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Cancer in Appalachia
Photo Exhibit

ACTION Photo Exhibit

Kentucky has the highest cancer incidence and mortality rates in the United States; no other state in the country has a worse cancer problem than does Kentucky. There are over 30,000 new cases and 10,000 deaths each year in the state. What is worse is that cancer rates are greatest in the Appalachian region of Kentucky. The high cancer rates are caused by elevated cancer risk factors and other issues including fewer health care facilities in the region.

The Appalachian Career Training in Oncology (ACTION) Program at the University of Kentucky Markey Cancer Center prepares high school and undergraduate students from Appalachian Kentucky to address the cancer problems in their communities now and in the future. By sharing cancer education information, ACTION students can increase community members’ cancer knowledge which can aid in reducing cancer rates in the area.

As a way to share cancer education, ACTION participants have been taking photographs in their communities that remind them of the causes and consequences of cancer. We share these images with you in our “Cancer In Appalachia” exhibit.

We thank our sponsors including the National Cancer Institute that funds the ACTION Program, University of Kentucky (UK) Markey Cancer Center, UK HealthCare, CREATE and UK Arts in Health Care.
 

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PAGES

Image 1
Irony in marketing.
Matthew Sanders, Laurel County
Image 48
The public road named after the local tobacco market.
Kaitlin Schumaker, Laurel County
Image 52
Tobacco field – This tobacco is almost ready to harvest. Tobacco and tobacco products are one of the main causes of cancer.
Karlee Compton, Montgomery County
Image 41
This is a picture of my grandparents holding hands. When my Mamaw Sharon was diagnosed with breast cancer, my Papaw Everett dedicated all of himself to helping her as much as he could. He exhibits the gentleness and love of caretakers, who help their loved ones when they need it most.
Allie Combs, Wolfe County
Image 7
A high school student’s vaping device, confiscated by his mother.
Nathan Hogg, Rowan County
Image 8
Crawl spaces can contain very high levels of radon. Radon gives off radiation, which can damage cells in the body and eventually lead to cancer.
Hanah Whisenant, Lawrence County
Image 9
Relay for Life – These are my great-great-aunt’s Relay For Life medals from all the years she battled breast cancer. We keep them close and think frequently about how this horrible disease took her life.
John Staton, Elliott County
Image 10
A photo of a butterfly seems like a weird way to express what cancer means to you, but do you know what a butterfly resembles? A butterfly resembles change. Kentucky needs change. We need a breakthrough. Every time I think of my Old Kentucky Home, I think of what it means to me, and how important it is that we see a decrease in cancer cases. I believe we can do it. I believe we will see a CHANGE.
Brianna Reyes, Carter County
Image 11
After my sister, Hailey, had finished her chemotherapy, my parents put the Hickman Catheter on a doll so that she would understand what she had undergone. This represents the innocence of the many childhood cancer survivors.
Allie Combs, Wolfe County
Image 12
“Exposure to silica dust can lead to the development of lung cancer, silicosis, kidney disease and chronic obstructive pulmonary disease. It is estimated that 230 people develop lung cancer each year as a result of past exposure to silica dust at work.”
Kassidy Burke, Lawrence County
Image 13
A tobacco market for local tobacco farmers.
Kaitlin Schumaker, Laurel County
Image 14
Although smoking inside the facility may be prohibited, at the edge of the parking lot you can see human nature running its course. People smoke before they go in, and get their fix before they can be told not to. There will always be loopholes in the systems, but any kind of change is better than no change at all.
Kinley Lewis, Elliott County
Image 3
This bench is located at my Papaw’s grave. He is missed greatly.
Matthew Sanders, Laurel County
Image 15
A Perry County, Kentucky coal tipple still in operation. Coal tipples are facilities in which the mined coal is loaded usually into train cars for transport. Numerous studies have linked the health problems like black lung disease and lung cancer developed by coal miners and other employees of the coal industry to the coal dust they were regularly exposed to while on the job.
