kind of cancer does he have?

Sam: The doctor said that I have lung cancer.

Mary (Sam’s wife): Starting with the type of cancer seems like a good place to begin to learn what things are associated with that type of cancer.

Luci (Sam’s daughter): And how old are you dad? The years just seem to go by so quickly. I learned that even though cancer can affect people of any age, the risk for cancer increases as you get older. About 75% of all cancers are in people over age 55. The average age for developing lung cancer is age 70.  

Sam: Well, I will be 68 on my next birthday so I guess in some ways I’m average.

Mary (Sam’s wife): It does seem like a lot of people we know are being diagnosed with cancer these days! And that helps explain why so many of our friends have gotten cancer. I guess we are at that age.

Luci (Sam’s daughter): Fortunately, we are learning new information about cancer all the time. Like things we can do to help prevent cancer or decrease our cancer risk. 

Bob (friend): That’s great because it gives us hope. So far we know that you were diagnosed with lung cancer and that you are 68 years old. I wonder what else might give us clues as to what caused your cancer.

Sam: I know that smoking certainly didn’t help. 

Luci (Sam’s daughter): I’m glad you decided to quit last year when I was pregnant so the baby wouldn’t be exposed to tobacco smoke.

Bob (friend): I think you’re right that smoking tobacco causes almost all lung cancer.

Mary (Sam’s wife): I also heard that poor indoor air quality and breathing in second hand tobacco smoke doesn’t help either. Didn’t you say both your parents smoked when you were a kid? 

Sam: We used to pretend we were airplanes flying through all that smoke. I’m sure that didn’t help my lungs.

Luci (Sam’s daughter): I’ve also heard that having other medical conditions can increase your risk of cancer. 

Sam: I think I’m pretty healthy for a 68 year old guy. (patting his belly)

Mary (Sam’s wife): Well, you did put on a few extra pounds when you retired. 

Luci (Sam’s daughter): I heard that being overweight can increase your cancer risk. But that reminds me about your job before your retired.

Sam: I worked construction, so I was always busy.

Bob (friend): Didn’t you help tear down that old building in town? 

Sam: Yea, that was a big job for sure. Remember we wore all that protective gear.

Luci (Sam’s daughter): That's right they were concerned that there might be asbestos in that building! Asbestos causes cancer, doesn't it?

Mary (Sam’s wife): What is asbestos?

Sam: Asbestos are bundles of fibers that can be separated into thin, durable threads. We used to use that a lot in construction because asbestos is resistant to heat, fire, and chemicals, and doesn't conduct electricity. It worked really well as an insulation material. We didn’t realize how bad that stuff was to our health!

Bob (friend): People may be exposed to asbestos without knowing…in their workplace, their communities, or their homes, if the buildings were built a long time ago. 

Luci (Sam’s daughter):  How does asbestos go from being part of a building to potentially causing cancer?

Bob (friend): If products containing asbestos are disturbed, such as tearing down walls of a building, then tiny asbestos fibers are released into the air. When asbestos fibers are breathed in, they may get trapped in the lungs and remain there for a long time. Over time, these fibers can build up and cause scarring and inflammation, which can affect breathing and lead to serious health problems. 

Mary (Sam’s wife): What factors affect the risk of developing an asbestos-related disease?

Luci (Sam’s daughter): Let’s look it up on the internet. The National Cancer Institute has a fact sheet about asbestos exposure. Says here that several factors can help to determine how asbestos exposure affects an individual, including:

• Dose (how much asbestos an individual was exposed to)

• Duration (how long an individual was exposed)

• Size, shape, and chemical makeup of the asbestos fibers

• Source of the exposure

• Individual risk factors, such as smoking and pre-existing lung disease

(NCI Asbestos exposure and cancer risk https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/asbestos/asbestos-fact-sheet)

Sam: Those are all good questions. I guess it’s kind of like looking for clues. Maybe asbestos was a factor in my lung cancer. Although no one really knows if there was asbestos in that building. It was more of a hunch and we wore protective gear just to be safe. 

Bob (friend): As far as I remember it was just that one old building that had folks concerned.

Mary (Sam’s wife): And what about family history. I heard certain cancers can run in families. 

Sam: Well Dad smoked a pack a day until he died at age 70. He didn’t ever get diagnosed with anything, just died in the village. As he got older he had a lot of trouble breathing but we don’t really know if he had cancer or just a poor heart.

Luci (Sam’s daughter): And what about grandma, did she have cancer? 

Sam: I’m not sure if she had cancer, but she had a lot of trouble with her bowels. I remember there was blood in the honey bucket. 

Luci (Sam’s daughter): That could be a sign of colorectal cancer.

Sam: That’s kind of what us kids thought as we got older and started hearing more about cancer. I heard that colon cancer can run in families so that’s why I’ve been good about getting a colorectal screening exam when I should. The Community Health Aide is good at reminding everyone in the village when they are due for their colonoscopy.

Bob (friend): And what about your brothers and sister?

Sam: Well, they’re all younger than me but we did grow up together so I guess we shared the same eating habits and breathed in a lot of tobacco smoke. None of them smoke. Matt just turned 50 and got his second colonoscopy. They found a polyp which they said could have turned into cancer, so that was lucky that they found it early and removed it. 

Mary (Sam’s wife): We always think of Betty as part of the family but she has different biological parents. She was diagnosed with breast cancer a few years back and is doing fine. 

Luci (Sam’s daughter): Then there’s your other brother and he seems to be as healthy as can be. Still beats us all playing basketball. 

Sam: (Laughing) You’re right about that. He will be 48 this year and so far seems pretty healthy. He got his first colonoscopy at age 40 and everything looked good so they said he didn’t need to come back until he turned 50 or unless he developed symptoms. 

