There are ways to both reduce the risk of cancer and to detect it early in many cases. Early detection is crucial as the survival and cure rate is usually directly proportional to the cancer load¹, the number of cancer cells at the point a patient presents.

You may have seen the recent initiative for lung cancer detection in smokers where CT scanners are positioned in supermarket car parks. Lung cancer is frequently one of the cancer types that presents late, and early detection and surgery may significantly reduce mortality.

Bowel Cancer

Bowel cancer is one of the most common treatable cancers. 2600 cases each year occur in those under the age of 50 and 1 in 15 men and 1 in 18 women will develop bowel cancer in their lifetime. 16800 people die each year from bowel cancer in the UK alone. The good news is that if caught early, it can be very treatable. The NHS national screening programme offers those over 60 a home FIT test Kit every 2 years and has already helped hugely in the detection of bowel cancers. These tests detect blood in your stools that may not be visible to the naked eye. However, these are only offered every other year and only to people over the age of 60. I argue that this is far too late. One in ten cases occur before that age.

FIT testing is surprisingly sensitive. This is a simple test where you dip a plastic stick into your faeces and send it to the laboratory. A negative FIT test combined with a normal examination and normal blood test makes bowel cancer very unlikely. It detects 95% of bowel cancers. As mentioned, I recommend FIT testing annually from the age of 40. It is such a simple test; it is cheap and sensitive. We can arrange the blood test, FIT test and examination for those interested.

If you have a family history of bowel cancer, you should be especially aware of the risk and have a FIT test annually from the age of 40. A colonoscopy is recommended for all people who are at high risk from the age of 40. This is a procedure where they look at your bowel using a flexible tube to see if you have any lesions or polyps that could be potentially cancerous. Bowel Polyps are very common and often run in families. Most are benign but they have the propensity, if not removed, to turn into cancers. This is where early detection and removal of polyps can be a life saver. 

Prostate Cancer

A PSA blood test which detects potential cancer of the prostate gland is another neglected test, not even recommended as a screening test currently. The argument is that screening would detect many low-risk cancers and cause more harm than good in a population. This is spurious in my opinion. We now have (privately at least) a PSA test that detects free PSA which is a much more sensitive measure of cancer risk (the NHS do not test for this). 

Screening in men really is a backwater currently. If we screen PSA annually from the age of 40, we get two measures, the rate of climb of the PSA figure and the measure of free PSA. We now also have in our armoury MRI scanners that can detect cancer in those with suspicious PSAs or rule it out. This avoids most people from going on to a biopsy. It was the need for a biopsy with its attendant risk of infection that was used as an argument against screening. Cost is the only reason for not screening men now in my opinion. Please let us know if you wish to commence PSA screening. It only involves a simple blood test.

There are even more sophisticated tests available to differentiate a benign raised PSA from a malignant one at an early stage.   There are now accurate tests to assess the risk that a raised PSA represents significant cancer. These are not yet adopted by the NHS but one of them, Stockholm3, now makes up the national screening test in Sweden. Unfortunately these tests remain expensive and this is the primary reason the NHS has not yet adopted them.

There are two tests available, Stockholm3 which can be used where the PSA is 1.5-20 and Proclarix which can be used when the PSA is between 2-10. Both provide an accurate assessment of the risk of significant disease in the prostate. Stockholm 3 is more expensive at £480, Proclarix is £259*. If you wish to have either test we would need two days’ notice to organise a courier to take the sample to the laboratory, the cost of this is included in the test.

Breast & Cervical Screening

Breast and Cervical screening have been in place for years, but many people do not take advantage of them. The cervical cancer virus vaccine which was introduced a few years ago is expected to reduce the incidence of cervical cancer significantly going forward.

Breast screening is available for all every three years from the age of 50. If you have a family history of breast cancer particularly in family members under the age of 50, we can do a test to see if you carry a gene that puts you at increased risk of both breast and ovarian cancer. More regular monitoring can then be undertaken. You can continue to request mammography after the cut off age for national breast screening.

Lung Cancer – Early Detection

Lung cancer remains the most common cause of cancer death in the UK. An Early CDT Lung test has been developed to detect lung cancers early. The blood test looks for the autoantibodies (antibodies your body produces against its own tissues) to antigens which are linked to lung cancer. Lung cancer is frequently diagnosed when it is advanced and difficult to cure. The sooner lung disease is detected, the greater the chance of successful treatment. In the event of a positive result, you may need to be referred for a CT scan of the chest. 

The Early CDT Lung test (£211.03)* is recommended routinely for heavy smokers over the age of 45. If you are concerned about your risk of lung disease, please book in for a consultation to discuss testing.

*Please see our Fees Page for up to date pricing on Private Prostate Cancer & Lung Cancer Testing

6 Tips To Help Reduce Our Chances of Developing Cancer

1. Start young. There is plenty of evidence that optimising your health from a young age will keep you healthier in later life.
2. Do not smoke or vape. Smoking is the greatest risk for not just heart/lung disease but also affects not only lung cancer but bladder cancer and others.
3. Wear sunscreen & do not use sun beds. Sunlight is a clear risk factor for melanoma (skin cancer). Be body aware and check for any dark moles on your skin particularly if they are growing, look angry or bleed. Mole mapping for people who are very moley is unfortunately not available on the NHS but can be requested privately. This is where a Dermatologist will do a full body check and images and measurements are taken of moles and compared on a yearly basis.
4. Weight control. Obesity is the second most powerful risk for cancer and four of the top five cancers by mortality are linked to obesity. This probably relates to the raised inflammation and insulin growth factor 1 associated with obesity.
5. Alcohol consumption. Reducing alcohol, eating plenty of fruit and vegetables and reducing red meat all help
6. Increase your exercise.  Exercise reduces the risk of several cancers including, breast, prostate, colon, endometrium, and possibly pancreatic cancer.

The Future with regards to Early Detection

Liquid biopsy offers a possible solution for the future. This is a process, available only in the US but being trialled in the UK, where blood is taken from a patient and tested for the DNA released by tumour cells. This may be a way of detecting both early cancers and recurrence of cancers, offering an opportunity for very early treatment at a time when the cancer load  is relatively low and at a point where MRI or PET scanning would not detect them. I hope these will become available privately in the near future.

For more interesting views on longevity and remaining healthy, please visit  www.privategphealthcare.com and go to ‘blogs’.

Dr Allan Fox, Private GP Healthcare in Canterbury.

1. Baseline serum tumour markers predict the survival of patients with advanced non-small cell lung cancer receiving first-line immunotherapy: a multicentre retrospective study
   Jian Huang et al ↩︎