Ronél van Rooyen is a Johannesburg-based registered professional nurse who regularly does health screenings at wellness days. She says most people these days know the importance of screening for blood pressure, cholesterol, glucose and, of course, HIV. For women, screening for breast cancer, especially if there’s a family history, and cervical cancer are the two most important tests, because these are the two most common cancers among South African women. If detected early, there is an excellent chance of survival.
Practical tips and steps for early detection of breast cancer
1 Breast self-examination is recommended for all women who are older than 18 years. it should be done once a month while lying down or showering. The best time is 10 to 14 days after the onset of a menstrual period.
2 If you detect a lump or breast tissue changes, your doctor will examine you and may then either schedule a mammogram or do a fine needle aspiration to draw cells from the lump that can be sent for evaluation.
3 If your mother, or an aunt, sister or grandmother has been diagnosed with breast or ovarian cancer, it may be wise to consider a genetic (DNA-based) test to check if you carry an identified breast cancer gene. If people with these genes adapt their lifestyle to a healthy one, and go for a mammogram annually, they can delay the onset of cancer or prevent it entirely, or at least ensure early detection and treatment.
4 Don’t smoke, eat four to five fruits and vegetables per day, and eat less than a tablespoon of animal fats per day.
5 Be good to yourself. Go for a walk outdoors, climb a mountain, have a good laugh with friends, or spoil yourself at a spa.
Cervical cancer tests & prevention
We spoke to Dr Annette Smith, a histopathologist at Pathcare (Voigt & Partners) in Bloemfontein, about screening for and immunisation to help prevent cervical cancer.
With the newer liquid-based cytology (LBC) method of testing for cervical cancer, do women still need an annual checkup? Dr Smith says: ‘Liquid-based cytology testing is more reliable than the standard Pap smear test so if this method is used, you need to have a checkup only every two years. Unless, of course, there is an abnormality, in which case your GP or gynaecologist will advise you about follow-up visits.’
What are the advantages of LBC? She says: ‘Apart from being more reliable than the standard Pap smear test, virus testing can be done on the same sample. So, if a virus change is detected in the sample, the patient won’t need to have another sample or swab taken.’ The downside is that this method is more expensive, but according to Dr Smith, most medical-aid schemes will cover the procedure.
Is LBC widely used or do you need to request it specifically from your GP or gynaecologist? She says: ‘In the private sector, liquid-based cytology is the most commonly used method these days. Some GPs and gynaecologists only use LBC.‘
What is your view on the vaccination against the human papilloma virus (HPV), meant to guard against cervical cancer? ‘The vaccination is very valuable as a preventive measure for women between the ages of 10 and 25, especially in high-risk cases, so there definitely is a place for it.’
Medical checks at every age
In your 20’s & 30’s:
General checkup by your GP or health practitioner: Have a checkup once a year (or a minimum of every other year). This should include an annual clinical breast exam. Include cholesterol and glucose testing every five years and blood-pressure testing every two to four years.
Dentist: Go every six months for teeth cleaning and for an oral examination. Your dentist should also do a check for temporomandibular joint (TMJ) syndrome. Jaw clenching, grinding, or bad alignment of teeth can cause this disorder. Even if you don’t notice any symptoms, such as headaches or jaw pain, your dentist should look at your bite and feel your jaw to ensure there is no stress on the joints.
Gynaecologist: Visit once a year, or, in the case of liquid-based cytology (LBC) testing, once every two years. Include a Pap smear or LBC to screen for cervical cancer, and pelvic and clinical breast examinations. If you have a new sex partner, add screenings for sexually transmitted diseases (STDs). If you have more than one sexual partner, you should have a Pap smear and STD tests every six months.
Dermatologist: If you’re fair-skinned or have a family history of skin cancer, you’ll want an annual appointment. Ask your dermatologist about mole mapping to assist in the early detection of skin cancer. Otherwise, go if you have any suspicious moles or any other skin problems.
In your 40’s ADD:
Mammogram: It is often recommended that you start annual screenings at 40, although some guidelines do suggest beginning at 50. Use your intuition and common sense based on your health and family history, and discuss your decision with your doctor.
Stress echocardiogram: Get a baseline analysis to check your heart’s health.
Eye examinations: Have your eyes examined regularly by an optometrist. Many doctors advise going annually, although others recommend every two to four years until age 65, then annually. The optometrist will check for changes in vision and eye conditions like cataracts, spots or floaters. The visit should include an intraocular pressure measurement for glaucoma.
In your 50’s & above ADD:
Colonoscopy: Have one every five years.
Bone mineral density scan: This test determines if you have osteoporosis – a disease that causes bones to become more fragile and more likely to break. It is recommended for all women – and men – 65 years of age and older. It’s also recommended for middle-aged women younger than 65 who have risk factors for osteoporosis. These include if you’re menopausal, very thin or small boned, you smoke, you’ve taken certain medications for a long time or you have a family history of osteoporosis.
Memory test: Tell a complex story and repeat key points, or have someone tell you a phone number and see if you can remember it – if you can’t pick it out of a list of numbers, this could be a sign of early Alzheimer’s disease.
Thyroid: Women should have their thyroid tested every five years after menopause. Also get tested if you have unexplained weight loss, irritability, irregular heart rate, insomnia or muscle weakness (symptoms of an overactive thyroid); or fatigue, depression, weight gain, dry skin or trouble concentrating (signs of an underactive thyroid).
The man in your life
In his 30’s: He should have a cholesterol test every five years as well as an annual faecal occult blood test.
In his 40′s or older: He needs an annual rectal exam and a blood test to screen for prostate cancer. He should have a colonoscopy every five years.