Q: I am 42 years old and after seeing all these media reports about cancer, I am worried about my health. I do not have any medical conditions but I am a little overweight. There is no one in the family with cancer but my best friend recently died from colon cancer. Her doctor said that she waited for too long before going to hospital and by the time they diagnosed her with cancer, it had spread to her liver and lungs. It was painful watching her suffer and I would not want to go through the same thing. I am thinking of going for screening for all cancers in India but my doctor has discouraged me. He tells me that it is a waste of my money. I, however, do not want to be a cancer victim. What would you suggest?
First, I am glad that you have a high level of self-awareness and want to take control of your health.
Although there are genuine concerns about cancer due to your experience dealing with your friend, you need to be more holistic in your approach to your health.
It is not just cancer
Most health conditions are diagnosed in middle age. This includes diabetes, high blood pressure, hormonal imbalance and thinning of bones.
All these diseases can be devastating if diagnosed late. For this reason, as you assess your cancer risk, ensure that your doctor assesses you for other issues that may arise at this stage in your life.
How to go about it
You have a right to seek healthcare anywhere in the world, however, if you are looking for cancer screening, these services are available locally.
Ideally, your doctor should be able to perform the necessary physical examination and tests to screen for cancer.
What your doctor needs to know
Family history: Most cancers have a familial predisposition — in other words, you may find more than one person in a family with a particular type of cancer.
It is, therefore, very important that you find out if any of your immediate and extended family have cancer.
Social habits: Be honest about your alcoholic intake, use of cigarettes and illicit drugs.
Contraceptive use: Tell your doctor about any contraceptives you may be using or have used in the past.
Weight changes: Inform your doctor about any unplanned weight loss or gain you may have noted.
Unexplained sweats and fever: If you are experiencing unusual sweating episodes and fever, be sure to inform your doctor
• Headaches that do not respond to painkillers
• Blurred vision or changes in speech, hearing, smell or taste.
• Weakness or loss of sensation in a particular limb.
• Chest pain or coughing up blood.
• Persistent abdominal pain.
• Blood in urine.
• Abnormal bleeding after intercourse or between periods.
• Painful intercourse
• Abdominal distension
• Yellowness of the eyes
• Lump in the breast or in any other part of the body.
• Swollen nodes (lumps) in the neck, armpit, groin or around the collar bone.
• Redness or dimpling of the skin overlying the breast.
• Changes in the appearance of the nipple.
• Changes in the appearance of a mole on the skin.
• Mouth ulcers that do not heal Changes in the voice (hoarseness).
• Difficulty breathing.
• Persistent unexplained back pain.
• Change in stool habits (especially if you have constipation alternating with diarrhoea).
• Heartburn that does not respond to antacids.
• Unexplained weight loss
There is no substitute for a good physical examination
The doctor can detect clues related to cancers during a physical exam. The information you give him/her when combined with a thorough check up should help them determine what tests need to be done and which ones need to be omitted.
What tests need to be done?
The tests that need to be done will be tailored to your individual profile.
Mammogram: At 42 years of age, you should get a mammogram done. This will help assess for any internal abnormalities in your breasts.
Pap smear: This will check for any problems in your cervix (opening of the womb).
The rest of the tests will be chosen based on your family history and the symptoms you present with to the doctor.
For example, if you have persistent heartburn, your doctor may ask for endoscopy to be done to look at your stomach or if you have a strong family history of colon cancer, your doctor may ask you to have a colonoscopy done.
Whole body scan
We currently do not recommend ‘whole body scans’ for screening for cancer.
They are often unnecessary and the dosage of radiation given does not justify their usage for screening.
The other question you must ask yourself before demanding for a whole body scan, is ‘should it be negative now (no cancer found), will you have to repeat it every year to see if a cancer has developed somewhere?’
‘What are the short term and long term complications of regularly exposing yourself to radiation?’
Truth is, the risks of consistent radiation outweigh the benefits. You cannot use whole body scans for cancer screening.