Vim & Vigor - Winter 2020 - GMC - 13

13

Screening:
Balancing
Risks and
Rewards

In some cases, knowing your genetic
makeup can change the screening protocol,
oncologists say. The BRCA1 and BRCA2
genes (also related to breast cancer) can put
some women at higher risk of ovarian cancer.
About 20 to 25 percent of cases of ovarian
cancer are women with a hereditary tendency
to develop the disease. For those with gene
abnormalities, doctors often recommend that
women get transvaginal ultrasounds (to look
for masses on the reproductive organs) along
with a CA-125 blood test (to look for an elevated protein that could signal cancer) and
follow increased risk guidelines for screening.

PHOTO AND ICONS BY GETTY IMAGES

Pancreatic Cancer:
Focusing on
Persistent Symptoms

Pancreatic cancer remains the only major
cancer with a single-digit survival rate-
just 8 percent of people live five years after
diagnosis-says Lynn Matrisian, PhD, chief
science officer at the Pancreatic Cancer

Not all screening is
necessary. It might
seem simple enough to
request a CT scan, an
MRI, an ultrasound or
a series of X-rays even
when they're not called
for, but unnecessary
testing can add to your
cost of care while taking
away critical resources
for other medical procedures. Also, incidental
findings might cause
you unnecessary stress
until more invasive tests
are performed.
Physicians caution
weighing the pros and
cons when it comes to
screening. Continuous
use of CT imaging disperses small doses
of radiation. In some
findings, the radiation
from a single CT scan
equals 200 chest X-rays.
"Even with low radiation
risk, you must consider
the potential for cancer brought upon from
exposure during an
unnecessary scan," says
Praveen Sivakumaran,
MD, an oncologist with
Northside Hospital
Cancer Institute.

Action Network. Most cancer is found in late
stages through a combination of CT scan, MRI,
endoscopic ultrasound and biopsy, she says.
Pancreatic cancer is typically diagnosed in
people older than 65. The cancer starts in the
tissues of the pancreas, a small organ in the
abdomen that aids in digestion and manages
blood sugar. Even though there is a big push
to develop biomarkers that can allow for
better early detection through a simple blood
test, we're not there yet.
Like ovarian cancer, symptoms of pancreatic
cancer can be nonspecific. But the persistence of
symptoms can be a key indicator of something
more serious, Matrisian says. "Indigestion, loss
of appetite and stomach problems are easy to
attribute to something I ate," she says. In these
situations, people might be treated for excess acidity rather than thinking about whether the persistence of these symptoms could point to a greater
concern. Other symptoms include new-onset
diabetes, jaundice (yellowing of the skin or eyes),
abdominal pain and aches in the middle back.
People who have chronic pancreatitis-
inflammation of the organ lasting five years or
longer-are more susceptible to pancreatic
cancer. For others, moderate risk factors
include smoking, obesity and advancing age,
Matrisian adds. Only about 10 percent of
cases have a family history.

Kidney Cancer:
Understanding Family Risks

Although early diagnosis is key to beating
kidney cancer-survival rates are 75 to 80
percent for those diagnosed in stages 1 or
2-no screening is recommended and proven
effective at saving lives. "It does not have any
sort of recognized blood test, blood marker
or imaging test. And there are no recommendations for renal [kidney-related] ultrasound
with any kind of organized screening program," says Scott Tykodi, MD, PhD, a member
of the American Board of Internal Medicine
who is certified in medical oncology.
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Vim & Vigor - Winter 2020 - GMC

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