No one has suddenly discovered a cure for cancer, though you might not know that given how much the topic has been in the news this year. Between changing screening recommendations and talk of a “moonshot” approach to a cure, what’s your average person to think about cancer these days?

                Easy Ways You Can Beat Cancer

                Let’s start with some good news and advice. Some of the most deadly and common cancers in the United States – and the world – are cancers we can actually do something about easily.                

                For example, the deadliest and second most common cancer everywhere is lung/bronchus cancer. Tobacco kills and there’s no two ways about it. Don’t use tobacco and the chances that you will end up with these cancers are almost none.

                But those cancers are not the only ones tobacco causes. It’s been proven more recently that tobacco also contributes to colon, liver, kidney, bladder, stomach, pancreatic, cervical and rectal cancers, as well as acute myeloid leukemia. Throw in the fact that tobacco is the leading cause of cardiovascular disease, which is the leading cause of death worldwide, and know that it’s a death wish to ever start the habit or not try to quit.

                That’s also why so many individuals, companies and communities are working on limiting access and exposure to the stuff through tobacco taxes, smoke-free policies, higher insurance rates, etc. And while many tobacco users (a minority of the population) like to claim its use is a matter of freedom, most people don’t usually think of ingesting poisons and other carcinogenics as “being free.” That’s why there are laws and regulations protecting people from other known toxins and why people don’t play in traffic. Sure, one is free to do so, but it’s not generally considered a good idea.

                The freedom argument is weakened further by the fact that non-smokers can get cancer from secondhand smoke, which takes away their choice or right to breathe non-poisonous air. And as tobacco users cost everyone more money in terms of higher monthly health insurance premiums and taxes (for example, direct smoking expenditures cost Louisiana families $1,207 each year), a smoker’s “freedom” is often very expensive for everyone else.

                Fortunately, a slew of other cancers don’t have addictive components with which to contend or big corporate backers. These are cancers that can be prevented or caught early. For example, the most common cancer of all is skin and there’s a really easy way to prevent that: protect yourself (and children!) from the sun. It’s that simple.

                And then there are cancers that can be prevented and/or caught early through regular screenings. These include breast, prostate, colon and cervical, which, again, are some of the most common and deadly cancers people get. That’s why it’s vitally important that people know what those regular screening intervals are.

                When Should I Get Screened?

                Ah, there’s the rub, you’re thinking. Haven’t health experts been changing up a bunch of those recommendations? They have and, as bothersome as that is to both the public and the health experts who have to convey that information, the fact is that when it comes to diseases and other scientific advancements, knowledge often comes in incremental bites and sometimes advice changes.

                Prostate Cancer: What Men Need To Consider

                Take for example, prostate cancer. Other than skin cancer, it’s the most common cancer in men. One in seven men will be diagnosed with prostate cancer at some point during their lifetime, while one in 38 will die from it. So when prostate-specific antigen, or PSA, screening tests came along in 1987, men were understandably counseled to get one.

                The problem, however, is that prostate cancer screening has had almost no effect in lowering prostate cancer death rates. And that’s because most prostate cancers consist of extremely slow-growing, nonlethal tumors, which never cause harm. Add to that the fact that prostate cancer treatment can often leave men impotent and incontinent, and you’ve got a case where “the cure is worse than the disease.” So the United States Preventative Services Task Force (USPSTF), which is charged with providing evidence-based recommendations on clinical preventive services, gave the PSA test a “D” rating and advised health providers not to recommend it.

                However, that is not to say men need not do anything. The Centers for Disease Control and Prevention (CDC), the American Cancer Society and other health organizations recommend that men learn about prostate cancer and then speak to their doctor to make an informed decision as to what they should do when it comes to screening. Factors such as age (the older a man, the greater the risk), family history (a father, brother or son with the disease means a two-to-three times higher risk) and race (African American men have higher incidence rates) should be considered before undergoing testing.  And if a localized cancer is detected, “active surveillance” or “watchful waiting” is emerging as a way of dealing with it. In that process, the cancer is monitored via PSA and digital rectal exams on an ongoing basis and if it worsens, only then treatment is undertaken.

                Breast Cancer: When Women Should Mammogram

                Then we come to women’s cancer screenings. When the USPSTF changed its breast screening recommendations recently, there was a lot of uproar. In dealing with average-risk women (no family history), the USPSTF recommended that women ages 50 to 74 get mammograms every two years, which was a change from the former annual recommendation. More controversially, the USPSTF recommended that average-risk women, ages 40 to 49, make the mammogram decision on an individual basis, stating that potential harms, such as false-positives and treatment for non-threatening cancers, increases in this age group, but does not substantially lower the death rate. 

                That’s a bit in contrast with the American Cancer Society, which says that average-risk women ages 40 to 44, should decide on an individual basis; recommends that women ages 45 to 54 get a mammogram every year; and women age 55 and older should get one every two years.

                Either way, the takeaway message here is that women need to get screened on a regular basis, either annually or biannually, perhaps starting at age 45 and definitely by age 50, as the risk of breast cancer increases in one’s later 40s and through the 50s. Fortunately, under the Affordable Care Act or “Obamacare,” breast cancer screening is covered (some grandfathered plans may not), so a woman can often choose with her doctor as to what age and how often she can get a mammogram.

                Cervical Cancer: Pap Tests How Often for Women?

                Cervical cancer screening recommendations have changed too. The days of the annual Pap test are gone, except for high-risk women, and though there are some slight variations in screenings recommendations from various expert health organizations, here is what everyone basically agrees on: Average-risk women ages 21-65 should get a Pap test every three years. Women ages 30-65 should get a Pap test every three years or co-testing with HPV every five years.

                And, of course, since the HPV vaccine prevents almost all cervical cancer, all girls age 11-26 should get the vaccine. Boys, age 11-21, need to get the vaccine too as it prevents a number of cancers that also affect them.

                Colon Cancer: It Affects Everyone

                This one is simple. Average-risk people, age 50 and over, need be screened regularly for colorectal cancer. The good news is that there are a variety of ways to do that, including simple, at-home options and that health insurance now covers those preventive screenings. So talk to your doctor and get screened!

                In the end, people should remember there are three easy ways to beat some of our worst cancers: 1) Don’t use tobacco; 2) Get regular screenings; and 3) Cover you and your children up in the sun.

 

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AuthorJoseph Gautier