Cancer Screening: Essential Tests and Their Effectiveness

Q: Cancer Screening: Essential Tests and Their Effectiveness

Hello： <br>1. <br>Cancer screening blood tests are primarily designed for monitoring patients who have already been diagnosed with cancer, with the hope of early detection of recurrence. <br>However, their significance for individuals who have never had cancer may not be as impac

How to know if you have cancer?

I have the following questions for the doctor:
1.
My mother is 75 years old and has been taking medication for hypertension and degenerative arthritis for a long time.
I personally paid for cancer screening tests including liver AFP, colon CEA, ovarian cancer CA-125, breast cancer CA-153, pancreatic and gastrointestinal cancer CA-199 blood tests, as well as abdominal, breast, and ovarian ultrasounds, a Pap smear for cervical cancer, and a colonoscopy.
However, I have heard from doctors that cancer screening blood tests are primarily for monitoring individuals already diagnosed with cancer and may not be very helpful for healthy individuals.
Can these cancer screenings indicate that she does not have cancer?
2.
Is it true that only a full-body PET scan or MRI can truly represent that one does not have any type of cancer?
3.
If economic considerations are a concern, are there alternative screening tests that can provide similar information to an MRI? What are these alternative tests?
4.
Currently, the tests performed are only for common cancer blood screenings, but there are many types of cancer, such as bone cancer, blood cancer, and oral cancer.
What tests can be done to determine if one has these cancers? Additionally, for less known cancers, what complementary tests should be conducted to ascertain if one has cancer?
5.
I have heard that PET scans may have some blind spots for liver cancer.
Is this true? In summary, cancer is truly terrifying; my father passed away from cancer last month.
Therefore, I kindly ask the doctor what tests should be done to help prevent cancer.
Thank you!

Yao Tiao Shu Nu, 30~39 year old female. Ask Date: 2006/12/14

Dr. Chen Sirong reply Oncology

Hello:
1.
Cancer screening blood tests are primarily designed for monitoring patients who have already been diagnosed with cancer, with the hope of early detection of recurrence.
However, their significance for individuals who have never had cancer may not be as impactful, although there is still a possibility of early detection of cancer.
Nevertheless, even if these tests yield negative results, it does not guarantee that cancer is not present, as there is a considerable chance of false-negative results.
2.
Even comprehensive imaging studies such as PET scans and MRIs may not definitively indicate the absence of cancer, as very early-stage cancers may still go undetected.
3.
There are no alternative screening methods that are comparable to MRI without radiation exposure issues, making them unsuitable for general screening.
4.
Currently, the best approach to facing cancer is to recognize early symptoms (discomfort) and seek medical attention promptly.
5.
All tests have their limitations, including the possibility of false-negative and false-positive results; it is merely a matter of the frequency of these occurrences.
Regular annual health check-ups and seeking medical treatment promptly if any discomfort arises are essential.
Sincerely,
Dr.
Kao Chung-Shu, Oncology

Reply Date: 2006/12/14

More Info

Cancer screening is a critical aspect of preventive healthcare, especially for older adults or those with risk factors. Your concerns regarding the effectiveness of various cancer screening tests and their implications are valid and deserve a comprehensive response.

1. Effectiveness of Blood Tests for Cancer Screening: The blood tests you mentioned, such as AFP for liver cancer, CEA for colorectal cancer, CA-125 for ovarian cancer, CA-153 for breast cancer, and CA-199 for pancreatic cancer, are indeed more commonly used for monitoring individuals already diagnosed with cancer rather than for screening healthy individuals. While these tests can sometimes indicate the presence of cancer, they are not definitive. A negative result does not guarantee that cancer is absent due to the possibility of false negatives. Conversely, a positive result can occur in benign conditions, leading to unnecessary anxiety and further testing. Therefore, while these tests can be part of a broader screening strategy, they should not be solely relied upon to rule out cancer.

2. Imaging Tests for Comprehensive Screening: Full-body imaging tests like PET (Positron Emission Tomography) and MRI (Magnetic Resonance Imaging) can provide detailed information about the presence of tumors. However, they are not foolproof. Early-stage cancers may not always be detectable, and these tests can also yield false positives, leading to further invasive procedures. Thus, while they can be useful in certain contexts, they should not be considered the only means of determining cancer absence.

3. Alternative Screening Options: If cost is a concern, there are other screening methods that can be effective. For instance, regular physical examinations, blood pressure checks, and routine blood tests can help monitor general health. Additionally, specific screenings like mammograms for breast cancer, colonoscopies for colorectal cancer, and Pap smears for cervical cancer are recommended at certain ages or intervals and are often covered by insurance. These tests are designed to detect cancer early when it is most treatable.

4. Screening for Various Cancer Types: Given the wide variety of cancers, the screening approach can differ significantly. For example, bone cancer is often diagnosed through imaging studies like X-rays or MRIs, while blood cancers such as leukemia may require blood tests and bone marrow biopsies. Oral cancers can be screened through visual examinations by a dentist or ENT specialist. For less common cancers, it is essential to consult with a healthcare provider about specific risk factors and appropriate screening tests.

5. Limitations of PET Scans for Liver Cancer: PET scans can indeed have limitations, particularly for liver cancer. They may not always detect small tumors or lesions, and there can be false positives due to inflammation or other non-cancerous conditions. Therefore, while PET scans can be part of a diagnostic workup, they should be used in conjunction with other tests, such as ultrasound or CT scans, for a more accurate assessment.

In conclusion, while cancer screening is vital, it is essential to approach it with an understanding of the limitations and appropriate contexts for each test. Regular check-ups with a healthcare provider, awareness of personal risk factors, and adherence to recommended screening guidelines are the best strategies for early detection and prevention of cancer. If you have specific concerns about your mother's health or screening tests, discussing these with her healthcare provider would be beneficial to tailor a plan that suits her individual needs.

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