Author: rudy.trevino

The short answer is YES!

“An estimated 3.2 million U.S. cancer deaths have been averted since 1991 because of improvements in early detection, and treatment, as well as reductions in smoking.”https://prescancerpanel.cancer.gov/reports-meetings/cancer-screening-report-2022/challenges-opportunities

Breast cancer deaths have gone down by 50% in the U.S. between 1975 and 2012 with the use of mammogram screening, along with advances in treatment.

Cervical cancer deaths have dropped by nearly 60% from 1975 to 2017 in the U. S. with the widespread use of Pap tests and, more recently human papillomavirus testing that accompanies the Pap test.

Colorectal cancer deaths have declined by more than 33% over the last 30 years and this trend has been credited to expansion of colorectal screening in the U.S. via colonoscopy, sigmoidoscopy, and stool-based tests such as fecal immunochemical tests(FIT).

Lung cancer deaths also have declined by 20% in high-risk individuals with the annual low-dose CT cancer screening that the USPSTF(U.S. Preventative Services Task Force) most recently started in 2013.

https://prescancerpanel.cancer.gov/reports-meetings/cancer-screening-report-2022/challenges-opportunities

I highly recommend that all of us follow the guidelines of doing breast, cervical, colorectal, and lung cancer screens. If I may, I have a few anecdotes about the subject of cancer screens.

I found out that this particular individual had not done a Pap test in over 10 years or so. With some prompting, she had her Pap cancer screen test done. The Pap cancer screen turned out to be abnormal. This led to her getting a biopsy that, although it was positive for cervical cancer, it was thankfully still at an early stage. Her cancer had not yet metastasized, and removing her uterus surgically(she was not planning on having more children) turned out to be a curative treatment.

Another example was that of a patient who was not as fortunate. By the time that I first saw him, he had already been diagnosed with colorectal cancer that had metastasized. He went on to die shortly afterward. I asked him during that one visit if he had known about colon cancer screening via colonoscopy. He said that his primary doctor had recommended it, but that he had been non-compliant about going through with the procedure.

My impression on the need for cancer screens, however began even before I started practicing medicine. I was in medical school in the late 1970s and I vividly remember a surgeon teacher who was to give a talk about the topic of colon cancer. He got to the lecture hall late because he had just finished doing surgery on a patient with colorectal cancer. He started talking in a very frustrated tone about the patient he had just finished operating on and about the many other similar patients that he had done colorectal cancer surgery as well. He mentioned that the majority of these patients were not going to survive because of their late-stage disease. He was at a loss as to what to do to catch the colon cancer sooner. It was shortly after this, in the early 1980s, that sigmoidoscopy cancer screening(precursor to colonoscopy cancer screening) would start.

Without a doubt lives are being saved with cancer screening of breast, cervical, colorectal, and lung. This is information that will help anyone of us be healthier.

My wife of 46 years had an abnormal Pap result when she was in her early twenties. This was for her routine Pap cancer screen for cervical cancer. She was then referred to a gynecologist who diagnosed her with abnormal cells (pre-cancerous cells that had the potential to become cancer) at the tip of her uterus or cervix. She went on to have cryotherapy(which will freeze and destroy abnormal cells). A follow-up Pap after her procedure was normal. She had close monitoring for a few years to make sure this pre-cancerous lesion would not return. My wife continued having normal Pap cancer screens thereafter.

Cancer screening is a medical procedure looking for cancer before a person has any symptoms. This cancer screening can help find cancer at an early stage where abnormal cells(pre-cancerous/not yet cancer) or cancer(rogue cells) are easier to treat or cure. The Pap cancer screen was life-saving for my wife.

The U.S. Preventative Services Task Force (USPSTF) currently recommends routine screening for cervical cancer(similar to the Pap test my wife did), breast cancer (via mammogram), colorectal cancer (via colonoscopy), and lung cancer (via low-dose CT scan for smokers).

What is the lifetime risk for getting cancer for you, me, and someone close to us? See what the American Cancer Society says:https://www.cancer.org/cancer/risk-prevention/understanding-cancer-risk/lifetime-probability-of-developing-or-dying-from-cancer.html

This blog addresses how we can be healthier. Cancer will be addressed first because all of us need to be aware that cancer may lurk within us without any telltale symptoms or signs as may occur with other illnesses. Other illnesses, for example, may include my adult-onset diabetes being discovered by a high fasting glucose at the doctor’s visit. With the discovery of my diabetes, I became very aware of my less-than-optimal health and took action to undo the many bad habits that I had acquired over my adult life. But I had over two decades to help me regain better health. Cancer may not allow such a luxury of time to correct anyone’s health. This is because cancer is like a silent invader. It can grow unnoticed, often without clear symptoms until it is advanced. This secretive nature of cancer makes it particularly dangerous because, by the time it is detectable through obvious signs, it is usually in a late rather than early stage. A proactive approach to finding cancer at earlier stages with cancer screens of cervical, breast, colon, and lung cancer has played a crucial role in the decline of cancer death rates. I will discuss this further in my next blog, What Is A Cancer Screen?