Chezney Boothe, Perry County
Image 61
Billboard advertising the local Appalachian Smoke that sells vaping products.
Zane Whitaker, Magoffin County
Image 46
Ultraviolent exposure is the leading cause of skin cancer, and many people don’t know the importance of protecting yourself against these rays.
Holly Dickens, Rowan County

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Image 17
Unhealthy diet. Continually eating an unhealthy diet can contribute to obesity, which can lead to cancer.
Karlee Compton, Montgomery County
Image 18
An empty field. An opportunity for a new Hope Lodge, or the start of a treatment center. An empty field, the opportunity to grow what has the power to kill us: tobacco. What is more important to us? Provision, or destruction.
Brianna Reyes, Carter County
Image 19
Devices like tanning beds and sun lamps can emit higher amounts of ultraviolent radiation than the sun, including both UVA and UVB radiation. UV radiation of any type increases your cancer risk, and the more you get, the higher your risk.
Bella Dunn, Magoffin County
Image 20
It is no surprise that pollution is a leading factor to lung cancer all over the world! This is Smithfield Ham Plant only 19 miles from my home, they pollute the air 7 days a week 24 hours a day.
John Staton, Elliott County
Image 21
Growing up this was always normal farmers planting tobacco this time of year. Not many farmers grow it anymore so there is no one there to teach young ones about tobacco. This could be why we have seen an increase in teenage smoking rates.
Nolan Marcum, Carter County
Image 22
Elevated levels of benzene, a cancer-causing component of oil, is found in water which can and will cause cancer.
Kassidy Burke, Lawrence County
Image 23
A teacher at Lawrence County High School creates a banner for the football players to run through at a game dedicated to childhood cancer awareness.
Haleigh Thompson, Lawrence County
Image 24
Lard is fattening ingredient that makes up many of the fried foods traditional to eastern Kentucky. This contributes to obesity, worsening the changes of one developing cancer.
Susanna Goggans, Johnson County
Image 25
This is a picture of a medicine bottle. When a person goes through cancer, they must take several types of medication.
Allie Combs, Wolfe County
Image 58
An abandoned barn, once used to store tobacco.
Nathan Hogg, Rowan County
Image 27
A recent study of public drinking water systems in Kentucky showed that half of them contained levels of cancer-causing chemical significantly higher than what is considered safe. This image of a river that is a public water source is not encouraging, due to the obvious bad health of its local environment.
Chezney Boothe, Perry County
Image 28
This picture is of a carbon power plant called Calgon Carbon. According to Clean Technica, “Because such workers had at least a 50% increased lung cancer risk, our results suggest that the high air concentrations of elemental carbon reported in some urban areas may confer increased risk of lung cancer.”
Hanah Whisenant, Lawrence County
Image 29
Some of the things we are around every day, such as this umbrella, are coated in cancer-causing substances.
Holly Dickens, Rowan County
Image 30
My father’s hard hat, taken with him to work in a coal mine. Coal dust is known to cause “black lung”, a type of lung cancer developed by inhaling coal dust.
Allisa Pack, Lawrence County
Image 31
Cigarettes contain a harmful chemical called Benzopyrene which is a chemical that becomes a DNA disrupter which causes mutations that may lead to cancer.
Makinna Caudill, Magoffin County
Image 32
Cancer is in our thoughts and prayers, constantly.
Natalie Barker, Elliott County
“Through these images, our ACTION students are sharing cancer education, raising awareness and building community that stretches far beyond the Appalachian region of Kentucky.”
- Jason Akhtarekhavari, UK Arts in Healthcare Manager
Image 33
A pair of Croc-like shoes that my grandmother wore and passed down to my sister.
Andrew Davidson, Rowan County
Image 35
This is a picture of an ashtray can at one of our local restaurants. As a kid I remember seeing these everywhere, it’s reassuring to know there are less and less of these today. As a Kentuckian, cancer is unfortunately not a shock to anyone. Although it used to be our “Normal”, we’re beginning to see exceeding triumph over this disease.
