A Family Doctor's Tale - CANCER SCREENING 3

DOC DO I NEED TO GO CANCER SCREENING 3

Cancer Screening:

C. Breast cancer

Breast Cancer is the most common cancer in women.
Women who are at high risk are those with:
1.family history of breast cancer
A gene has been identified which indicates high incidence of breast cancer.


2.family history of other cancers such as ovary and colon


3.women of age 55 years and above

Cancer screening procedures includes:
1.monthly breast self examination(BSE) is recommended for all women from the age of 30 to detect breast lumps which may be early cancer


2.Mammography once every 2 years from the age of 50 years can help to detect breast cancer.


3.Ultrasound of the breasts together with mammogram  also helps in the detection of breast cancer.


4.Blood test-tumor markers such as CEA, CA 125 and CA 15.3 may be raised in cancer of the breast but are not significant in making a diagnosis.

D.Liver Cancer

Liver Cancer is the 4th most common cancer in men in Singapore.


Men are more often 4 times affected than women.


People who are at risk of developing liver cancer are:
1.Chronic hepatitis B carriers and infections


2.Hepatitis C liver cirrhosis and infection


3.Liver cirrhosis from other causes (eg alcohol)

Screening for hepatitis B is recommended for:
1.Healthcare workers because they are exposed to hepatitis patients


2.Pregnant women because the hepatitis infection can spread to her baby at birth


3.Dialysis patients because the fluid or plasma used in dialysis may contain the hepatitis B infection


4.Those people with a history of hepatitis B infection or liver cancer in the family


5.Those people with high risk behaviour having unprotected sex, multiple sex partners, drug addicts who share needles.

Cancer screening procedures includes:
1.Blood test-tumor marker alpha feto-protein level should be done every 3-6 months.


Patients with hepatitis and liver cancer has been found to have raised levels of serum alpha feto-protein.


However patients with germ cell cancers of the testes and ovary also have raised level of alpha feto-protein.

Pregnant women may also have raised alpha feto-protein at certain stage of their pregnancy.

2.Ultrasound of the liver including the gallbladder and bile ducts
should be done every 6 to 12 months.

E.Ovarian Cancer

Ovarian Cancer is the fifth commonest cancer in Singapore and can be potentially fatal if not detected early.

Early ovarian cancer may not have any symptoms and may be undetected unless screening is done.

Women who are at high risk are those with:
1.family history of ovarian cancer


2.abnormal menses

Cancer screening procedures includes:
1.Annual pelvic examination


2.pelvic ultrasound


3.Blood test-tumor markers CA125 and alpha feto-protein level should be done yearly for those with high risk of ovarian tumors