Cancer Prevention and Early Detection
Wouldn’t it be good if we could prevent cancer from starting? And wouldn’t it be amazing if we could detect the presence of cancer early enough so that everyone would be cured of cancer? I think so.
This is a renewed focus in cancer care. While most of our efforts today have two goals — stop people from dying, and continuing cancer research to find new ways of keeping people alive — it’s time to focus more attention on preventing people from getting cancer in the first place.
Your primary doctor is often the person who first notices that something is off and sends you to a specialist, like a urologist or a gastroenterologist, to find out what it is. They do tests and scans, find some answers, and send you on to a medical oncologist, who does other tests, finds out more, and sends you on to someone like a radiation oncologist or surgeon for further testing or treatments. This sequence can take months to find out what is happening inside your body. While all of this is going on, your cancer continues to grow and spread.
One of the ideas that some cancer institutions are discussing is having primary doctors check their patients for signs of cancers because they are the ones who see patients more often. Specialists only see patients after a problem has started.
Can primary doctors take this on? My feeling is that they are already overwhelmed by the number of patients they have to see every day. But then, so is every specialist, and it takes three to six months to get in to see them. Once you start the diagnostic process, why can’t you see the next doctor in one week, or less? There are several concerns with having primary doctors run point on screening for cancers. Besides the time factor, do they know what to look for with each kind of cancer? What resources or training will they need?
Would they also do genetic testing to see who has Inherited a gene that puts them at risk of developing cancer? Hereditary genes are responsible for 5-10% of cancers. Do you, for example, have the BRCA gene? It makes a big difference when you have breast cancer and are deciding what kind of chemotherapy to use. Maybe they will if there is some history of cancer in your family. But how do patients get tested if there isn’t a history, or what steps can you take to prevent an inherited gene from turning on? Will insurance pay for genetic testing? Maybe for those with a history, but not yet for everyone. When insurance companies realize they will save a lot of money by preventing cancers from starting, rather than paying for years of high tech procedures and expensive drugs, I bet they will come around. Someone needs to goose them because 1 in 3 Americans will get some kind of cancer.
Most cancers aren’t hereditary. Some 20% have Environmental causes, like a much higher rate of prostate cancer among those who were exposed to Agent Orange. Doctors have also noticed that people who live in Illinois and Iowa have a much higher rate of getting cancers like non-Hodgkin lymphoma, leukemia, prostate, thyroid, pancreatic, and skin. It’s believed this is due to the massive amounts of pesticides and herbicides that are sprayed on farmland. We can do more to prevent these cancers. This is where politicians have to stand up for their constituents and pressure agribusiness to scale back the use of the chemicals that are killing people.
Other cancers are caused by the Lifestyle choices we make, like being overweight or not exercising, and the correlation between smoking and lung cancer. Once it’s determined that you have cancer, somatic testing can be done on the cancer cells. Almost all cancers are Somatic, by the way, meaning that they begin when cells inside you mutate in response to different triggers. More research needs to be done to learn how we can prevent and detect these changes early on. Somatic testing can also determine the kind of mutation you have and be crucial in deciding which targeted therapy would be the most effective.
It would be the dawning of a new day if we could prevent cancer from starting.
April is Cancer Prevention and Early Detection Month.
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