Brianna Reyes, Carter County
Image 36
In many rural areas, fast food is one of the only options when eating out. When eating a lot of processed foods is associated with cancer, this is not good for the people that live in these rural areas.
Holly Dickens, Rowan County
Image 37
An abandoned family coal mine.
Kaitlin Schumaker, Laurel County
Image 55
One of the many carcinogens seen in high schools.
Natalie Barker, Elliott County
Image 39
Fried chicken, mashed potatoes with gravy, and green beans cooked with bacon. A delicious and classic meal, however full of grease and fat. Foods like these commonly make the people of eastern Kentucky unhealthier and increase their risk of cancer.
Susanna Goggans, Johnson County
Image 40
All throughout my Mamaw’s treatment, she always moved forward with bravery and hope. She is a perfect representative of the bravery of cancer patients. She wore this beanie after her hair had fallen out from the treatment.
Allie Combs, Wolfe County
Image 6
This photo depicts the hands of a coal miner after working in the mines. Coal miners often develop black lung disease and/or cancer because of coal dust.
Caylee Caudill, Johnson County
Image 42
Medals for runners of Corbin’s annual Paint The Town Pink Run/Walk for breast cancer awareness.
Katelyn Nigro, Whitley County
Image 43
A leg and prosthetic belonging to another friend of my mother’s, who was diagnosed with osteosarcoma of the femur after x-rays of her leg showed a tumor. The cancer was so advanced that amputation of the entire leg was the only option for treatment. She named her new prosthetic leg Lucille and discusses life with a prosthesis on a personal blog on Facebook called The One-legged Librarian.
Chezney Boothe, Perry County
Image 44
Almost everywhere you go, you will see littered tobacco products. Many people ignore the harsh effects of using tobacco in Appalachia, which correlates with the high cancer rate.
Holly Dickens, Rowan County
Image 38
A nearby coal field.
Kaitlin Schumaker, Laurel County
Image 34
A few papers important to my mother’s treatment. Most of them are pages of information written on by her oncologist; one has a pedigree tracking her gene mutation that may have led to her breast cancer.
Andrew Davidson, Rowan County
Image 2
The London-Laurel County Wellness Park is a sign of hope for the future. Officials built the park around two old coal silos. Coal was essential to our area in the past, but the wellness park provides us with ways to keep our community healthy now and into the future. Walking trails, bike ramps, and basketball courts are a few things that can be enjoyed here.
Matthew Sanders, Laurel County
Image 47
These are signs that my family purchased from Relay for Life team to help raise money for a cure. In memory of Amanda Binion (my aunt), Patty Frazier (my great great aunt), and Terry Maggard (my grandpa).
John Staton, Elliott County
Image 4
The photo is of my mother’s coat and stethoscope that she wears to work as a nurse. She has been one of the biggest inspirations in my interest in oncology and often works with cancer patients at her job.
Caylee Caudill, Johnson County
“We hope that some people will think about their own cancer risk factors and how to modify behaviors that can reduce their cancer risk.”
- Nathan Vanderford, PhD, ACTION Program Director
Image 49
A family tobacco barn.
Kaitlin Schumaker, Laurel County
Image 57
An old sign for “Eastern Ky. Tobacco Warehouses”.
Nathan Hogg, Rowan County
Image 51
Polluted creek – This polluted creek has potentially harmful chemicals. Some of these chemicals can be harmful to humans if they do not wear the proper personal protective equipment. These chemicals can also contaminate drinking ater. When farmers spray herbicides, pesticides and other chemicals, the run-off when it rains eventually ends up in creeks like this.
Karlee Compton, Montgomery County
Image 5
If I had to name this photo, I would definitely call it “The First Light.” When I took this, it made me think of when someone first tries smoking and it leads down a dark path.
Caylee Caudill, Johnson County
Image 53
Whitley County’s volleyball team wears ribbons in support of a senior student being diagnosed with testicular cancer.
Katelyn Nigro, Whitley County
Image 54
Tap water may contain lead acetate which is proven to be a cause for multiple types of cancer.
