Face your fear: early di­ag­no­sis of can­cer

The Malta Independent on Sunday - - DEBATE & ANALYSIS -

Can­cer in­ci­dence is in­creas­ing in the de­vel­op­ing world, mainly due to the in­crease in life ex­pectancy but also due to in­creased ur­ban­i­sa­tion and the adop­tion of cer­tain life­styles that can in­crease the risk of can­cer. More than 90 per cent of women di­ag­nosed with breast can­cer at an early stage sur­vive the dis­ease for at least five years com­pared to about 15 per cent of those di­ag­nosed with the most ad­vanced stage of the dis­ease ( Can­cer Re­search UK).

There are sev­eral pos­si­ble rea­sons that lead to a late di­ag­no­sis of can­cer. The most com­mon cause is the low aware­ness of signs of the dis­ease by the in­di­vid­ual, mean­ing that they do not ap­proach their health­care providers as soon as they have the first sus­pi­cious symp­toms, thus de­lay­ing di­ag­no­sis. Ad­di­tion­ally, some peo­ple are too wor­ried to ap­proach their doc­tor with cer­tain symp­toms be­cause of what the doc­tor might find and di­ag­nose them with.

There are two ma­jor groups of ac­tiv­i­ties that can play an im­por­tant role in in­creas­ing the early de­tec­tion of can­cer. These are mainly ed­u­ca­tion to pro­mote the early di­ag­no­sis and re­fer­ral for sus­pi­cious symp­toms and signs of can­cer and screen­ing for asymp­to­matic (before any no­tice­able symp­toms ap­pear) signs of can­cer. En- courag­ing in­di­vid­u­als to learn about how to recog­nise the pos­si­ble warn­ing signs of can­cer is the first im­por­tant step lead­ing to an early di­ag­no­sis. The in­di­vid­ual should be made aware of pos­si­ble warn­ing signs, for ex­am­ple: lumps, ab­nor­mal bleed­ing, sores that fail to heal and chronic hoarse­ness. Early di­ag­no­sis of can­cer has a ma­jor im­pact on sev­eral can­cers, in­clud­ing can­cers of the breast, mouth, cervix, colon and rec­tum, lung, lar­ynx and skin. One im­por­tant re­source is the Euro­pean Code against Can­cer, which can be ac­cessed at https://can­cer-codeeu­rope.iarc.fr/in­dex.php/en/

Adult women of all ages are en­cour­aged to per­form breast self-ex­am­i­na­tion in the com­fort of their own home. Forty per cent of di­ag­nosed breast can­cers are de­tected by women who ap­proach their health­care provider af­ter feel­ing or notic­ing some­thing dif­fer­ent in their breasts (John Hop­kins Breast Cen­tre). While mam­mo­grams can help de­tect breast can­cer before one can feel a lump, do­ing reg­u­lar breast self-ex­ams can help the in­di­vid­ual to be fa­mil­iar with how their breasts look and feel and no­tice if there are any changes. How­ever, ed­u­ca­tion by it­self is not enough when it comes to the early di­ag­no­sis of can­cer and in­di­vid­u­als should al­ways ac­cept in­vi­ta­tions that are sent to them to par­tic­i­pate in or­gan­ised can­cer screen­ing pro­grammes.

Screen­ing for can­cer takes place when sim­ple tests are per­formed on healthy in­di­vid­u­als to search for any pos­si­ble signs of early stages of can­cer even before (of­ten long before) there are any demon­stra­ble symp­toms. There are two dis­tinct types of screen­ing meth­ods: or­gan­ised pop­u­la­tion-based screen­ing pro­grammes and op­por­tunis­tic case-find­ing tests. The lat­ter usu­ally hap­pen when an in­di­vid­ual goes to see her or his health­care provider for rea­sons that may be un­re­lated to the dis­ease and a can­cer-screen­ing test is of­fered. On the other hand, or­gan­ised pop­u­la­tion­based can­cer screen­ing pro­grammes in­vite mem­bers within set pop­u­la­tion age and gen­der groups to at­tend screen­ing tests on a reg­u­lar time ba­sis.

Or­gan­ised pop­u­la­tion-based can­cer screen­ing pro­grammes for breast can­cer have been shown to be ef­fec­tive in re­duc­ing the in­ci­dence or im­prov­ing the prog­no­sis of three com­mon can­cers: namely cer­vi­cal, breast and colon. In Malta, the na­tional screen­ing pro­gramme for breast can­cer was in­tro­duced in 2009 and is presently invit­ing women from the ages of 50 to 67 years to at­tend for screen­ing mam­mog­ra­phy every 2-3 years.

Let us all keep an open mind, make sure we know our bod­ies well and ac­cept screen­ing in­vi­ta­tions. Face your Fear is the slo­gan of this year’s Pink Oc­to­ber Cam­paign. We are stronger than fear. Let’s tackle can­cer to­gether be­cause to­gether we can beat can­cer.

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