Screening For Cancer

By Tom Roebuck

December 4, 2009 5 min read

Researchers continue to work on finding exactly what causes cancer, but we know that genetics and lifestyle are major factors. We can't control the genes that our parents pass down to us, but we can control how we live. The choices we make regarding smoking, what we eat and our commitment to exercise can make a difference. Talking to your doctor about scheduling regular cancer screenings is another vital step to take to stay cancer-free.

"Even though we can't get away from the hereditary ones, we can control our risk for cancer about 65 to 70 percent of the time just by making proper lifestyle choices, and that includes proper screening," says Dr. William Hicks, a cancer specialist at the Arthur G. James Cancer Hospital, located on the campus of The Ohio State University.

Cancer screening consists of three categories: self-examinations, which individuals can perform on themselves; examinations by primary physicians, which take family history into account; and diagnostic tests, which are performed at certain ages.

Breast and testicular cancers can be detected by self-examinations, which are done by exploring with your hands, looking for lumps or anything else that wasn't there before. If something is found during a self-examination, a visit to the doctor should be scheduled right away to have it checked out. Skin cancer also can be detected at home. Any skin lesions that change size, color or shape are cause for concern and should be checked, according to Hicks. Enlarged lymph nodes that won't go away also may indicate cancer. They are located throughout the body, including the neck, underarm and groin areas.

Just because something unusual is found during a self-examination doesn't mean that cancer is the culprit. A primary care physician should be consulted first to determine the next step.

Breast cancer is one of the most common cancers, and it is also one of the easiest to detect. People of all ages (especially women) are encouraged to check their breasts periodically and take notice of any changes, and mammograms should be done each year for women 40 or older. If a family's history includes relatives that have developed breast cancer before they turned 40, earlier mammograms should be considered, Hicks says. Most high-end radiology centers have digital mammograms that have higher resolution, providing clearer pictures of breast tissue.

But debate continues on what age a woman should consider a mammogram. In mid-November, the U.S. Preventive Services Task Force recommended that women put off mammograms until they are 50 and wait two years between screenings. However, the American Cancer Society still advises that women older than 40 get annual mammograms.

Once a person turns 50, a colonoscopy is recommended. The experience is far from pleasant, but it gives a doctor a clear view of a colon's condition and whether any polyps are present.

"There is certainly a relationship between polyps and cancer," Hicks says. "We're blessed, in a way, in that we get this period of being able to diagnose a precursor, a polyp, and if you can remove the polyp, then you can remove the risk of the polyp developing into a cancer."

A Hemoccult test checks stool samples for traces of blood, which could indicate colon cancer. But Hicks warns that it is no substitute for a colonoscopy, because a blood-positive reading can be attributed to several things besides cancer.

Hicks says that one of the biggest mistakes people make is not seeing a doctor as soon as they notice symptoms. Men who notice any problems urinating should bring it up with their doctors as soon as possible.

"Many patients with prostate cancer will have symptoms, but some will not. But if you do have a lot of urgency and frequency and a lot of urinating at night, that needs to be evaluated," Hicks says. "Many times, it will not be prostate cancer, but it's one of those things that require evaluation."

People with a high risk for lung cancer, mainly smokers and those with family histories of it, should talk with their medical providers to determine whether they should undergo CT scans, which are effective in detecting lung cancer but carry a high price tag.

"For those (high-risk) groups, there may be some benefit of doing regular CT scans of the chest," Hicks says. "But for the whole population, there is no effective way of screening, because the cost-effectiveness would be just terrible. It would just be too much."

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