Makinna Caudill, Magoffin County
Image 45
Pictured are breast cancer cells produced in a lab at the University of Kentucky, an institution working to reduce the prevalence of cancer in Kentucky.
Holly Dickens, Rowan County
Image 56
Tobacco sticks n my great grandparent’s barn.
Nathan Hogg, Rowan County
Image 50
Coal from the once family coal mine.
Kaitlin Schumaker, Laurel County
Image 26
A Letcher County, Kentucky coal tipple, no longer in operation.
Chezney Boothe, Perry County
Image 59
The famous “Roundup weed killer” which has been linked to cause cancer. This product maybe found in lots of homes and even used by the cities to get rid of weeds. This product has been tested and found to cause Non-Hodgkin’s Lymphoma.
Rachel Collins, Clay County
Image 60
Ashtray used by a 44-year-old female that has smoked since she was a teenager.
Zane Whitaker, Magoffin County
Image 61
A tobacco section in a convenience store. Everyone who checks out here has to walk past the counter and see all the advertising.
Joshua Griffith, Greenup County
Image 62
Coal mining played a massive role in the economic development of the Eastern Kentucky region; however, it has probably also played a role in the elevated cancer rates of the region. Both cancer incidence and mortality rates in communities located near mines are high. This underground mine is located in Van Lear and went out of operation many years ago.
Kaylee Compton, Montgomery County
Image 63
An empty cigarette box and cigarette butts scatter the ground, showing the obstacles present in Appalachia.
Olivia Thornsbury, Pike County
Image 64
Every time the principal at my school catches someone with a vape, she puts it in this fishbowl. I was shocked at the quantity of vapes representing the number of young people hurting their lungs. This habit could really affect them when they get older.
Camari Parker, Elliott County
“I’ve learned a lot about how cancer has affected Appalachia. By being in ACTION, I can go back to my hometown to spread information about how to prevent habits that lead to cancer and help the people in my community.”
- Camari Parker, Elliott County, ACTION Program Participant
Image 65
Easter sunrise with Nana: a look into life on hospice care and what it means to accept your diagnosis with grace.
Katie Anne Brown, Laurel County
Image 66
An appreciation note from my mother while taking care of her during her cancer treatments.
Haleigh Thompson, County
Image 67
Hope Scarf: A scarf passed from woman to woman undergoing chemotherapy as a symbol of strength and a reminder that patients are not alone.
Haleigh Thompson, Lawrence County
Image 68
A tan could turn into skin cancer. Is the tan worth it?
Kelci Blair, Johnson County
Image 69
Start your morning off right with a daily serving of carcinogens.
Lily Kate Hubbs, Knox County
Image 70
An angel that was gifted to my family when my aunt was diagnosed with breast cancer. Embedded on its wing is a quote that highlights the courage those with cancer carry when facing their battle with the disease.
Mackenzie Caldwell, Madison County
Image 71
This knot is called a burl. Burls pull nutrients from the rest of the tree to grow, just as cancerous tumors do. These knots remind me of tumors and are similar to cancers in that they both have the capacity to kill.
Jonathan Ramsey, Pulaski County
Image 72
With cancer comes medication - chemotherapy. An IV is what carries chemotherapy through the body.
Eryka Criswell, Wayne County
Image 73
Cancer is like kudzu: invasive, aggressive, and, if left unchecked, deadly.
Griffin James, Carter County
Image 74
These pill bottles represent the medication and treatment that goes along with cancer.
Isabelle Pace, Leslie County
Image 75
Tobacco hanging to dry in a barn. Tobacco is a leading ingredient in many products that can lead to cancer.
Rachel Henderson, Green County
Image 76
I found these in my grandparents’ basement. They’re a good example of how commonplace tobacco is in Appalachia.
Sophia Beaudoin, Wayne County
Image 77
These were found in a bag of old family recipes. Tobacco and coal advertisements are so second-nature that things were written on them without a second thought.
