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  • Writer's pictureMark Roberts

Diagnosis "C"

Visiting your primary care doctor at least once a year for your annual checkup is what most people do, and since it is typically covered at 100% on most health insurance plans, it makes sense to make the trek to your physician's office for the visit. At the very most you may have to pay a small co-pay depending on the type plan you have. After all, being pro-active on your health makes sense. However, some studies show that the actual exam isn't very helpful in discovering problems and may lead to unnecessary tests. Leading doctors and medical groups have called the annual physical exam "not necessary" in generally healthy people.


Exercising, keeping a healthy weight, and not smoking are enough to keep most of us in good health, with or without an annual exam. Still, no one can argue with keeping up a good relationship with your doctor through regular visits. As long as you and your doctor are paying attention to prevention and your overall health, the details are up to you. But if you are on maintenance prescriptions that require you to have blood work done, then you are guaranteed that your family doctor is going to see you at least once a year if not every six months. As well, if you have a history of some illness such as heart disease or cancer in your family, then it makes sense to get checked out at least once a year.


Surprisingly, though, there are no absolutes in a routine physical. A good doctor may be thorough or brief, but they will spend time listening to your concerns and providing counseling for your particular complaints and risk factors. This is your chance to mention any complaints or concerns about your health. Your doctor will also likely quiz you about lifestyle behaviors like smoking, excessive alcohol use, sexual health, diet, and exercise. The doctor will also check on your vaccination status and update your personal and family medical history. Your doctor will also check your vital signs, and other areas of your body to proper a proper diagnosis. Even if you are in top physical shape and take no medications, the smart thing to do is to see your doctor to get officially cleared with a clean bill of health.


The office exam and lab work that happens is the first step in any health diagnosis that may indicate some underlying health issues that otherwise may go unnoticed for some time. One of those concerns is cancer. Cancer is a broad term, referring to hundreds of different conditions that can develop in any part of the body, according to Yale Medicine.


For this reason, symptoms range widely—from a tumor that you can see or feel, to one that affects how your body functions, to no symptoms at all. What’s the main thing all cancers have in common? They all begin when abnormal cells in the body start to grow and spread uncontrollably in the affected area. When doctors give a diagnosis of cancer, it’s never an assumption. They rule out other possible causes before they zero in on cancer. Then, working with other medical specialists, they carefully perform a series of tests to check (and double-check) the diagnosis.


The truth is that cancer can cause almost any symptom, depending on where the tumor is located, how big it is and whether it’s begun to spread. Some patients will be able to feel a lump (the tumor). This is mainly true for cancers that occur close to the body surface, like skin or breast cancer. Yet for cancers that grow internally, like stomach or pancreatic cancer, the tumor may go unnoticed for some time, allowing the cancer to advance. Meanwhile, general symptoms—weight loss, fever, fatigue—often develop.


Once doctors suspect a patient might have cancer, they’ll ask about the family medical history and perform a physical exam. Then, they’ll run a series of diagnostic tests, including the following:


  • Lab tests - These check the levels of certain chemicals in the blood, urine and other body fluids—a level that’s too high or too low may be a sign of cancer.

  • Imaging tests - Images of internal organs may be examined for signs of cancer. Common imaging tests include MRI, CT scan, ultrasound, PET scan and X-ray.

  • Endoscopy or Colonoscopy - This procedure uses a specialized tool with a light or camera to look inside the body for a tumor.

  • Biopsy - A sample of the patient's tumor will be obtained and analyzed. This can be done during surgery or with a less invasive biopsy technique, in which the doctor inserts a needle into a targeted area, using an X-ray image as a guide. The biopsied (or resected) tissue is examined under the microscope by pathologists. These are the specialists who make the diagnosis of cancer, as well as determine the specific type of cancer and its aggressiveness, based on the tumor stage and grade. Pathologists use a number of methods to diagnose and characterize cancer cells, including, for example, molecular profiling to determine prognosis and the best therapy.  


Doctors use systems called staging and grading to measure how advanced the cancer has become. Staging indicates the extent of the cancer in the body, particularly whether it has begun to spread. Several staging systems have been devised. One example is the “TNM” staging system, which considers three features of the cancer: the size of the main tumor (T), the number of affected lymph nodes (N) and the presence of metastasis (M). A number is assigned for each feature, with higher numbers meaning more severe disease. 


Grading is used to identify how different the tumor cells are from normal cells, based on the appearance of the cancer cells under the microscope. There are a number of different grading systems, and many cancers have their own. In general, a low number or grade indicates the potential for less aggressive behavior, whereas high numbers and high grade are often associated with potentially more aggressive cancers. 

These systems lead to a very precise understanding of the cancer, ultimately guiding decisions about treatment options. 


High or low levels of certain substances in your body can be a sign of cancer. So lab tests of your blood, urine and other body fluids that measure these substances can help doctors make a diagnosis. However, abnormal lab results are not a sure sign of cancer. Lab test results are used along with the results of other tests, such as biopsies and imaging, to help diagnose and learn more about a person’s cancer. 


It is important to keep in mind that lab results for healthy people can vary from person to person. Reasons for these differences include age, sex, race, medical history, and general health. In fact, your own results can vary from day to day. Because normal results can bounce around a bit, they are often reported in a range, with lower and upper limits. These ranges are based on test results from large numbers of people who have been tested in the past.


For many tests, it is possible to have normal results even if you have cancer. And it is possible to have test results outside the normal range even if you are healthy. These are some of the reasons why lab tests alone can’t say for sure if you have cancer or any other disease.  Your doctor is the best person to explain your lab test results and what they mean for you. He may refer you to an oncologist to further test and diagnose your situation. At the very least, your family doctor can provide a baseline for additional conversation with a cancer specialist.


