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Fight these taboo cancers, just like they did

There are two types of cancer — the kind that we talk about, and the other that is hushed up. This is largely because they are linked to our private organs. But this doesn’t mean that we turn a blind eye to it. In Part II of our Fit at 40 series, The GUIDE reveals these taboo cancers, and why it’s important to be aware about them, especially when you hit your 40s

What’s common between billionaire Warren Buffet, actors Robert De Niro, Roger Moore, and Australian singer Kylie Minogue? They were all detected with cancer, but managed to survive it. Apart from cancerous cells in their body, their stories have another thing in common: timely detection that saved their lives. Cancer is deadly whether it’s prostate, breast, cervical or ovarian, and it can kill, whether or not we like to talk about it. There is no sure-shot treatment for all types of cancer, but an early detection can go a long way to prevent them.

Australian singer Kylie Minogue
Australian singer Kylie Minogue was detected with breast cancer in 2005, in the middle of a concert tour. She resumed her career in 2006 after treatment. The 45-year-old compared her breast cancer operation to going on to the stage. Pics/ AFP

Know about cancer and the risks
Dr Monica Goel, consultant physician, PD Hinduja Hospital says that awareness about the different types of cancer, the various risk factors and an understanding of their signs and symptoms goes a long way in preventing them. For example, “Breast / ovarian cancer risk is higher among women with early menarche and late menopause as the body gets used to more estrogen which causes increased proliferation of cells in the breast and uterus.”

Known for “tough guy” roles in films including Taxi Driver and Raging Bull, Robert De Niro was detected with prostate cancer at the age of 60. His cancer was detected at an early stage because of regular check-ups. He went on to make a full recovery and, in 2011, at 68, became a father for the sixth time.
Known for “tough guy” roles in films including Taxi Driver and Raging Bull, Robert De Niro was detected with prostate cancer at the age of 60. His cancer was detected at an early stage because of regular check-ups. He went on to make a full recovery and, in 2011, at 68, became a father for the sixth time.

Besides, women who had their first delivery after 30 years of age, are regular smokers or have a family history of the diseases are more likely to get breast cancer. An active sex life or multiple sexual partners puts women at risk for cervical cancer, because it’s caused by the DNA-altering Human Papillomavirus (HPV), most of which transmit through sexual contact.

Why early detection always helps
Dr Goel says that simple measures like a regular health check-up and early detection of symptoms, if any, can go a long way in preventing a disease. “For example, mammograms can detect breast cancer in women two years prior to the appearance of physical symptoms,” she says. Also, smoking cessation and curtailing the intake of alcohol can go a long way in preventing the onslaught of these illnesses, she advises.

Dr Rishma Dhillon Pai
Dr Rishma Dhillon Pai

Dr Rishma Dhillon Pai, gynaecologist and author of Fit at 40, writes in her book that though screening for ovarian cancer is possible through a pelvic exam, it is usually advanced by the time the signs are visible by a pelvic exam. But still, she advises a pelvic exam to be a part of women’s routine check-ups, and to visit a doctor if symptoms like lower abdominal pain, feeling like urinating all the time, pelvic pain, back pain, swelling of the abdomen continue longer.

A pap smear (cytology) of the cervix reduces cervical cancer incidence and mortality. — Dr Amrapali Patil
A pap smear (cytology) of the cervix reduces cervical cancer incidence and mortality. -- Dr Amrapali Patil

However, there are methods available to detect pre-cancerous changes in prostate, cervix and breasts, which if not treated can lead to cancer, says Dr Amrapali Patil, weight management expert and founder, Trim N Tone. Dr Patil advises women post 40 to undergo mammography at least every two years. She also suggests that women should physically examine their breasts regularly for any lumps, changes in breasts or their size, or get it physically examined from their doctor.

“A pap smear (cytology) test of the cervix reduces cervical cancer incidence and mortality. Pap is more frequently and successfully used to screen cervical cancer,” she adds. A research report by The American Society of Cancer, suggests that women begin with pap tests every three years after 30, and every five years for those above 50. It suggests a physical breast examination every year when women touch 40.

Men and the big ‘C’
Prostate cancer is the sixth leading cause of cancer deaths among men. Though Indian men are at a lower risk when it comes to prostate cancer, they are not safe from it. And, as with other cancers, early detection helps, immensely.

Dr Patil advises men to opt for prostate examinations at least once when they enter their 40s. “The tests for prostate cancer include digital rectal exam and Prostate Specific Antigen (PSA) test, which measure the level of PSA in the blood. Levels are higher in men who have prostate cancer or other afflictions of the prostate,” she adds.

Surprising as it might sound, men are also likely to get breast cancer, the most common being Gynecomastia. The symptoms usually include increase in sensation around the breasts, growth in size, or formation of lumps. 

Tests to sign up for
3 must-do tests when you turn 40
There’s no hard and fast rule that if you do something, you won’t ever fall sick, but regular check-ups come very handy when it comes to diagnosing certain life-threatening diseases. We asked some of our doctors on-board to prepare a list of tests that should be done once you turn 40, as the sooner you start treatment, the better are your survival chances.

Women
> Breast physical examination and mammogram for breast cancer. Every three years after 40.
> Pap Smear Test: Especially if you are sexually active. It helps in detecting cervical cancer, if present.
> Pelvic exam: This is one of the few tests which help diagnose ovarian cancer.

Men
> Colonrectal cancer screening -- stool test, sigmoidoscopy, colonoscopy.
> Prostate Specific Antigen Test -- screening for prostate cancer
>Testicular exam during every physical exam.

Tests for men and women
> Blood sugar screening -- fasting as well as post-meal. This is to rule out diabetes.
> Comprehensive eye tests to rule out glaucoma, presbyopia, etc.
> Cholesterol profile / screening for any heart condition.
> Body composition analysis -- to keep body weight, fat percentage, visceral fat, Body Mass Index (BMI) in check.
> Dental check-up.
> Blood pressure screening- this might increase with age. It can be lowered with the help of diet, exercise and medications. Lose weight if overweight or obese.
> Colorectal cancer screening.
> Bone mineral density test for Osteoporosis screening.
> Immunisation status: Check with your doctor for your immunisation status. You might need booster shots of tetanus or flu vaccine or pneumococcal vaccine or hepatitis vaccine. 

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