Three sisters were diagnosed with lung cancer within one year! Doctors remind: It is crucial to do a good physical examination, and beware of several misunderstandings in cancer prevention physical examinations

Recently, the news that three sisters from a family were afflicted with the same cancer one after another has become a hot topic. From June last year to June this year, three sisters from a family in Shaoxing were diagnosed with lung cancer one after another and underwent lung cancer resection surgery one after another.

Doctors remind: Frequent physical examinations are crucial to prevent cancer

In the case of the Lin sisters, there are no obvious predisposing factors. For example, none of the three sisters smoke and do not work in special occupations. This is basically a problem of genetic susceptibility.

But they paid attention to physical examinations, and fortunately the cancer was discovered in time, and there was no metastasis. The prognosis was good, and the disease can basically be cured after resection.

Who are the high-risk groups for cancer? How can we prevent it? It is crucial to do a good physical examination. Is the more expensive the cancer prevention physical examination, the better? Let's find out together...
Who are the people at high risk of cancer?

Unlike routine physical examinations, some examinations in cancer prevention physical examinations are invasive and radioactive and are not suitable for everyone. They are mainly aimed at "high-risk groups", and the high-risk groups for each type of cancer are different.

In summary, there are six points:

1. Elderly people:

Unless there is a family hereditary tumor, young people generally have a relatively low chance of getting cancer. Studies have shown that a person's risk of cancer increases after the age of 50, so it is recommended that people aged 40 or over 45 undergo regular cancer prevention physical examinations;

2. People with a family history of cancer;

3. People with bad living habits, such as long-term smoking, drinking, staying up late, irregular work and rest, people who like to eat red meat, processed meat products, and people who like to eat pickled, smoked, grilled, and fried foods for a long time;

4. People who sit for a long time and are overweight;

5. People related to specific occupational environmental factors:

Occupational carcinogens include chemical, physical and biological factors, but among the carcinogens of occupational tumors, the most common occupational carcinogen is chemical substances. Long-term exposure may lead to cancer.

6. Populations related to infection factors

Human papillomavirus (HPV): cervical cancer

Helicobacter pylori (Hp): Gastric cancer

Hepatitis B virus (HBV) and hepatitis C virus (HCV): primary liver cancer

Epstein-Barr virus: nasopharyngeal carcinoma, lymphoma.

Are cancer prevention checkups more expensive the better?

Cancer prevention physical examinations are not the more expensive the better. The key is to be targeted and to choose cancer prevention physical examination items and methods that are suitable for the examinee.

1. Choose a special anti-cancer physical examination

Many regular hospitals have cancer prevention physical examination packages. Cancer prevention physical examinations are different from general physical examinations. Different cancer high-risk groups have different physical examination methods to choose from. For example:

Lung cancer: Choose low-dose spiral CT of the chest instead of chest X-ray.

Thyroid cancer: thyroid color Doppler ultrasound.

Nasopharyngeal carcinoma: Epstein-Barr virus testing, nasopharyngeal endoscopy.

Liver cancer: liver color Doppler ultrasound + AFP testing, and enhanced CT and enhanced MRI if necessary.

Gastric cancer: gastroscopy + Helicobacter pylori examination.

Esophageal cancer: gastroscopy.

Colorectal cancer: colonoscopy + fecal occult blood test.

Breast cancer: breast color ultrasound, X-ray mammography.

Cervical cancer: TCT+HPV test.

Ovarian cancer: CA125+color ultrasound (transvaginal ultrasound for married women).

Kidney cancer: kidney color Doppler ultrasound + urine routine examination.

Prostate cancer: PSA test and MRI if necessary.

2. Choose the appropriate plan based on the patient's symptoms and medical history

Everyone's family history, eating habits, living and working environment are different. In other words, everyone's high-risk factors are different, and the risk of cancer is also different.

3. Don’t neglect basic inspections.

1) Blood routine test

Some important diseases can be reflected in blood routine tests, such as leukemia, lymphoma, etc. Digestive tract tumors may cause anemia.

2) Urinalysis

Positive urine occult blood and increased red blood cells may be caused by bleeding from urinary tract tumors.

3) Routine stool examination and fecal occult blood test

Since the examinees are afraid of dirt, stool examination is the item that is most easily abandoned. However, the examination is economical, simple, and very important. If the fecal occult blood is persistently positive, there is a possibility of stomach cancer or intestinal cancer, and further gastroscopy and colonoscopy must be performed.

4. It is said that "genetic testing" can prevent cancer. Is it necessary to do it?

Preventive genetic testing has suddenly become very popular. Genetic testing can only tell us whether we have gene mutations associated with cancer. If we have them, it does not necessarily mean that we will get cancer; if we do not have them, it does not mean that we will not get cancer.

Among known cancers, only 5% to 10% are caused by internal factors such as genetic genes. Cancer is closely related to an unhealthy lifestyle.

Before preparing for preventive cancer genetic testing, you must fully understand your family medical history, communicate with professionals, and find out what genetic testing can bring to you and whether it is really necessary.

If a close relative has breast cancer, ovarian cancer, or other related cancers; or if a premenopausal woman has breast cancer;

Or suffer from multiple related tumors at the same time, such as breast cancer, ovarian cancer, etc.;

If there is male breast cancer in the family, it is very important to undergo BRCA gene testing.

Lynch syndrome screening can be performed for colorectal cancer patients under the age of 70, or those whose immediate family members have colorectal cancer, endometrial cancer, etc.

In addition, Septin9 gene methylation detection has positive significance for the early diagnosis and prognosis evaluation of colorectal cancer.

5. Tumor markers

Tumor markers are controversial as a physical examination item. They are not very sensitive and may produce false positive or false negative results. However, some indicators such as AFP, CEA, CA199, PSA, etc. are still meaningful, especially for people over 40 years old. Therefore, many packages include this item.

However, many people become very nervous and suspect that they have cancer once they find that their tumor markers are elevated. In fact, some people may have cancer but their markers are completely normal; some people may not have cancer but their markers may be elevated.

Because benign tumors, inflammation, bad living habits, etc. can cause certain markers to increase, doctors need to analyze the level of tumor marker concentration exceeding the standard, the duration, and whether the indicators continue to rise. Dynamic examination of tumor markers is more meaningful and can be further clarified based on endoscopic and imaging examinations.

6. Is it necessary to use PET-CT to screen tumors in normal people?

The full Chinese name of PET is “positron emission tomography”, which uses labeled substances such as glucose to identify whether there are lesions in the human body and determine the severity of the lesions.

A PET-CT scan that costs nearly 10,000 yuan also has the problem of false positives and false negatives. If PET-CT is used to differentiate between benign and malignant tumors and to diagnose cancer stages, the positive significance of PET-CT examination far outweighs the impact of radiation on the body, and it is worth doing.

If the PET-CT examination indicates a problem, it is still impossible to determine whether cancer has occurred. It is necessary to combine physical signs and other examination results, such as gastrointestinal endoscopy and pathological examination, to make a judgment.

Frequent PET-CT examinations also have the risk of cancer. Normal people often use PET-CT to screen for tumors, but at present, it seems that the disadvantages outweigh the advantages!

Author: Deputy Chief Physician Member of the Youth Science Popularization Innovation Professional Committee of Hunan Medical Education and Technology Association