Early detection is still the best cure for cancer
Early detection is vital in the battle against cancer because the earlier you identify the disease, the greater your chance of survival, says PPS Insurance executive Dr Dominique Stott.
Marking World Cancer Day 2011on Friday, the World Health Organisation said cancer was a leading cause of death.
The WHO estimates that 84 million people will die of cancer between 2005 and 2015 without intervention. The organisation also says that more than 30 percent of cancer deaths can be prevented.
Defining cancer, the WHO says: “Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumours and neoplasms.
“One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs. This process is referred to as metastasis. Metastases are the major cause of death from cancer.”
Stott says international statistics show that mortality rates for cancer patients have improved dramatically over the past 50 years. The five-year survival rate (the chances of surviving for five years after being diagnosed) for breast cancer has increased from 60 percent half a century ago to 91 percent today.
The same survival rate for prostate cancer has risen from 43 percent to 99.9 percent, and for malignant melanoma of the skin – the most dangerous form of skin cancer – the five-year survival rate has risen from 49 percent to 92.9 percent.
Stott says that the main cause of these better survival rates is an improvement in the means of early detection and the much better forms of treatment available for these cancers.
But, she says, there is still a huge need to educate people about the benefits of screening tests, such as medical exams, blood tests and other tests like colonoscopies and XR and CT scans.
Medical practitioners screening for cancer will usually look to a patient’s risk profile, Stott says.
“The risk profile of the patient includes age, sex, family and genetic history, smoking status, alcohol intake and risky behaviour patterns, such as excessive sun exposure.
“By combining these various factors, a medical practitioner will put together appropriate tests for that patient,” says Stott.
She advises the following for patients who do not have a family history of cancer or a known genetic abnormality:
l Women over the age of 50 should have an annual mammogram and clinical examination. If there is a family history of breast or ovarian cancer, this test should start at an earlier age, on the advice of the doctor. Breast cancer is the second highest cause of cancer deaths among women in South Africa.
l Men over 50 should have a Prostate Specific Antigen blood test with a digital examination. Prostate cancer is the third highest cause of cancer deaths among men in South Africa.
l Both sexes over the age of 50 must have a colonoscopy every five years. If there has been a family history this should be more frequent and should start at an earlier age. Bowel cancer is the sixth leading cause of cancer deaths in South Africa for both sexes.
l Women aged 25 to 60 should have annual pap smear tests, because cervical cancer is the leading cause of cancer deaths among women in South Africa.
l Both sexes should annually have a skin examination for skin cancer, especially if they have had excessive exposure to sun in their childhood. The incidence of malignant melanoma in South Africa is increasing, says Stott, largely because of increased sun exposure.
l People who have a high risk of cancer (two or more first degree relatives – parent or siblings who have had cancer), people who have had cancer in the past or those who have genetic changes which are linked to cancer should be checked more often.
Graham Anderson, the principal officer at Profmed Medical Scheme, says these tests should always be conducted only on the advice of the doctor. False results may lead to unnecessary anxiety, or lack of early detection of cancer.
He says there is no single blood test which is the gold standard as yet for diagnosing cancer.
“What these blood tests (tumour markers) can do is indicate that there may be an abnormality present and further testing such as invasive biopsies are required.”
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