CANCER SCREENING… taking control of our health to ensure our future-self’s wellbeing.

What is meant by cancer screening and why should one screen for cancer?

Cancer is a genetic disease caused by changes in the genes that control the way cells grow and multiply. While some genetic changes that cause cancers can be inherited, most mutations happen during a person’s lifetime. It is true that some people may have a higher risk for developing certain types of cancers due to their genes, however, there are many things that you can do to reduce the risk of developing cancer, such as maintaining a healthy lifestyle, avoiding tobacco, and excessive alcohol consumption and getting regular cancer screenings.

Cancer screening refers to tests used to detect cancer in individuals who do not have any symptoms. It aims to detect cancer at an early stage when it is most treatable and potentially curable.

Screening tests may include physical exams, blood tests, imaging tests, or genetic tests. One should screen for cancer because early detection of cancer increases the chances of successful treatment and survival. Screening can help detect cancer before symptoms appear, making it easier to treat and potentially saving lives. However, it is important to note that not all cancers can be detected through screening, and some screening tests may have risks or lead to false-positive results, which require further testing and evaluation. It is essential to consult with a healthcare professional to determine if cancer screening is appropriate for an individual’s age, gender, and medical history.

What are some modifiable risk factors for the development of cancers?

There are several modifiable risk factors that can increase the risk of developing cancer,
including:

1. Tobacco use – smoking cigarettes, cigars, or pipes can increase the risk of lung, throat, and other types of cancer.
2. Poor diet – eating a diet high in processed and red meat, fried foods, and low in fruits and vegetables can increase the risk of several types of cancer.
3. Lack of physical activity – leading a sedentary lifestyle can increase the risk of certain types of cancer, such as colon and breast cancer.
4. Excessive alcohol consumption – drinking alcohol in excess can increase the risk of cancers of the liver, colon, and breast.
5. Exposure to harmful chemicals – prolonged exposure to certain chemicals, such as asbestos, can increase the risk of developing certain types of cancer.
6. Using HRT >2yrs for breast cancer risk.

It’s important to note that while these risk factors can increase the likelihood of developing cancer, they do not guarantee that an individual will develop cancer.

What are blood tumour markers and which cancers have predictive value?

Blood tumor markers are substances produced by cancer cells or normal cells in response to the presence of cancer. These markers can be detected in blood tests and may be used to monitor the progression of cancer or to detect the recurrence of cancer after treatment. There are many different types of tumor markers, and their predictive value varies depending on the type of cancer. Some examples of cancers that have predictive tumor markers include: – PSA for Prostate cancer, CEA for Colon cancer, CA125 for Ovarian cancer, CA199 for Upper GI cancers, CA153 for Breast cancer, etc.

What are predictable screening tools to assist in diagnosing early cancers?

There are several screening tools that can help in diagnosing early cancers. Some of the most common ones include:

1. Mammograms: A mammogram is an X-ray of the breast tissue that can help detect early signs of breast cancer.
2. Pap smears: A pap smear is a test that can help detect early signs of cervical cancer by looking for abnormal cells in the cervix.
3. Colonoscopies: A colonoscopy is an exam of the large intestine that can help detect early signs of colon cancer. Colonoscopic screening is recommended every 4-5years, unless concerning symptoms arise.
4. Prostate-specific antigen (PSA) test: A PSA test is a blood test that can help detect early signs of prostate cancer.
5. Skin exams: A skin exam can help detect early signs of skin cancer, such as abnormal moles or lesions.

It’s important to note that not all screening tools are appropriate for every person or every type of cancer. Your doctor can help you determine which screening tools are right for you based on your age, sex, medical history, and other factors.

Explain the importance of screening for cancers and in particular, what are the recommendations for Breast Cancer screening in South Africa?

Screening for cancers is important because it allows for the early detection and treatment of cancer, which can improve outcomes and increase the chances of survival. Breast cancer screening is important because breast cancer is one of the most common types of cancer in women worldwide.

Breast cancer screening typically involves a mammogram, which is a low-dose X-ray of the breast tissue. This can detect changes in the breast tissue that may indicate the presence of cancer before a lump is clinically palpable, or other symptoms develop. Early detection of breast cancer allows for more treatment options and a better chance of successful treatment.

It is generally recommended that women between the ages of 50 and 74 undergo mammography screening every two years. Women with a family history of breast cancer or other risk factors may be advised to start screening at an earlier age or to have more frequent screening.

Overall, breast cancer screening is an important tool for the early detection and treatment of breast cancer, which can ultimately improve outcomes and increase the chances of survival.

How do we manage cancers and what are some of the options available?

Cancers are managed in a multi-disciplinary manner which includes potentially surgery, chemotherapy, targeted therapies, radiation therapies, immune-therapies and other trial therapies including viral therapies, vaccine therapies.
The decision is usually made in a multi-disciplinary team manner.

What are the benefits of having a multi-disciplinary team for the management of cancers and in particular breast cancer?

A multi-disciplinary team (MDT) is a group of healthcare professionals who work together to provide coordinated and comprehensive care for patients with cancer. The MDT for breast cancer typically includes a surgeon, medical oncologist, radiation oncologist, pathologist, radiologist, and breast care nurse. Some of the benefits of having a MDT for the management of cancers, and in particular breast cancer, are:

1. Improved patient outcomes: A MDT approach ensures that patients receive the most appropriate and effective treatment plan tailored to their individual needs. This can lead to better outcomes, including higher survival rates and improved quality of life.
2. Holistic care: A MDT approach takes into account the physical, psychological, and social needs of the patient. This results in more holistic care, where the patient receives support not only for their physical symptoms but also for their emotional well-being.
3. Faster diagnosis and treatment: A MDT approach can lead to faster diagnosis and treatment, as all the necessary healthcare professionals are involved in the patient’s care from the outset.
4. Reduced treatment-related side effects: A MDT approach can help to minimize treatment- related side effects, as the team can work together to develop a treatment plan that balances the benefits and risks of each treatment option.
5. Cost-effective care: A MDT approach can lead to cost-effective care, as the team can work together to ensure that the patient receives the most appropriate and effective treatment without unnecessary or duplicative tests and procedures.

In summary, a MDT approach for the management of breast cancer provides a comprehensive, coordinated, and patient-centered approach to care, resulting in improved outcomes and quality of life for patients.

Are we winning the fight against cancer and in particular breast cancers?

There has been significant progress in cancer research and treatment in recent years, leading to improved survival rates for many types of cancer including breast cancer. However, there is still much work to be done and cancer remains a major global health challenge.

It is important to continue supporting cancer research and prevention efforts. In terms of breast cancer specifically, early detection through regular screening and advances in treatment options have led to improved outcomes for many patients.

However, there are still disparities in access to care and outcomes for certain populations, and ongoing research is needed to identify new treatment options and better understand the biology of the disease.

Screen today, for a better tomorrow.
Dr Pramod Reddy
Director of the Surgical Screening Clinic and the Durban Breast Clinic, based at Busamed Gateway Private Hospital.
Dr Reddy is a Specialist Surgeon with a special interest in Cancer Screening and in particular, the surgical management of Breast Cancers.