Once you are underway with therapy there is almost a sigh of relief. Yes, there’s concern about side effects, what to expect, interruptions in schedules and “real life“ ,but pretty much everyone gets on with it and finds a way to manage. The toughest conversations both for patients and their families is when they rethink the last few months or even years. With full knowledge that cancer found early is much more curable than after it has metastasized, a missed opportunity disheartens everyone. Trust me that doctors feel this way as well. Many patients leave their primary care doctors having a full battery of blood tests and a physical exam with a “clean bill of health“. Too often a matter of weeks or months thereafter, disease is found and occasionally it is overwhelming.

Patients are always surprised that these yearly check ups are so disappointedly unrevealing. They thought that bloodwork would show the cancer. Routine bloodwork does not. They wondered why no scans were ordered, even a chest x-ray. Years ago we did chest x-rays just as a screen during cataract surgery, and many small curable lung cancers were found, and that is long gone. Now, unless you actually have chest symptoms, a chest x-ray is almost never ordered. Only patients with the history of smoking get to be reviewed with CT scans routinely. Lung cancer notoriously is one that if found early could be cured, but generally are found in stage is three and four hence the poor prognosis. You’re intake on all the many forms tries to guide your physician as to whether there could be a sign or symptom to follow up on, but as people age, there are all sorts of confusing tidbits that arise and confuse the picture.

Here is the recommendation: get all of your screenings and don’t let anyone tell you are “too old to have them“. Colonoscopies,gyn exams, mammograms, PSA testing,skin checks for skin cancer are the minimum. A physical exam where a lymph node could be palpated or an abdomen that is distended or an enlarged liver or even a rectal or anal mass could be found, abnormal breath sounds, abnormal ear, nose and throat exam all of these take laying on of eyes and hands by your doctor. or even a rectal or anal mass could be found.The good news today is that the future is very bright for finding cancer early.
A pioneer blood test will detect more than 50 cancers before symptoms appear, saving tens of thousands of lives a year. It is being called the “Holy Grail“ for cancer. It is titled the Galleri test by pharmaceutical firm Grail, which looks for fragments of cancerous DNA that have broken off of a tumor and are circulating in the blood. This signal will allow doctors to pick up traces of cancer when it is most treatable months or even years ahead of symptoms. The blood test alone will transform outcomes for patients. This was presented at the American Society of Clinical Oncology (ASCO) , demonstrating a transformational shift in cancer detection, moving us to more comprehensive and proactive approach. It will also help reduce false positives that current screening programs provide. We expect in the future to see a substantial decrease in stage four cancers with this new detection agent. When you see your doctor, ask about this since it will move quickly into clinic from trial and we are hopeful that insurances will begin to cover. This will make that once a year visit with your doctor so much more valuable and revealing.

It is heartbreaking when one of our patients or a loved one is diagnosed too late to have significant impact on the disease with treatments. I am excited about this new tool in our armamentarium to evaluate patients and be proactive in their care. New treatments are evolving rapidly, but we must know the disease first. Help is on the way for all of us and as always, I am grateful to the researchers and companies providing us with this outstanding and necessary tool. There is good news every week in cancer management. Stay aware, stay strong and prepare for victory. God bless.