Cancer Screening Guidelines and Why They Are So Important.
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Following cancer screening guidelines is incredibly important.
A few months ago, my 89-year-old grandmother was pretty sick and was admitted to the hospital. During a series of tests, they found a “mass” on her colon. She refused any further testing. The doctors were sure that the “mass” was Colon Cancer. And he suggested that her children and her grandchildren should all be checked.
One Bad Decision
My mother (who should have had one years ago) had never had a colonoscopy before. She thought the procedure was disgusting and she didn’t want to do it.
So, she didn’t do it. And, according to our local hospital, 1 in 3 people react the same way and don’t get the screening.
In her defense, we had our hands full helping my dad battle cancer for 21 months. And then coping with his decision to stop treatment and begin Hospice.
Being in a caregiving situation can make it difficult to find time to take care of yourself.
It’s easier to push things off and say “I’ll do it later.” But later never comes.
So, we go in for her scheduled colonoscopy (now several years late).
And when she is finished with the test, they tell us “they found something, and the doctor will be in to talk to us.”
Waiting For The Results
We spend the first of many agonizing hours waiting for the doctor. When he finally comes out of surgery, he states that “there is a large polyp in the area and it was too big to remove. They took a biopsy and are awaiting the results and we will need to schedule an appointment with a surgeon to have this removed.”
We left the doctor that day pretty terrified.
I just lost my dad to this horrific disease. I seriously can’t even deal with the idea of losing my mom too.
The panic and anxiety that creeps in while you are waiting for results, the next steps, and 2nd opinions is so incredibly intense. And when you’ve already been through this, your panic skyrockets.
It’s Cancer
The results came back and of course, it’s cancer. So they need to do CT scans to see if it’s spread.
More stressful and intense waiting for appointments, for results, for the plan to deal with this. This place was quick, so we had the results in a few days, but a few days in a state of panic (when you feel like you are in a pressure cooker) can feel like DECADES.
The CT scans are good, with no spread showing, although 2 little spots on the liver (where we’ve now been told Colon Cancer likes to spread) would need further evaluation.
The trauma continues. We’ve already been through, “2 little spots”… ☹
We had contacted Memorial Sloan Kettering as soon as this was identified as cancer. They fit us into an appointment at the end of that same week.
That day they also did an MRI of the “2 little spots” and they were not cancer! No spreading. (And yet another reminder that we shouldn’t panic until there is actually something to panic about.)
What Happens Now
Right now, we are scheduled for surgery and they are going to remove a large piece of her colon and some surrounding lymph nodes. Once the polyp is removed, they will seal the two ends of her colon back together.
The worst part is, if she had done the colonoscopy at age 50, they could have probably removed this polyp when it was a “blip” during the colonoscopy, and we would have never dealt with it again.
If you ask my mom today how bad the colonoscopy was she will tell you it was no big deal and she should have gotten the first time it was recommended instead of ending up in this position.
Thank God (and any of our family up there who may have pulled some strings for us) we are in a position to overcome this. It won’t be a cakewalk, but we’ll do whatever we have to do and take steps forward from here.
Cancer screenings, no matter how uncomfortable save lives! But, you have to actually do the test to get the lifesaving stuff!
Recommended Cancer Screening Guidelines
All of the guidelines below are taken directly from Memorial Sloan Kettering Cancer Center. We have approximately 3 years of experience with Memorial Sloan Kettering with 4 different cancer diagnosis’s and we trust them implicitly.
The following recommendations have come directly from the MSKCC website.
Unless specified, these screening recommendations are based on an average risk or no known risk. If you have a family history talk to your doctor.
Note: You should discuss ANY family history of cancer with your primary care doctor as soon as possible. Family history can be a huge factor in cancer prevention.
MSK Guidelines For Breast Cancer
- Women between the ages of 25 and 40 should have an annual clinical breast examination.
- Women 40 and older should have an annual mammogram in addition to an annual clinical breast examination.
- Ultrasound may be recommended for women with dense breast tissue.
- All women should consider performing a monthly self breast exam beginning at age 20 and become familiar with their breasts so they are better able to notice changes.
