Take Charge of Your Health
An article by Dr. Kirtland Culmer

Fight Cancer…Some Battles Can Be Won
The month of May was cancer month, and I had the privilege and honour of being one of the volunteers asked to assist the Cancer Society with giving the public the opportunity to have free Pap smears at several of the government clinics. It gave me the opportunity of getting the views of a larger variety of folks than I would not ordinarily see in my private office. Some of the ideas expressed in our conversation will be shared with you in the following paragraphs. But first, here is why Pap smears are so important. CANCER OF THE CERVIX IS PREVENTABLE.

The Pap smear was introduced by Papanicolaou in the 1930’s and endorsed by the American Cancer Society in 1945. Although it is a great prevention tool, education, regular examinations, lab testing, and other clinical procedures are also a part of the prevention program. I saw patients who had never had a medical examination or Pap smear. Some had gone six to ten years without one. Some used the excuse of living far away from doctor’s offices or clinics. Others indicated that they were poor, had no insurance, and did not know that the government provided free or inexpensive examinations according to their circumstances. Some were old, and did not have enough caring friends or relatives to get them to the care areas. Some were embarrassed to have such an intimate examination. Their friends told them that it was painful. Some had an innate fear of doctors, and were terrified that they would find something bad. Others failed to follow up after they had their tests, and when anything abnormal was found, they were too frightened to continue with the additional procedures.

In other words, there are people who do not adhere to the care plan, and that is the reason why so many ladies are still dying of this cancer which is a preventable disease. Although these responses are quite human and understandable, it is still our job to produce effective communication, patient education and counseling to improve the adherence to the care plan. You ladies must TAKE CHARGE to reduce the incidence of unnecessary deaths by getting regular checkups at your doctor’s office or clinic, have your Pap smear ideally once per year, and follow seriously your doctors care plan.

The other most talked-about cancer in females is cancer of the breast. I mentioned in one of my previous articles that there is a growing body of evidence that suggests that postmenopausal obesity and a sedentary lifestyle are important risk factors for breast cancer. Therefore you ladies, who think that it is cute to get fat and lazy as you become older, need to think of this, eat less and exercise. It is also suggested that a high fat intake increases the incidence of breast cancer. We know that if a relative has breast cancer, the risk is extremely great.

Although there are no tests for cancer of the breast that are as reliable and fool proof as the Pap smear, we know that early detection increases the chances of survival. So TAKE CHARGE ladies, get a healthy lifestyle, do your regular breast self-examinations, get your checkups on schedule, and press the alarm with any suspicious discovery.

Finally, a big topic for the men during the ball games is cancer of the prostate. It is a topic of fear for the men because it is truly the greatest cause of death from cancer in men. Again, although screening and early detection seem to be of some but slightly doubtful benefit, there is still nothing for men as reliable as the Pap smear.

The large increase of prostate cancer in the past ten years is attributed to PSA testing, and reflects the prevalence of the disease rather than the true incidence. Prostate cancer represents about 29% of all newly diagnosed cancers. It is a disease associated with aging, as more than 75% of prostate cancers occur in men 65 years and older. It is more common in black men than in white men. Hereditary factors also play a role in the development of prostate cancer.

The best means of detecting prostate cancer involves both a serum PSA and a digital rectal examination. Neither test alone can detect all tumours, and at least 20% of prostate cancers will have a PSA below the upper limit of “normal”. So the test results have to be interpreted according to age, race, PSA velocity and PSA density. This simply means that there have been some refinements in cancer detection.

So it is apparent that in spite of controversies with regard to screening, treatment and the prediction of outcomes for this disease, recent studies have shown that there is a definite decline in deaths from this disease, and a reduction in the incidence of spread to other organs. This is attributable to more effective screening and staging, and early treatment. TAKING CHARGE is effective even with this one. It is our prayer that, some day soon, the GREAT ONE will give us the wisdom to take complete charge and find a cure for all of them.