Joey Wahler (Host): It can lead to prevention and save lives. So we're discussing cancer screening and testing. Our guest, Tina Unsworth. She's a Registered Nurse and also Clinical Oncology Navigator and Coordinator for Montefiore St. Luke's Cornwall. This is Doc Talk, presented by Montefiore St. Luke's Cornwall. Thanks for joining us. I'm Joey Wahler. Hi there Tina. Welcome.

Tina Unsworth, MSN, RN, CMSRN: Thank you. Welcome. Thank you.

Host: Appreciate the time. So first, why is cancer screening so important? What should people know about it?

Tina Unsworth, MSN, RN, CMSRN: So cancer screening is so important because early detection really does save lives. So knowing the screening recommendations and knowing your risk factor really aids in detecting cancer early and improves your overall survival rate of cancer.

Host: Absolutely. And so speaking of which, what risk factors make cancer screenings crucial for some people in particular?

Tina Unsworth, MSN, RN, CMSRN: So we want to talk about things that we can do ourselves to reduce our risk factors of getting cancer. So some of those things are staying away from tobacco totally. And if you are a smoker, quitting smoking. Staying at a healthy weight. So getting physical activity each week, getting at least 150 to 300 minutes of physical activity a week.

Eating healthy foods such as fruit, vegetables, and whole grains, and limiting or avoiding processed meats, sugary drinks, and highly processed foods. And it's best not to drink alcohol. If you do drink, have no more than one drink per day for women and two drinks per day for men. And when you're outside, you want to protect your skin, wear sunscreen, protective clothing, and seek shade when available.

Host: Definitely great advice there. So when we talk about screenings, Tina, which ones does MSLC offer?

Tina Unsworth, MSN, RN, CMSRN: We offer a range of screenings, and our navigation team will help patients get those screenings done. So, for breast cancer screenings, the guidelines, and we do offer a mammography here at St. Luke's; women's ages 40 to 44, according to the American Cancer Society guidelines should have the choice to start annual breast screening with mammographies if you choose to do so. And women ages 45 to 54 should get yearly mammograms. Women ages 55 and older should switch to mammograms every two years or continue yearly screening. And the key is knowing your normal. If there's any changes, no matter what your age is to your breast, whether you're a male or female, let your provider know so they can get the appropriate testing. And that's regardless of any age.

We, connect patients with services for colon cancer screenings. For people of average risk for colorectal cancer, the American Cancer Society recommends starting regular screening at age 45, and that could be done with a stool sample. You can talk to your PCP or GI doctor about that, or a colonoscopy. No matter which test you choose, the most important thing is you get screened. Cervical cancer begins screening at age 25. People between the age of 25 and 65 should get a primary HPV test done every five years, and there is an HPV vaccine available to patients. It's best that they get it between nine and 11, that they start, but you can get this vaccine up until age 45.

For lung cancer, the American Cancer Society recommends yearly screening for lung cancer with a low dose CT for smokers, or people that have a history of smoking from ages 50 to 80. And those smokers include someone that has a 20 pack a year history of smoking. So we do that here at St. Luke's. You can always call the phone number and we will get you set up for lung screening if you qualify.

Prostate cancer, begins starting at age 50. Men should talk to their healthcare provider about pros and cons of prostate testing and what's right for them. If you decide to be tested, you should get a PSA blood test with or without a rectal exam. And the American Cancer Society guidelines are for a person with average risk of cancer.

So if you have a family history of cancer or it's a genetic mutation, that can increase your risk of cancer. So talk to your healthcare professional to evaluate your risk. And when it comes to skin cancer, personal examination and a professional examination can be done. So you really want to look at, does your family have a history of skin cancer?

Have you had a history of sunburns? Are you light and fair skinned and recognize any changing spots. So you want to see a provider or dermatologist. If you have an increased risk factor, you want to get yearly skin cancer exams done by a professional. And for any of the guidelines that are out there, that's for a patient of average risk.

So if you have an increased risk of getting cancer, like a family history or you fall into the risk factors we talked about earlier, then definitely talk to your healthcare provider about a personal guideline for yourself.

Host: Now genetic testing has become so sophisticated throughout the medical world, so what are the cancer screening benefits there?

Tina Unsworth, MSN, RN, CMSRN: So if you have cancer diagnosed at an early age, such as breast cancer before 45, colon cancer before age 50, or had a close family member diagnosed with cancer young, you have two or more close family members diagnosed with the same cancer, or you had more than one cancer or a close family member with more than one cancer, or your family has a known inherited cancer syndrome or rare cancer such as male breast cancer, or some type of genetic mutation; you want to get genetic testing done. That is offered here at St. Luke's. That is offered by our genetic counselors. They're certified and they can set up a consultation with you, see what's best testing for you. They offer saliva and a blood draw, and it detects any genetic mutations. So if you came back with a positive genetic mutation, then your cancer screenings might change. You might be getting screening more often.

