Why should receiving a diagnosis of early cancer be good news? Well the reason is simply that, in most instances, early cancer is completely curable.
This of course calls into question the definition of curable, but if we accept that a reasonable definition is dying of an unrelated cause, with no evidence of the “cured” disease in question, then the majority of cases of early cancer are truly curable.
In my own field of colorectal cancer, cure of early disease usually involves surgical excision. This may require removal of part of the bowel, but very early colorectal cancer can be removed endoscopically and indeed some 15% of all screened detected bowel cancers are treated effectively (and cured) in this way. There is even now evidence emerging that early rectal cancer can, in many instances, be cured by radiotherapy with no need for any surgical intervention at all.
Early cancer is almost unique in non-communicable disease, in that it can be cured in a substantial proportion of patients. When we think of other conditions: chronic obstructive pulmonary disease, ischaemic heart disease, peripheral vascular disease, diabetes, osteoarthritis to name but a few, none of these can be cured. It is true that they can now be very effectively managed, but the patient who develops any of these diseases is destined to suffer from them to a greater or lesser extent for the rest of their lives. This is not the case with early cancer, and it is this, of course, that makes early diagnosis so crucially important.
Currently, we have screening programmes for breast cancer, bowel cancer and cervical cancer, and there is no question that screening is the most effective method of early detection.
There is also considerable interest worldwide in screening for other cancers – prostate, lung and ovary in particular – and it is quite possible that screening programmes for these diseases will be introduced within the next decade, if it can be shown that the benefits of screening outweigh any harms.
In the meantime, second to prevention, any approach that will increase the proportion of cancers diagnosed at an early stage must be taken very seriously as this is how we will make a real impact on these diseases.
Anyone engaging in cancer screening or thinking about going to their doctor with symptoms that could be due to cancer has to face the fear of receiving a cancer diagnosis. The most important message to get across is that early cancer i.e. cancer that is still localised and has not spread, is curable. However, not every cancer will be caught early, and some will have spread by the time the diagnosis has been made. Today, however, even this is not such bad news as it used to be. Disseminated cancer has now joined the ranks of the other chronic non communicable diseases. It is not an immediate death sentence, it can be managed and many patients with advanced cancer can live for many years with a good quality of life.
So, the key messages are: if you don’t have cancer do everything you can to prevent it; if you do, find it as quickly as you can and deal with it.
Bowel Cancer Awareness Month
Bowel cancer is the second biggest cancer killer in Scotland but it is treatable and curable especially if diagnosed early. Taking part in bowel cancer screening is the best way to get diagnosed early which is why the UK’s leading bowel cancer research charity, Bowel Cancer UK, is using Bowel Cancer Awareness Month to focus on screening.
Screening saves lives but at the moment in some areas of the UK only a third of those who receive a test in the post complete it. Thousands of people are missing out on the best way to detect bowel cancer early when it is easier to treat and there is the greatest chance of survival.
“The decision to complete the screening test was the best decision I have ever made in my life. Had I not taken that course of action, there is no doubt in my mind I would not be alive today. Just do it!”
Over 50? Take the test when you receive it in the post. If you are younger, tell the people over 50 in your life, to take the test.
For more information about screening visit http://www.bowelcanceruk.org.uk/screening/.