Sophia Beaudoin, Wayne County
Image 78
Small towns stand strong with their community members battling cancer, and sometimes the person you’re standing with is closer than you think. We wear Pink for Coach Heather.
Tessa Goble, Carter County
Image 79
To see someone smoking is a common occurrence in Clinton County. The stubs of cigarettes are all over parking lots, and there are ashtrays outside of almost every business and restaurant. Smoking caused my late grandfather’s small cell lung cancer after he smoked for almost 40 years. Even though public awareness has somewhat increased, the number of smokers in Clinton County appears to show no sign of stopping.
Tyler Guffey, Clinton County
Image 80
The Kentucky Capitol building in Frankfort is a symbol of the lives and voices of Kentuckians across the state. Unfortunately, cancer disproportionately affects the lives of individuals living in the Appalachian region of our Commonwealth. Could the legislature do more to combat the hardships facing so many in Appalachia?
Kaylee Compton, Montgomery County
Image 81
Vapes that have been collected from my school.
Rachel Henderson, Green County
Image 82
Right in the center of Albany, Kentucky, this store seeks to capitalize off the vaping trend that has swept both my county and the country.
Tyler Guffey, Clinton County
Image 82
Vapor Pit: Ironically named vape shop/lounge, one of many moving into London, KY.
Katie Anne Brown, Laurel County
Image 82
My uncle drives this school bus. He has many stories of students who have overdosed in school from dap pens and other harmful substances.
Hannah Hamric, Elliott County

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Image 83
Cards we made in my high school business class for a little girl diagnosed with cancer at our local elementary school.
Abagail Miller, Carter County
Image 84
A daughter of a local cancer survivor asking for guidance.
Abigail Jordan, Montgomery County
Image 85
Cancer can seem like a roadblock in life; however, with caring hospital facilities and researched treatment, hospitals can unlock the high way to save lives.
Ava Carver, Rowan County
Image 86
This is a stocking my Mimi’s friend made me around her death after battling with Glioblastoma. It has two pockets so I can write my Mimi letters. It is made out of her jeans and flannel, so I always have something of hers with me.
Cambria Bowen, Estill County
Image 87
Color Run 5K supporting a cancer warrior in the community of Louisa, Kentucky.
Chase Kendrick, Lawrence County
Image 88
While working at a daycare with children ranging from 5 to 9 years old, the kids brought the halloween candy they had received from school that day and when I looked to see what they had I discovered one of my students holding the stick candy as if it were a cigarette. This disappointed me because it shows how easily children can be influenced by the public from such a young age, and still being so naive that they do not know how harmful the actual product is.
Delilah Combs, Carter County
Image 89
Our school, East Carter High School, raised money during our powderpuff game and released pink balloons in support of a woman in our community with breast cancer.
Emily Ledford, Carter County
Image 90
Cancer can develop in so many ways, but commonly through genetics. This tree is meant to symbolize blood lines and family roots to remember those who have developed cancer due to their genetics.
Emma Ray, Edmonson County
Image 91
My grandfather, who died from Prostate Cancer at just 56 years of age, was a World War II veteran and loved to fish. Even 50 years after his passing, his tackle box is just the way he left it the last time he went fishing. Cancer steals the lives of those we love.
Lydia Grace McDougal, Letcher County
Image 92
This bridge in Blackey, KY, was damaged after the devastating flood that hit Eastern Kentucky in July 2022. When the Transportation Cabinet deemed the only direct access to the main road unsafe, its closure left the 100 residents of the small city stranded across the river. This signifies the isolation and physical barriers faced by Appalachians that decrease accessibility to things such as food and medical treatment.
Lydia Grace McDougal, Letcher County
Image 93
My grandfather’s mining gear including his boots, pick hammer, work belt held together by electrical tape, hard hat, and light represent the 43 years he spent working underground in the coal mines in Letcher, Harlan, and Leslie counties. The broken down, patched, and dented hard hat represents the dangers faced when working underground in the coal mines. He developed Black Lung Disease from the same coal dust that can still be seen on his gear.
