Life-saving screening

DID you know that most people whose medical conditions, including cancer, when detected early, and treated then, would survive?

Next to the best strategy, which is prevention, early diagnosis of any condition offers the best chances for either a cure or reduction in the morbidity (complications) and mortality (death).

This is the rationale for the popular recommendation and push for medical screening tests, for women, and many of them also applicable to men.

Hypertension

With age, hypertension (high blood pressure) goes up in prevalence. Those with excess weight and or diabetes, and those who consume a lot of sodium (salt and salty food items) are prone to develop hypertension, especially those with a strong family history of high blood pressure. Hypertension increases the risk for heart disease and stroke. Preventing this with a diet of controlled-salt, low-fat, low-cholesterol, high fiber (fish, vegetable, nuts and some fruits), together with daily physical exercises of at least 30 minutes a day, will lower the risk for cardiovascular and kidney diseases by at least 80 percent. It is best to have a baseline blood pressure data as early as age 20, and checked every couple of months or so.

Cholesterol

It is prudent for people as young as 30, or younger for those with family history of hypercholesterolemia or cardiovascular diseases, to have a baseline Lipid Profile (cholesterol and its components and triglycerides level), for future reference, and at least every five years thereafter. Desired values are: Total Cholesterol – 170 mg/dL;  LDL (bad cholesterol) – less than 100 mg/dL; HDL (good cholesterol) – 60 mg/dL or higher; Triglycerides – less than 150 mg/dL. Depending on the family history, the individual’s past cholesterol level and health condition, the Lipid profile may be done more frequently as prescribed by the physician, even yearly, or every three to five years.

Diabetes

Screening for diabetes could be as simple as a needle stick using a glucometer at home or a needle stick to draw blood specimen for testing the fasting (no food after midnight) blood glucose (sugar) level. As easy as that, the information gathered could provide peace of mind and prevent a subtle pre-diabetic condition from growing into a full-blown Type 2 diabetes mellitus. A pre-diabetic will have a blood glucose level of 100-125, and any level higher than that, on repeated testing, could mean diabetes.

Cancer of the skin

Basal cell and squamous cell skin cancers are common cutaneous malignancy. Skin cancers are caused by repeated and prolonged exposure of the sun, direct or indirect (reflexion of the rays from sand, water, etc). The most dangerous is melanoma, which is partly hereditary, but much enhanced by sun exposure. All of these skin cancers can be cured by early detection. Prevention is still the best strategy against skin cancers.

Breast cancer

Women in their 20s and 30s should have breast examination every one to three years when they go for any medical check-up. Those with family history of breast cancer should have it done more often. The earlier breast cancers are diagnosed, the better the survival rate is. There are hundreds of thousand women whose breast malignancy has been cured simply because the cancer was detected early.

Cancer of the cervix

Pap smears of the cervix (mouth of the womb) should be done at least once every three years, starting about three years after the woman begin to have sexual intercourse, but not later than age 21. For those 65 to 70, who had at least 3 normal pap smears in the last 10 years, pap smear may no longer be needed if the OB-Gyne so suggests. Pap smears detect abnormal cells on the cervix, which could be surgically excised before they become cancer. The virus that causes cancer of the cervix is the HPV (Human Papiloma virus, transmitted through sexually intercourse. Gardasil and Cevarix are two vaccines that can protect women under age 26 (and even those in their teens) from several strains of HPV cancer-causing virus.

Osteoporosis

Osteoporosis is a condition that causes thinning and weakening of the bones, making them fragile and easily fractured. Following female and male menopause, the bone mass is reduced because of the hormonal changes. Half of the fractures in women and 25 percent of the fractures in men age 50 and older are due to osteoporosis, following even minor fall or a quick twist of the body or extremity. Dual energy X-ray absorptiometry (DXA) can measure bone mass and strength and detect osteoporosis before fractures happen. This screening is recommended for those 65 and older.

Colorectal cancer

Cancer of the rectum and colon are the second most common cause of cancer deaths, the first being lung cancer. Tiny balloon-like polys, with a slender stalk  attached to the inner walls of the colon (large intestine) could grow larger and turn into cancer. Many of them are benign polyp but it is hard to tell by looking at them. Screening colonoscopy should first be done at age 50, and every 5 to 10 years thereafter,

except for those with a family history of colorectal cancer, in whose case, they could be done even at age 20 or younger. The decision to excise the polyp for

microscopic examination rests on the attending

gastroenterologist, who will take all the patient’s

history and other factors into consideration.

Glaucoma

This eye condition, which is a build-up of pressure inside the eye, could be treacherous and subtle. My daughter, Emily C. Greenlee, MD, Clinical Assistant  Professor in Ophthalmology and Glaucoma expert  in the University of Iowa Hospitals and Clinic, emphasizes that “glaucoma usually produces no symptoms until the vision is damaged, and without treatment, glaucoma destroys the optic nerve and causes blindness.” The risk factors are race (African-American or Hispanic), age over 60, history of injury to the eye or steroid use, and family history of glaucoma. These individuals should be checked without delay. Those others, at age 40, should have a routine eye exam, to include test for glaucoma.

Prostate cancer

There is about 15.9 percent lifetime risk for the

development of prostate cancer and about 2.8 percent of dying from the disease. It is rare before age 50 and very few die of prostate cancer before age 60. Most are slow-growing and have good prognosis but a few are the aggressive form. Most deaths are after age 75. Screening includes digital rectal exam, PSA blood test and possibly ultrasound testing. This strategy is widely followed but is currently being re-evaluated.

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