 Luci (Sam’s daughter): It’s recommended that Alaska Native people begin colon screening at age 40 or younger if there is a family history.  

Mary (Sam’s wife): Oh I just got thinking about things and remembered that we had our house checked for radon.

Luci (Sam’s daughter): I remember that. It was January’s radon action month and ANTHC was encouraging everyone to learn more about radon. What is radon?

Bob (friend): Radon is a colorless, odorless, radioactive gas. It’s formed through the decay of uranium beneath the earth’s surface. 

Luci (Sam’s daughter): Say’s here on the ANTHC website that radon is the second-leading cause of lung cancer in the U.S., after smoking. What did the radon check show? (https://anthc.org/news/check-your-home-during-januarys-radon-action-month/)

Sam: We ordered a radon detection kit and followed the directions on how to do the test.

Mary (Sam’s wife): I remember it came back positive for radon. 

Bob (friend): I remember helping you to seal the cracks in your floor. That was a big job, but it seemed to work.

Sam: And we retested, and it came back negative. 

Mary (Sam’s wife): You both did a good job of protecting our house from any radon leaks. I guess that’s been about 5 years ago now so we probably should retest. 

Luci (Sam’s daughter): The ANTHC website recommends testing your home every 5 years.

Bob (friend: They usually recommend testing during the winter season when homes are insulated and have less ventilation. 

Luci (Sam’s daughter): I think ANTHC still has that program so you might want to look into that. 

Sam: Thanks for helping me think about all the things that could have caused my cancer. And to understand cancer risk. It’s good to have a friend like Bob and my curious family. I’m glad Luci knows how to use that computer to find accurate information.

Narrator: Sam, his family, and Bob talked about several different factors that can influence cancer risk. What are some of the ideas discussed in this story? (Ask participants to share their ideas and write them on a board for everyone to see.) 

Possibilities include:

·       Type of cancer

·       Person’s age

·       Medical history

·       Obesity

·       Family history

·       Lifestyle choices

·       Screening exams

·       Tobacco use

·       Environmental exposures such as asbestos and radon

Cancer and the Environment Activity: Radio Show

Directions: The teacher has a copy of the radio script and reads the radio announcer words. Print a copy of the script and cut apart the caller questions and the expert answer. Class participants are given a caller question or an expert answer. The caller reads their question when the radio announcer asks for that caller number. The expert responds to that caller’s question by reading their information on the paper. The teacher/radio announcer can add additional information if needed to help answer the caller’s question. There are 8 callers and 8 experts.

Radio Announcer: Welcome to Wellness Ways Radio show. Thank you to everyone out there in radio land for tuning in to our radio show. Today we will be talking about cancer and the environment. We have several callers on the line and a group of experts to help us answer their questions. Let’s start with caller number 1.

Caller number 1: Thank you so much for talking about such an important subject today. You hear a lot about cancer and the environment. What exactly do we mean when we talk about environment?

Radio Announcer: That is a very good question. Let’s see if we have an answer to go with that question…What do we mean by environment?

Expert (What do we mean by environment?): Usually when we think about environment and cancer it falls into 2 categories. There are lifestyle factors such as the choices we make about the things we do. Changing these kinds of lifestyle factors can prevent about 70% of all cancers. Making choices like not using tobacco, being physically active, and eating healthy foods. The other part of environment is exposure to cancer causing substances in the air, water, soil or food. 

Radio Announcer: Thank you. That’s pretty amazing – we can prevent almost 70% of all cancers just by the choices we make to live healthy. That seems like some pretty good motivation. Do I have caller number 2 out there in radio land?

Caller number 2: Good day and thank you for inviting me to ask my question. I hear the word carcinogen but what does that mean?

Radio Announcer: That is a pretty challenging word to say - What does carcinogen mean?

Expert (What does carcinogen mean?): A carcinogen is any substance that causes cancer. We can come in contact with carcinogens in the soil, the air we breathe, the water we drink, or the food we eat. For example, when the body metabolizes alcohol, it produces acetaldehyde, a chemical compound that may damage DNA, which may lead to cancer. Research has found that the more alcohol you drink, the higher your risk for developing certain kinds of cancer, such as head and neck, esophageal, liver, breast and colorectal cancers. Eating processed foods such as Sausages, Ham, Bacon, Hot Dogs, Salami which are usually high in nitrates are known to increase a person’s risk for developing colorectal cancer. 

Radio Announcer: I like how you gave examples of things we drink or eat that can increase cancer risk. Caller number 3 is also interested in learning more about carcinogens.

Caller number 3: Thank you that is great timing. I am wondering about specific chemicals that have been found to cause cancer or at least increase cancer risk. I’ve heard about radon and programs to have your home tested. 

Radio Announcer: Is there an expert that can tell us more about radon? 

Expert (How are radon and asbestos related to cancer?): Radon is a colorless, odorless, radioactive gas that occurs naturally outdoors in harmless amounts. It’s produced from the breakdown of uranium in soil and rocks. It sometimes gets concentrated in homes built on soil with natural uranium deposits. ANTHC has programs to test people’s home for radon. When someone breathes in radon gas, it goes into their lungs, exposing them to small amounts of radiation. This may damage the cells in the lining of the lungs and increase a person's risk of lung cancer. Radon is the second-leading cause of lung cancer in the U.S., after smoking. If you are exposed to radon and smoke, your risk for getting lung cancer is even higher. However, radon detection is possible and exposure is preventable. 

Radio Announcer: That helped to answer the question, but for me this also raises some other questions that our next caller is also interested in.

Caller number 4: Oh, I’m glad it is my turn. The lines have been busy and I wasn’t sure I would get through. I’m wondering who decides if something is a carcinogen and is there a list?

