A few words about breasts

“I don’t examine myself, because they’ll find something else for me…” – if I got a day off every time I heard this, I wouldn’t have to work for the rest of my life.

Unfortunately, in society the fear of being diagnosed with cancer during preventive examinations has been persistent, so that all too often we encounter delayed diagnosis, resulting in a worsening prognosis and increased aggressiveness of treatment.

Every day around the world, thousands of women hear a cancer diagnosis.

Breast cancer accounts for 23% of all cases in Poland and is responsible for about 14% of deaths from malignant tumors. According to estimates, about 1,700,000 cases of breast cancer are diagnosed worldwide each year.

Poland still does not present the best disease statistics in this matter, but their much-talked-about layout draws attention. There is still a high mortality rate from breast cancer, but at the same time we are among the countries with the lowest diagnosis – what is the reason?

It is not a matter of bad treatment methods. Unfortunately, the low rate of patients performing preventive examinations is responsible for this state of affairs. Among other things, we are still struggling with a very low percentage of ladies enrolling in the screening mammography program.

Can breast cancer be cured?

Yes. A diagnosis of malignant breast cancer is not a sentence! With each passing day, modern treatment methods are being developed and improved around the world, allowing for effective therapy and a return to normal life. Early diagnosis of the disease dramatically increases the chance of treatment success.

Is breast cancer always a mastectomy?

Mastectomy is still a common and effective treatment for breast cancer, but not the only one! Early diagnosis of the disease allows consideration of minimally invasive surgical treatments, including sparing procedures.

What does breast cancer prevention look like?

Start with yourself.

One very important part of taking care of your own health and detecting diseases early is self-examination.

Get to know your body.

Remember the role of regular breast self-examination. Many patients say they don’t examine their breasts because they don’t know how to do it, or they feel numerous lumps in the breasts and are unable to identify abnormalities. These numerous “globules,” as patients call them, are usually glandular tissue, which, depending on the structure of the breast, can be clearly felt in the form of numerous “clusters” and wake up distorting the image in the patient’s mind. Remember, however, that by examining yourself regularly, you get to know your body, and by creating a kind of “map” in your head, you will be able to more easily pick up abnormalities and deviations from the previous appearance of the gland.

According to scientific studies, breast self-examination is characterized by a high percentage of errors on the part of patients, and only 2-3% of women perform this examination correctly, one year after pre-instruction.

Does it mean that it’s not worth getting tested?

NO!  The same studies emphasize that regular testing increases the diagnosis of the disease in its early stages, thus reducing the incidence of diagnosis at an advanced stage with metastasis to the axillary lymph nodes.

If you are unsure how to perform the test, ask your gynecologist, midwife or family doctor for instruction, or alternatively, take advantage of available training on the Internet or at prevention events.

Another extremely important step is to undergo regular ultrasound examinations. Ultrasound is now the standard for detecting lesions and allows us to catch pathology at a very early stage, giving a chance for complete recovery.

 How often to perform an ultrasound examination?

An ultrasound examination should be performed every 12 months, or more often in case of alarming symptoms or complaints. Ultrasound is used during this type of examination and there is no risk of exposure to harmful forms of radiation. The procedure itself is relatively short and painless, and the result is available immediately afterwards in most cases.

It is recommended that the first preventive breast ultrasound be performed around the age of 20, and after the age of 25 it should be performed regularly 1 x a year.

Should mammogram be performed?

Mammography is still the undisputed king of breast cancer prevention, and cannot be replaced by ultrasound, but in the coming years, due to the development of ultrasound technology, this trend may change.

Regular mammography screening is recommended every 2 years between the ages of 40 and 50, and 1 x a year after turning 50.

Ideally, mammography and ultrasound should be performed together, with the goal of combining the capabilities of both procedures and increasing the chance of early, effective diagnosis of the disease.

Is mammography harmful?

Modern digital mammograms emit negligible amounts of X-rays, which are a fraction of the radiation dose we take in due to the mere fact of inhabiting an earthly planet suspended in space. The discomfort, reported by some women, of breast compression during the procedure itself carries no significant health risks.

I was recommended a biopsy, does that mean I have cancer?

No! The mere fact that a biopsy was recommended does not mean a diagnosis of malignant tumor. Histopathological examination, carried out in this case by fine-needle biopsy or, increasingly, by thick-needle biopsy, is a diagnostic method with very high accuracy, and if there is any doubt during imaging, histopathological verification is the best option. This solution avoids unnecessarily prolonging the period until the start of proper cancer treatment. Remember that each time a biopsy is the result of an individual decision by the treating physician, based on the specific clinical picture.

