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Don’t dread a cancer screening: It may save your life

Cancer deaths would surely drop if patients followed the advice of the American Cancer Society. To be sure, part of the problem is awareness—people just don’t understand how important it is to find cancer early, when treatment is most effective.

You might feel fine, eat lots of fruits and vegetables, exercise all the time and not smoke. But despite taking every possible precaution, you can have cancer and not know it. Fact is, cancer rarely shows itself early. Years usually pass before a tumor grows large enough to be felt or starts interfering with your health.

Stalling for time is risky

Do you put off making an appointment for a mammogram or colonoscopy because you’re afraid of receiving “bad news”? You’re not alone. Fear of having cancer is the number one reason most people procrastinate being tested. What you may not realize is that cancer can be cured if it’s found early enough.

In fact, screening can prevent cancer from ever getting started. For example, cancer of the colon usually develops from polyps—tiny, precancerous growths that form along the inner walls of the bowel. Screening can find polyps before they turn cancerous, and your doctor can remove them right away. You may never have to suffer colon cancer, if you get screened.

Screening can also find an existing cancer before you develop symptoms. For example, a mammogram can find breast cancer a couple of years before you or your doctor can feel a lump. According to the American Cancer Society, screening offers you the best chance of finding a tumor while it’s still localized (confined to the organ it started in).

When treated at this stage, the percentage of people who live five years or more after they’ve been diagnosed is more than 95 percent for the following cancers: breast, colon, rectum, cervix, testicles, mouth and skin.

However, once a cancer spreads to the surrounding tissues and organs, called metastasis, the five-year survival rate can drop to 70 percent or less, depending on the type and stage of the cancer. Metastasis is what makes cancer deadly. Fear that causes you to avoid or delay screening gives a precancerous condition or a localized tumor all the time in the world to spread.

Afraid you’re a hopeless case?

If you smoke, chances are you avoid screening not only for fear of what testing might find, but because you’re afraid that if cancer is detected, you’ve only got yourself to blame. That’s a double whammy you don’t need, and one that can stop you from making any healthy choices.

While smoking can increase your risk of cancer, the single most important risk factor is your age. About 80 percent of all cancers are diagnosed in those over age 55. Men and women are equally affected. Only about one-third of all cancers are hereditary. One theory suggests that aging makes us more vulnerable to cancer-causing agents in the environment.

Seniors are at highest risk for cancer, but many over age 75 don’t bother getting screened because they fear they’re too old to beat the disease anyway. Consequently, their cancer isn’t found until it’s in the late stages.

If that describes you, talk to your doctor. Treatment in the elderly depends on the cancer, not the patient. Not only can the screening outcome add years to your life, it can also preserve your independence and quality of living.

Do you suffer from test anxiety?

Do rectal exams or mammograms embarrass you? The fear of pain or embarrassment is the second most common reason people don’t get screened regularly, if at all. Often, both fear and pain make the discomfort worse.

The best way to manage your fears about a screening test is to learn as much as you can about it. Knowing what to expect will lessen your pain by at least getting rid of the fear of the unknown. Don’t be afraid to find out exactly how much pain you should expect and how to handle it.

Distracting yourself with music may be worth a try, as studies show that music lowers the sensation of pain in patients who’ve undergone surgery. An inexpensive radio and headphone set may be all you need. You can lessen feelings of embarrassment by taking deep breaths and thinking of other things such as the beach or any other place that makes you feel relaxed.

On the other hand, if you believe in screening but are afraid that you can’t afford it, you’ll be happy to know that most insurance policies, including Medicare and Medicaid, pay for cancer-related screening tests. And take advantage of free screenings offered in your community.

Finally, don’t be afraid to ask for a referral. If you’re not sure how to do it, and don’t want to risk looking foolish, call the American Cancer Society at 1-800-227-2345; they will be happy to walk you through the process. Whatever you do, don’t let fear cost you your life.

The American Cancer Society’s recommendations for cancer screening

General: Men and women between the ages of 20 and 39 should have a cancer-related checkup every three years, beginning at age 20. Men and women ages 40 and older should have a cancer-related screening every year. Screenings should include counseling on cancer prevention and physical assessment of the patient’s thyroid, mouth, skin, lymph nodes, testes and ovaries.

Breast: Women between the ages of 20 and 39 should have a clinical breast exam by their doctor every three years. Women over age 40 should have an annual clinical breast exam and mammogram. All women should consider monthly breast self exams. Most women who are at high risk for breast cancer should have both an annual mammogram and a magnetic resonance imaging scan beginning at age 30.

Cervical: Starting by age 21, women should have an annual Pap test. The frequency can be reduced to every two to three years for women over 30 who have had three normal Pap tests in a row. Women over 70 may choose to stop cervical cancer screening after discussing their medical history with their healthcare provider.

Colon and rectum: Starting at age 50, men and women should begin one of these seven screening options: (1) a flexible sigmoidoscopy (a thin tube with a camera attached that checks the lower part of the colon) every five years, (2) a double-contrast barium enema every five years, (3) a colonoscopy (a thin tube with a camera that checks the entire colon) every 10 years, (4) a CT colonography (virtual colonoscopy) every five years, (5) a yearly fecal occult blood test (FOBT), (6) a yearly fecal immunochemical test (FIT) or (7) a stool DNA test as often as recommended by your physician. The first four tests are preferred because they can find polyps before cancer even starts.

Prostate: An annual prostate-specific antigen (PSA) test and digital rectal exam should be considered beginning at age 50. Discuss this with your doctor. Men at high risk (African-American men and those with an immediate family member who was diagnosed with prostate cancer) should begin PSA screening at age 45, or even age 40 for those with multiple first-degree relatives affected at an early age.

Endometrium: Beginning at age 35, women at high risk for hereditary non-polyposis colon cancer should undergo endometrial biopsy annually to screen for endometrial cancer.

Stalling for time is risky

Afraid you’re a hopeless case?

Do you suffer from test anxiety?

The American Cancer Society’s recommendations for cancer screening