Prevention

Cancer prevention. What tests to perform?

In many cases, the cancer can be detected early, while it is still small and before it has spread. If detected early, cancer is easier to treat, and the chances of a full recovery are much higher. An example of such a relationship is cervical cancer, which (according to the American Society of Clinical Oncology) is curable in more than 92% of cases detected at an early stage, and breast cancer, according to the American Cancer Society, is 99% curable at an early stage. Since cancer in its early stages usually develops asymptomatically, the only way to find it early is to have regular examinations.

Who is screening for?

Regular screening tests should be performed on people in the higher risk groups - due to genetic load or exposure to harmful factors, such as, for example, smoking. The increased risk also applies to age groups, so people over 40 should also undergo control tests. The benefits of doing so are much more than the harm. Many people assume that by avoiding research, they will also avoid diagnosis, and thus will be able to live more peacefully in ignorance. This is very harmful thinking, because delaying a possible diagnosis is perfect conditions for the silent progression of the disease. Usually, once symptoms appear, this indicates that the cancer is advanced. Treatment of such cases is difficult, long-term and the prognosis is not optimistic.

For more information on cervical cancer prevention, see: Cervical Cancer Prevention - What You Need To Know?

What tests are worth doing?

1. Genetic test

It consists in taking a sample of biological material from the patient. Usually it is the blood or saliva from which the DNA is extracted. In the next step, they are analyzed by means of, inter alia, sequencing. Genetic testing has many advantages:

they are usually performed only once in a lifetime (the DNA code does not change);
they are very sensitive;
they can be carried out regardless of the state of health;
there is no need to prepare for them in any way.

Genetic testing allows to detect or exclude many mutations that are responsible for neoplastic changes of various nature.

Mutation

Meaning

BRCA1 i BRCA2

A mutation of these genes significantly increases the risk of developing breast cancer.

PALB2

It is presumed that a mutation of these genes is responsible for an increased risk of ovarian cancer.

CHEK2

It is a gene that is responsible for inhibiting the development of cancer, so people with its mutation are at risk of many types of cancer - breast cancer, colon cancer, prostate cancer, as well as thyroid and kidney cancer.

TP53

A mutation of this gene is also referred to as Li-Fraumeni syndrome; it is associated with an increased risk of developing breast cancer, leukemia, sarcomas and brain tumors.

CDKN2A

People with a mutation of this gene are at risk of developing pancreatic cancer, melanoma, and lung cancer.

2. Cytology

Cytology is a test that should be performed at least once a year by every woman. More frequent smear tests are recommended for women who are at increased risk – with weakened immune systems, after chemotherapy, patients with HPV or HIV-positive. During cytology, the doctor places a speculum into the vagina that holds the vaginal walls in place so that the cervix can be accessed. Then, using a special tool – a spatula, spatula or brush – it takes a sample of cells from its surface, which is sent to the laboratory.

3. Testing the concentration of tumor markers in the blood

Tumor markers are chemicals that are produced in many tissues in the body. They can take the form of proteins, enzymes, hormones, or antigens. Their production increases with the appearance of cancerous tissues in the body. The study of tumor markers gives a picture of the current state of the body. Tumor markers play a very important role during treatment, and thanks to their measurements, doctors can assess the stage of its course. After the end of treatment, the concentration of indicators should be constantly monitored in order to be able to assess the patient's health as accurately as possible.

Marker

Meaning

CA 125

It is a marker that is used in the diagnosis of ovarian cancer. In addition to it, it can indicate the presence of kidney or lung cancer and sometimes also occurs with endometriosis.

PSA

It is a marker that is characteristic of prostate cancer and is sometimes associated with other prostate cancer conditions (e.g. inflammation). The concentration of PSA in the blood varies with age, so it is recommended that the first test be performed around the age of 40 and should be repeated regularly.

CA 72-4

Its increased level may indicate adenomas occurring in various places - in the stomach, large intestine, esophagus or ovary.

AFP

A marker that is characteristic of primary liver cancer. It is also detected when testicular cancer is suspected. Its concentration may be increased in people suffering from cirrhosis of the liver or hepatitis caused by HBV. This also applies to pregnant women and people with benign tumors in the liver.

Beta-HCG

It is found in trophoblastic disease and acinar, in germ cell and testicular neoplasms. It is produced by the cells of the placenta and therefore appears in the blood of pregnant women.

CA 19-9

A marker characteristic of pancreatic cancer, but its increase is also noted in stomach, esophagus and colon cancer.

CA 15-3

It is an antigen, the increased concentration of which is removed in the case of metastatic breast cancer.

Calcitonin

It is characteristic of thyroid cancer.

CEA

Its elevated level occurs in the following cancers: colon, pancreas, liver, bladder, and lungs. For people with colorectal cancer, it is helpful in monitoring your health. In addition, elevated levels also appear in hepatitis, ulcerative colitis and in people suffering from cirrhosis.

4. Biopsy

This test involves collecting biological material from tissues in which cancer cells are suspected to develop. Then the sample, which is called a biopsy, is subjected to a histopathological examination in the laboratory. Usually the sample is taken with a fine needle (fine needle biopsy), however the process may vary depending on the nature of the lesions examined. It is also possible to excise the entire fragment with the lesion (excision biopsy) or only a part of it (fragmentary biopsy) for further diagnosis

5. Imaging tests

Test

Meaning

Ultrasound (USG)

A test that shows the size and shape of internal organs, and thus also the changes within them.

Computed tomography (CT)

Radiological examination that allows you to obtain accurate and high-quality pictures of both internal organs and bones. Due to the harmfulness of electromagnetic radiation, it should not be performed frequently.

Magnetic resonance imaging (MRI)

A test that uses a magnetic field and radio waves to take cross-sectional photos of internal organs on all planes. Its biggest advantage is the lack of negative impact on the health of the examined person.

Mammography

An examination that involves taking pictures of the mammary gland using X-rays.

6. Endoscopy

Endoscopy is an examination that allows you to see the body from the inside in detail. This is possible thanks to a small camera located at the end of a flexible and thin tube that is inserted into the body. During the examination, it is also possible to take specimens for histopathological examination. Sampling is performed using forceps, which are introduced through a special channel. Many organs can be examined with an endoscope:

stomach (gastroscopy);
larynx (laryngoscopy);
pleura (laparoscopy);
bronchi (bronchoscopy);
vagina (colposcopy);
large intestine (colonoscopy);
peritoneum (laparoscopy);
bladder (cytoscopy).

What else is worth remembering?

Self-observation and periodic self-examination are also very important issues in the case of cancer prevention. The self-examination concerns women in particular, who should inspect their breasts as often as possible, which gives a chance of early detection of any tissue changes. We should be very alert to the occurrence of suspicious symptoms and changes in our body. When we notice symptoms of the disease, we should immediately see a doctor. A healthy lifestyle also plays a key role in the prevention of cancer, which mainly consists in a balanced, wholesome diet, physical activity and giving up smoking. The implementation of this part is not difficult and depends only on our motivation.