Affordable cancer screening?
September 9, 2011 5:58 PM Subscribe
What procedure should I go through for cancer screening?
My primary care doctor says its expensive, but I am so frightened of getting some form of it, especially pancreatic cancer.
I don't smoke, use sunscreen most days and don't drink. I don't exercise, though. Is there a way to get a cancer screening annually without going bankrupt? I'm 33, but that doesn't mean breast cancer isn't possible. I get an annual PAP smear and request a physical at my primary care.
My primary care doctor says its expensive, but I am so frightened of getting some form of it, especially pancreatic cancer.
I don't smoke, use sunscreen most days and don't drink. I don't exercise, though. Is there a way to get a cancer screening annually without going bankrupt? I'm 33, but that doesn't mean breast cancer isn't possible. I get an annual PAP smear and request a physical at my primary care.
First off, full disclosure: I've had cancer twice (thyroid cancer in my 20s, colon cancer in my early 40s). Believe it or not, it's not actually the worst thing that's ever happened to me. In fact, I'm fine with having had cancer because it changed my outlook on life, and has made me a lot more grateful and happy, and I hope it has made me a more compassionate person overall. Treatment wasn't a lot of fun, but it worked and I'm in remission. If it comes back, I'll probably die from it; if it stays in remission, I'll eventually die of something else. Mortality is a fact for us all, cancer or no cancer, so now that I've had it I don't really worry too much about dying from it. I don't know if this makes you feel more or less fearful about getting cancer, but that's my two cents on the experience.
That said: no, there's not an affordable, feasible way to screen generally for the many dozens of cancers that exist; there's not a single test that will give you a combo colonoscopy/mammogram/pap smear/thryoid update scan/liver function test/etc. all in one go. Whole body imaging absolutely does not accomplish this -- it's not reliable and it carries its own risks (on preview: jinx, craichead).
If you have a family history of certain types of cancer, however, early screening (even when you're non-symptomatic) is available and appropriate. Absent that, however, I would suggest that the issue that's going to be more productive for you to address is your fear/anxiety.
posted by scody at 6:34 PM on September 9, 2011 [5 favorites]
That said: no, there's not an affordable, feasible way to screen generally for the many dozens of cancers that exist; there's not a single test that will give you a combo colonoscopy/mammogram/pap smear/thryoid update scan/liver function test/etc. all in one go. Whole body imaging absolutely does not accomplish this -- it's not reliable and it carries its own risks (on preview: jinx, craichead).
If you have a family history of certain types of cancer, however, early screening (even when you're non-symptomatic) is available and appropriate. Absent that, however, I would suggest that the issue that's going to be more productive for you to address is your fear/anxiety.
posted by scody at 6:34 PM on September 9, 2011 [5 favorites]
Concur with scody and craichead. It's just not reasonable to be screened for every kind of cancer every year. Get screening for things you have a family history of, elsewise just pay attention to your general health.
Cancer sucks, to be sure, but I would think that living in terror of cancer would suck more. Have you considered looking into counseling to address this fear?
I've had skin cancer twice. It wasn't any fun, but it (obviously) wasn't the end of the world for me. It was caught early both times because I pay very careful attention to changes in my skin. (Pasty white girls who were stupid and laid in the sun without sunscreen as teenagers should do that.) No amount of "annual screening" would have caught it as quickly as me being aware of my own body did.
posted by MissySedai at 7:17 PM on September 9, 2011
Cancer sucks, to be sure, but I would think that living in terror of cancer would suck more. Have you considered looking into counseling to address this fear?
I've had skin cancer twice. It wasn't any fun, but it (obviously) wasn't the end of the world for me. It was caught early both times because I pay very careful attention to changes in my skin. (Pasty white girls who were stupid and laid in the sun without sunscreen as teenagers should do that.) No amount of "annual screening" would have caught it as quickly as me being aware of my own body did.
posted by MissySedai at 7:17 PM on September 9, 2011
Agreed with the others on trying to address your anxiety. I suggest you do this by doing things like eating a healthy diet, being at a healthy weight, and not smoking or drinking, because all of those things are related in some way to getting cancer. It is much easier and makes more sense/is more cost effective to preventatively address your risk factors for cancer than it is to go to the doctor and screen yourself for various cancers. You might like Prevention magazine. Here are a few sites on cancer prevention:
http://www.mayoclinic.com/health/cancer-prevention/CA00024 (7 Things You Can Do To Prevent Cancer)
http://www.who.int/cancer/prevention/en/ (Cancer Prevention, from the World Health Organization - notice the section on physical inactivity and its importance)
There are only some cancers for which an adequate screening test is available for the general public, like Pap smears, or colonoscopies or mammograms once you reach the age at which you are more at risk. You can look at the USPTF web site to find out more about these things and what is appropriate for you. http://www.ahrq.gov/consumer/index.html This site also goes over what the evidence is for each of the tests and how it is used, and prevention issues.