Radio Announcer: I’m glad you asked that question. I was also curious to learn more about carcinogens. I hope there is an expert in radio land to help answer your question. Who decides if something causes cancer?

Expert (Who decides if something causes cancer?): Every two years, scientists from a wide range of government agencies and educational institutions work with scientists from the National Toxicology Program (NTP) to publish the Report on Carcinogens. The report identifies substances that are either known to cause or suspected of causing cancer and that a significant number of people in the United States are exposed to. As new potential carcinogens are identified, they are evaluated scientifically by the NTP’s Board of Scientific Counselors and the NTP Director.

Radio Announcer: That is good to know. I didn’t know that. I just love this radio show because I learn new things all the time. We have time for just a few more questions. Let’s see do we have caller number 5.

Caller number 5: What determines if cancer may occur from an environmental exposure?

Radio Announcer: Great question. I can see where that might be confusing. Let’s hope we have an expert to help us learn more.

Expert (What determines if cancer may occur from an environmental exposure?): That really depends upon a lot of different factors. You really need to be a bit of a detective or enjoy putting together pieces of a puzzle. To know if a chemical will harm us, we need to ask the questions: What was released? Where? And When? And, it also depends on how that chemical gets into our body. For example, did we breathe it or eat it or touch it? We also want to learn how much of the chemical we were exposed to, how often and for how long. So, you can see there is a lot of information gathering to help best understand that question. 

Radio Announcer: Thank you for sharing that helpful information. I am glad that there are organizations and people that study these things to help keep our land, air, and water safe. We are almost out of time for our radio show today. The time goes so quickly when we are learning so many interesting things. Let’s see, do we have caller number 6.

Caller number 6: I’m really enjoying today’s show, so much helpful information! But after listening to the last calls I am wondering why is it difficult for scientists to decide if an environmental exposure caused cancer? 

Radio Announcer: Thank you for listening to the show and calling in. Everyone’s questions really help us to learn so much from our experts! And now let’s go to our knowledgeable expert to help answer your question. Why is it difficult for scientists to decide if an environmental exposure caused cancer?

Expert (Why is it difficult for scientists to decide if an environmental exposure caused cancer?): There are lots of different reasons. Cancer is a word used to describe over 100 different kinds of diseases and we don’t always know why a person develops cancer. For example, not all chemicals cause cancer and maybe the exposure was too small. Sometimes there can be lots of years between an exposure to a carcinogen and when a person actually develops cancer. So, linking the two events can be difficult.  Also, genetics plays a role in that some cancers are related to genes you inherit from your parents so it is important to learn about your family history. Of course, timing of exposure is also important. Exposure to carcinogens is often worse for children whose bodies are developing. For example, tobacco smoke is very harmful for kids. We do know that the leading cause of cancer death among Alaska Native people is lung cancer and that is almost always caused by tobacco. 

Radio Announcer: Wow if you think about it the leading cause of death among Alaska Native people is almost totally preventable if people chose not to use tobacco.  Caller number 7 – thank you for waiting so patiently.

Caller number 7: Oh I’m so glad we didn’t run out of time yet. How do scientists know which substances to test? 

Radio Announcer: Do we have an expert to answer that important question?

Expert (How do scientists know which substances to test?): Scientists look at lots of different information to decide. They want to test chemicals that affect a lot of people or chemicals that have a high exposure level. They also investigate if they notice that people exposed in the workplace are getting more cancer than expected or if people living in a specific place are getting more cancer than expected. Epidemiologists track the number of people who have been diagnosed with cancer and this helps scientists to see if there is a high incidence of cancer and look at what might be the cause. 

Radio Announcer: Excellent job in answering that question. Unfortunately, we are almost out of time for today. It has been great to visit with folks.  Do we have caller number 8?

Caller number 8: Thank you for having time for one more call. It has been a great radio show. I always look forward to learning so much on Wellness Ways. I’ve learned a lot about cancer and the environment. I’m wondering if, I should be worried about my subsistence foods?

Radio Announcer: That is a great question for all our listeners out there in radio land to help keep us healthy. What ideas does our expert have on our subsistence foods?

Expert (Should I be worried about my subsistence foods?): In general, subsistence foods are very healthy. Being involved in getting subsistence foods can also help you get physical activity, stay connected to the land, and connected to your culture, which are all ways to stay healthy. Subsistence foods often provide more nutrients and healthier fats than western foods. 

For example nitrate- or nitrite-based additives in processed meat when eaten regularly pose a greater risk of colorectal cancer than red meat that is unprocessed such as caribou or seal.

Some examples of processed meats include bacon, sausage, hot dogs, pepperoni, ham, corned beef, and cold cuts like bologna and salami. If you include these meats frequently with your breakfast, sandwiches, or barbecues, explore other delicious options that you can swap to replace them most of the time.

Radio Announcer: Thank you so much for sharing that information. I hope everyone will keep eating their subsistence foods as a way to keep their bodies strong and healthy. It sounds like they are very healthy. Thank you very much for all of our callers and experts for helping us to learn more about cancer and the environment. Until next time this is Wellness Ways Radio signing off. 

 “I’ve used this tool many times and love it! Works well with elders and youth.”

“Dance is a very important part of our culture and fitting it in with an important lesson is great. We were dancing and learning at the same time. Dancing brings laughter - good for the soul.”

 Background. Being physically active, eating healthy, and maintaining a healthy body weight can reduce the risk of getting cancer, improve outcomes after diagnosis, improve response to cancer treatments, and decrease the risk of cancer returning among people living with cancer.

Alaska Native people have a long tradition of being active – hunting, fishing, gathering plants and berries, and walking on the land.  Many of our ancestors were fit from the way they lived every day.

