Doctor: Good evening, Mrs. M. How are you?
Mrs. M: I am fine, thank you. Now that I am 40, I thought I should get
my yearly check-up for blood pressure and diabetes.
Doctor: Don’t forget cancer screening tests also.
Mrs. M: Cancer? Why should I get checked for it? I don’t use tobacco in
any form, I exercise regularly, I feel fit and fine, and nobody in my
family has had cancer. Why should I get tests for cancer?
Doctor: I know you lead a healthy life and that nobody in your family
has had cancer, but that does not mean that you may never get
cancer. All types of cancer have been found in people who have good
habits and no family history.
Mrs. M: What should I do?
Doctor: You should continue your healthy lifestyle and have regular
screening tests. These tests can help find problems before cancer
develops. The tests can also find cancers in a very early stage when
there is more effective treatment.
Mrs. M: I have heard that if you get these screening tests done, you
are likely to find cancer. I am worried about finding something wrong
in these tests.
Doctor: Screening does not increase the risk of cancer. The tests used
today for screening have been tested over several years, and they do
not increase the risk of cancer. By screening a patient, we can actually
find a problem before it becomes cancer.
Mrs. M: That is encouraging! So may I get screened for all cancers?
Doctor: Effective screening tests are available for the most common
cancers in women in India – breast cancer and cervical cancer.
Mrs. M: What are these screening tests?
Doctor: For breast cancer, you should do a self-breast examination. Look
at your breasts in front of the mirror, and examine your breasts every
month. Do this about one week after your menses when your breasts
are less likely to be tender. With this exam, you are feeling and looking
for changes in your breasts –such as a lump that was not there last
month, a change in the size of a breast, dimpling of the skin, rash, or
redness. If you find any changes, tell your doctor. You should also get
a breast examination by your family physician or gynecologist every
year. A doctor is trained to detect problems in your breast.
Mrs. M: That sounds easy enough. I can start these tests now.
Doctor: We can test for cervical cancer with a Pap test. A Pap test can find
precancerous changes that can be treated easily and this will prevent a
cervical cancer. It can also find cancer in an early stage.
Mrs. M: Does it hurt?
Doctor: It is not painful. In this test, a sample is taken from the outer
part of the cervix (the lowermost part of the uterus) with a wooden or
plastic spatula. The sample is spread on glass slides and then examined
under a microscope by a pathologist. If he finds a problem, he may
suggest other tests. If everything is fine, you need to repeat the test
every year. If the test is normal for 3 years, then you can have the Pap
test less often.
Mrs. M: How much do these screening tests cost?
Doctor: A breast exam by your doctor will be part of the cost for your
visit. A Pap test will cost about Rs 200/-.
Mrs. M: Are there any other tests?
Doctor: A mammogram (x-ray of the breasts) can also be done. But
this is done only in some women after a discussion with their doctor.
Mrs. M: What if the test shows I have cancer?
Doctor: If that should happen, then you and I will talk about what our
next steps will be.
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