General Advice On Early Detection:

  1. Many times, the earlier cancer is diagnosed and treated, the better a person’s chances are for full recovery. Cancer in its earliest stages rarely has warning signs, so take the steps that will give you an added edge for early detection:
  2. Get regular checkups by your doctor – Often your doctor can find early cancer during a physical exam or with routine tests, even if you have no symptoms. Ask your doctor about your cancer risk, problems to watch for and a schedule of regular checkups.
  3. Ask to be screened for cancer – Research shows that Pap tests (for cervix cancer), mammograms (for breast cancer) and colon cancer tests save lives.
  4. Do regular self-exams – Examining yourself on a regular basis can help you – Check your skin regularly for new growths; sores that don’t heal; changes in the size, shape or colour of moles; or any other changes on your skin. Report these warning signs to your doctor at once.
  5. Look in a mirror to check the inside of your mouth for changes in the colour of your lips, gums, and tongue or inner cheeks. Also look for scabs, cracks, sores, white patches, swelling or bleeding. Have these symptoms checked by a doctor or dentist.
  6. If you are a man, regularly do a testicular self-exam. Report a lump or other changes, such as heaviness, swelling, and unusual tenderness or pain to your doctor.
  7. If you are a woman, do breast self-examination every month. This will help you learn what looks and feels normal for your breasts and will help you notice any changes. Report anything you feel is not normal to your doctor.

Breast Cancer

Early detection of Breast Cancer

As of current statistics in India, 1 in every 22 women is at a life time risk of developing a breast cancer. When breast cancer is detected early, women have a much greater chance of being treated successfully and for most women the cancer will not come back after treatment. Screening mammograms are currently the best method available for detecting breast cancer early. Mammograms may find a breast cancer which is too small to feel.

What is Screen Mamogram

Mammograms are low dose x-rays of a woman’s breasts. Screening mammograms are performed on women without any symptoms of breast cancer. Women over 50 years of age are advised to have a mammogram every year.

Who should have regular Screening Mammogram?

The biggest risk factors for developing breast cancer are being a woman and getting older. Screening mammograms are often less reliable for younger women. The density of breast tissue in younger women often makes it difficult to detect cancers on mammograms. All women aged 50 and above should have a screening mammogram every year.

When should I do a breast Self examination?

From age 20 on, monthly Breast Self-Examination (BSE) is recommended seven to 10 days after a woman’s period begins. After menopause, BSE should be performed on the first day of the month. BSE only takes a few minutes, costs nothing, and helps find tumors at a smaller size.

What to look out for?

Women of all ages should be familiar with the normal look and feel of their breasts. If you notice any of the following changes please see your doctor immediately:

  • A lump, lumpiness or thickening of the breast.
  • Changes in the skin of a breast, such as puckering, dimpling or a rash.
  • Persistent or unusual breast pain.
  • A change in the shape or size of a breast.
  • Discharge from a nipple, a nipple rash or a change in its shape.

Nine out of every 10 breast lumps are found by women themselves. Although eight out of every ten lumps are NOT cancerous, it is important to seek medical help immediately when a change or lump is detected.

What if I have family history of Breast Cancer?

A woman’s risk for developing breast cancer increases if her mother, sister, or daughter had breast cancer, especially at a young age. Screening should begin early in these cases. Breast self examination should be performed regularly and screen mammography should begin at as early as 35 years of age.

Intestine(Bowel)

Early Detection of Intestine(Bowel) cancer

Bowel cancer, also known as colorectal cancer, occurs in the colon or rectum. Bowel cancer is the third most commonly diagnosed cancer. If bowel cancer is detected early, the chance of successful treatment and long-term survival improves significantly.

What are the Symptoms?

Not all bowel cancers show symptoms, however you should see your doctor if you notice:

  • Bleeding from the back passage or any sign of blood after a bowel motion.
  • A change in usual bowel habit, such as straining (constipation) to go to the toilet or loose motions (diarrhoea).
  • Abdominal pain or bloating.
  • Weight loss for no obvious reason, or loss of appetite.
  • Symptoms of anaemia – including unexplained tiredness, weakness or breathlessness.
  • Experiencing any of the symptoms listed does not necessarily mean you have bowel cancer. Any unusual or persisting symptoms should be reported to your doctor immediately.