Many cancer treatments are available. Your treatment options will depend on several factors, such as the type and stage of your cancer, your general health, and your preferences. Together you and your doctor can weigh the benefits and risks of each cancer treatment to determine which is best for you. Cancer treatments, according to the Mayo Clinic, have different objectives, such as:


  • Cure. The goal of treatment is to achieve a cure for your cancer, allowing you to live a normal life span. This may or may not be possible, depending on your specific situation.

  • Primary treatment. The goal of a primary treatment is to completely remove the cancer from your body or kill the cancer cells.

  • Adjuvant treatment. The goal of adjuvant therapy is to kill any cancer cells that may remain after primary treatment in order to reduce the chance that the cancer will recur.

  • Palliative treatment. Palliative treatments may help relieve side effects of treatment or signs and symptoms caused by cancer itself. Surgery, radiation, chemotherapy and hormone therapy can all be used to relieve symptoms and control the spread of cancer when a cure isn't possible. Medications may relieve symptoms such as pain and shortness of breath.


Doctors have many tools when it comes to treating cancer. Cancer treatment options include:


  • Surgery. The goal of surgery is to remove the cancer or as much of the cancer as possible.

  • Chemotherapy. Chemotherapy uses drugs to kill cancer cells.

  • Radiation therapy. Radiation therapy uses high-powered energy beams, such as X-rays and protons, to kill cancer cells. Radiation treatment can come from a machine outside your body (external beam radiation), or it can be placed inside your body (brachytherapy).

  • Bone marrow transplant. Bone marrow transplant is also known as a stem cell transplant. Your bone marrow is the material inside your bones that makes blood cells. A bone marrow transplant can use your own cells or cells from a donor.

  • Immunotherapy. Immunotherapy, also known as biological therapy, uses your body's immune system to fight cancer. Cancer can survive unchecked in your body because your immune system doesn't recognize it as an intruder. Immunotherapy can help your immune system "see" the cancer and attack it.

  • Hormone therapy. Some types of cancer are fueled by your body's hormones. Examples include breast cancer and prostate cancer. Removing those hormones from the body or blocking their effects may cause the cancer cells to stop growing.

  • Targeted drug therapy. Targeted drug treatment focuses on specific abnormalities within cancer cells that allow them to survive.

  • Clinical trials. Clinical trials are studies to investigate new ways of treating cancer. Thousands of cancer clinical trials are underway.


Other treatments may be available to you, depending on your type of cancer. Additional tests can be performed that can help analyze certain aspects of your diagnosis and treatment plan, according to the National Cancer Institute (https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis).


January is designated by the Centers for Disease Control as Cervical Cancer Awareness Month. More than 11,000 people in the United States are diagnosed with cervical cancer each year according to the Department of Health and Human Services (HHS). The good news: vaccination and regular screening can prevent the disease.


The cervix connects the vagina (birth canal) to the upper part of the uterus. The uterus (or womb) is where a baby grows when during pregnancy. Anyone with a cervix is at risk for cervical cancer. It occurs most often in people over age 30. Long-lasting infection with certain types of human papillomavirus (HPV) is the main cause of cervical cancer. HPV is a common virus that is passed from one person to another during sex.


At least half of sexually active people will have HPV at some point in their lives, but few will get cervical cancer. Screening tests and the HPV vaccine can help prevent cervical cancer. When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life according to the CDC (https://www.cdc.gov/cancer/cervical/basic_info/index.htm).


You may think that life is over upon initial diagnosis. Once your doctor confirms your cancer, you have some decisions to make about your treatment plan and how to deal with this new normal (which is not really normal). The Mayo Clinic has developed tips to help cope with your health situation (https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-diagnosis/art-20044544):


  • Get the Facts.

  • Communicate - doctor, family, friends, pastor.

  • Anticipate some physical changes - weight loss, weight gain, hair loss, etc.

  • Maintain a healthy lifestyle.

  • Let friends and family help where needed.

  • Review goals and priorities.

  • Consider financial needs and obligations.

  • Fight the cancer stigma.

  • Talk with cancer survivors.

  • Develop your own ways to cope.


One major element of dealing with cancer is the costs involved in medical care, even if you have health insurance. However there are other financial stressors that develop. Everyone should have a cancer insurance policy in place. This type of coverage acts as an additional cushion to offset the expenses that arise once you are diagnosed. Cancer Insurance benefits are paid for hospital stays, radiation, chemotherapy, surgery, medications, prosthesis and other associated treatments.


Cancer insurance doesn't just help with medical expenses, but the cash benefits can also help you with everyday costs. With cancer insurance, cash is delivered straight to the policyholder rather than going through a doctor or hospital first. You can use these benefits to help pay for your mortgage payments, electricity bills or medication refills – it’s completely up to you.


Cancer insurance, also known as specified-disease insurance in some states, is a type of supplemental health insurance that pays cash benefits for various cancer diagnoses and treatments. You can use that money to pay out-of-pocket medical costs and other expenses, including travel, lodging and meals during treatment, child care and home health services. Cancer insurance is intended to supplement a comprehensive major medical health plan, and is not suitable to be a person’s only coverage for healthcare.


As a licensed agent, I have multiple affordable options for cancer insurance that you can review. Cancer insurance policies can be for anyone - children and adults. It's not just a plan for seniors. More information is also on this website: https://www.careingdentalgroup.com/senior-health-and-wellness. Contact me soon for a conversation about how to help put a program in place to provide an extra layer of financial protection.



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