Category Archives: Cancer Screening Tests

Prostate Cancer Screening: The Scientific View

By Otis W. Brawley, MD, FACP

Actor Ben Stiller revealed Tuesday that he had been diagnosed with prostate cancer two years ago and he discussed his experience in an article published on Medium.  Stiller’s prostate cancer story is not unusual. There are countless instances where men with no symptoms, no known family history, no other risk factors, undergo screening for prostate cancer, who have prostate cancer detected, treated, and are left better off. And it would be hard to convince these men that screening did not save their lives.

But we now know that the majority of men with prostate cancer will not die of their disease, whether they receive aggressive treatment, are watched carefully, or even if it was never diagnosed.

The harsh truth is that even under the best conditions, with careful screening, some men will still die of prostate cancer.

This is why no major health group recommends all men be screened. The PSA test can be useful, but it is not perfect, not by a longshot.

Mr. Stiller admits he is “not offering a scientific point of view here, just a personal one…” So what is the scientific point of view? Twelve professional organizations in the United States and Europe have looked at the scientific data.… Continue reading →

What keeps people from lifesaving colon cancer testing?

By Richard Wender, MD

We have made amazing progress in reducing colon cancer death rates. This progress is a direct result of increasing screening for colon cancer and pre-cancerous polyps. We are actually preventing thousands of cancers by finding and removing pre-cancerous polyps. The nation has embraced the goal of increasing national screening rates to 80% by the end of 2018 – an achievement that will substantially reduce the terrible toll that colon cancer exacts every year.  Everyone is at risk for colon cancer, whether or not someone in your family has ever had a colon polyp or colon cancer. For that reason, everyone has to start being screened for colon cancer at age 50, and people with inflammatory bowel disease or a family history of colon cancer or polyps have to start before they reach age 50. Colon cancer screening is one of the best opportunities to prevent cancer that we’ve ever discovered.

Despite this compelling reason to be screened, many people either have never had a colon cancer screening test or are not up-to-date with screening. Interestingly, nearly all of these unscreened people know that they should be screened, In fact, awareness about colon cancer screening recommendations approaches 100%.… Continue reading →

Are lung cancer breath tests more than hot air?

By Ted Gansler, MD, MBA, MPH

Can breath tests (like those used to check whether drivers have been drinking alcohol) be used for lung cancer screening? Or, is this (pardon the pun) just a lot of “hot air?” Although breath tests for lung cancer are “not ready for prime time,” there has been some encouraging research.

There are 3 main ways to fight cancer – prevention, screening, and treatment. Although lung cancer remains the leading cause of death from cancer worldwide and in the United States, researchers are making progress against this disease on all 3 fronts. 

Over nearly a half century, researchers tried several tests for lung cancer screening, none of which were accurate enough for widespread use. Because of research results released in 2010, the American Cancer Society and several other organizations now recommend that people at high risk for lung cancer (certain groups of current and former smokers) ask their doctor about CT scans for lung cancer screening.

On average, people in these high risk groups who have this test every year according to the ACS guidelines can reduce their risk of dying from lung cancer by about 20%. This can save a lot of lives and prevent a lot of suffering, so if you are a current or former smoker, you should read more about our lung cancer screening recommendations.… Continue reading →

Mom, Dad, Let’s Talk about Colon Cancer

By Durado Brooks, MD

 

How often do you think a family conversation about cancer occurs? The truth is, not nearly often enough.

Colorectal cancer (often called simply “colon cancer”) is cancer that develops in the colon or the rectum, and it’s the third most common cancer in the U.S.  While most people diagnosed with colon cancer do not have a family history the disease, people who have this cancer in their family have a significantly higher chance of being diagnosed.  The good news is that colon cancer is one of the most preventable cancers, and this prevention can work even for people who are at high risk of the disease. [more]

Colon cancer is preventable because it usually starts as a non-cancerous growth called a polyp.  Not all polyps will progress to cancer, but for those that do the transformation usually takes a number of years.  Cancer can be prevented by finding and removing these polyps with colon cancer screening tests during this transition period.   