Who is at risk?

Everyone is at risk of developing bowel cancer; however the risk greatly increases with age. Some people may be at a greater risk of developing bowel cancer, including those with:

  • A previous history of polyps in the bowel.
  • A previous history of bowel cancer.
  • Chronic inflammatory bowel disease (eg. Crohn’s disease).
  • A strong family history of bowel cancer.

People who are at an increased risk of developing bowel cancer should discuss possible surveillance options with their doctor.

How is bowel cancer detected?

Bowel cancer can be detected using a variety of methods.

Faecal Occult Blood Test (FOBT) or commonly called Stool test is a simple screening test that looks for hidden traces of blood in a bowel motion in people without symptoms. It can help detect bowel cancer in its early stages. People should have an FOBT every two years from age 50 years. If stool test finds blood other further diagnostic tests are needed.

Colonoscopy is a test that involves a long, thin, flexible tube with a video camera lens on the end, enabling a specialist to look at the inside of your bowel. If a polyp or bowel cancer is found, it can be removed during the procedure. Colonoscopy is usually performed under sedation as a day procedure. Colonoscopies are also used as a surveillance test for people at increased risk of developing bowel cancer.

Sigmoidoscopy is similar to colonoscopy, however only explores the lower part of the bowel, where cancer is more likely to develop. If a precancerous polyp is detected during the procedure a full bowel examination by colonoscopy is usually needed.

What else Can I do?

Bowel cancer is one of the most preventable cancers. Many lifestyle risk factors may contribute to bowel cancer. Your most effective protection against bowel cancer is to:

  • Be screened for bowel cancer every two years if over 50 years of age.
  • Get 30 to 60 minutes of moderate to vigorous intensity exercise per day.
  • Maintain a healthy body weight.
  • Eat a well balanced diet.
  • Avoid processed and burnt meat. Limit red meat intake to three to four times per week.
  • Avoid or limit your alcohol intake.
  • Quit smoking.

Ovarian Cancer

Early Detection of Ovary cancer

Each year many women are diagnosed with ovarian cancer. The main risk factor for ovarian cancer is getting older, with over 80 per cent of women diagnosed when they are over 50 years of age, and the average age at diagnosis 64 years of age. Ovarian cancer can be difficult to diagnose at an early stage, largely because symptoms can be vague and similar to those of other common illnesses.

Is there a screening test for Ovarian cancer?

Currently there are no tests effective enough for a population based screening program for ovarian cancer. In addition, there is no evidence to suggest that screening will reduce the number of deaths from ovarian cancer.

What about the blood test CA125?

The blood test CA125 can be used to help diagnose or exclude ovarian cancer. CA125 is a protein found in the blood and can be produced by ovarian cancer cells. However, there are other causes for raised CA125 levels such as menstruation, endometriosis or ovarian cysts.

The CA125 test is more reliable in post menopausal women. Half of all women with early stage ovarian cancer do not have elevated CA125 levels. It is for these reasons CA125 is not recommended as a screening test for women with no symptoms.

For those women with symptoms, the CA125 test alone cannot be used to investigate their symptoms. Transvaginal ultrasound should be used in conjunction with the CA125 test to diagnose ovarian cancer.

What if I have family history of Ovarian cancer?

Having a genetic family history of ovarian cancer is an important risk factor in developing the disease. A family history of breast cancer and/or bowel cancer is also a risk factor. However, only 5 to 10 per cent of all ovarian cancers are associated with a family history. The risk of developing ovarian cancer increases with the number of affected first degree relatives (parents, siblings, children).

What are the symptoms should I look out for?

Symptoms that may indicate ovarian cancer are vague and may include one or more of the following:

  • Abdominal bloating or a feeling of fullness.
  • Loss of appetite.
  • Unexplained weight gain.
  • Constipation.
  • Heartburn.
  • Back, abdominal or pelvic pain.
  • Frequent urination.
  • Fatigue.
  • Indigestion.
  • Pain during sexual intercourse.

These symptoms are often related to more common, less serious health problems and most women will have these symptoms at some time. However, if you notice any unusual changes or these symptoms persist, visit your doctor. Remember, if you have any concerns or questions, please contact your doctor

Cervical cancer

What is Cervical cancer?

