Cancer

the facts; the truth; the real, genuine information

      There is no general answer; no one test can tell you for certain whether or not the disease is already present although many attempts have been made and many quacks pretend they can. Reading other pages on this site will tell you why it is difficult. The common symptoms and signs that people talk about depend on the particular nature, location and size of the cancer and every cancer begins with changes in a single cell, so impossible to detect among 10 billion others.

What screening tests should be done?

      There is no strong evidence that cancer screening tests are helpful, including the better-known ones, cancers of the breast and uterine cervix . Some medical writers will disagree and we agree enthusiastically that earlier treatment must be better treatment; the science and commonsense agree on that, so there must be a case for selective testing, for people at higher risk, or who are worried and choose to pay themselves. The argument then is whether the extra worry is itself harmful and that may be so; but also it is not clear why anyone else should interfere.

      Higher risk includes nature, nurture, familial or genetic predisposition, or special exposure. Tests available include for BRCA genes and other similar cases, colonoscopy or MRI screening of the large bowel, frequent inspection and recording of moles, self-testing for lumps, looking for changed cells in urine, sputum (lung) or other body fluids, and blood tests including for PSA (prostate) and other much-used markers such as AFP, CEA, CA19-9, CA125, etc. All can produce false-positive and false-negative results, which is why we don't like using them for screening, though PSA might be an exception (opinion is turning against its use, even in the USA). Monitoring the progress of a case is quite different. You will be able to find more detail on specialist websites.

      In future, we hope to see much improved screening tests. For now it is hard to beat the commonsense approach. It will be enough if patients seek advice immediately for any relevant symptom – lump, ulcer, bleeding, cough, change of bowel habit, pain, fever, weight loss and so on – so as to allow timely selective testing.

      If you feel well and are not losing weight, should you be worrying at all? Your best bet is to get advice from a proper doctor, and one who does not stand to gain from arranging treatment for you.