“Cancer doesn’t like knife/needle” won’t a biopsy cause the disease to progress?

A properly performed biopsy procedure does not carry a serious risk of spreading potential cancer, and the mere fact of “stabbing” a lesion will not cause it to transform into a malignant process, if we were initially dealing with a benign lesion.

Remember, don’t be afraid of examinations. Preventive examinations are the most effective method of diagnosing early, asymptomatic or sparse forms of malignant cancer, allowing you to implement the most effective treatment possible and giving you a chance after recovery.

Bibliography:

Bojakowska, Urszula Jolanta, Paweł Kalinowski, and Marta Kowalska. “Epidemiology and prophylaxis of breast cancer= Epidemiology and prophylaxis of breast cancer.” Journal of Education, Health and Sport 6.8 (2016): 701-710.

Male challenge – testicles and prostate

During ultrasound examinations of the testicles, countless times I have heard from the mouth of a 40-year-old man the words ” I figured that at this age I should already get myself examined”.

What surprise is painted on the patient’s face when he hears that he was actually very lucky, because the peak age for testicular cancer is behind him.

Most cases of testicular cancer are recorded in men between the ages of 15 and 40, and it is they who should pay special attention to prevention and early detection of testicular disease.

Does this mean that after the age of 40 the topic no longer concerns me?

Absolutely not! At the same time, I always say that the potential risk of disease is as long as the patient has testicles. Therefore, prevention should not be abandoned throughout life.

Testicular cancer is the most common cancer among young men, and according to the data, every year 8 out of 100,000 Polish men receive such a diagnosis.

Is testicular cancer curable?

Yes. Testicular cancer, if diagnosed early, is one of the better prognostic types of malignant tumors, and in such cases we can achieve a 5-year survival rate from the time of diagnosis, of 95-100%.

How to diagnose testicular cancer?

As with breast cancer in women, self-examination and the ability to self-examine the testicles play a very important role in this case. Every man from his teenage years onward, should regularly evaluate his testicles and skillfully check them for abnormalities.

Every man should perform a self-examination of the testicles and the contents of the scrotal sac at least once a month. This is best performed after or during a bath, when the skin of the scrotal sac is relaxed and the testicles are accessible to examination to the maximum extent possible. Remember to examine each testicle separately, checking the entire surface of the testicle with your fingers, assessing whether the outline of the organ is smooth, whether nodules or bumps have appeared, whether the testicle has not become enlarged, whether it has not become painful, and whether its mass has not changed and does not differ significantly from the other testicle. If any abnormalities or deviations are found, you should see your doctor and usually perform a follow-up ultrasound.

Is there any point in doing an ultrasound of the testicles?

As much as possible, yes. As studies report, it is frighteningly common that the first perceptible symptoms appear and are already related to the stage of metastasis of the cancer to other organs – a situation that affects up to 14% of patients. Even in 75% of patients, the diagnosis was made only thanks to ultrasound examination and was not associated with the onset of symptoms.

The ultrasound examination allows the detection of even very small pathologies that correspond to the earliest stages, thus dramatically increasing the chance of a complete cure.

Does an ultrasound of the testicles hurt?

Testicular ultrasound is a brief and non-invasive examination, and painless. The superficial location of the testicles in the scrotal sac makes them well accessible to examination and the procedure itself is not too complicated. The most common barrier is a sense of embarrassment on the part of the examinee, but it should be remembered that the examination is performed by doctors for whom the human body has no secrets and nudity and dealing with the patient’s intimacy is no different from other examinations, such as auscultation of the lungs or examination of the throat.

The ultrasound examination is completed with the issuance of a description by the examining physician and allows rapid follow-up, if necessary.

How often to perform an ultrasound examination?

In preventive terms, such an examination should be performed every 12 months or more often if there are any worrisome symptoms or changes.

Is it possible to live normally with one testicle?

A diagnosis of testicular cancer is usually associated with surgical treatment and may take the form of an orchidectomy, or removal of the testicle with the lesion. Many patients are concerned about functioning after removal of the testicle, but it should be noted here that having one functioning testicle is in the vast majority of cases perfectly sufficient for normal functioning and does not result in clinically significant hormonal disturbances, and does not even have a negative impact on the ability to have offspring. In terms of aesthetics, there are also options for implanting a testicular prosthesis, so that visually it is very difficult to notice the difference with the state before surgery.