The cervix is the lower part of the uterus (womb). It is sometimes called the uterine cervix. The body of the uterus (the upper part) is where a foetus grows. The cervix connects the body of the uterus to the vagina (birth canal). Most cervical cancers begin in the cells lining the cervix. These cells do not suddenly change into cancer. Instead, the normal cells of the cervix gradually develop pre-cancerous changes that turn into cancer. The change from pre-cancer to cancer usually takes several years.

Importance of Cervical cancer screening.

The goal of screening for cervical cancer is to find cervix cell changes and early cervical cancers before they cause symptoms. Screening tests offer the best chance to detect cervical cancer at an early stage when successful treatment is likely.

Cancer of the cervix may be prevented or detected early by regular Pap tests. If it is detected early, cervical cancer is one of the most successfully treatable cancers.

What are the risk factors for Cervical cancer?

The most important risk factor for cervical cancer is infection by the human papilloma virus (HPV). The Pap test looks for changes in cervical cells caused by HPV infection.

You can prevent most pre-cancers of the cervix by avoiding exposure to HPV. In women, HPV infections occur mainly at younger ages and are less common in women older than 30. The reason for this is not clear. Certain types of sexual behaviour increase a woman’s risk of getting HPV infection, such as:

  • Having sex at an early age
  • Having many sexual partners
  • Having a partner who has had many sex partners
  • Having sex with uncircumcised males

I have heard about some vaccines, what are they?

Vaccines have been developed that can protect women from HPV infections. So far, a vaccine that protects against HPV types 6, 11, 16 and 18 (Gardasil®) and one that protects against types 16 and 18 (Cervarix®) have been studied. Both vaccines require a series of 3 injections over a 6-month period. Side effects are usually mild. The most common one is short-term redness, swelling, and soreness at the injection site.

In clinical trials, both vaccines prevented pre-cancers and cancers of the cervix caused by HPV types 16 and 18. Both vaccines only work to prevent HPV infection — they will not treat an infection that is already there. That is why, to be most effective, the HPV vaccine should be given before a person starts having sex.

The American Cancer Society guidelines also recommend that the vaccine be routinely given to girls ages 11 to 12 and as early as age 9 at the discretion of doctors. The Society also agrees that “catch-up” vaccinations should be given to females up to age 18. The independent panel making the Society recommendations found that there was not yet enough proof that catch-up vaccinations for all women aged 19 to 26 years would be beneficial. As a result, the American Cancer Society recommends that women aged 19 to 26 talk with their health care provider about their risk of previous HPV exposure and potential benefit from vaccination before deciding to get the vaccine. These vaccines have been tested in older women, and do seem to be effective in producing an immune reaction to the HPV types in the vaccine and also reduce cervical cancers and pre-cancers in those vaccinated.

It is important to realize that the vaccine doesn’t protect against all cancer-causing types of HPV, so routine Pap tests are still necessary. One other benefit of the vaccine is that it protects against the 2 viruses that cause 90% of genital warts.

Who should get screened?

The American Cancer Society recommends the following guidelines for early detection:

All women should begin cervical cancer testing (screening) about 3 years after they start having sex (vaginal intercourse). A woman who waits until she is over 18 to have sex should start screening no later than age 21. A regular Pap test should be done every year. If a liquid-based Pap test is used instead, women should be tested every 2 years.

Beginning at age 30, many women who have had 3 normal Pap test results in a row may be tested less often – every 2 to 3 years. Either the conventional (regular) Pap test or the liquid-based Pap test can be used.

Women who have certain risk factors should continue getting tested yearly. This includes women exposed to diethylstilbestrol (DES) before birth, those with a history of treatment for a pre-cancer, and those with a weakened immune system (from HIV infection, organ transplant, chemotherapy, or chronic steroid use).

Women who have had a total hysterectomy (removal of the uterus and cervix) may choose to stop having cervical cancer testing, unless the hysterectomy was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix (called a supra-cervical hysterectomy) need to continue cervical cancer screening. They should continue to follow the guidelines above.

Women 70 years of age or older who have had 3 or more normal Pap test results in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer testing. Women with a history of cervical cancer, DES exposure before birth, HIV infection, or a weakened immune system should continue to have testing as long as they are in good health.

Some women believe that they can stop having Pap tests once they have stopped having children. This is not correct.