This morning I was “hit by a Mack truck”. Well actually it was parked and I walked into the enormous side mirror, clocked my head and almost passed out. Sheesh! I would need that like a hole in the head. Good thing I was at the market so I grabbed a bag of frozen peas to buy and that controlled the expected huge lump! But everyone gets a chance at a “Mack truck moment” and cancer provides it in spades. No Doc, it’s just a lump….. No it’s just a headache. For thousands of patients I have seen over thirty years, it always starts with “just”. While a diagnoses of cancer is usually unexpected, how we impact the diagnosis and result is in our control.

As insurers are squeezing the healthcare out of your paid-for plan, and Docs are getting more and more scarce (you know this by now trying to get any appointment lately) being your own advocate is incredibly cumbersome but really important.

So, when to see a doctor?

Let’s start at the top. Any neurologic dysfunction requires an MRI – always. Think its a stroke, a headache that doesn’t go away? A change in speech or decreased memory or inappropriate behavior. Tell your doc you want an MRI.

Head and neck. No it’s not tonsillitis at 70 years of age. It can be HPV positive head and neck cancer or smoking related cancer. Ask for an ear nose and throat doc and a scope, especially a scan if there is swelling. Norm said he went thru rounds of antibiotics for months. His new found base of tongue cancer now is in the lymph nodes.

Chest: A cough that does not resolves in a week needs a chest xray at minimum. Any coughing of blood, a CT scan and probably scope by a pulmonologist.

Fullness in the belly not weight related? especially if there is any pain. You need a CT scan- pancreatic, liver and ovarian can increase fluid in the abdomen quickly. Seem off color? Yellow eyes and dark urine requires CT abdomen to r/o pancreatic or bile duct cancer.

Up at night to pee? You may have an enlarged prostate, but what is your PSA and family history? See a urologist. Blood in urine- do not let them just give an antibiotic. See urology for a scope. Bladder cancer increases with age.

Bone pain that is increasing, not intermittent requires an MRI, ask for it always. Multiple myeloma may be found or metastatic cancer to bone. Skin issues are everywhere…This spot isn’t going away and changing color…and now it’s bleeding – its skin cancer so get it biopsied.

Peggy told me she hasn’t had a mammogram for 30 years because she gets CT scans for lung screening (since she was a smoker and thought it would show there). No it doesn’t. When she found it, she had 3 lesions and needed surgery chemo and radiation, now hormones. “But no one in family had breast cancer.” I replied , “But 85% are not genetic”.
Yes, everything is cancer to me until proven otherwise. Mostly all the aches, pain, memory loss, skin “marks” are really signs of an aging body. But wouldn’t you like to NOT MISS something important so that you are not blindsided? We don’t need the clunk on the head. We just need to be aware of our bodies. You can’t wait until a yearly check up.

Self care is hard work and takes vigilance. No one knows your body like you do. Docs rely on your own insight; they are not clairvoyant. With one in two-three of us developing cancer in our life time, we cannot become complacent. Treatment, even for the most aggressive tumors, is most successful when found early. Be your own watch dog. Pay attention. Don’t wait for a yearly check up to take action. I say we should expect the unexpected to have the greatest chance for success. You are smart. You can do this, and frankly health is everything. Best wishes, friends.