Unfortunately, there is no screening test for pancreatic cancer for the general population. There are only tests that are used to monitor it when you already know that you have it. If you have risk factors for skin cancer like having a lot of moles or having close family members with skin cancer, or having a lot of bad sunburns when you were young, you might be able to find a free screening program for skin cancer in your area that runs sometimes. If you don't have any of these risk factors, just keep wearing your sunscreen and only see a doctor if you see a mole that you're concerned about.
posted by treehorn+bunny at 7:29 PM on September 9, 2011 [1 favorite]
http://www.mayoclinic.com/health/cancer-prevention/CA00024 (7 Things You Can Do To Prevent Cancer)
http://www.who.int/cancer/prevention/en/ (Cancer Prevention, from the World Health Organization - notice the section on physical inactivity and its importance)
There are only some cancers for which an adequate screening test is available for the general public, like Pap smears, or colonoscopies or mammograms once you reach the age at which you are more at risk. You can look at the USPTF web site to find out more about these things and what is appropriate for you. http://www.ahrq.gov/consumer/index.html This site also goes over what the evidence is for each of the tests and how it is used, and prevention issues.
Unfortunately, there is no screening test for pancreatic cancer for the general population. There are only tests that are used to monitor it when you already know that you have it. If you have risk factors for skin cancer like having a lot of moles or having close family members with skin cancer, or having a lot of bad sunburns when you were young, you might be able to find a free screening program for skin cancer in your area that runs sometimes. If you don't have any of these risk factors, just keep wearing your sunscreen and only see a doctor if you see a mole that you're concerned about.
posted by treehorn+bunny at 7:29 PM on September 9, 2011 [1 favorite]
Is there a way to get a cancer screening annually without going bankrupt?
I get the feeling that you think that cancer is one "disease" and/or there's one or a small number of tests for all or most cancers. That's not true. At all. There are thousands of different types of cancers, that express in a fiendishly ambiguous number of ways, most of which have no "test" that doesn't involve "take out a chunk on my body and see if it's cancerous". Things like prostate cancer, for which there is a blood-borne indicator, are fortunate exceptions.
I suggest gaining a solid grounding in probability and statistics. Not just read a Wikipedia article, really understand the subjects. Then get your family history and lifestyle factors and look how those effect your chances of developing any given cancer over your lifetime. If you do this right, and you're still letting fear of getting some arbitrary cancer because you haven't screened for all of them, get therapy. Your problem isn't cancer, it's mental health.
posted by kjs3 at 7:32 PM on September 9, 2011
I get the feeling that you think that cancer is one "disease" and/or there's one or a small number of tests for all or most cancers. That's not true. At all. There are thousands of different types of cancers, that express in a fiendishly ambiguous number of ways, most of which have no "test" that doesn't involve "take out a chunk on my body and see if it's cancerous". Things like prostate cancer, for which there is a blood-borne indicator, are fortunate exceptions.
I suggest gaining a solid grounding in probability and statistics. Not just read a Wikipedia article, really understand the subjects. Then get your family history and lifestyle factors and look how those effect your chances of developing any given cancer over your lifetime. If you do this right, and you're still letting fear of getting some arbitrary cancer because you haven't screened for all of them, get therapy. Your problem isn't cancer, it's mental health.
posted by kjs3 at 7:32 PM on September 9, 2011
I get the feeling that you think that cancer is one "disease" and/or there's one or a small number of tests for all or most cancers. That's not true. At all. There are thousands of different types of cancers, that express in a fiendishly ambiguous number of ways, most of which have no "test" that doesn't involve "take out a chunk on my body and see if it's cancerous". Things like prostate cancer, for which there is a blood-borne indicator, are fortunate exceptions.
You're right...except that prostate cancer isn't really an exception. A PSA test is a useful indicator for monitoring the possibility of prostate cancer, but prostate-specific antigen levels can be elevated by an enlarged prostate or other non-cancerous reasons. I don't think that there are any truly cancer-specific biomarkers, actually.
posted by desuetude at 9:24 PM on September 9, 2011
You're right...except that prostate cancer isn't really an exception. A PSA test is a useful indicator for monitoring the possibility of prostate cancer, but prostate-specific antigen levels can be elevated by an enlarged prostate or other non-cancerous reasons. I don't think that there are any truly cancer-specific biomarkers, actually.
posted by desuetude at 9:24 PM on September 9, 2011
@desuetude: You're right...except that prostate cancer isn't really an exception. A PSA test is a useful indicator for monitoring the possibility of prostate cancer, but prostate-specific antigen levels can be elevated by an enlarged prostate or other non-cancerous reasons. I don't think that there are any truly cancer-specific biomarkers, actually.
Which is probably why I specifically used the phase "blood-borne indicator" and did not reference a "test which tells you that you have prostate cancer".
posted by kjs3 at 12:57 PM on September 10, 2011
Which is probably why I specifically used the phase "blood-borne indicator" and did not reference a "test which tells you that you have prostate cancer".
posted by kjs3 at 12:57 PM on September 10, 2011
Sorry, kjs3, was just intending to clarify for the OP, not pick on you -- your comment sounded to me like it could easily be interpreted as "blood tests that show cancer" by someone not familiar with the technicalities.
posted by desuetude at 9:32 PM on September 10, 2011 [1 favorite]
posted by desuetude at 9:32 PM on September 10, 2011 [1 favorite]
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It's not a good idea to get annual screenings for all kinds of cancer. The reason for that is that all screenings result in some false positives, and the next step is generally uncomfortable and carries some risk. It doesn't make sense to be screened for things that you're not likely to get.
Is there anything bringing on this fear?
posted by craichead at 6:26 PM on September 9, 2011