Lydia Grace McDougal, Letcher County
Image 94
My grandmother, who was diagnosed with Stage IV Colon Cancer in July of 2014 passed away 4 short months after her diagnosis in October 2014. She was an avid painter but was unable to finish this homestead painting. Cancer can change lives in an instant and leaves us with little time.
Lydia Grace McDougal, Letcher County
Image 95
Junkyard on HWY 80 in Clay County which is locally operated buys various recyclable metals and materials like aluminum and copper. With ‘junk’ strewn into a localized area, this can make for a hotspot of chemical exposure, air pollution, and water contamination. This could cause various health problems and cancer for the local population.
Haley Griebel, Laurel County
Image 96
In rural areas in London, KY a heat source is often burning wood. Burning wood without proper ventilation can contribute to an increased risk of cancer due to the harmful pollutants released during combustion.
Haley Griebel, Laurel County
Image 97
This photograph was taken of my Mamaw’s flower bed. I can remember going outside to play in her yard and she would tend to her flower bed raising a variety of different flowers. After her passing from lung cancer, we were able to transplant some of the flowers she had cherished to our home flower bed. They are a reminder of who she was every time they bloom.
Jeffrey Brock, Leslie County
Image 98
Cancer creates heartache, fear, anxiety, and distress—however, in an Appalachian community, astounding unity and support are also present. LG was a pillar of the community of Greensburg, Kentucky. The weight of her diagnosis and fight with metastatic breast cancer was taken on by all who surrounded her, which is why the barn shown is proudly branded with her initials and stands as a reminder to all of her legacy. It is a testament to the love and devotion of the community, as her memory is continuously held in the hearts of all who knew her.
Kameron Jackson, Green County
Image 99
Lemons, often associated with resilience, remind us that even in the face of breast cancer, we can find strength and support through community and awareness.
Kasey Burke, Carter County
Image 100
A replica of my papaw’s coal truck that I was gifted after he passed away. I remember driving around with him in his truck, and it is some of my earliest memories. He died of colon cancer and black lung that he got from his career in coal. My family still celebrates his coal career, despite the toll it took on his health.
Kennedy Lamb, Laurel County
Image 101
Cancer patients find comfort and strength in their beliefs through their journey with cancer, and religion is a guide for them to deal with the challenges and sadness. Spiritual comfort and purpose; connection to a community of faith can be very important for patients.
Lincoln Calico, Whitney County
Image 102
Cancer is a journey of constant change. The journey through illness brings a multitude of challenges and learning how to find hope daily is an important part of emotional health and wellness for both cancer patients and their loved ones.
Lincoln Calico, Whitney County
Image 103
Car emissions are a major contributor to air pollution. The more someone’s been around air pollution, the greater their risk for lung cancer will be. Inhaling gas fumes at high levels can cause chemicals like benzene to go into the body, which ultimately causes cancer.
Om Patel, Johnson County
Image 104
This shirt is a reminder of how vital legislation, policies, and funding is when working towards preventing, treating, and potentially curing cancers.
Rebecca Spradlin, Johnson County
Image 105
Cancer strips away so much from patients including personal parts of their identity such as their hair, so it is very important they have resources available like wigs to restore some normalcy.
Rebecca Spradlin, Johnson County
Image 106
Just as Canadian Geese migrate away from the cold to better weather, Kentucky needs to migrate away from cancer and toward a better future.
Sophia Jiang, Breathitt County
Image 107
Found in a Walmart in Hazard, Kentucky, this mural shows what the city is most famous for: coal, otherwise known as 'black gold'.
Sophia Jiang, Breathitt County
Image 108
Childhood is different for everyone. Childhood should be filled with toys, playing, and adventures. However, at 18 months old my sister was diagnosed with Neuroblastoma; her childhood doesn't represent this photo, as she was battling cancer.
Sophie Harless, Martin County
Image 109
Your body is like glass. Some damage is temporary, some is permanent.
Tucker Lawson, Knox County
Image 109
Your body is like glass. Some damage is temporary, some is permanent.
Tucker Lawson, Knox County
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