So what is cancer? Cancer is a rogue cell that deviates from normal cell behavior. Healthy cells, grow, divide, and die in a controlled manner. A rogue cancer cell grows uncontrollably. Our bodies are made so that our aging or injured cells are replaced by cells of the same kind. However, a cancer cell continues to divide nonstop. It stops listening to the body’s signals that tell it when to stop dividing leading to the formation of tumors.

A couple of examples may best illustrate the next concept of cancer. A relative of mine was diagnosed with a tumor in her brain. She went on to have surgery and was told that her tumor was benign. Her tumor was not cancerous and was of the type of tumor, and in a location that rendered it likely not to return once removed by surgery. If the tumor had been classified as cancerous, a different story would have been apparent. This was the story of an uncle and a cousin of mine who went on to have surgeries for their brain tumors but did not survive because they had cancerous(malignant) brain tumors. Unfortunately, these were detected in a later stage where the process of metastasis had already occurred. Metastasis is a hallmark or unique characteristic of cancer. It is the process by which cancer cells spread from their original location(primary tumor site) to other parts of the body, forming new, secondary tumors. Unfortunately, although much of the original brain tumors for both my relatives were removed, the cancer had had time to metastasize and travel to other parts of the body. It is the process of metastasis that is responsible for the majority of cancer-related deaths. (see introduction in the following link)https://www.nature.com/articles/s41392-020-0134-x Early-stage cancer is generally more treatable and has a higher survival rate than advanced-stage cancer. When detected early, cancer is often confined to its original site and has not yet spread to other parts of the body(metastasized) making it easier to remove or treat effectively.

It is still very important to notice any unusual changes in our body, however, subtle, and be always vigilant, regardless.

Cancer affects all of us in one way or another, even if not individually.https://www.cancer.org/cancer/risk-prevention/understanding-cancer-risk/lifetime-probability-of-developing-or-dying-from-cancer.html

“Wellness is an active process through which people become aware of, and make choices toward, a more successful existence.” This statement comes from the National Wellness Institute. Its founder and the main person who brought “health and wellness” into awareness was physician, Dr. Bill Hettler in 1976. The above definition goes on to “describe a shift from unconscious living, where you do not think about your health until you have a problem or experience symptoms, to conscious living, where you are actively making healthy choices to promote your success and well-being.https://med.umkc.edu/sa/wellness/wellness-2(hover marker over HTTP address, left click, then left click again over the HTTP that lights up, just below).

Dr. Hettler graduated from medical school much earlier than I did in 1969. At his commencement graduation ceremony, he remembers a speech given by his medical school’s preventative medicine professor, Dr. John Phair, M.D.. This professor, whom he had never met, went on to say, ” If we would spend our time helping people learn how to live instead of practicing traditional medicine, we would indeed save more lives and alleviate more suffering.” Dr. Hettler wrote this toward the latter part of his years of practicing medicine: “I have to admit that at that point in my career, I did not see the wisdom of Dr Phair’s words. It is almost 30 years since I heard Dr. Phair give his sage advice. I have since learned that what people do for themselves in the way of lifestyle choices has a much greater impact on their chances of survival than anything physicians are likely to accomplish”.

So here I am in very much the same situation as Dr. Hettler, having paid much more attention to disease processes and treatments the same through the years that I practiced medicine. There is one important distinction, however. I also became a patient!

How true to the above definition, that is, after I acquired adult-onset diabetes, I became very much aware, and in fact, alarmed! I am very thankful, however, that I “made choices toward a more successful existence.” I had a “shift from unconscious living, where you do not think about your health until you have a problem or experience symptoms, to conscious living, where you are actively making healthy choices to promote your success and well-being”.

Indeed, wellness, more than anything, will entail, for some, an awareness of a health problem and subsequent action toward improved health!

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”  Beginning with the above definition of health, the word well-being is important. https://www.who.int/data/gho/data/major-themes/health-and-well-being This is because it projects a positive mindset of what all of us want, which is to be as healthy as possible.

A good example of this positive mindset would be about the time that I became a diabetic. I developed adult-onset diabetes more than twenty years ago. I was very alarmed because I saw that for the first time that I might not be in the best of health. I asked myself: “Where do I go from here?” My answer was that while I may not be in the best of health, this might be the best time to change the many bad habits that had contributed to my becoming diabetic. While somewhat late to avoid a chronic illness such as diabetes, I could then, and of course now, certainly strive to become healthier than I had been.

The benefit of wanting to become healthier did not end just with the last couple of decades of my starting to exercise regularly and eat more nutritiously. I believe that my children, while in their youth, began their health and wellness journey by not doing whatever bad habits I had acquired. This was certainly the case for me when in my youth I was determined never to smoke. This decision came because of my father’s bad smoking habit. I remember this one particular very early morning where I was awakened by my father coughing repeatedly. Finally he stopped coughing after being able to hack up a chunk of sputum from his lungs. It was then that I said to myself “I will never, ever be a smoker.” And thank goodness I never had the temptation to smoke in my life.

As we strive to improve our Health, a positive mindset is needed. It is also important to have compassion for one’s current health situation (image above). Regardless of age or whatever chronic illnesses we have, we can Be Healthier: As the saying goes: “ Plant the tree today and enjoy its shade tomorrow.”