“Studies have shown that regular annual mammography screening of women with no symptoms of breast cancer has lowered the number of women who die from the disease by about 30 percent.”
MSK Cancer Screening Guidelines For Cervical Cancer
Ages 21 to 29
Pap tests every three years.
Ages 30 to 65
Pap test alone every three years or an HPV test along with a Pap test every five years.
Over 65
No screening necessary if previous screening guidelines have been followed and the woman is not at a high risk for cervical cancer.
MSK Guidelines For Colorectal Cancer
For people with an average risk who have no symptoms, MSKs doctors recommend screening tests for colon cancer every ten years, starting at age 50.
People at a higher risk may benefit from earlier, more frequent screenings.
At MSK, a colonoscopy is the preferred screening method. This procedure both finds and removes small clumps of cells on the inner lining of the colon. These are called polyps, and they can grow into cancer.
“Our experts can usually cure colon cancer if they find it early enough. But the more that colon cancer grows, the more difficult it can be to treat.”
“Today, more than 60 percent of people age 50 to 75 are regularly screened for the disease. Doctors are detecting colon cancer more often and at an earlier stage, when it’s most treatable. In fact, 90 percent of people with colon cancer live five years or more after treatment if the cancer is found and removed at any early stage.”
Head and Neck Cancer
“The term “head and neck cancer” encompasses a wide range of tumors that occur in several areas of the head and neck region, including the nasal passages, sinuses, mouth, throat, larynx (voice box), swallowing passages, salivary glands, and the thyroid gland. The two major known risk factors for head and neck cancer are exposure to tobacco and heavy use of alcohol.
Currently, there are no screening methods that have been proven to increase survival rates for HNSCC. A screening physical examination of the neck, oropharynx (the middle section of the throat that includes the soft palate, the base of the tongue, and the tonsils), and the mouth has been widely adopted as part of a routine dental examination. However, there is no evidence that this intervention reduces mortality from oral cancer. It is likely that in the coming decades this routine screening will allow earlier identification of oral cancer, when it is in a less advanced form, but this has yet to be proven in clinical studies.
At Memorial Sloan Kettering Cancer Center, we offer yearly free head and neck screenings in the spring to anyone in the community. These screenings provide an opportunity to educate interested patients on awareness of oral cancer and its risk factors.
MSK Head and Neck Guidelines
Our doctors advise that all individuals have a yearly physical examination of the head and neck and oropharynx (the middle section of the throat that includes the soft palate, the base of the tongue, and the tonsils) conducted by their primary care physician, as well as a yearly routine dental evaluation to include examination of the neck and inspection of the oropharynx and the mouth.
MSK Guidelines For Lung Cancer
Our doctors recommend lung cancer screening for people based on their age and the number of years they’ve smoked.
People between the ages of 55 and 80 with no history of cancer or who have been cancer free for five years* and who have smoked at least one pack of cigarettes per day for 30 years (a marker referred to as 30 pack years) should be screened with low-dose helical CT of the chest.
Such individuals should have low-dose CT of the chest once a year for a total of three years.
MSK Guidelines For Ovarian Cancer
“Ovarian cancer is the fifth most common cancer in women and the most common cause of gynecologic cancer deaths. In 2008, about 22,000 women will be diagnosed with ovarian cancer, with approximately 15,500 women dying from the disease. Approximately one in 70 women will develop ovarian cancer in her lifetime.”
Women with a risk near that of the general population (relative risk less than three times greater than that of the general public)
- Ovarian cancer screening is not recommended. An annual gynecologic examination with pelvic examination is recommended for preventive healthcare.
Women with increased risk (relative risk of three to six times greater than that of the general public)
- There is no clear evidence to suggest that ovarian cancer screening with currently available methods will result in a decrease in the number of deaths from ovarian cancer. If, after careful consideration of risks and benefits, ovarian cancer screening with serum markers such as CA-125 and/or transvaginal ultrasound is to be pursued, it is recommended that such screening be done within the framework of research studies to evaluate the efficacy of this approach.
Genetic counseling may also be helpful for women in this group to better clarify the risk of ovarian and related cancers.
