Ladies, it’s your turn


Every week I will be confronted by a worried farang male who has just found out that his PSA test has become elevated.  This must obviously herald the end of his world.  Several pages have been printed out from that well-known medical guru, Dr. Google.  The end is nigh!  But maybe it isn’t.

For the vast majority of cases, Prostate cancer is a very slow growing cancer.  In other words, you will die with your prostate cancer, and not from your prostate cancer.  The most recent figures I have to hand are that 16 percent of males will be diagnosed with prostate cancer in their lives, eight percent will develop significant symptoms, but only three percent will actually die from prostate cancer.  97 percent don’t die.  There!  Feel better now?

Having now dealt with the farang male obsession, as I indicated in the heading – Ladies, it’s your turn.  And let’s deal with breast cancer, an emotive subject, and unfortunately then it becomes a very popular subject for the ‘pulp’ press, especially when Angelina Jolie pops up with a double mastectomy for genetic reasons.  However, you should not ignore the fact that having the breast cancer gene is not a 100 percent indication that you will develop breast cancer.  Ms. Jolie might have jumped the gun a bit.

Unfortunately, diagnosis and detection are “real time arts”, not sciences, even though we would like them to be.  Sure, we use “science” as a tool, but that is all it is.  A tool to help us see the problem.  Just like we can use a telescope to see things at a distance – even if we can’t see the object, that doesn’t mean to say it isn’t there.

You will hear of a lady who has three annual clear mammograms and then finds she has advanced breast cancer during year number four.  Was the testing useless?

So today cancer was found.  When did it start to grow?  This week, this month, this year?  The answer depends upon the type of the cancer.  Some fast growing cancers would be impossible to pick up, even if the person had monthly mammograms.  The slow growing variety can be picked up years ahead.  Unfortunately mammography cannot be a 100 percent indicator – we are not that good – yet.  But it is still one of the best diagnostic procedures we have.  And it is better than nothing.

Breast cancer is like all cancers – the sooner you find it, the sooner you can deal with it and the earlier treatment is administered, the better the outcome.  In fact, did you know that Studies from the American National Cancer Institute show that 96 percent of women whose breast cancer is detected are still alive 5 or more years after treatment.  This is called a 96 percent five year survival rate, one of the ways we measure the severity of life threatening cancers.  If the five year survival rate was only 10 percent – in other words, after 5 years only 10 percent were still alive, then I would also probably feel that predictive testing was not all that worthwhile.  But it is not that bleak an outcome in this case – 96 percent are still alive and many go on for many, many years.

Now I mentioned breast cancer at the start of this item for a couple of reasons.  One is the fact that screening tests can be done, and I would suggest that all you ladies over the age of 40 (or over the age of 30 if your mother or a maternal aunt died of breast cancer) should consider annual mammograms.

The second reason I mentioned breast cancer is that it is not, as many western women think, the greatest killer of women.  For many 10 year groups of women, heart disease is the greatest killer.  Yes, heart disease, the greatest killer of men is now firmly entrenched in women’s medicine.  Emancipation has its price?

So what can you do about this?  The first thing is to give up smoking.  Smokers have a much higher risk of developing ALL cancers than non-smokers.  The other thing is to adopt the Thai ‘jai yen yen’ approach to life’s problems.  It helps, believe me!