…..Breast cancer and Lynch syndrome genes are carried by over one million people in the United States, and these two conditions are associated with the most common hereditary gynecological cancers. At present, only a very small percentage of the women who carry these genes have been identified. Therefore, the protocols that can be used to decrease the risk of dying from the cancers that these genes can cause are not being instituted.
…..Our family history will be the first indication that these genes may be a part of our genetic pool, and this can lead to testing for our carrier status. If identified, the cancer screening tests start earlier for the individual carrier and for their relatives in future generations.
…..We must remember that, based on family history, about ten percent of women are at an increased risk for a gynecological cancer. Due to the increased risk of breast, ovarian, colorectal, and prostate cancer, which is determined from the family history, a more intense and earlier testing program may be needed.
…..A woman with a first degree relative with breast cancer has an increased risk for developing that cancer, and it is greater if that cancer was found in that relative before the age of 50. A first degree relative is a parent, brother, sister, or child.
Last week, I spent the day attending a conference at the Icahn School of Medicine at Mount Sinai in New York City. It was called Lung Cancer Screening: A Paradigm Shift in Primary Care. The main focus was on the changing thoughts and new protocols for screening for lung cancer in high risk patients. Of course I looked at the course through my OB/GYN glasses, and here are some of the points I took home:
- Lung cancer is the #1 cancer killer in the United States, and it is now found as often in women as it is in men.
- Therefore, for women in the United States, lung cancer is the #1 cancer killer, and its numbers are greater than breast, ovarian, and uterine cancer combined.
- Smoking and exposure to passive smoke are the main causes of lung cancer.
- Finding lung cancer at an early stage and having it removed can give an overall cure rate of 80% at the Stage 1 level.
- Low-dose lung screening CAT scans can pick up these early cancers, and the radiation exposure can be low, thus decreasing the radiation exposure risks.
- With the new thoracic laparoscopic surgical techniques, post-op pain and recovery time have been greatly reduced.
The questions that need to be resolved are many. When do you start the screening process? In the high risk patient, do you screen yearly? How do you define who is the high risk patient? How are the scans paid for?
I left the conference more determined than ever to try to help my patients stop smoking and to help the younger ones not to start. If you do smoke and have been smoking for a while, please speak to your health care providers to see if these new developments may be of help for you. The lung cancer screening protocols are evolving so keep your eyes and ears open!