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

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DOC I HAVE OVARIAN CANCER

Ovarian cancer can occur in relatively young girls as well in older women . The cases that I have seen involved a 12 year old girl whose enlarged lower abdomen although painless made her mother worried. I examined her and found that there was large swelling in the region of the left lower abdomen. A X-ray of the abdomen confirmed that it was an ovarian tumor.I quickly got a surgeon to see her as soon as possible. It turned out to be an ovarian cancer. Although the cancerous ovary was removed, there was spread outside of the ovary . She was put on chemotherapy and after 5 years she was well and now doing her study in the university.

The parents were so relieved that she manage to survive her ordeal.

Ovarian Cancer is a disease which cause abnormal cells in the ovary to proliferate and spread to the rest of the ovary or outside the ovary.

The most common type, the epithelial carcinoma that begins from the surface of the ovary is discussed here.

The cause of cancer of the ovary is unknown. However, studies show that certain factors may increase the chance of developing this disease.
1.family history of ovarian cancer.
2.history of cancer of the breast or colon.
3.age over 60 years.
4. Infertility or not having children. The more children you have, the lesser your risk is.
5.Early menstruation before the age of 12
6.late menopause
7.high fat diet
8.Use of fertility drugs, or Hormone Replacement Therapy (HRT).

Attempts are being made to detect early stages of ovarian cancer, especially among women who have an increased risk. A blood test is done to check for a substance called CA 125. If the sample contains raised amounts of CA 125, you may be given an ultrasound scan to see if your ovaries appear abnormal in any way.

Ovarian cancer is the most dangerous of gynaecological cancers because it is often silent and difficult to detect.
There is no early detection method, so you must be vigilant and take note of persistent warning signs seriously.
If you are having some of the following symptoms persisting for more than a week or so, see your doctor.

1.Vague gastrointestinal symptoms such as gas, indigestion, nausea and a bloated feeling
2.Swelling in the abdomen, unexplained weight gain
3.Pelvic or abdominal pain or discomfort, and/or feeling of fullness
Backache
4.Urinary symptoms e.g. frequency and/or urgency of urination in the absence of an infection
5.Unexplained or changes in bowel habits
6.Loss of appetite/loss of weight
7.backache or pain inthe legs
8.Abnormal vaginal bleeding, although this is rare

If you do have any of the above symptoms you must have them checked by your doctor. Remember, they are non specific and most women with these symptoms will not have cancer.

If you are at risk of ovarian cancer, see your gynaecologist regularly.
A following may be done:
recto-vaginal bimanual pelvic exam,
Pap smear,
blood test for CA-125
transvaginal ultrasound

Treatment depends on a number of factors, including the stage of the disease (the extent of spread of the disease) and the general health of the patient.
Surgery, chemotherapy and various types of radiotherapy may be used alone, or in combination to treat ovarian cancer.

Surgery
Surgery is normally the first choice of treatment for ovarian cancer, and may sometimes also be needed to make the diagnosis.
If detected is in the early stages, surgery is all the treatment that may be required. The ovaries, fallopian tubes, uterus and cervix are usually removed. The omentum (thin tissue covering the stomach and intestines) and lymph nodes (small organs located along the channels of the lymphatic system) in the abdomen are often removed too.
If the surgeon feels the cancer may be difficult to remove, a few cycles of chemotherapy may be applied first and surgery carried out thereafter, in the hope that the tumour would have been reduced.

Chemotherapy
Chemotherapy may be given to destroy any cancerous cells that may remain in the body after surgery, to control cancer growth or to relieve symptoms of the disease. Sometimes a few cycles of chemotherapy may have to be applied before surgery is carried out.

Radiotherapy
Radiotherapy is less commonly used in this cancer but may sometimes be used to treat individual spots of cancer which have recurred after surgery and chemotherapy.

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