 Stretch. Ask participants to stand in a circle and invite participants to stretch: look up and reach towards the ceiling, slowly roll over and stretch towards the floor then roll back up slowly to standing, etc.  There are 3 types of physical activity that help to keep bodies strong and healthy: stretching or flexibility activities, strength training, and aerobic exercises.

 Activity: Wellness 

Invite Participants to:

1.  Consider all the ways to support their health and wellness…physically, mentally, spiritually, emotionally, and socially. Brainstorm ideas. Everyday we move in wellness ways and make choices about our health and wellness.

2.  Consider a wellness movement you want to add to your life to live more fully in balance or perhaps a wellness activity that you already do and want to keep doing.

3.  Each person thinks of one wellness activity movement to support their physical health. What physical activity do you like doing or wish you could do more of? Examples could be playing basketball, berry picking, going for a walk, etc.

4. During an in-person class, have everyone turn to face the outside of the circle (or their backs to the camera during a distance class). Ask people to turn to face the inside of the circle (or the camera) once they have their movement picked out. When everyone is back facing the inside of the circle (or the camera), tell the group that everyone will do their movement all together on the count of 3. Count to 3 and everyone does their movement at the same time!  

5.  Create a wellness dance. Ask one person to share their movement individually and then everyone joins in and copies their movement. Then another person shares their movement and everyone copies their movement. Put together the first person's movement and then the second person's movement.  The game continues until everyone has shared their movement and you have added all the physical activity movements to your wellness dance. For example, if there are 15 participants than your dance will have 15 movements. 

 Discuss: What can you do to help you and your community stay active?

 Thank people for their participation and sharing.

This lesson plan was created through the project “Community engaged development of cancer education for Alaska Native youth,” funded by the Alaska Native/American Indian Clinical and Translational Research Program (2020). For more information, please visit the website at https://sites.google.com/view/akcancer/home, email the project team at akcancer20@gmail.com or contact the PI Katie Cueva at kcueva@alaska.edu 

Labels

Name:______________________________              Date:_________________

Look at labels from two similar foods to see what’s in them, and make a choice about which is healthier. Foods could be canned vs. frozen vegetables or fruits, different kinds of beans, different kinds of meats, two kinds of drinks, etc. 

1.     What two foods did you choose?

a.     :

b.     :

2.     What pictures are on the packages?

a.     :

b.     :

3.     Do these foods look healthy based on their packaging?

a.     :

b.     :

4.     Look at the list of ingredients. Ingredients are listed by quantity.  The first ingredient listed is the ingredient the food manufacturer used the most of.  The last ingredient listed is the ingredient the food manufacturer used the least of. What is the first ingredient listed on the packages?  

a.     :

b.     :

5.     Are you surprised by the order of any of the ingredients listed in the foods? 

6.     How many servings are in each of the packages?

a.     :

b.     :

7.     In your opinion, do these foods have a realistic serving size (i.e. would someone actually eat or drink just that much)?  Do you think most high schoolers would agree with you? 

a.     :

b.     :

8.     The 2015-2020 Dietary Guidelines for Americans recommend that people eat no more than 2,300 milligrams of sodium each day. Sodium is another word for salt. How many milligrams of sodium are there in the whole package? 

a.     :

b.     : 

9.     The 2015-2020 Dietary Guidelines for Americans recommends eating no more than 10% of calories from added sugar a day. That's 200 calories, or about 12 teaspoons, for a 2,000 calorie diet. How many grams of sugar are there in each package?

a.     :

b.     :

10.  The recommended dietary allowance for protein is about .36 grams for each pound of body weight. Multiply your weight in pounds by .36 to see about how many grams of protein is recommended for you to eat each day:

11.  How many grams of protein are there in each package? 

a.     :

b.     :

12.  A food with 3 grams or more of fiber per serving is considered a “good” source of fiber. High school students are recommended to eat 25-31 grams of fiber a day. How many grams of fiber are in each package?

a.     :

b.     :

13.  Saturated fats increase cancer risk while unsaturated fats decrease cancer risk. How many grams of each fat do the packages have?

Saturated Fat:                                           Unsaturated Fat:

a.     :                                                                 a.    :

b.     :                                                                 b.    :

14.  Based on what you’ve learned about the foods – which of the two foods do you think is a healthier choice and why?

Nutrition and Cancer

What’s the connection between nutrition and cancer? 

The World Cancer Research Fund estimates that at least 18% of all cancers diagnosed in the US are related to body fatness, physical inactivity, alcohol consumption, and/or poor nutrition.[1]

What kind of eating reduces cancer risk? 

Healthy diets full of fruits, vegetables, whole grains, and traditional meats like salmon, and diets low in processed meat, alcohol, and sugars, could prevent about 1/5 of all cancers.

What kind of protein is healthy? 

Beans, fish, birds, sea mammals, all types of eggs, and game are all foods that are good sources of protein.  

What kind of fruits and vegetables are healthy?

Eating a plants-based diet or lots of fruits and vegetables are rich in cancer fighting nutrients. Fresh, frozen, and canned all count. Reading the label and choosing products that have no or low added sugar or salt, keeps all fruits and vegetables healthy choices.  Each plant food has a variety of healthy nutrients, antioxidants, and phytochemicals so it’s best to eat a rainbow of colored plants. Local plants like salmonberries, blueberries, and greens are all healthy options.

What kinds of grains are healthy?

Whole grains such as oats, brown rice, quinoa, and whole-grain foods like whole-wheat pasta and whole-grain bread provide cancer-protective fiber and phytochemicals.  Whole grains contain all parts of the grain, including the healthy germ and bran. The germ and bran have cancer fighting fiber and protective compounds. Refined white rice, white bread, and pasta lose that nutrition during processing from whole grains to refined grains. 

