For Breast Cancer
Q. I fear I have breast cancer...I have no insurance and lost my job. My symptoms have become too huge to ignore. What can I do?
I am sorry to hear about all that you are dealing with—this must be a stressful time full of uncertainty. It is certainly important to be aware of changes in your breasts and to seek medical attention when you notice unusual symptoms that persist for a period of time. But keep in mind, too, that 80% of breast lumps are not cancerous. For instance, breast cysts, fibroadenomas, and infections are all considered to be benign, or not related to cancer.
That said, you should contact the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), to locate a free screening program. Medicaid coverage is available through the program to women who have been screened and diagnosed with cancer. For more information go to the NBCCEDP website or call 1-888-842-6355.
The thought of having cancer can be upsetting and overwhelming. Are there people in your life to whom you can turn for emotional support? You may find it comforting to bring a trusted loved one along to appointments. Not only will you have a hand to hold, but you’ll have an extra set of eyes and ears to help you take in information. I also welcome you to call CancerCare and speak with one of our professional oncology social workers at 1-800-813-HOPE (4673). Oncology social workers have professional training to counsel people coping with cancer and help them access practical assistance. They are available to help you manage emotions such as anxiety and sadness, find reliable information, and locate resources in your community. Read more about CancerCare’s free, nationally-available services.
For Lung Cancer
Q. My grandpa died from lung cancer at age 58 and my brother at age 38. What tests can I have done for early detection, and what are my odds of having lung cancer?
There’s been considerable research into the increased risk of lung cancer faced by people who have a family history of lung cancer. In a recent meta-analysis reported in the European Journal of Cancer it was found that a family history of lung cancer in a first degree relative (parent, sibling) was associated with a 51% increase in the risk of lung cancer (controlling for smoking and other risk factors). Further it was determined that if the first degree relative is a sibling the risk is increased by 82% and if a parent the risk is increased by 25 to 37%. The risk is higher for individuals who engage in smoking tobacco, even if they are light smokers.
A review of information provided by the National Cancer Institute revealed that there is no current screening procedure available which tests for genetic variants believed to be associated with family lung cancer history.
The only currently approved screening for lung cancer is for people between the ages of 55 and 74 years who have a 30 year, 1 cigarette pack/day smoking history; which consists of getting annual low dose spiral CT scan with contrast. You might be able to have your doctor provide you with a referral for this procedure on the basis of your family history, but you might have to self-pay for it.
You may find the following information helpful :
- Schwartz. 2004. Genetic predisposition to lung cancer. CHEST. 2004;125(5_suppl):86S-89S.
- Cassidy et al. 2006. Family history and risk of lung cancer: age-at-diagnosis in cases and first-degree relatives. British Journal of Cancer (2006) 95, 1288–1290.
- Cote ML et al. 2005. Risk of lung cancer among white and black relatives of individuals with early-onset lung cancer. Journal of the Americn Medical Associaton 293(24):3036-3042.
- Chen and Kaphingst. 2010. Risk perceptions and family history of lung cancer: Differences by smoking status. Public Health Genomics. December; 14(1): 26–34.
- Genetic Variant Greatly Increases Lung Cancer Risk for Light, Nonsmokers (National Human Genome Research Institute)
Studies of interest to those with a familial history of lung cancer:
- Family Lung Cancer Study (University of Cincinnati College of Medicine)
- Lung Cancer Study – family members and those diagnosed with lung cancer may be eligible to join (LSU Health Sciences Center – New Orleans)
- Coté ML, Liu M, Bonassi S, Neri M, Schwartz AG, Christiani DC, et al. Increased risk of lung cancer in individuals with a family history of the disease: A pooled analysis from the International Lung Cancer Consortium. Eur J Cancer 2012;48(13):1957-68
Q. My husband has black moles on his face - could this be melanoma? How serious are they if they change?
Moles are pigmented (colored) cells that can look like small, dark spots on your skin. They can range in color, but the majority are dark brown. Moles can become cancerous, but this is rare. To help recognize the signs of melanoma, the American Academy of Dermatology created the ABCDEs of melanoma detection:
- Asymmetry: One half of the mole or pigmented spot is different than the other half
- Borders: The mole or spot has irregular or poorly defined borders
- Colors: Color is varied from one area to another. Includes shades of tan, brown, black (also can include white, red or blue)
- Diameter: Spot is usually greater than 6mm (size of pencil eraser)
- Evolving: A mole or spot that looks different from others or changes in size, shape, or color.
Your husband should have the moles on his face (and any others) checked out by a doctor. You can search for a dermatologist through the American Academy of Dermatology’s Find a Dermatologist database. The National Cancer Institute offers information about preventing skin cancer and melanoma. Additionally, the Melanoma Research Foundation provides a wealth of information about the prevention and treatment of melanoma.
For Pancreatic Cancer
Q. My husband, his mother, and her brother died of pancreatic cancer. My daughter has had breast cancer. I also have two sons, one with Crohn's disease and one with type 2 diabetes. What protocol should we be following?
Pancreatic cancer is often difficult to diagnose. That’s because of where it is located in the body (right in the middle of the body) and the way it often presents (generalized pain either in the belly or the back, right or left side). There is no distinct cause for pancreatic cause but there are findings that certain risk factors increase the likelihood of the disease.
According to the Pancreatic Cancer Action Network (PanCan) strong family history is one of the risk factors for pancreatic cancer as well as a family history of breast cancer and diabetes. Make sure you are detailed and clear with your health care providers when giving your family health history and ask about getting a blood test called CA19-9 as a baseline. When the test is trending upwards, it might mean that there is some pancreatic cancer activity in the body. You might also consider pursuing genetic testing.
Again, it is important for you and your family members to discuss your specific family history (including all illnesses) with your health care providers so that you will know what protocol is best to follow.
Learn more about The Genetics of Pancreatic Cancer from Cancer.Net.