Know your own body
View(s):This is the best way to be alert to any sudden changes that could indicate the beginnings of some cancer, says Consultant Oncologist Dr. Prasad Abeysinghe, who warns against over-testing
By Smriti Daniel
A burgeoning cancer will sometimes leave traces of its presence in your body – dramatic changes in your weight or how your bowel functions, a streak on your nail or jaundice in your eyes and skin – but in some cases it’s a test or a doctor’s examination that will reveal its presence. This week Dr. Prasad Abeysinghe, a Consultant Oncologist at the Maharagama Cancer Hospital, explains the pros and cons of testing for some of the most commonly occurring cancers in Sri Lankan men and women.
Pap Smear
A baby develops in the hollow, pear-shaped organ known as the uterus. At the lower end of the uterus, is the cervix which in turn extends into the vagina. A doctor can test for cervical cancer using a simple procedure known as a pap smear. A pap smear is when cells are scraped from the opening of the cervix and then examined in a lab for traces of irregularities.
The aim of the test is to identify pre-cancerous changes (called cervical intraepithelial neoplasia (CIN) or cervical dysplasia), which are usually caused by sexually transmitted human papillomaviruses. Most cervical cancers can be detected early if a woman has routine pap smears, says Dr. Abeysinghe explaining that women, especially at the age of 35, should undergo this test. Depending on the results, your doctor will tell you how often you should return. Women do not need a prescription and can request a pap smear be taken at any well woman clinic or hospital.
Breast Examination:
Every woman should be aware of her breasts, says Dr. Abeysinghe, explaining that a woman herself is most likely to notice changes in their shape and weight as well as asymmetries that could hint at the presence of cancer. Once you know what your breasts normally look and feel like, you’re more likely to spot a change and report it to your doctor. Breast lumps can be benign (non-cancerous) or malignant (cancerous). They can occur at any age, though they most often develop in women over 50 years of age.
Women should set aside a day every month on which they thoroughly examine their breasts. (Choose a day at least a week after your periods to ensure the breast tissue is not swollen or tender.) Dr. Abeysinghe says he’s often surprised by how long women wait before they bring any abnormalities to the attention of a doctor. Delaying seeking medical advice could put your health seriously at risk. While he recommends you do these monthly examinations at home, it is advisable to have a medical professional also examine you.
Examination of the mouth, throat and lungs:
Oral cancer is one of the most commonly occurring cancers in men, while men and women both are struck by oesophageal cancer. Dr. Abeysinghe recommends that you ask your dentist or even your GP to examine your mouth and throat for any irregularities. This includes lumps, patches of red or white, ulcers that don’t heal or any other abnormalities in the lining of the mouth. “We have found that we can detect early mouth cancers by just clinical examination,” says Dr. Abeysinghe. Other red flags are when patients have trouble opening their mouth or sticking their tongue out. If the doctor notices anything suspic-ious he will recommend a biopsy.
Eating and swallowing
In the case of oesophageal cancer, Dr. Abeysinghe says an early warning sign can be difficulty eating and swallowing. As with other symptoms, any that last more than 2 weeks should be brought to the attention of a doctor. A change in voice or a loss of weight are more advanced symptoms but patients who develop oesophageal cancer are most likely to first notice that they have trouble consuming dry food, and that soon this is the case with both solid and semi-solid food.
Prostate problems
Left unchecked, prostate cancer doesn’t always kill but when treated patients can suffer from a range of lower body related problems, including issues related to bowel function and sexual activity. Deciding whether to treat a case of prostate cancer or not can be tricky and over diagnosis is a real issue. “They were treating most of them, and now we have realised that we don’t really have to treat all these cancers,” says Dr. Abeysinghe, explaining “quality of life goes down for nothing.”
In the end the best advice he can offer is to be aware of your own body and to pay attention and to track any worrying symptoms that may develop. Wounds that don’t heal, abnormal bleeding, a worrying cough, inexplicable weight loss should all be brought to the attention of your doctor. If you feel you are more at risk because of you and your family’s medical history or because of your exposure to carcinogens, Dr. Abeysinghe encourages you to speak with your oncologist or surgeon or even your family doctor.
The dangers of testing
More tests aren’t always a solution. Sometimes, such as in the case of lung cancer, the cancer progresses so quickly between one test and the next that it is already untreatable.
“The outcome has not really changed,” says Dr. Abeysinghe, “despite exhaustive screening methods, the mortality rates have not come down.”
Sometimes the test itself may involve exposure to ionizing radiation as in the case of Computed tomography or CT scans and to a lesser degree X-Rays. These can damage DNA in cells, causing mutations that, ironically, can trigger cancer. A study published last year in the medical journal Lancet revealed a significant link between CT scans in children and their subsequent risk of developing brain tumours or leukaemia.
“Unless the symptoms are really suggestive, we don’t recommend a scan,” says Dr. Abeysinghe, adding, “any test that uses radiation is a double-edged sword. Its risk goes up when the dose goes up but any amount is a risk. We have to weigh the benefits against the risks. No testing is entirely harmless.”
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