For the past month, I’ve joined what appeared to be a massive crowd trying to catch up on routine health care. The pandemic has made me think seriously about cancer, public health and society, and has forced me to (re)examine how I act when I’m scared. Just like with cancer and its endless aftermath, the idea of ”living with COVID-19″ means figuring out what risks I’m willing to take when complete trust is impossible.
Here, in this landscape of cancer, fear, risk, and lack of absolute trust, so many of us are seeking greater care.
Aside from an oncologist telling me to postpone a colonoscopy because there were more pressing issues — and they have been since I was newly diagnosed and started my first treatment — I was thankful for my doctors who tried to help me with the to keep care up to date. My GP is a crucial person here because she gets clearance for almost anything other than breast and breast cancer treatment arranged by my oncologist.
The fact of the matter is, I continue to try to balance my acceptable risk of COVID-19 with my risk of other health issues. Actual risk can differ greatly from perceived risk, which in my case is heavily influenced by the psychological implications of a stage 4 de novo cancer diagnosis and ongoing cancer treatment at a time when people are ignoring so many risks to others.
In short, it has been difficult to maintain routine care, but it is also difficult to put aside the many fears we have when it comes to our health. For a person like me who doesn’t like to think about all the other ways my body could be telling me off, it’s important to stay on top of prevention lest I fall into the trap of making excuses. If you’ve been holding back screening and other treatments, getting back on schedule might be important.
Although some with metastatic breast cancer don’t proceed with mammograms, I do. It can be a first step in seeing a new or local cancer coming back, but be sure to talk to your doctor about your specific treatment. For example, an MRI or ultrasound of the breast may be needed in people with dense breasts or lobular breast cancer. Inflammatory breast cancer may not show up on a mammogram or an ultrasound, but may appear as a rash or irritated skin on your breast. In addition, men with changes in their breast tissue should request a mammogram.
PSA and pap smear
Prostate specific antigen (PSA) testing is not recommended for all men and it is important to ask your doctor about your individual risk. For women, the Pap test (or Pap smear) is an important tool for detecting cervical cancer before symptoms appear. It is recommended for people under the age of 65 who are sexually active. Human papillomavirus (HPV) is linked to several types of cancer, including cervical cancer, and your doctor may recommend HPV screening at the same time as your Pap test. While it can be difficult to relate cancer to these sensitive and private issues, it’s important to be honest with your doctor so they can make the best recommendations possible.
This is the test that got me thinking about how easy it was to delay standard procedures. But a colonoscopy can detect changes in your body before cancer develops. A screening colonoscopy is recommended for people aged 50 and older, after which your doctor will inform you about future tests, and sooner for those who have risk factors such as family history. If a polyp is found, colonoscopy becomes diagnostic. The polyp will be removed and analyzed by a pathologist, and your doctor will advise on the timing of future tests.
A test of your cholesterol level is a blood test that is much simpler than some of the other screening tools. Many people only need to be tested once or twice a decade. If you have a family history of risk factors, such as diabetes, heart disease, or high cholesterol, your doctor may recommend more frequent testing and prescribe medication.
diabetes and prediabetes
Your doctor can recommend which tests and test frequency are right for you. Some doctors recommend that everyone over the age of 45 be tested, regardless of weight or other risk factors.
Regular dental care is important for everyone, especially cancer patients, as oral health can affect the health of your body. If you’ve put this off because of COVID-19 fear (or any other fear), consider getting back on track with an oral hygiene improvement appointment.
Just starting the conversation about screening is a good first step with your doctors. Find out as much as you can about your family history and be open about your behavior so your team can help you live well for as long as possible.
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