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Cancer - Testing and Screening by Dr Helen Webberley


One of the scariest outcomes for patients is to be told that they have cancer. Dr. Helen Webberley talks through cancer screening and diagnosis.

Helen Marsden

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One of the scariest outcomes for my patients is to be told that they have cancer. The big C just seems to be the worst thing. I see a lot of chronic illness and the difficulties that my patients bravely struggle through, yet still it is ‘cancer’ that seems to frighten us the most.

Maybe it is the uncertainty; we all have plans for our future, both for ourselves and our families, and we have all seen the devastation that a sudden illness can have on our dreams for our remaining time ahead. What lies just around the corner? Who knows? Who can tell?

It still surprises me when my patients eventually summon up the courage to tell me their symptoms - "You’ve had that lump for five months and you haven’t told me?" "You’ve been passing blood for six months and you haven’t told me?" "You’ve been coughing for four months and haven’t had it checked out?"

And then of course there is the young chap with a cough for two weeks who is so relieved when I reassure him that cancer is extremely unlikely.

So some want to know straight away and some are too scared to face the possibility. As doctors we know that the earlier we find cancer, the better chance there is of good treatment and a potential cure. Often the best outcome by far is for us to find cancers even before they have caused the lump or the blood or the cough. With mammograms, we are looking for tiny calcified spots on an x-ray that wouldn’t be palpable as a lump. With smear tests we are looking for very early cell changes that indicate cancer might develop in the future. With the FOB blood in the stool test, we are looking for tiny amounts of blood in the stool which may not be evident in the toilet pan.

There are many tests for early cancer currently available, and more are being developed all the time. Due to health economics, not all of these tests are routinely available on the NHS as screening tests for all of us. This may be because the tests haven’t been fully evaluated, or that they are not completely accurate and may cause more worry than reassurance. Sometimes it is because the NHS can’t afford to follow up on all early positive results. The NHS budget is not unlimited, even though we sometimes wish it was.

Medichecks offer a wide range of cancer tests. Some are blood tests which might indicate the presence of early cancer. Some are stool tests which look for bowel cancer. Some are genetic tests which can look for genes which make us more likely to develop cancer in the future.

No test is absolutely guaranteed to say whether you definitely have cancer or will get cancer, and no test can promise that you don’t have cancer and never will. But they can give us reassurance and they can help pick up cancers that we might not know were there and before they grow too big to manage.

For example, there is a blood test that we use for prostate cancer (PSA). A normal result does not mean that there is definitely no prostate cancer there, but it is very reassuring. A high level does not say for certain that there is cancer there, but it does tell us to get that prostate gland checked out with scans and maybe a biopsy.

Similarly, with the genetic screening tests - carrying the breast cancer gene does not definitely mean you will get breast cancer, but it does greatly increase the chances, and it might be worth discussing the options available to you. Similarly, not having the gene does not mean you won’t ever get breast cancer.

Some people like an annual cancer check up to set their mind at rest or reassure themselves that any cancers may be detected early. Other people may have had cancer in the past and want a more regular check on the blood test for their cancer than the NHS budget allows.

Cancer is all too common, but early detection and diagnosis can improve treatment and outcome.

If you would like more information about screening tests or blood tests for cancer then please contact us.

Dr Helen Webberley, MBChB MRCGP

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