People who have a history of colon cancer or polyps in a close family member (parent, sibling, or child) may have twice the risk of developing the disease compared to those with no family history.  This is especially true if cancer appears in the relative before age 60.  If there are multiple family members with colon cancer, the risk may be even higher. 

Polyp detection and removal is best accomplished by regular screening – recommended to start at age 50 for people at average risk for developing colon cancer.  However, screening recommendations may be quite different for those with an affected relative.… Continue reading →

The Prostate Cancer Quandary

EDITOR’S NOTE: This blog was originally published on June 29. Due to recent questions on this topic, it’s been reposted. News reports say the United States Preventive Services Task Force will next week release new recommendations saying that healthy men should no longer receive a PSA blood test to screen for prostate cancer. Reports say the USPSTF will say the test does not save lives and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence. Otis W. Brawley, M.D., chief medical officer of the American Cancer Society, says the Society cannot comment on the evidence review or on the recommendations until they are made public.

By Otis W. Brawley, MD, FACP

 

 

Prostate cancer is a major public health problem.   The American Cancer Society estimates that 240,890 American men will be diagnosed with prostate cancer in 2011 and 33.720 will die of it.  It is the second leading cause of cancer death among men, only surpassed by lung cancer. 

 

Prostate cancer screening became common in the U.S. in the early 1990s and dramatically changed the demographic of cancer in the U.S. Prostate cancer quickly became the most commonly diagnosed non-skin cancer.  Today an American male has a lifetime risk of prostate cancer diagnosis of about 1 in 6 and a lifetime risk of dying of only 1 in 36.… Continue reading →

Get Past the Yuck to Help Save Lives

By Durado Brooks, MD

Has your doctor ever talked to you about collecting part of your bowel movement to be examined (referred to as a “stool test”)?  If you’re anything like the patients I’ve treated, you recoiled in shock and horror!  The idea just sounds disgusting, doesn’t it?  Without getting too technical, stool tests have what we doctors call a high YUCK factor. (No, it’s not an acronym; it’s what patients say when we ask them to do the test: “Are you kidding, doc?  Yuck!”) 

But stool tests are one of the tried and true approaches to finding colorectal (colon) cancer early and saving lives.  There are a number of different tests for colon cancer that are recommended by the American Cancer Society and other organizations, including colonoscopy, flexible sigmoidoscopy, and CT colonography (a special type of x-ray test, sometimes called “virtual colonoscopy”).  But the fact is, out of all the tests that are recommended for colon cancer screening, stool tests actually have the strongest evidence that they save lives – a fact that most patients (and many doctors) don’t appreciate.  [more]


How the FOBT Works

There are different types of stool tests, but the ones that have been around for the longest time and have the best scientific evidence work by finding microscopic amounts of blood in the stool.  These tests are known as Fecal (another word for “stool”) Occult Blood (which means “hidden blood”) Tests, commonly abbreviated as FOBTs

|As you may know, most colon cancer starts as a non-cancerous growth called a polyp.  Not all polyps will progress to cancer, but for those that do, the transformation usually takes a number of years.  Many cancers (and some polyps) bleed, but the amount of bleeding in most cases is small, and when mixed with the stool becomes invisible to the naked eye.  To check for this blood, patients must collect a small sample from one or more bowel movements (depending on the brand of test used).  This sample is then sent or taken to a lab or to the doctor’s office where it is exposed to a chemical reaction that indicates whether blood is present. 


What Happens After the FOBT

When blood is found in a stool sample it is referred to as a “positive FOBT.”  Fortunately, most patients with a positive FOBT do not have cancer.… Continue reading →

Ovarian Cancer: Do Screening Tests Work?

By Debbie Saslow, PhD

For years, patients, doctors, and researchers have been trying to find a way to catch ovarian cancer early, when it’s most treatable. For women, the chance of getting ovarian cancer is about 1 in 70.  In most cases, the cancer is found at an advanced stage and survival is, sadly, quite low.

Most women get tested regularly for breast cancer and cervical cancer, and hopefully colorectal (colon) cancer. Why aren’t they checked for ovarian cancer, too?  Unfortunately we don’t have tests like mammograms or Pap tests for the ovaries. Doctors often do a pelvic exam, which includes checking the ovaries, but this exam rarely finds ovarian tumors unless they have grown very large.

