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THE ideal strategy against any form of cancer is prevention.

 

To complement this, one must be armed with current information, most of which are available on the Internet, for the early detection of the malignancy before it develops into a more serious stage or becomes incurable.

Periodic medical examination for those 20 and older should include exam for cancers of the skin, oral cavity, thyroid, ovaries, testes and lymph nodes, and other tests for non-cancerous illnesses.

The following helpful guidelines were developed by the American Cancer Society for the various common cancers, which can aid the public in the early detection of these cancers.

We are presenting them hereunder:

Breast cancer

1. Annual mammogram starting at age 40 and yearly thereafter.

2. Breast examination by a physician every three years for women in their 20s and 30s, or sooner if concerned, and every year for women who are age 40 and older.

3. Every woman must feel and look at their breast in front of a mirror regularly and be familiar with their breasts, so that when a change or an abnormality in shape, size, color, is noted, she can promptly report it to her healthcare provider. Breast self-exam is an initial option for women in their 20s.

Those women with a family history of breast cancer, a genetic tendency, or other factors, are advised by the American Cancer Society to have screening by MRI on top of a mammogram.

This subset of women is less than 2 percent of all women in the United States.

Colorectal cancer and polyps

The following testing schedules are recommended for both men and women beginning age 50 by the American Cancer Society:

Tests that find polyps and cancer:

• flexible sigmoidoscopy every five years* 

• colonoscopy every 10 years 

• double contrast barium enema every five years* 

• CT colonography (virtual colonoscopy) every five years*

Tests that mainly find cancer:

• fecal occult blood test (FOBT) every year*,**

• fecal immunochemical test (FIT) every year*,**

• stool DNA test (sDNA), interval uncertain*

*Colonoscopy should be done if test results are positive.

**For FOBT or FIT used as a screening test, the take-home multiple sample method should be used.

A FOBT or FIT done during a digital rectal exam in the doctor’s office is not adequate for screening.

Those with any of the following colorectal cancer risk factors (as listed by the American Cancer Society) should confer with their physician about having colorectal cancer screening earlier or having it more often:

• a personal history of colorectal cancer or adenomatous polyps.

• a personal history of chronic inflammatory bowel disease (Crohns disease or ulcerative colitis).

• a strong family history of colorectal cancer or polyps (cancer or polyps in a first-degree relative [parent, sibling, or child] younger than 60 or in two or more first-degree relatives of any age)

• a known family history of hereditary colorectal cancer syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC).

Cervical cancer

All women should begin cervical cancer screening about three years after they begin having vaginal intercourse, but no later than when they are 21 years old.

Screening should be done every year with the regular Pap test or every two years using the newer liquid-based Pap test.

Beginning at age 30, women who have had three normal Pap test results in a row may get screened every two to three years.
 
Another reasonable option for women over 30 is to get screened every three years (but not more frequently) with either the conventional or liquid-based Pap test, plus the HPV DNA test.

Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.

Women 70 years of age or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening.

Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue to have screening as long as they are in good health.

Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or pre-cancer.

Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.

Endometrial (uterine) cancer

The American Cancer Society recommends that at the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer, and strongly encouraged to report any unexpected bleeding or spotting to their doctors.

For women with or at high risk for hereditary non-polyposis colon cancer (HNPCC), annual screening should be offered for endometrial cancer with endometrial biopsy beginning at age 35.

Prostate cancer

The American Cancer Society (ACS) does not support routine testing for prostate cancer at this time.

ACS does believe that health care professionals should discuss the potential benefits and limitations of prostate cancer early detection testing with men before any testing begins.

This discussion should include an offer for testing with the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) yearly, beginning at age 50, to men who are at average risk of prostate cancer and have at least a 10-year life expectancy.

Following this discussion, those men who favor testing should be tested.

Men should actively take part in this decision by learning about prostate cancer and the pros and cons of early detection and treatment of prostate cancer.

This discussion should take place starting at age 45 for men at high risk of developing prostate cancer.

This includes African-American men and men who have a first-degree relative (father, brother or son) diagnosed with prostate cancer at an early age (younger than age 65).

This discussion should take place at age 40 for men at even higher risk (those with several first-degree relatives who had prostate cancer at an early age).

Remember, if cancer “sneaks in” in spite of preventive measures through healthy lifestyle, early detection could lead to a possible cure.

***

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