Nutrition and Cancer

Name:______________________________              Date:_________________

What’s the connection between nutrition and cancer? Read the handout and answer the following questions. 

1.     What percent of cancers could be prevented by healthy eating and drinking? 

2.     What kinds of proteins are healthy?

 3.     What kinds of healthy fruits and vegetables are eaten in your community?

4.     What kinds of fruits and vegetables grow in your community?

5.     What’s the difference between a whole grain and a processed grain?

6.     What are three examples of whole grain foods that are available in your community?

7.     What are two questions you have about the connection between cancer and food?

8.     Look up the answers to those questions (from #7), and write down what site you got the answers from (make sure it’s a credible site!)

[1] https://www.cancer.org/cancer/risk-prevention/diet-physical-activity/diet-and-physical-activity.html

This activity was created in 2020 through the project “Community engaged development of cancer education for Alaska Native youth,” funded by the Alaska Native/American Indian Clinical and Translational Research Program. For more information, please visit the website at https://sites.google.com/view/akcancer/home, email the project team at akcancer20@gmail.com or contact the PI Katie Cueva at kcueva@alaska.edu

Invite 3 people to read the parts of Joel, Ashley, and Amira in the following story. This script is adapted from a play written by Alaska high school youth and playwright Shane Mitchell.

Choosing Tobacco Free

Instructor: Lights come up on two cubes painted to resemble cigarette ash. Three teenagers enter, dressed entirely in black.

JOEL: The first thing I remember about cigarettes…

ASHLEY: I don’t remember a time when I wasn’t around cigarette smoke…

AMIRA: The first time a person’s smoking really bothered me…

JOEL: …was when I was in Elementary School.

ASHLEY: …because my parents have smoked my whole life.

AMIRA: …I was in the village.

JOEL: My parents quit smoking when I was born so I was never really exposed to how much the rest of my family smoked until my Grandfather died of cancer and we went to the funeral. Afterwards I noticed all of my relatives were just sitting around and smoking. Cigarette after cigarette…

ASHLEY: When I was very small I was diagnosed with asthma. We found out that asthma is an inflammation of the airways in the lungs, which makes it hard to breathe and may even lead to death. We also found out that it gets worse when I’m around tobacco smoke.

AMIRA: In my village, a lot of people smoke or chew tobacco. And not just adults or teenagers but little kids!

JOEL: Later, we learned that my Grandmother had emphysema…

ASHLEY: My parents tried to quit for my sake but they couldn’t.

AMIRA: Cigarettes or chew are still easy to get! But more and more people are learning the facts about tobacco.

JOEL: …then my Uncle had to have surgery related to smoking.

ASHLEY: I think they really wanted to quit, they just…couldn’t.

AMIRA: One night I was hanging out with my friend in her bedroom and she was chain smoking. I asked her, “Don’t you know how much that damages your body”? “Yes” she said, “but I can’t stop.”

JOEL: But they all kept using tobacco.

ASHLEY: I could get cancer from someone else’s cigarette smoke. Second hand smoke could kill me.

AMIRA: I don’t like the smell. On my clothes. On people’s breath. It makes it hard to breathe. I don’t smoke. Why should I put up with it?  It really stinks!

JOEL: I hate smoking.

ASHLEY: I hate chewing tobacco.

AMIRA: I hate second hand smoke.

JOEL: It’s ruining my family.

ASHLEY: It’s bad for my health.

AMIRA: It’s making people sick.

JOEL: But the thing I hate most about smoking…

ASHLEY: But the thing I hate most about second hand smoke…

AMIRA: But the thing I hate most about tobacco…

Instructor: All three students pause to put on a Death’s head mask. All three turn their backs as the lights fade to black.

DISCUSS:

What messages do you think the youth in this story are sharing?

How does this relate to you or your community?

Why do you think this happens?

What can we do about it?

This lesson plan was created through the project “Community engaged development of cancer education for Alaska Native youth,” funded by the Alaska Native/American Indian Clinical and Translational Research Program (2020). For more information, please visit the website at https://sites.google.com/view/akcancer/home, email the project team at akcancer20@gmail.com or contact the PI Katie Cueva at kcueva@alaska.edu 

Activity: Community Snapshot

Adapted from Healthy Native Community Fellowship (2012) Guide to Community Wellness Planning. Healthy Native Communities Partnership, Inc: Shiprock, NM. http://hncpartners.org

 “I love this activity because everyone can participate.”

 Helpful Materials

·        Flip chart paper posted on the wall for participants’ drawings

·        Markers, pencils, crayons, tape

·        Three pieces of paper for each participant. If in-person, these could be large (5”x7”) post-it notes

 Description:

This fun activity helps participants to learn about how each person sees their community by showing some of the things that are the same and some of the things that are different. Additionally, it might help participants to see new people they can learn from to support community health and wellness based on their community’s strengths and resources.

Before the activity:

If in-person, find three areas of the room where people could tape up pictures. This could be on large sheets of flip chart paper (as shown above), on white boards, or on blank walls. Label each of the three sections with one of the following items:

·        what you love about your community

·        what makes it a special place to live and work

·        who lives in your community

During session:

·        Ask the group to each think about their community in ways that answer a stranger’s question “What is it like in your community?”

·        Ask each participant to imagine they have a camera that they are using to take pictures of the things they see in their community to show a stranger what their community is like. 

·        Once participants have a visual in their mind, ask them to draw or write what they would like people to know and understand about their community on three separate pieces of paper. One paper for each of the following questions:

1.      What do you love about living in your community?

2.      What makes your community a special place to live and work? What’s different about your community that’s maybe different from other communities?

