The big "C" diagnosis can be terrifying and confusing, to name just a few of the emotions one might feel.  Our mission this Thursday night at 8 on Smart Talk is to answer some of the "starter" questions many people have about cancer, as well as explore ways to both prevent and treat it.  Our segment is part of witf's new multimedia venture, Facing Cancer Together, that launched earlier this week.

Our guests include Dr. Randall A. Oyer, program director for the Lancaster General Health Oncology Program and the Cancer Risk Evaluation Program at Lancaster General Health.  Lancaster General is a partner in the "Facing Cancer Together" project.  "All cancer is genetic," Dr. Oyer explains.  "However, genetic abnormalities are acquired during a lifetime.  Very few people inherit cancer ... There are certain factors that increase or decrease a person's chance of getting it.  You can't do anything about your genes. But being significantly overweight, taking hormones, eating poorly, not exercising, those are the kinds of behaviors that can affect your likelihood of getting it.  You don't inherit cancer.  You inherit a genetic susceptibility."

Dr. Oyer emphasizes that we all face a risk of developing cancer no matter which genes we have. "We can all make genes behave or misbehave and we can all affect how genes behave by diet and exercise and other lifestyle choices," he says.  "We need to take responsibility for our own health and understand what we are specifically at risk for.  Sometimes it's a proven genetic abnormality, a family history or sometimes it has to do with other medical problems or lifestyle factors such as cigarette smoking.  Pointing at genetics and saying, 'I can't do anything about it' is not the right approach.   There's much more we can do to be proactive and to protect our own health."

Dr. Oyer explains that a cancer cell grows out of control without a signal or a need from the body.  It is, essentially, on auto pilot.  Another guest,Dr. Ronald Hempling, is director of oncology services at WellSpan Health and specializes in women's health issues, including breast cancer and gynecologic oncology.  WellSpan also is a partner in "Facing Cancer Together."  Dr. Hempling tells me the incidence of malignancy is dropping about one percent a year probably as a result of interventions that have been developed over the last few decades.  "It took a long time for things like mammography to make an impact on mortality and incidence.  Incidence and mortality are both declining, slowly, but they are both declining.  It's a novelty.  People died of it wholesale and now that's not necessarily the case.   For most people, they hear cancer and they stop hearing because what they've learned up to that point is that the disease is a death sentence.  Not true," he says.

"In 1971, there were three million people who were alive with cancer that had survived, meaning they lived 5 years after their diagnosis.  In 2007, there were 11 million.  That's a lot.  That's a bunch.  So the nature of the disease hasn't changed," Dr,. Hempling notes.  "We're a bit more effective at getting people to live longer and that is definitely a result of three things:  a development of sub-specialty people who deal with disease at core levels, the development of more effective therapies tailored to the knowledge of the molecular genetics of the cells, and third, maybe most significantly of all, a recognition that cancer does not appear de novo -- that it goes through a process and there is a place where it can be aborted in its progression,  where it can be stopped and not return.  And lifestyle and behavior certainly play an enormous part in whether that happens."

The greatest factor in achieving success with most cancers is early detection.  Genetic screening is the gateway to proper prevention and treatment  Screening has helped lead to the reduction in cancer mortality.  Doctors start with a patient's cancer history and then explore the family history of cancer.  They then put together a pattern and decide whether to do further testing.  Dr. Oyer says, "It's not just a shot-in-the-dark approach.  The last couple decades laid a huge foundation of knowledge of the mechanism  of cancer.  We developed many laboratory tools to find the genes responsible for certain cancers.  Breakthroughs are sure to come."

Dr. Maria Baker, an associate professor in medicine and a genetic counselor at the Penn State Milton S. Hershey Medical Center, also will join the panel.  Penn State Hershey is an underwriter of Smart Talk on witf.  Dr. Baker developed and coordinates the Penn State Hershey Cancer Genetics Program. She provides genetic counseling services to individuals who are concerned about their risk of cancer.  And finally, Dr. Roy Williams, an oncologist with Pinnacle Health and a "Facing Cancer Together" partner, will round out our panel.  Each of these doctors is ready to answer your cancer-related question.  Simply call in during the program at 1-800-729-7532, send us an email now to This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or post a comment now to www.facebook.com/witf.org.