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Friday, July 22, 2011

A Family Doctor's Tale - CANCER SCREENING 4

DOC DO I NEED TO GO FOR CANCER SCREENING 4

Cancer screening :


F.Cervical Cancer

Cervical Cancer is the sixth most common cancer in women in Singapore but can be prevented and treated early if regular screening is done.

Women who are at high risk of cervical cancer are those with:
1.sexual intercourse at an early stage


2.sexual intercourse with multiple partners


3.history of sexually transmitted infections


4.infection with certain high risk strains of human papilloma virus (HPV)


5.weakened immune system such as HIV infection


6.prolonged use of combined oral contraceptive (birth control)pills

Cancer screening procedures includes:
1.Pap smear test should be done yearly in women who has sexual intercourse or abnormal vaginal bleeding.
The Pap smear test involve a simple procedure in which the doctor obtains some scraping from the neck of the womb or cervix to detect abnormal cell changes.
Early detection of cancer of the cervix means early treatment and cure.
Patients who had HPV vaccination should also continue to go for regular Pap smear every 3 years


2.Yearly vaginal examination and pelvic examination which involve the Pap smear

G.Nasopharyngeal Cancer

Nasopharyngeal Cancer or NPC is a common cancer of the head and neck region especially common in Chinese men between the age of 40-65.

People who are at risk of developing Nasopharyngeal Cancer or NPC are:
1.family history of nasopharyngeal cancer -common in Chinese males, less so in other races and females


2.Viral infection of the nose-Epstein-Barr (EBV) virus has been shown to be present in most cases of nasopharyngeal cancer

3.Smoking with its 40 or more toxic chemicals in cigarette smoke can stimulate abnormal cells in the nose to mutate and become cancerous


Cancer screening procedures of nasopharyngeal cancer includes:
1.Blood test-tumor marker EBV. Blood is tested for raised level of EBV IgA antibodies against Viral Capsid Antigen(VCA) and Early Antigen).
Patients with raised EBV IgA antibody have a higher risk of developing NPC.
If these antibodies are seen to rise significantly, there is an indication of possibility of NPC in which case an endoscope examination of the upper nose and nasal biopsy can be done to exclude NPC.


VCA IgA test is more sensitive than EBV but remains high for 6 months following a viral upper respiratory tract infection.


EA IgA test is more specific in diagnosing NPC but the levels are also high in cancers of salivary glands, lung and stomach.


2.nasoendoscopy for patients with family history of of nasopharyngeal cancer or NPC.

 

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