3.      Who lives in your community? Examples may include the elders, children, EMTs, post office workers, store owners, dance group members, fishermen, teachers, etc.

·        Ask participants to do a quick self-check: Their pictures should answer a stranger’s question - “What is it like in your community?”

 IF IN-PERSON:

·        For everyone who wants to share their drawings, tape each drawing to one of the areas in the room:

o   what you love about your community

o   what makes it a special place to live and work

o   who lives in your community

·        Arrange drawings into similar groups.

·        As participants post their drawings, talk about what they drew.

 IF OVER DISTANCE:

·        Ask individuals to share their pictures about each of the three topics:

o   what you love about your community

o   what makes it a special place to live and work

o   who lives in your community

·        As each person shares, talk about common themes that are coming up.

After all the drawings have been posted or shared, reflect upon the group’s communities. Think about all the ways our communities support health and wellness.  Who can you think of that can join in supporting the group’s communities to be well? What things support wellness in each community? (nature, wisdom of elders, cultural traditions, etc… )

This lesson plan was created through the project “Community engaged development of cancer education for Alaska Native youth,” funded by the Alaska Native/American Indian Clinical and Translational Research Program (2020). For more information, please visit the website at https://sites.google.com/view/akcancer/home, email the project team at akcancer20@gmail.com or contact the PI Katie Cueva at kcueva@alaska.edu 

Community Core Values

Adapted by Margaret David to support Alaska Native Core Values from the Healthy Native Community Fellowship (2012) Guide to Community Wellness Planning. Healthy Native Communities Partnership, Inc: Shiprock, NM. http://hncpartners.org

“This activity gives people a chance to see their community values; a chance for people to talk about how to work together as a community.”

Helpful Materials

·        Community Core Values Handout for each participant

Description:

Wellness choices and health behavior are often influenced by what we value. The following activity is designed for participants to reflect upon what is important to them. Additionally, this activity has been used to bring people together. Often, even within a large group of people, individuals value the same two to three things.

• Ask participants to look over the list of community values and see what’s missing.

• Ask the group to share any values that are important to them, that they would like to add to the list.

• Ask participants to put a star next to all the values that are meaningful to them.

• Ask participants to narrow their personal values down to five by crossing off the less important values and circling the more important values. Remind participants that they’re not throwing away the values they cross off; simply narrowing down the list to determine their core values.

• Ask participants to choose their top 2 core values from their list of 5 values - choose the 2 values that are the most important to them.

Depending upon the size of the group, 2 discussion options are listed below:

• Option 1: Invite participants to work together in groups of 3-5 people. Ask each person within the group to share their top 2 values, and why they chose them. After each person has shared their values, ask the group to choose the top 1-2 core values for their group.

• Option 2:  Ask for a volunteer to share one of their core values. Then ask everyone to stand who also had that value as one of their top 2 core values. Look around the group and call on someone who is not standing to stand and share one of the top 2 core values they identified. Ask everyone who had that value in their top 2 choices to stand. Continue until everyone is standing. Often within a group everyone is united by one or two core values.

Thank people for participating and sharing their values.

To summarize this activity, invite participants to discuss the following questions:

• How do values influence health and wellness?

• What did you learn from this activity?

This lesson plan was created through the project “Community engaged development of cancer education for Alaska Native youth,” funded by the Alaska Native/American Indian Clinical and Translational Research Program (2020). For more information, please visit the website at https://sites.google.com/view/akcancer/home, email the project team at akcancer20@gmail.com or contact the PI Katie Cueva at kcueva@alaska.edu 

Activity: Visioning a Healthy Community

Adapted from the Healthy Native Community Fellowship (2012) Guide to Community Wellness Planning. Healthy Native Communities Partnership, Inc: Shiprock, NM. http://hncpartners.org

Helpful Materials

If in-person:

·        Space in the room for participants drawings (whiteboard or flip chart paper)

·        Four 5”x7” large post-it papers per participant

·        Markers, crayons, tape

·        Via distance:

·        Four pieces of paper for each participant

Description

Before class:

·        On a whiteboard or on large sheets of blank flip chart paper, write the heading “Your Healthy Community.” 

 In class:

·        Give each participant four 5x7 colored post-it papers and a variety of markers. 

·        Invite participants to close their eyes and imagine: “Think about your community 15 years from now.  It is the healthiest community you can ever imagine.  People are no longer being diagnosed with diabetes, heart disease, or cancer…What do you see around you?  What are people doing? What things are happening?  What does your community look like? Now open your eyes.” 

·        Ask students to draw activities they see in the vision of the healthiest community, like, behaviors they see, things in the environment, etc. Encourage participants to use their imagination to draw their vision of their healthy community.

·        While participants are drawing, encourage them to:

©  Be supportive of people’s drawings. This is about ideas. 

©  Express themselves by drawing pictures.

©  Share their ideas in positive ways. For example instead of drawing a no tobacco sign, maybe draw a tobacco free community gathering. 

If in-person:

·        After participants have finished drawing, ask them to work in groups of 3-5 people. Ask each person to share their drawings within the smaller group. After participants have shared their vision for a healthy community, have each group post their pictures on the whiteboard or large flip chart paper. Ask a representative from each group to share the common ideas they talked about in their group.

If via distance:

·        After participants have finished drawing, ask students to share their drawings. Once someone has shared, ask if anyone has something similar. Then ask someone who didn’t speak what they drew and again ask if anyone has something similar.

 After sharing ideas, discuss the following questions.

• What do you see? What common themes do you see in people’s pictures?

• What cultural values do you see here?

• How does culture influence community health and wellness?

• How do you think connection to core values and culture contribute to a healthy community?

