It might seem as if you can’t go a week without hearing something about cancer. One day it’s about revolutionary treatments, the next it’s updated screening guidelines. It’s an exciting time, but what’s the best way to take care of your health? Make sure you’re savvy about the latest advances to maximise their benefits for you.
IS THERE A LESS PAINFUL WAY TO HAVE MY BREASTS SCREENED?
Good news – in the next five years, a new scan will be available that will see the end of painful breast squishing between compression plates. Taking only 15 minutes, this approach uses near-infrared light from a hand-held probe to look for tell-tale cancer changes to blood supply and tissue. In the meantime, these other options are available now:
MRI breast scans
Mammograms don’t work as effectively for “dense” breasts, which have more glandular tissue. And it turns out that a more effective alternative has been under our noses all along. “A landmark Netherlands trial has just found that MRI scans find more cancers and miss fewer cancers than mammograms in women with high breast density,” says Dr Bruce Mann, specialist breast surgeon and Chair of the Board of Breast Cancer Trials Australia. If this applies to you and you’re due for a mammogram, ask your doctor about an MRI option.
Molecular breast imaging (MBI)
This uses a radioactive tracer that works a little like a magnet attracted to metal, attaching itself to clusters of breast cancer cells as small as five millimetres. A special camera then takes images to record the exact location of the cancer. If you have a breast lump, or your mammogram is inconclusive, this test can help determine an accurate diagnosis.
WHAT HAPPENS IF I FIND A BREAST LUMP?
Your doctor may send you for an ultrasound or a small needle biopsy to take a sample of breast tissue to test. In 80 per cent of cases, breast lumps are not cancerous. But if cancer cells are present, surgery may be recommended. In most cases, this involves a lumpectomy – where the breast lump and some tissue around it are removed. Within the next fiveyears, a surgery-free technique called large needle biopsy will also be available to remove very small growths. “This is great news because it allows us to quickly address small cancer tumours when they’re less likely to have spread and easier to effectively treat,” Dr Mann explains.
IS A PAP SMEAR STILL THE BEST WAY TO CHECK FOR CERVICAL CANCER?
In 2017, the Pap smear or Pap test was replaced by a new Cervical Screening Test, which is more effective. Instead of just picking up signs of cancer, it can detect the Human papillomavirus that causes cervical cancer. What this means is that you need to be tested less often. “If you’re aged 25 to 74, your first cervical screening test under the new program is due two years after your last Pap smear test, then five yearly after that,” says Professor Sanchia Aranda, CEO of Cancer Council Australia. In the next five years, a new test called PapSEEK will use that same test to also screen for signs of ovarian and endometrial cancer.
IS IT OKAY TO USE A HOME TESTING KIT INSTEAD OF HAVING A COLONOSCOPY?
If you’ve turned 50, you will already have received your “happy birthday” home-testing kit from the Federal Government to screen for bowel cancer. The kit is a helpful screening check recommended every two years after you turn 50.
Called the faecal occult blood test (FOBT), it can pick up small amounts of blood in your bowel motion (sometimes caused by cancer). It’s free for people who are aged 50 to 74, but at any age you can pick up a kit from your GP and have the test done for a low fee or no fee (most pathology labs bulk bill for the test and a Medicare benefit is available for it too).
What’s important to remember is that the stool-testing kit only picks up signs of blood, which can be due to numerous causes. To confirm whether it’s cancer, you still need a colonoscopy.
“Your doctor might also recommend a colonoscopy if you have a strong family history or symptoms of bowel cancer, or have previously had bowel polyps or bowel cancer,” Prof Aranda says. As the frequency of colonoscopies is different for each person, ask your doctor about how often you should have one, based on your health, family history and any previous bowel test results.
Meanwhile, these two screening alternatives are both available. As they may not be as accurate as a colonoscopy, ask your specialist if they’re a good option for you:
A special scanner takes a 3D movie of the colon from different angles. This only takes around 20 minutes, requires no prep or downtime, and there’s no risk of bleeding or perforation of the bowel wall.
The capsule, which you swallow, contains a minuscule camera that travels through your bowel, recording a video, transmitted to a small device around your waist. Your specialist analyses the video for signs of polyps. The capsule comes out in your bowel motion. This method may be used to find benign bowel growths and cancerous polyps or to investigate bleeding in your stool. It may also be used as a follow-up test if other tests were not clear or were inconclusive. Ask your specialist if you are a good candidate for this test.
IS IMMUNOTHERAPY THE BEST WAY TO CURE CANCER?
Cancer cells cleverly hide from the body’s immune system, which is why the body is unable to fight the cancer in the way it fights the flu or other diseases. In recent years, immunotherapy, which allows your body’s natural immune defences to see the cancer cells and attack them, has become available. What’s great about this treatment is that it doesn’t have the unpleasant side effects often caused by chemotherapy and radiotherapy, because it’s harnessing the body’s own natural defence system. “Though immunotherapy does not work for everyone when it is successful, it can rapidly stop or reduce cancer growth – sometimes within just weeks," Prof Aranda says. These drugs are already being used to treat cancers, such as melanoma and bladder cancer, in Australia.
Are skin cancer detection apps really accurate? No, they are often inaccurate, says Cancer Council Australia. “If you’re concerned about a spot on your skin, have your skin examined by your GP, who might refer you to see a dermatologist,” says Cancer Council Australia CEO, Professor Sanchia Aranda.
Your specialist may use a hand-held microscope called a dermatoscope to take a closer look at suspicious spots. Total body photography to record all your freckles, moles and spots may also be recommended. At your next visit, you will then have another set of photographs taken, and a computer program, such as MoleMatch and MoleMap, will compare them to the previous shots to pick up any changes that might point to any possible skin cancer.