CancerChronic Disease

The ‘C’ Word

Version 3

The scariest, life altering, awful, illness that can be imagined - Cancer. So, let’s talk about it.

Cancer can affect any part of your body and can form as a large mass such as a tumor or can affect your blood, in which case, a tumor does not usually form. Tumors begin as abnormal cells that continue to grow and copy (replicate). These cells are considered abnormal because either they are not needed or, they are old and damaged and should have died. Tumors get their nutrients from the body and blood flow around them, this helps them grow. The blood supply also helps remove wastes from the tumor and because of this, the cells can travel to other places in the body and develop tumors there. If you would like to read more detailed information, click here.

How does cancer happen?

Cancer is a genetic condition. Genetic refers to your genes, which are made up of your DNA and, live at the center of cells. Your genes provide cells with instructions on how to function. Cancer can either be hereditary – passed on in your genetic makeup from your parents at birth or, your genes can be affected by environmental factors. Environmental factors include toxins like smoke inhalation, chemical inhalation or radiation. Because of hereditary or environmental factors, the genes are no longer signaling the cell to grow and function in a normal way –abnormal cells that should die continue to live and replicate affecting the body’s ability to function normally.

What types of cancer have regular screening programs?

Colorectal screening (bowel) – Screening starts at age 50 in Ontario and is best done by colonoscopy. A colonoscopy involves visualizing the bowel with a small camera that is advanced through your intestines. For comfort, patients are usually put to sleep or given medication for pain and comfort (conscious sedation). There are other tests including a fecal occult blood test and a low dose CT scan however, the benefit of screening through a colonoscopy is that abnormal cell growths can be detected and removed prior to being a concern. People who do not have a family history of colon cancer, who do not have symptoms and have no had polyps are screened every 10 years.

Mammogram (breast screening) – This test has been proven as an effective screening tool for women ages 40-74. An x-ray of the breast is taken and reviewed for suspicious nodules. Risks and benefits to screening between 40-49 years of age should be discussed with your practitioner. As mentioned prior, radiation exposure in general should be limited in individuals. If screening is started in this age group, it is suggested screening should take place every 2 years. Screening for all women should start at 50 years of age. Frequency of screening should be discussed with your family doctor. Also note, that symptoms of breast cancer include: hard nodule, breast redness and tenderness, discharge. If you have any symptoms or concerns, contact your health care practitioner to discuss further.

Pap test and HPV testing (cervical screening) – This screening generally starts at age 21. A sample of the cervix is taken during a PAP test and reviewed for abnormal cells. An HPV test is done via swab of the cervix. Generally, under OHIP guidelines, if a PAP test is normal, no HPV testing is required. If a PAP test is abnormal, HPV testing will be done. Depending on your PAP and HPV testing, the frequency of follow up testing will be determined by your health care practitioner. If your PAP test is normal and your sexual partner is unchanged, it is likely that follow up every 3 years will be suggested.

PSA and Digital Prostate Exam (prostate screening) – There are no specific screening recommendations for prostate cancer as they are still being studied. The PSA test is a blood test for prostate specific antigen; a protein produced by cells in the prostate. It can be elevated for a few reasons, one of them being cancer making it difficult to use this test to screen for cancer, because it lacks specificity, PSA levels should be used in screening and interpreted with caution. The digital rectal exam is done by inserting a finger in the rectum to feel the prostate. Unfortunately, this exam has limitations as well, cancer could be developing in areas of the prostate which cannot be felt during the exam and further, prostate cancer detected during the exam is already at an advanced stage.

Skin exams (skin screening) – This screening should start as necessary. People who are at risk for skin cancer should frequently check their skin for any concerning features and review with a physician the need for treatment.

Today's pearls...

  • Cancer happens when deadly, abnormal cells grow in your body.
  • Cancer happens because of changes in your genes that you are born with or, happen because of the environment.
  • Participating in screening increases your chances of finding and treating cancer before it's too late.

We will explore cancers more specifically and their effect on physical and mental wellbeing in upcoming blogs. If you have any questions in the meantime, you can find us at .


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