Early Diagnosis of Cancer

Cancer is defined as a malignant mass that arises from the uncontrolled and abnormal division and proliferation of cells in a tissue or organ. Early detection of cancer significantly increases the chance of treating the tumor before it metastasizes (spreads to other organs).

How is Cancer Screening Done in Check-up Programs?

When preparing check-up programs, basic tests for early cancer diagnosis are included along with evaluations of the patient's metabolic status, body functions, and risk factors for heart diseases. Some of these basic tests, which are included in all check-up packages, are chest X-ray, abdominal and thyroid ultrasound, mammography and breast ultrasound, smear tests, occult blood test in stool, and PSA test.

How Should Detailed Cancer Screening Be Done?

In addition to basic check-up programs, Anadolu Sağlık Merkezi Cancer Screening Check-up Panels (Cancer Screening Panel for Women/Men or Exclusive Cancer Screening Panel for Women/Men) include detailed laboratory and radiological tests (chest tomography, abdominal and brain MRI) and examinations in urology, gynecology and obstetrics, dermatology (examination of body moles with dermatoscope), and ENT (detailed examination of the larynx and vocal cords). During these screenings, pre-cancerous lesions (such as a risky nodule) are monitored and treated successfully before they metastasize.

Can Detailed Cancer Screening Provide a Definitive Diagnosis?

Recent advances in modern medicine have made significant progress in early cancer detection. However, it is still not possible to determine with 100% certainty whether a person has cancer. Scientific studies have promising results for markers that can detect certain types of cancer at the cellular level. For example, the "circulating tumor cell (CTC) method" performed at Anadolu Sağlık Merkezi Pathology Center is based on a simple blood test and can detect cancer cells, their quantities, and even the type of cancer through findings from a blood sample analyzed by a special device. The CTC method enables the detection of tumor cells in the bloodstream before they reach a detectable size with current screening methods. This allows for early diagnosis of some cancer types (such as lung, breast, prostate, and colon cancers). The CTC method is not included in check-up packages as it is more beneficial for evaluating the effectiveness of treatment in diagnosed patients rather than screening healthy individuals. It is also only applicable to certain cancer types. Additionally, the absence of detectable cancer cells in the blood does not necessarily mean there is no cancer, as cells may not yet have entered the bloodstream or may alter their surface properties to become undetectable.

What is the Role of PET-CT in Cancer Screening?

PET-CT is an imaging technique that combines PET (Positron Emission Tomography) and CT (Computed Tomography) technologies in the same device, providing more information than each technique separately. PET-CT is very useful for initial cancer diagnosis and evaluating the extent of metastasis but is not commonly used for cancer screening during check-ups. This is because PET-CT may not detect all types of cancer or tumors smaller than 1 cm. Additionally, due to the radioactive substance used in PET-CT, patients need to avoid contact with pregnant women and young children for 8 hours after the procedure, which poses an unacceptable risk for healthy individuals.

Are Cancer Markers or Tumor Markers Useful in Cancer Screening?

Cancer markers are substances such as enzymes, proteins, antigens, or hormones that can be used to screen, diagnose, classify, and monitor the response to treatment and recurrence of cancer. Common cancer markers include: PSA (Prostate-Specific Antigen) for prostate cancer, CA 125 (Ovarian and uterine cancers, peritoneal cancer), CA 15-3 (Breast cancer), CA 19-9 (Pancreatic, colon, stomach, bile duct, esophageal cancers), CEA (Carcinoembryonic Antigen) for colon, esophageal, stomach, bile duct, pancreatic cancers, and some ovarian cancers, HCG (Human Chorionic Gonadotropin) for trophoblastic tumors and testicular cancers, and AFP (Alpha-Fetoprotein) for testicular cancers, some ovarian cancers, and liver cancer. These markers are released not only by cancer cells but also by normal cells, which can lead to variable and sometimes confusing results. Elevated levels of some tumor markers may be due to smoking, infections, liver fat, or medications affecting liver function. In some cases, cancer markers may remain within normal ranges even if cancer is present. Certain cancers do not have specific markers, such as soft tissue cancers, brain cancer, bladder cancer, and laryngeal cancer. If a cancer marker is elevated in a healthy person, it may cause concern. When such elevations are first detected, necessary tests should be conducted by a specialist to rule out cancer. Subsequent follow-up with no unexpected increases in the marker may suffice for annual monitoring.

In Which Check-up Programs Are Tumor Markers Found?

Tumor markers are not included in normal check-up packages but are offered as a separate panel (Onco-marker Panel). They are also included in detailed cancer screening packages. Onco-marker panels should be requested by a physician based on the patient's age, sex, family history, and other risk factors. If cancer or a pre-cancerous condition is suspected, it is recommended to consult an oncologist.

How is Hereditary Cancer Genetic Screening Done?

Hereditary cancer genetic screening involves analyzing DNA from a blood sample to identify changes or mutations in specific genes that increase the risk of developing cancer. Such mutations are inherited from parents and can be present in either of the patient's parents. The most common hereditary cancers include breast cancer, ovarian cancer, and colorectal cancer. Genetic testing is performed for individuals with a family history of these cancers, multiple relatives with cancer, or early-onset cancer. The testing is done by analyzing blood samples and checking for known mutations associated with hereditary cancers. Genetic counseling is essential for understanding the implications of genetic test results and making informed decisions regarding preventive measures, early screenings, and lifestyle changes.

Who Should be Recommended Hereditary Cancer Genetic Testing?

Hereditary cancer genetic testing is recommended for individuals with a strong family history of cancer, especially if multiple family members have been diagnosed with cancer, particularly at a young age. Other indications include having a known genetic mutation in the family or having been diagnosed with cancer at an early age. Genetic counseling is crucial for interpreting the results of genetic testing and determining the best course of action based on the findings.

What is the Role of Colonoscopy in Cancer Screening?

Colonoscopy is a procedure used to examine the inner lining of the colon and rectum for abnormalities or signs of cancer. It is a crucial tool in screening for colorectal cancer, especially for individuals over 50 years old or those with a family history of colorectal cancer. During a colonoscopy, a long, flexible tube with a camera is inserted into the rectum to view the colon. The procedure allows for the detection and removal of precancerous polyps, which can prevent the development of colorectal cancer. Colonoscopy is recommended as part of routine screening for colorectal cancer, and its frequency may vary depending on individual risk factors and family history.