We are often bombarded with alarming statistics related to diseases such as breast cancer, which is the main type of cancer that affects women in Malaysia and around the world. While there is no question that regular health checks are essential for women — which ones should you prioritise and how often should you be tested?
According to Dr Sharad Ratna, obstetrician, gynecologist and founder of Subang Jaya OBGYN Women’s Specialist as well as senior lecturer at Monash University, Sunway Campus, the first thing to think about when it comes to health checks is whether the tests are being conducted by trained medical personnel. He recalls meeting patients whose tests were performed in unrecognized screening centers and who later discovered that the results were misinterpreted. This is a dangerous thing as misinterpreted results cause anxiety or sometimes even a false sense of reassurance, which affects peace of mind and could pose a health risk.
“For example, a test result showed that bacteria was detected in the vagina and this made the patient worried. The presence of bacteria in the vagina is normal — it is a matter of type and severity. In this case, the test results were nothing to worry about but the patient was anxious when she was told about the results, believing that she had contracted a sexually transmitted disease,” reveals Dr Sharad.
Many health screening centers package tests with the purpose of raising sales revenue. Therefore, you may end up paying a huge amount of money for these tests, which may turn out to be unnecessary. Worse, you are indirectly supporting unscrupulous test centres that are out to make a quick buck. Dr Sharad stresses that screening tests should only be performed when necessary and should provide benefits rather than cause anxiety.
“All health screenings should fulfill the Wilson’s criteria for screening which emphasises the important features of screening programmes,” says Dr Sharad. For women, the must-do gynaecological health screenings are screenings for cervical cancer, breast cancer and ovarian cancer.”
The gynaecological health screenings Dr. Sharad recommends include the following:
PELVIC ULTRASOUND SCAN AND GYNAECOLOGICAL EXAMINATION
Women should have regular gynaecological assessments and pelvic ultrasound scans to detect cervical cancer or pre-cancer, fibroids and ovarian cysts.
If you have a family history of cancers such as breast cancer, ovarian cancer or bowel cancer, an examination by a gynaecologist is best whereby a pelvic ultrasound scan and a blood test may be recommended.
A specific blood test will be carried out which includes tumour markers and genetic markers to detect the presence of cancers or if further medical attention is needed.
Aside from a gynaecological assessment, other health screenings that Dr Sharad recommends for women are:
In some countries, a pap smear is recommended for women above the age of 21. “However, a woman should get herself regularly tested one year after becoming sexually active,” says Dr Sharad. Pap smears, which are also known as Pap tests or HPV tests, can detect any abnormalities in the cervix (the neck of the womb)such as the presence of human papilomavirus (HPV), which causes cervical cancer at the high risk level and genital warts at the low risk level.
The doctor uses a lubricated speculum to open the vaginal canal and will collect cells from the outer opening of the cervix. You may feel a little pressure but the procedure usually causes minimal to no pain. If you do experience discomfort or pain, be sure to let your doctor know.
Sexually active women are encouraged to have a pap smear yearly for the first few years after their sexual debut. If the results turn out to be normal for the first few years, your doctor may recommend a pap smear every 2-3 years instead.
You will need cervical cancer screening if
- You are sexually active
- Have multiple sexual partners
- Your partner has previously engaged in sex with other partners
- You practice unprotected sex
- You are a smoker
The American Cancer Society also recommends women between the ages of 30 to 65 to have a pap smear plus a HPV test every five years as part of a cervical cancer screening.
SELF BREAST EXAMINATION
“Self breast examinations should be conducted every month during a woman’s menstrual cycle,” says Dr Sharad. A girl should practice monthly breast examinations from the first month she gets her period. Self breast examination is a simple technique which can be done in the comfort of the home.
Performing this examination monthly will help a woman detect changes or lumps in her breast, which may be an indication of breast cancer. Log on to the Breast Cancer Welfare Association Malaysia’s (BCWA) website at www.breastcancer.org.my for guidelines and techniques on how to conduct a self breast examination.
BREAST ULTRASOUND SCAN AND MAMMOGRAM
The breast ultrasound scan is basically a scan of the breasts while a mammogram is an x-ray of the breast. Mammograms and breast ultrasounds are effective when it comes to breast cancer screening. In Malaysia, women aged 40 and above, are recommended to make an appointment for an annual screening
Dr Sharad advises women with relatives who had breast cancer to go for a breast ultrasound scan or mammogram 10 years before the cancer was detected for the family member. For instance, if you know of an immediate family member who was diagnosed with breast cancer at the age of 40, you are advised to get yourself screened from the age of 30.
Colorectal cancer is the third biggest killer among women in Malaysia. Colonoscopy or sigmoidoscopy is used to screen and diagnose colorectal cancer. This type of cancer generally exhibits no symptoms but be on the lookout for blood in the stools, diarrhea or abdominal pain. The American Cancer Society recommends both men and women above the age of 50 to undergo colorectal screening.
BONE DENSITY TEST
Postmenopausal women are at high risk for osteoporosis due to the hormonal changes they face at this stage. Women who have experienced menopause and who have a family history of osteoporosis should go for a bone density measurement test.
Dr Sharad says that DEXA is one of the best options available as it involves scanning your entire body to measure bone density. However, he advises that one of the best ways to guard against osteoporosis is to exercise and to eat a diet rich in calcium and Vitamin D. Specific medications are also available for menopausal women and can help combat bone density issues.
A cholesterol test is done via a blood test, which helps to determine the buildup of plaque, which narrows or blocks arteries in your body. There are no evident warning signs or symptoms for high cholesterol, which is why a cholesterol test is very important.
You should ideally opt for a cholesterol test in your 20s and if you have a healthy cholesterol level, you should go for the test every five years. A cholesterol test is especially important if you are overweight, practice a sedentary lifestyle and have a family history of high cholesterol or heart disease.
BLOOD SUGAR LEVEL SCREENING
Non-communicable diseases like diabetes are on the rise so a blood sugar level screening is recommended for men and women of all ages. Blood sugar tests are simple and quick and may just save your life.
If you cannot resist those sugary treats and oily food, be sure to take the necessary precautions and get yourself checked yearly.
As Dr. Sharad says, “early prevention leads to detection and cure.” He also reiterates that health screenings should not be conducted on a whim but should be done when necessary.
If a health problem is detected in your results, be sure to immediately make an appointment with a specialist as various helpful treatments are widely available today.
Here’s how you can take control of your health and reduce your risk of getting cancer.
• Stay away from tobacco.
• Stay at a healthy weight.
• Get moving with regular physical activity.
• Eat plenty of fruits and vegetables.
• Limit how much alcohol you drink (or don’t drink at all).
• Protect your skin.
• Know yourself, your family history, and your risks.
• Have regular check-ups and cancer screening tests.
* Information derived from www.cancer.org