Prevention is better than cure is a popular saying. We’d love to let you know that prevention is more often than not cheaper than cure. There is a body in the United States that gives recommendations as to prevention of diseases called the U.S Preventive Task Force (USPSTF). Breast cancer remains the second leading cause of death in women in the United States. These deaths can be further reduced by early detection, diagnosis, and treatment if screening is taken seriously.

Ques: What is mammogram?

Ans: Mammogram is a form of X-Ray of the breast routinely done to screen for breast cancer. It is done in middle-aged women.

Ques: At what age and how frequently should a woman have Mammogram?

Ans: Up until 2009, there was a consensus among several professional groups to have mammogram every year starting at age 40. In 2009, the U.S Preventive Task Force (USPSTF) changed the recommendation to screen to once every two years and to start at the age of 50. The American Cancer Society and many other professional groups, however, still advocate starting screening at the age of 40. Most health insurances pay for mammogram.

Ques: My mother is 80 years old; does she still have to do a mammogram?

Ans: After the age of 75 there is no definite rule. According to the USPSTF, at this point, there is insufficient evidence to assess if there are any additional benefits or harms in screening women who are above 75 years of age. As such, cases will have to be determined on an individual basis.

Ques: Some of my relations had breast cancer. At what age should I have mammogram?

Ans: A direct family relationship is important when it comes to cancer screening. History of breast or ovarian cancer in first-degree relatives warrants starting screening earlier than the youngest person in the family who got breast cancer. Let’s assume your aunt had breast cancer at age 35, you must have breast cancer screening before that age.

Ques: My friends told me there is a blood test that can be used to screen for breast cancer, is this true?

Ans: Blood test is not routinely used to screen for breast cancer. However, there is a genetic test that can be done on blood samples in people who are at a high risk for having breast cancer. These are people who have first-degree relatives with breast, ovarian, and some other cancers occurring at ages below 50. The test is done in special centers. The genetic test is not a replacement for a mammogram.

Ques: Is mammogram ever done in men?

Ans: Mammogram can be done in men, but not for routine screening purposes. It can be done in men who have breast lump or complaints related to the breast as determined by their doctor.

Take Home Message

It is better to get screened than to avoid doing so because of stories surrounding mammogram that you may have heard. No matter how uncomfortable people have described mammograms to be, it cannot be compared to the pain and consequences of having breast cancer. It is good to know that you can get free breast mammogram if you have no insurance and you are above 50 years in New York through various centers. For example, Amazing Medical Services will be hosting one in mid-December.

 

 

 

PROSTATE CANCER SCREENING

According to the American Cancer Society, about 192,280 men were diagnosed with prostate cancer in 2009 and about seven percent of them will die from it. There have been a lot of controversies about the benefit of prostate cancer screening and its impact on saving lives. There are two tests used primarily to screen for prostate cancer. The digital rectal examination (DRE) is done by a doctor. The doctor uses a finger passed through the rectum to feel the size, texture, and assess the presence of any irregularities of the prostate. Of course, this method does not appeal to most men. The second which can be used in conjunction with the DRE is a blood test call Prostatic Specific Antigen (PSA).

Ques: Will a PSA test give definite proof that I do not have prostate cancer?

Ans: No. A so-called normal PSA does not exclude prostate cancer. If, however, your PSA is high further testing/investigation is required to make definitive diagnosis.

Ques: At what age should prostate cancer screening be done?

Ans: According to USPSTF, there is insufficient evidence to support justifying routine screening with PSA in men below the age of 75 years. There is no need to screen men older than 75 years. The American Cancer Society encourages information to be made available to men at the age of 50. For African-American men, and for people at moderate risk (those who have first-degree relatives who had prostate cancer before age 65), information should be given by age 45. The decision to have a PSA should be that of the patient after information has been made available. The American Cancer Society does not recommend routine prostate cancer screening.

Ques: How frequently should PSA testing be done for screening purposes?

Ans: There is no definite recommendation from the USPSTF for the frequency either. The USPSTF suggests that if PSA reduces mortality screening, every four years may be as beneficial as annual screening. This question should not be confused with men who the specialist has instructed to have PSA done annually because they already have the diagnosis of prostate cancer.

Take Home Message

There is insufficient evidence that prostate cancer screening reduces death related to prostate cancer. As such, definite recommendation as to screening age and intervals are not available. Your doctor should make information relating to the benefits and harms of testing, diagnosis, and treatment available to you. The decision to have testing largely depends on you.

 

Dr. Oluwatoyosi Dairo can be reached by phone at 718 526 7600 or at Amazing Medical Services at 110-16 Sutphin Blvd, Jamaica NY 11435. Uninsured women 50 years and older can call for information about a free mammogram.