Screening for Better Health

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Uterine Cancer: Screening means Knowing your Risk Factors

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Screening for uterine cancer – which affects 2% of women in their lifetimes – is a controversial subject. There is no clear consensus of whether early screening in average-risk women can help prevent cancer deaths. On the other hand, we have a very good idea of what the risk factors for uterine cancer are, and they are relatively straightforward. As a result, the best way to screen for uterine cancer is to simply be aware of whether or not you classify as “high-risk”.

In preventive medicine, there are sometimes risk factors that cannot be controlled and must simply be monitored. In the case of uterine cancer, these are your genetics. If your family has a history of uterine cancer, there is a reasonable chance you have inherited genes that make you more likely to develop this disease. Furthermore, many of the same genetic mutations that can cause breast cancer and are passed down from parents to their children can also cause uterine cancer, so if your family has a history of breast cancer you should also be aware of the potential to develop uterine cancer.

There are also risk factors that are a direct result of actions you take, rather than your DNA. For uterine cancer the first major risk factor is being on hormone replacement therapy, which many women use to control menopausal and postmenopausal symptoms such as hot flashes, sweating, and flushed skin. Taking hormone replacement drugs for 5 years increases the chances of developing uterine cancer 30-fold. While it’s possible to use progesterone to reduce this risk, that has the unfortunate side effect of increasing breast cancer risk, so it is controversial as a preventive tool.

The second major risk factor is Tamofixin use, which is used in breast cancer treatment. However, the risk for developing uterine cancer is generally considered much smaller than the risk of not using tamofixin to treat breast cancer, so while you should discuss this risk with your doctor and be aware of the symptoms of uterine cancer, you should understand that tamofixin is important to your treatment.

There are other, less significant risk factors for uterine cancer, and many of them similarly apply to other cancers and diseases as well. These are things such as obesity, poor diet, tobacco smoke, and lack of exercise. These can be controlled for by living a healthy lifestyle and exercising regularly. Uterine cancer also occurs in a higher rate among women who have never birthed a child, and those with early menstruation or late menopause.

The best way to prepare to beat uterine cancer is to know the risks, know your family history, and know the signs of uterine cancer so you and your doctor can catch it early. The survival rate for uterine cancer is high if caught early – so if you suspect yourself to be at a high risk due to relatives with breast or uterine cancer, be sure to speak to your doctor early in life about the signs you should be on the watch for!

Osteoporosis: Treatment starts with prevention

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Most of us are familiar with the symptoms of osteoporosis. It is a fairly common condition: approximately 44 million Americans have thin bones from calcium loss! It’s very likely you have relatives with osteoporosis, and there is a reasonable chance you or someone you are close to will develop it some day.

Osteoporosis is a condition in which your bones lose the calcium from their matrix or structure and become fragile. This loss of calcium results in a decrease in bone mass and bone density, and the outer mineral layer of your bone begins to thin. The inner mesh skeleton of the bone also begins to thin. This results in very brittle and fragile bones. People who have osteoporosis are at risk for fractures that can occur with very minimal trauma. A step down the stairs, a minor fall in the house, a slight slip on ice, or in some rare cases, even a hard cough can result in bone fracture.

You might be aware that osteoporosis affects both men and women, though women are about 4 times as likely to develop it as men. And it is fairly well known that the risk of developing the condition increases with age. But did you know there are several other major risk factors, many of which are controllable?

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Treatment for osteoporosis can help mitigate the effects of the disease, but the best defense is to prepare your body in advance to fight off the approach of the disease. Taking care of yourself now can lead to a long and healthy future!

 

 

Why the new breast cancer screening guidelines matter

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pink_ribbon_imageIn October 2015, new breast cancer screening guidelines were published by the American Cancer Society. At the time, we were halfway through the publishing process for our new book. We immediately threw on the breaks and started all over again in order to rewrite the chapter on breast cancer. Even though the ACS is one of several organizations that propose breast cancer screening recommendations, their recent data provides strong evidence that screening too early for breast cancer can do more harm than good.

It may seem like a minor change to have pushed back the starting date for mammograms from 40 years of age (the previous recommendation) to 45 years of age, along with decreasing the frequency of exams after age 54, but the change represents a significant shift in how doctors are approaching early breast cancer detection. [1]

Most people are not aware that 1 in 8 women will develop breast cancer over the course of their lifetimes, and are unfamiliar with the progression of the disease. Breast cancer is a serious life-threatening condition, though the difference in life expectancy between early-detection and late-detection can be enormous. Finding breast cancer early is key… but doctors and medical data have often disagreed on the best way to do it.

While many doctors still recommend breast self-exams, and perform breast exams in the clinic, there is no longer scientific consensus that these tests are effective at detecting early cancers. I’ll be discussing the reasons behind this in a future post, but for now it’s important to understand that the most important and accurate test for breast cancer remains the mammography.

There are several reasons for these changes in recommendations. The most significant is that while mammograms are reasonably accurate tests, they do sometimes result in false positives, and the test performs poorly in young women. The younger you are, the less likely you are to have breast cancer, and the more likely you are to have a false positive test. New research has shown that a large percentage of positive mammograms performed on young women are false positives, and a relatively low frequency represent actual cancers. [2]

A false positive can result in enormous amounts of stress and mental anguish, as well as medical costs, time, and invasive procedures. Unless you are a high-risk individual (in which case starting your screening early is advised – speak to your doctor about this), pushing back the screening start-date should help alleviate the frequency of these false positives while continuing to detect early and potentially fatal cancers.

A review of the new guidelines for women of average risk follows, from the American Cancer Society’s website:

  • Women with an average risk of breast cancer – most women – should begin yearly mammograms at age 45.
  • Women should be able to start the screening as early as age 40, if they want to. It’s a good idea to start talking to your health care provider at age 40 about when you should begin screening.
  • At age 55, women should have mammograms every other year – though women who want to keep having yearly mammograms should be able to do so.
  • Regular mammograms should continue for as long as a woman is in good health.
  • Breast exams, either from a medical provider or self-exams, are no longer recommended.

It’s important to keep abreast of changing screening recommendations, especially with something as common and potentially deadly as breast cancer!