Is an ultrasound of the testicles harmful?

Ultrasound, or ultrasonography, is a test that uses ultrasound and does not use harmful forms of radiation, so the test is safe even if it involves such sensitive structures as the testicle.

Does ultrasound only detect cancer?

No. Ultrasound is used for early detection of cancer, but it also allows assessment of potential post-traumatic changes, blood supply to the testicle and vascular structures such as the choroid plexus – dilatation of the choroid plexus vessels, called varicocele, if not properly treated can have a negative impact on testicular function, including male fertility.  During the examination, the entire contents of the scrotum and possibly the structures are also evaluated adjacent structures, which allows, among other things, to diagnose certain hernias.

Remember! Regular self-examination of the testicles and regular prophylactic ultrasound examination allows early diagnosis of cancer and possibly other pathologies, the appropriate treatment of which carries the chance of complete recovery.

“Do I already have a prostate?”

This is one of the common questions I hear from patients. At first I see the anxiety on their faces when I firmly answer, yes you definitely have a prostate!

The prostate, or prostate gland, is a part of every man’s body in normal anatomy. It plays an extremely important role in sexual and reproductive functions, and its secretions are an extremely important component of male semen.

Unfortunately, it also has its drawbacks. A common condition affecting up to one in two men over the age of 55, its benign prostatic hyperplasia can result in urinary problems, frequent urination, a tendency to urinary tract infections and even, in extreme cases, complete stoppage of urine outflow from the bladder, requiring urgent urinary catheter insertion or surgical methods.

Equally alarming is the increase in the incidence of malignant prostate cancer, which is particularly dangerous in young men. Cases of advanced prostate cancer have been reported as early as in men in their 3rd decade of life.

How to examine the prostate?

An important aspect is to observe one’s own body and, in case of alarming symptoms, to see a urologist or family doctor early.

Examination of the prostate gland is usually done through what is known as a per rectum examination, when the doctor palpates the structure, size and cohesiveness of the prostate with his finger, from access through the rectum. The examination, although considered embarrassing by many, is a common procedure that is short and usually completely painless. The patient may only experience brief discomfort during the examination due to the need to insert the finger into the rectum.

Another test, usually performed by urologists, is a transrectal ultrasound, which is performed with a special probe and allows an accurate assessment of the structure of the gland.

If necessary, the doctor may recommend supplementing with an MRI or CT scan.

The prostate gland, with proper patient preparation, is usually available for ultrasound imaging during a standard abdominal ultrasound, performed through the abdominal layers. This examination is not very accurate, but usually allows a preliminary assessment of the size of the prostate and any visible pathology.

PSA test. PSA has nothing to do with veterinary It is a test of the level of specific steroidal antigen ( PSA), which allows assessment of prostate function and is a very good tool for screening, early detection of pathologies such as hypertrophy or even malignancy.

Such a determination is performed from venous blood, which is obtained by a standard collection method as with many other laboratory tests, such as peripheral blood count. 

Can the prostate be treated?

Treatment of prostate disease depends on the type of condition and includes pharmacological and surgical methods. As in many other cases, early recognition of the pathology makes it possible to reduce the invasiveness of therapy and facilitate treatment management.

How often to get examined?

A preventive examination should be performed at least once a year, or more often if there are worrisome conditions or medical recommendations.

Remember! Take care of the condition of your prostate to enjoy a healthy and happy life.

Bibliography:

Rębiałkowska-Stankiewicz, Małgorzata, Magdalena Gajewska, and Jacek Mianowski. “Prevention activities targeting testicular cancer in men aged 15-40. Promotion of the campaign “Brave wins”-the Toronto experience.” Pomeranian Journal of Life Sciences 65.1 (2019).

 Brzozowska, Joanna, et al. “Demand for education on testicular cancer prevention in a group of young men-preliminary research.” Journal of Education, Health and Sport 5.7 (2015).

Scientific, Committee. “Metastasis as the first symptom in patients with testicular cancer Article published in Urologia Polska 1993/46/4.”

Heart to heart

The cardiovascular system, otherwise known as the circulatory system, is one of the foundations of the functioning of the human body perfected over centuries of evolution. Unfortunately, despite this, it is not without imperfections that can pose a serious threat to human health and life.