• What needs to happen to move towards this community vision of health and wellness?

• What is one thing you/we could do to help make this vision happen?

After visioning a healthy community, participants can begin to identify small steps to move towards their shared community vision of health and wellness. Visioning may be a step in developing a shared action plan to help realize a healthier community.

This lesson plan was created through the project “Community engaged development of cancer education for Alaska Native youth,” funded by the Alaska Native/American Indian Clinical and Translational Research Program (2020). For more information, please visit the website at https://sites.google.com/view/akcancer/home, email the project team at akcancer20@gmail.com or contact the PI Katie Cueva at kcueva@alaska.edu 

Sun Health

The sun’s ultraviolet (UV) rays can damage anyone’s skin causing skin cancer, no matter what the person’s ethnicity. To protect skin from the sun’s harmful rays, people wear protective clothing, hats and long sleeve shirts, sunglasses, and sunscreen. Sunglasses that block both UVA and UVB rays offer the best protection and can also help protect a person’s eyes from developing cataracts. Sunscreens have a sun protection factor (SPF) number that rates their effectiveness in blocking UV rays. The higher the number the better the protection. Using tanning booths is not recommended.

Activity: Sun Health

Play a vicarious game of catch.

1. Each person thinks of 1) an activity they enjoy doing outside to stay healthy and 2) how they can protect themselves from the sun’s harmful rays.

2. Give participants a minute to think of their activity and what they can do to protect their skin from the sun’s harmful rays.

3. Ask for a volunteer to go first to share their ideas. 

4. After the person finishes sharing their idea, ask them to think of an object that relates to their activity. The person then tosses that vicarious object to another player. For example if they were talking about playing basketball they could choose to toss a basketball to a new person, calling them by name. For example, “I’m going to toss a basketball to Mary” It then becomes Mary’s turn.

5. Then Mary shares her idea and tosses a new imagined object to another player.

6. The vicarious game of catch continues until all participants have shared a healthy activity they enjoy doing outside and how they can protect themselves from the sun.

7. At the end of the game, the teacher and students review the ideas of sun health.

 To learn more:

CDC (Center for Disease Control) https://www.cdc.gov/cancer/skin/basic_info/sun-safety.htm

ACS (American Cancer Society) https://staging.cancer.org/healthy/be-safe-in-sun.html

Skin Cancer Screening (adapted from the CDC website)

Skin cancer is the most common form of cancer in the United States. The most common types of skin cancer include basal cell carcinoma, squamous cell carcinoma, and melanoma.

Signs of skin cancer may include:

• Irregular borders on moles (ragged, notched, or blurred edges)

• Moles that are not symmetrical (one half doesn’t match the other)

• Colors that are not uniform throughout

• Moles that are bigger than a pencil eraser

• Itchy or painful moles

• New moles

• Sores that bleed and do not heal

• Red patches or lumps

This lesson plan was created through the project “Community engaged development of cancer education for Alaska Native youth,” funded by the Alaska Native/American Indian Clinical and Translational Research Program (2020). For more information, please visit the website at https://sites.google.com/view/akcancer/home, email the project team at akcancer20@gmail.com or contact the PI Katie Cueva at kcueva@alaska.edu 

Screening  Exams Activity: BINGO

 Background:

Having recommended cancer screening tests helps find cancer early, sometimes before there are symptoms. When cancer is found earlier, it can be easier to treat.

Some screening tests may also help to prevent cancer, like a Pap test and a colonoscopy. A Pap test can find abnormal cell changes before they become cancer. During a colonoscopy exam the health care provider looks at all the colon to find and remove abnormal growths called polyps before they become cancer. 

According to the National Cancer Institute (NCI), effective screening tests:

• Find cancer early.

• Reduce the chance that someone who is screened regularly will die from the cancer.

Description:

Play BINGO as a fun way to talk about recommended cancer screening tests.

Every person gets a BINGO card (below). Each BINGO card has all the answers but in a different order. 

Before Class:

·       If in-person: print out the BINGO cards and cut the list of questions and answers apart (so each person gets a question and its answer). 

·       If via distance: email each participant one version of the BINGO card (so each person has a different version).

During Class:

·       If in-person: give each participant a different version of the BINGO card, and one (or more) of the cut up questions and answers (until all questions/answers are gone).

·       If via distance: ask participants to pull up their BINGO cards, and pull up the list of questions on the screen, showing just one question at a time.

·       Ask a participant to read their question

·       After a person reads their question, all participants look at their BINGO sheet and find the answer. Participants call out the answer and the person who reads the question says whether their answer is the correct one listed with the question (scroll down to see the answer if on a shared screen via distance).

·       Once the correct answer is shared, everyone can cross it off their BINGO sheet.

·       As participants share their question you can add to the information.   

·       When a person gets a straight, she or he can yell “BINGO” for fun. 

·       Play until all the questions have been asked and all the answers discussed. 

Discussion:

What gets in the way of people having recommended screening tests to help prevent cancer disease and death? Together, brainstorm helpful ways to support community members to have recommended screenings.

To learn more:

American Cancer Society: https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines.html

National Cancer Institute: https://www.cancer.gov/about-cancer/screening/screening-tests

Bingo Questions

What is the name for more than 100 different diseases in which abnormal cells divide without order or control?  Cancer

What do you call the spread of cancer from one part of the body to another part of the body?  Metastasis

Tumors that are cancer are called what?  Malignant

What virus causes almost all cervical cancer?  Human Papillomavirus (HPV)

This screening exam helps to prevent colorectal cancer by finding and removing polyps before they become cancer? Colonoscopy

What is the exam called when a person looks at their breasts and feels for any breast changes to become aware of their body and learn what is normal for them? Breast Self-Exam

What is the name of the x-ray breast exam used to find abnormal breast changes?  Mammogram

What is the biggest risk factor for breast cancer?  Being Female

Why is it important for people to have regular cancer screening exams? 