Some other tests, like the CA-125 blood test and transvaginal ultrasound, have been studied to see if they can be used to test for ovarian cancer, but none have proven to be accurate enough to consistently find cancer. [more]

The CA-125 test measures a protein that can be found in the blood of many women with ovarian cancer. However, other conditions, including but not limited to normal ovulation, endometriosis, pelvic inflammatory disease, can also raise CA-125 levels in the blood, and some women with ovarian cancer may still have normal CA-125 levels.… Continue reading →

The HPV vaccine: 3 shots of prevention

By Debbie Saslow, PhD

Many people ask me about whether or not their daughters should get the human papillomavirus (HPV) vaccine, which can help prevent cervical cancer. As with all new vaccines, there has been some controversy. Some parents have been reluctant to get their daughters vaccinated before they are sexually active, yet this is precisely when the vaccine will be most effective. Others were concerned about safety; the HPV vaccines are extremely safe, based on tens of millions of doses distributed worldwide. There was also an initial push, generated by the manufacturer, to require HPV vaccination for middle school enrollment. To date only Virginia and Washington, D.C., have such a requirement.

To answer the question of whether to vaccinate, it helps to have some background:

In the United States, an estimated 12,200 cases of invasive cervical cancer were expected to be diagnosed in 2010, with an estimated 4,210 deaths. But there have been fewer deaths over the past several decades due to cancer screening tests. That’s great news. But we can reduce the number of people even getting cervical cancer by doing what  we know works. [more]

Virtually all cervical cancers are caused by HPV. There are more than 100 types of HPV, of which a few dozen can infect the genital tract and about 15 can cause cancer of the cervix.… Continue reading →

Is Cancer Screening Going to the Dogs?

By Ted Gansler, MD, MBA

There’s been a lot of news lately about cancer-sniffing dogs after a new study by Japanese researcher Hideto Sonoda and his colleagues was published in the medical journal Gut. So we couldn’t help but wonder, is that possible?

 

If you haven’t heard about it, the recent study suggests that specially-trained dogs can identify the scent of volatile chemicals (those that evaporate into the air at room temperature) present in colon cancer. [more]

 

In the study, a Labrador sniffed breath samples and stool samples from patients who were known to have colon cancer, which had been identified by colonoscopy and biopsy. The dog correctly recognized cancer-related scents in 91% of the breath samples and 97% of the stool samples. And amazingly, when the dog was allowed to sniff breath and stool samples from patients who didn’t have colon cancer, the dog incorrectly “diagnosed” only 1% as malignant. This study adds to a small number of other published articles showing similar results for bladder, lung, and breast cancers, and to a recent conference presentation regarding prostate cancer.

 

In addition to these experimental studies, there have been several anecdotal reports of patients whose pet dogs seemed attracted to or upset by skin and breast cancers.… Continue reading →

Never Tested for Colon Cancer? What’s YOUR Excuse?

By Durado Brooks, MD, MPH

Embarrassing!  Painful!  Disgusting!!

 

These are some of the words that come to mind for lots of folks when they think about getting tested for colorectal cancer. Let’s face it – this involves a part of the body and bodily functions that people don’t talk about in polite conversation. Hopefully I can convince you that they (and you) need to get past this attitude and get on with testing.

Cancers of the colon and the rectum (the last sections of the digestive system) are extremely common.  In fact, they’re the third most common cancer in US men and women. The good news is the rates of this disease have been falling steadily over the past 20 years, and a big part of the decrease is directly related to testing for colorectal cancer.  You see, not only can testing help find the disease early, when it’s highly treatable, but testing can actually help to prevent the disease! That’s because most colorectal cancers start as a small, non-cancerous growth called a polyp. Finding and removing these polyps stops cancer before it starts. 

[more]

You’d think that with these proven benefits people would be lining up to get tested – yet 4 out of every 10 adults who should get tested are missing out on this possibly life-saving opportunity.… Continue reading →