Women with inherited risk (relative risk more than six times greater than that of the general public)
- While it is not clear that ovarian cancer screening will result in a decrease in the number of deaths in women at inherited risk, those who have mutations in ovarian cancer susceptibility genes should undergo ovarian cancer screening using a combination of transvaginal ultrasound and CA-125 testing. For women with mutations in BRCA1or the mismatch repair genes, MLH1, MSH2, and MSH6, this screening should generally begin between ages 30 and 35. For women with mutations in BRCA2, ovarian cancer screening should be initiated between ages 35 and 40.
MSK Guidelines For Prostate Cancer
There is clear evidence that screening with a prostate-specific antigen (PSA) test can reduce the number of deaths from prostate cancer. However, prostate cancer is often so slow-growing that it would not cause a man any problems during the course of his life. For that reason, many men do not benefit from treatment for prostate cancer and may unnecessarily suffer from its side effects, such as long-term problems with urinary and sexual function.
The Memorial Sloan Kettering prostate cancer disease management team recommends that men interested in the early detection of prostate cancer be informed of their risk and be advised to consider screening according to the guidelines below.
Our experts created these screening guidelines to reflect a careful balance of the benefits — reduced cancer deaths — versus the harm that may result from unnecessary treatment of men whose cancers would not threaten their health or survival.
The guidelines are based on the following principles:
- Many men with prostate cancer can be followed by active surveillance. A diagnosis of prostate cancer is the information used to help make decisions, not an indication for immediate treatment.
- Compliance with screening will increase if men are told whether they are at high, intermediate, or low risk and are informed about their need for subsequent screening.
- There is a balance between the harms and benefits of screening. By focusing screening on men at the highest risk for life-threatening prostate cancer, we can better achieve this balance.
Screening should begin at age 45.
Guidelines For Skin Cancer
“Each year more than a million people in the United States are diagnosed with the most common forms of skin cancer — basal cell carcinoma and squamous cell carcinoma — which together are known as non-melanoma skin cancers. Fortunately, there are ways to detect most non-melanoma skin cancers early, when they are curable.”
Skin Cancer Screening Studies
“For people without a history of skin cancer in their families, no studies have been done to test the effectiveness of routine screening for melanoma. Periodic skin examinations are the key to diagnosing skin cancer at its earliest stage, when it is most easily cured. Most cases of basal cell carcinoma and squamous cell carcinoma first appear as changes in the skin, which, once noticed by the patient or primary care doctor, are then verified as skin cancer by a dermatologist after a skin examination and biopsy have been performed. Since basal cell and squamous cell carcinomas are almost always cured without specified screening, no studies have shown that such screening will improve the already high cure rates for those types of skin cancer.
Family history is a risk factor for melanoma. In addition, there is strong evidence that the risk of melanoma increases for individuals who have atypical moles or many common moles. (Atypical moles, also known as dysplastic nevi, have irregular borders, vary in color, or are asymmetrical, meaning if you cut the mole in half, the two halves would not look the same.) Other melanoma risk factors include previous melanoma or non-melanoma skin cancers, skin that burns readily and fails to tan, freckling, blue eyes, red hair, and a history of blistering sunburns. To date, there is no evidence to show that screening individuals with any of these risk factors will reduce the number of melanoma deaths.”
MSK Skin Cancer Guidelines
Our doctors do not recommend routine skin cancer screening. We do recommend lifelong dermatologic surveillance for patients with a personal history of melanoma. In addition, we recommend that individuals identified during routine care who meet any of the following criteria be considered for skin cancer risk assessment by a dermatologist:
- A family history of melanoma in two or more blood relatives
- The presence of multiple atypical moles
- The presence of numerous actinic keratoses (precancerous lesions that are grey to pink colored scaly patches of skin on sun-exposed areas of the body)
You can find a complete listing of cancer screening guidelines from MSK here…
At the end of the day, we are incredibly lucky to be able to tell this story. None of the cancer screening guidelines can save you if you don’t get them done.
Talk to your doctor today so you can schedule any screenings you need now.
P.S.
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