To Stay Healthy.  You are Important to your Family and Friends.

Why do we recommend colorectal exams, testicular exams, Pap tests, breast exams, and mammograms?  Early detection.  It can save your life. 

What can you do to decrease your risk of developing cancer? 

Make Healthy Choices. (eat healthy foods, stay tobacco free, avoid alcohol, be physically active and have recommended screening tests)

Now that you have learned the importance of cancer screening tests, what is one thing you can do to decrease cancer deaths?  Tell a Friend.

What cancer is the most common cancer in young men between the ages of 15 and 35? Testicular Cancer

What can young men do every month to help find testicular cancer early? 

Testicular Self-Exams

What is the name of the screening exam that finds abnormal cells in the cervix before they become cancer?  Pap Test

At what age do Alaska Native people (without a family history of colon cancer) begin having colon cancer screening? 

Age 40

Beginning at the age of 50, men need to talk with their health care provider about a prostate screening exam that may include a rectal exam and a blood test called what? PSA

A tumor that is not cancer is called what kind of tumor? Benign

A substance or agent that is known to cause cancer is called what?  Carcinogen

The basic unit or building block of human tissue is called a what?  Cell

What vaccine helps to prevent six cancers? HPV Vaccine

Additional Information: HPV infection can cause cervical, vaginal, and vulvar cancers in women and penile cancer in men. HPV can also cause anal cancer, cancer of the back of the throat (oropharynx), and genital warts in both men and women.

Who should get the HPV vaccine? Boys and Girls (9-26 years old)

At what age do women begin having recommended Pap tests? 21

What is a record of diseases and conditions that run in your family called? Family Health History

Additional Information: Family members or blood relatives may share genes, habits, and environments that can affect your risk of getting cancer. It is helpful to learn what diseases people in your family or blood relatives have had and at what age they were diagnosed.

If you have a first degree relative (mother, father, sister, brother) who has been diagnosed with breast or colon cancer you may need to begin having a recommended colon exam or breast exam at a   ___________age? Younger

This lesson plan was created through the project “Community engaged development of cancer education for Alaska Native youth,” funded by the Alaska Native/American Indian Clinical and Translational Research Program (2020). For more information, please visit the website at https://sites.google.com/view/akcancer/home, email the project team at akcancer20@gmail.com or contact the PI Katie Cueva at kcueva@alaska.edu 

Adapted from Healthy Native Community Fellowship (2012) Guide to Community Wellness Planning. Healthy Native Communities Partnership, Inc: Shiprock, NM. http://hncpartners.org

This activity invites participants to reflect upon a completed learning activity by asking a series of questions. The questions can be used to extend learning after watching a digital story, movie vignette or participating in any activity.

A few ways in which the questions can be used to stimulate conversations are listed below. You could choose to use the Talking Journey Questions beginning in the east, moving to the south, west, and concluding in the north. You could also opt to use the Reflecting questions beginning with question number 1 and moving through the 4 questions.

Option 1: The facilitator or a participant asks one of the 4 questions and invites participants to share their ideas. This activity can be done as a group conversation.

Option 2: The facilitator writes one question from each direction at the top of 4 sheets of flip chart paper and hangs it on the wall. As participants share their response to the question, the facilitator writes participants’ ideas under the question until all 4 questions have been discussed.

Option 3: A question from each of the 4 directions is written on the top of a sheet of flip chart paper and hung in that direction of the room. For example the question from the east: What did you see? is written on the top of a large sheet of flip chart paper and hung on the wall in the east direction of the room.

Individually participants reflect upon each question and write their personal reflection on a post-it note. Each person posts their post-it note on the flip chart paper in each of the 4 directions of the room.

After each person has hung their post-it notes, the facilitator begins with the east direction and reads participants’ post-it notes aloud. Together, the group has a conversation in the east about what they saw. The group conversation then moves to the south direction and the conversation continues. Depending upon the size of the group, participants can stand around each sheet of paper for the group conversation and move around the room as the discussion continues until all 4 questions have been talked about.

 Thank participants for sharing their ideas.

Talking Journey Questions

Adapted from Healthy Native Community Fellowship (2012) Guide to Community Wellness Planning. Healthy Native Communities Partnership, Inc: Shiprock, NM. http://hncpartners.org

This lesson plan was created through the project “Community engaged development of cancer education for Alaska Native youth,” funded by the Alaska Native/American Indian Clinical and Translational Research Program (2020). For more information, please visit the website at https://sites.google.com/view/akcancer/home, email the project team at akcancer20@gmail.com or contact the PI Katie Cueva at kcueva@alaska.edu 

Name:______________________________              Date:_________________

1.     Which communities were the sharing circles held in?

2.     What did many people in the sharing circles want to see?

3.     What is the second leading cause of death in the Northwest Arctic recently (2017-2019)? 

4.     The top three combined cancers make up more than        _____     of all new cancers in the region.

5.     What is the second leading cause of cancer mortality in the Northwest Arctic?

6.     What regions in Alaska have the highest cancer incidence rate and what regions have the lowest?

7.     On the cancer incidence rate map of Alaska, the __________ the color there are less people being diagnosed with cancer. 

8.     What is one state that is the same color as Alaska on the CDC New Cancer in the United States map? 

9.     What is one state that has a very high rate of cancer mortality? 

10.  Why is lung cancer particularly deadly?  

11.  On the graphs about current adult smokers, what does the green dotted line represent?

 12.  On the graphs about current adult smokers, what does the solid brown line represent?