Joey Wahler (Host): Now the Litman Cancer Center has cancer and breast accreditation. So what exactly does that mean?

Tina Unsworth, MSN, RN, CMSRN: Yeah, so the accreditations that we have here at the Litman Cancer Center, we are COC accredited and NAPBC accredited. So the Cancer Accreditation refers to the voluntary process where the cancer programs are evaluated against standards set by the organizations like the Commission on Cancer.

And that ensures high quality patient-centered care through ongoing data reporting, specialized program like breast and accreditation provides benefits like improved patient outcomes, data and quality improvements for the cancer program.

Host: Now Montefiore St. Luke's Cornwall offers radiation and other services. So what should people know about that?

Tina Unsworth, MSN, RN, CMSRN: So we offer here radiation oncology. We have genetic counseling and testing, like I mentioned before. We also do community outreach. So, we go into the community and we do cancer screenings and education. We also do online education with our providers. We do clinical trials, lung screening program, smoking cessation program, infusion therapy, outpatient nutrition counseling, palliative care, lymphedema therapy, support groups, and patient navigation.

Host: What's most rewarding about what you do on a daily basis?

Tina Unsworth, MSN, RN, CMSRN: It is so rewarding working here because I see patients at their best and worst days. I like to be there from start to finish. They can call us at any time. So our navigation team works together, booking appointments, checking up on the patients.

Our breast cancer patients we follow for many years. So they really, really get to know us and we really get to know them. We offer support groups for cancer patients and caregivers because going through something like a cancer diagnosis is really hard on your family and yourself and some things you just don't want to talk about with family members.

So that support group with other members that also have a cancer diagnosis going through the same things is really nice to see and nice to be there for them.

Host: So speaking of which, Tina, you and yours obviously offer not just services, quote unquote, but a real human touch, right? You're dealing with people first and foremost, and that's a big part of what this is all about. Yes?

Tina Unsworth, MSN, RN, CMSRN: Yes, exactly. So our patient navigation oncology services reach out to everyone. So, patients in the community, patients that are not one of ours, not a Monty patient. Anyone can join our support group. It is all about the human touch regardless if they can pay. Most of our services for navigation are free.

So, just doing the right thing for the cancer patients.

Host: Gotcha. Because oftentimes, and you've touched on this a bit, people dealing with cancer and their families, there's a lot to navigate. Hence that being part of your title, that has to do with more than just health, right? In terms of trying to maintain their lives away from what's going on health wise. Yes?

Tina Unsworth, MSN, RN, CMSRN: Yes, that's exactly right. So navigating the healthcare system is pretty difficult for any person. So on top of having a cancer diagnosis, it can be very distressful for our patients. So we're here to relieve any distress they have. We offer emotional support, financial grants, anything we can do to assist the patient.

 Food pantry information. The support groups, anything that that patient needs, we go over like a needs assessment and really cater to what that person needs. There's charities in this neighborhood that deliver food for patients going through cancer. So anything that we can think of that they need, a wig, anything, we just try to get them their resources.

Host: And I would imagine that in doing all of the above, that you and those you work with, really get to know some of these people and stay in touch with them for years, right?

Tina Unsworth, MSN, RN, CMSRN: That's correct. They do call us for years. We let them know that we are literally just a phone call away. They can always call us. Just because they might be done with their treatment journey, they're always going to be a cancer patient to us. So we are always there for them.

Host: And so it must be great knowing that Montefiore St. Luke's Cornwall has this reputation of providing really everything under that one umbrella of just lending a helping hand in any way that's needed.

Tina Unsworth, MSN, RN, CMSRN: Yes. And we also started a navigation department that navigates other illnesses, not just cancer. So anyone can call our navigation department, whether you have congestive heart failure, diabetes, just don't understand your medications. There's going to be someone in navigation to assist you.

Host: Because often people dealing with cancer, they've got other stuff going on in terms of their health, right?

Tina Unsworth, MSN, RN, CMSRN: Oh, exactly. Everyone's living their lives not thinking that they're going to have a cancer diagnosis and it's usually very unexpected. So we try to help them get to where they need to go.

Host: Absolutely. Well folks, we trust you are now more familiar with cancer screening and testing and the navigation of all of the above and more. Tina, keep up all your great work and thanks so much again.

Tina Unsworth, MSN, RN, CMSRN: Thank you.

Host: And to schedule a screening or be connected with a patient navigator, as Tina mentioned, it covers a lot of different stuff, you can call 845-458-4444. For more information, please visit montefioreslc.org. That's montefioreslc.org. Please remember to subscribe, rate, and review this podcast and all the other Montefiore St. Luke's Cornwall podcasts. I'm Joey Wahler, and thanks so much again for being part of Doc Talk, presented by Montefiore St. Luke's Cornwall.