I was expecting a visit from Susan.
My imaginary friend, patient and Susan’s husband, Dave, had warned me about this a few days ago.
Susan wanted to know how screening tests can prevent cancer.
Susan had good reasons to worry about cancer. Her sister had surgery for breast cancer. Her mother has had colon cancer. Susan’s recent pap smear was abnormal.
Susan is thirty eight years old. Weighs 130lbs. She is five feet seven.
She is very athletic. Plays squash and racquetball. Jogs regularly.
Does not smoke and drinks alcohol socially.
Susan works as legal secretary and has two children.
Susan is a fine example of a healthy person. Can anything go wrong with her health?
“Hello Dr B, I hope you are having a good day today!” Susan greeted me as I entered the examination room.
“Yes, Susan, I am having a wonderful day.”
I was running on time. I didn’t have to give any bad news to patients that day. Sun was shining and I was looking forward to a relaxing evening with my family.
Unlike Dave, Susan likes to call me Dr B or doctor. I have never heard her say “What’s up doc?”
Without wasting any time, Susan came straight to the point: “Doctor, what are my risks of developing cancer?”
“Cancer will develop in 1 in 3 Albertans during their lifetime” says the Alberta Cancer Board document, A Snapshot of Cancer in Alberta (1996).
“What about my family history, doctor? That does put me at a higher risk than other Albertans. Surely, I need to be more careful.”
Yes, Susan is right. Unfortunately, we are all at the mercy of our genes.
“Doctor, is there a difference how cancer affects men compared to females?”
Yes, men outnumber women in total numbers of cancers and deaths related to cancer.
It is also important to remember that there is a high level of premature deaths from cancer among women than men. Some of the cancers affecting women tend to occur at a younger age, says the Alberta Cancer Board document.
“Dr B, what are the top five cancers which kill Alberta women?”
Breast cancer tops the list. This is followed by lung, colon and rectum, unknown primary (original site of cancer cannot be found) and pancreas.
“What about men?”
Lung, prostate, colon and rectum, stomach and pancreas in that order.
“Doctor, what about cancer of the cervix?”
Cancer of the cervix has been decreasing among Canadian women. This is most likely due to the widespread use of pap smear, says the Cancer Board document.
“Dr B, what sort of screening tests would you recommend for me and Dave?”
Cancer screening in 1995 is an interesting article (Current Oncology -March 1995) written by Dr B. P. Higgins. He mentions five tumor sites where screening has been recommended.
“What are these sites, doctor?”
Prostate, breast, colon and rectum, ovary and cervix.
Susan looked at her watch. It was time to pick up Andrew and Tamara from school.
“Dr B, can I bring along Dave next time so we can go through this together?”
“Sure, Susan. I would be happy to sit down and discuss this with both of you.”
Susan stepped out of the examining room. After a couple of steps, she turned back and whispered, Doctor, do know what Dave said the other day?”
“What did he say?” I asked. She smiled. I asked again, “Susan, what did he say?” Curiosity was killing me.
He said that trying to stay healthy was more difficult than ………improving his golf game!”
I was having a wonderful day and I wasnt going to spoil it by talking about golf. Golf…..who invented that game?