The circulatory system, in general, consists of the heart, which is a kind of suction and pressure pump, and a kilometer-long network of venous and arterial vessels, through which all the cells that need it can receive the oxygen and nutrients necessary for life, as well as dispose of the products of metabolism or distribute the produced regulatory substances throughout the body.

The cardiovascular system, as a form of hydraulic system is governed by the laws of biology but also physics. A prerequisite for the proper functioning of the body is, among other things, the maintenance of normal pressure and the diameter and elasticity of blood vessels.

Do heart diseases affect me?

Heart disease affects people of all ages and is not just the domain of the elderly. Proper lifestyle and preventive measures are aimed at early detection of deviations and introduction of lifestyle modifications, allowing to avoid often irreversible and adverse changes in the cardiovascular system.

According to Global Burden of Disease, in 2019, 95,000 women and 79,000 men will die from cardiovascular diseases in Poland, accounting for 48.6% of causes of death among the female sex and 37.8% among the male sex.

Let’s remember that diseases related to the cardiovascular system are not only conditions directly related to the heart. Pathologies related to blood vessels, such as arteriosclerosis, can lead to stroke, which can cause disability or ischemic limb disease.

What does looking at store windows have to do with cardiovascular disease?

A surprising connection? Just as surprising and not obvious may be the symptoms of cardiovascular problems. In the case of untreated high lipid (“cholesterol”) levels, for example, along with the coexistence of other risk factors such as smoking, arteriosclerosis can develop. In the case of atherosclerosis of the lower extremities, there is a narrowing of the lumen of the vessel and a reduction in the amount of oxygen-rich blood supplied to the muscles. A characteristic symptom then is the phenomenon of so-called “stoppage chroma”, when after walking even a small distance, there is severe pain in the muscles of the lower limbs, which subsides after rest. Affected people often have to stop walking, and they use these breaks, for example, to look at store windows, which is a kind of sociological-medical phenomenon and is related to the sense of “shame” associated with the health ailment – in order not to draw the attention of those around them to their ailments, they try to justify their rest breaks in this way.

How to prevent cardiovascular disease?

The condition of our cardiovascular system is extremely dependent on lifestyle, including physical activity, diet or use of stimulants.

In order to maintain the best possible fitness of our heart and vessels, it is important to remember to exercise regularly, tailored to individual abilities, involving at least 30 minutes of activity, of moderate intensity, at least 3 times a week. Another important element is to avoid smoking, including the use of nicotine in other forms, as well as avoiding the consumption of alcohol or other psychoactive drugs.

An obvious, often downplayed element is the use of a proper, varied diet, limiting carbohydrates, eliminating simple sugars and increasing the supply of protein and fatty acids, aimed at improving the lipid profile and lowering triglycerides.

How to treat cardiovascular diseases?

Treatment of cardiovascular disease is related to the individual profile of the disease and is difficult to put in a general form. Unfortunately, an underestimated and extremely effective method is lifestyle modification, with reduction of risk factors – in most cases, especially low-grade pathologies, this may be the only and effective treatment. In other cases, pharmacological and, if necessary, interventional methods are most often used.

Is it worth getting tested?

Prevention of cardiovascular disease is, as in many other cases, one of the most effective methods of “treatment” in terms of the well-known law “prevention is better than cure.”

Adequate early recognition of a disease lb even an increased risk of developing it, allows the implementation of health-promoting measures and lifestyle changes that can result in prolonged and improved quality of life. It is often the case that timely implementation of preventive and corrective measures, allows to delay or avoid the use of drug treatment, and in the perspective of invasive procedures.

What to test?

In prevention efforts, a frequently used tool is the SCORE risk scale, which is an internationally recognized tool that allows the occurrence of life-threatening incidents of cardiovascular events over the next 10 years, based on non-modifiable factors such as gender or age and modifiable factors, such as cholesterol levels, complete lipidogram, smoking or blood pressure.

The lipid profile, blood pressure blood, glucose levels, as well as uric acid, which are components of the metabolic syndrome, which is a prelude to cardiovascular disease.

Such tests are among the quick and minimally invasive procedures, based on drawing venous blood or even examining a drop of blood, and the these few minutes spent, can result in many years of healthy and happy life!

Bibliography:

Maćkowska-Kędziora, Agnieszka, et al. “Changes in trends of global dietary guidelines in the prevention of cardiovascular diseases cardiovascular diseases.” Forum of Metabolic Disorders. Vol. 5. No. 3.2014.