Prostate Cancer Screening

 Prostate cancer is the most diagnosed cancer (aside from non-melanoma skin cancers) for men in Canada. While there is no formal screening program in Manitoba, men are encouraged to get a simple blood test each year that can detect prostate cancer. This blood test is for Prostate Specific Antigen and it is recommended for men aged 50 and over, and younger if there is a family history of prostate cancer or if you are of African-Canadian heritage. Most family doctors will suggest this blood test or you can ask for it.

Another option is to bypass your family doctor and go to Manitoba Men's Health Clinic. You can even book an appointment online. https://mhclinic.ca/prostate-cancer-screening/

Prostate Specific Antigen (PSA) is a protein made by the prostate. It is elevated if you have prostate cancer. Unfortunately it is an imperfect test and some men with cancer can have a normal PSA and some men who do not have cancer can have a high PSA. It is important to consider the overall health of the man and not just focus on the PSA result. This is why some doctors will repeat a PSA test after an interval of time to see if the result is higher or lower than before. Additionally doctors will also do a digital rectal exam to determine if the prostate is enlarged. It is particularly important to use the blood test as a screening tool in men who have a longer life expectancy. It is less valuable as a test of men in what is expected to be their last decade of life. The biggest benefit of the blood test is for men in their 50s and 60s as it has lead to a lower mortality rate and better outcomes due to the cancer being detected earlier.

If your results are normal nothing further need to be done, except to repeat the test yearly. If it is abnormal or if a physical exam suggests an enlarged prostate you will be referred to the Dr. Ernest W. Ramsey Manitoba Prostate Centre for further testing. This is the provincial centre for prostate diseases. They have a whole team of professionals that will provide assessments, diagnosis, treatment and support.

Prostate cancer is highly survivable especially with an early diagnosis. Treatments are improving and expanding all the time, giving most men a very good outcome and many more good years with their loved ones. Over 90% of men survive 5 years after diagnosis and almost 100% of men survive if diagnosed in the first 3 stages of prostate cancer. Please ensure a similar outcome by asking your doctor for a PSA blood test. Do not wait!

Letter of thanks

 A gentleman wrote a nice letter of thanks. He said Cancer Crossing helped him at a time when it was needed the most. He was grateful also for all the help from the cancer team and his advice to others is to never give up! Help us to help more Manitobans with cancer, by donating at https://cancercrossing.com/. You will receive a tax deductible receipt.

International student in Winnipeg

 Imagine being in Winnipeg on a student visa, far from home. Your wife and two young children are with you but everything and everyone else that is familiar and comforting to you is far away. Then you are diagnosed with cancer and the floor drops out beneath you. This was the case for a university student here. He is undergoing an intensive treatment program here. Unfortunately the compounded pain medications he needs are not covered by Manitoba Health nor the Home Cancer Drug Program. Fortunately Cancer Care was able to step in and assist with costs so that he can concentrate on his health. Help us to help others that fall through the cracks. Donate at https://cancercrossing.com/, you will receive a tax deductible receipt.

Thank you

 We at Cancer Crossing enjoy reading the letters of thanks sent by grateful recipients. A woman wrote us to tell us how very much she appreciated the swift response and financial assistance that she received. Her advice to others who are diagnosed with cancer is to stay calm and relaxed and stay positive. Please donate so that we can continue to help others, a tax receipt will be given. https://cancercrossing.com/

Woman with two different cancers

 Cancer Crossing was recently approached to help a woman in her mid-70s. She lives in western Manitoba and she has both lymphoma and lung cancer. She lives in a small town and must travel to all her appointments. She had been going to Brandon but must now travel to Winnipeg for treatment for the newly diagnosed lung cancer. What a double blow! She has a lot to deal with by herself, as she lives alone. It's a lot for anyone to cope with and we were happy that we could help lift some of the financial burden she has been experiencing. Your donations help Cancer Crossing to help Manitobans living with cancer. Please give generously at https://cancercrossing.com/. A tax deductible receipt will be given.

Colon cancer screening, part two

 Colon cancer screening - the colonoscopy.

Here is what happens if you are referred for a colonoscopy. You will be asked to not consume corn or seeds like poppy seeds for a week before your procedure. You will be fasting the entire day before your colonoscopy. That means you may have clear broth (no veggies, no rice or noodles, only broth), jell-o except red or purple, popsicles except red or purple, coffee or tea - sweetener or sugar is allowed but milk or cream is not. You may not eat any other foods for this entire day. You will be asked to drink one glass of water every hour.

You will need to buy a "lyte" prep at the pharmacy. Pro tip, if you are over 50 you probably qualify for a discount at the pharmacy, usually one day a week. The prep costs about $50 so if you get your discount you can save about $10. Plan ahead by buying your prep on whatever day your pharmacy gives discounts in order to save a little money. Mix the prep on the morning you will start taking it and refrigerate it. Drinking the prep is the hardest part of this all and if it is cold it will go down easier.

You will start your bowel prep the day before your appointment, at either 4 pm if you have a morning appointment or 6 pm if you have an afternoon appointment for your colonoscopy. Instructions may vary a little but overall you drink one cup of the bowel prep solution every 15 minutes for two hours. This will be a total of 2 liters. Then you take a two hour break. After two hours you will start drinking one cup of prep every 15 minutes for 2 hours, until you finish the entire container of prep solution. It helps to set a timer to keep on track as you must finish 2 liters of prep within 2 hours. Note, if you have an afternoon appointment for your procedure you will wait until the following morning to drink the second course of prep solution. This solution will empty your bowels so plan on staying home and close to the bathroom. It's not uncomfortable but you will have sudden urges to "go".

The day of your procedure you may consume liquids only, up to 4 hours before your appointment. You may not drink anything after that, and of course no solid food this day until after your colonoscopy.

You will arrive at the clinic or hospital one hour before your scheduled appointment. You will be asked to undress and wear a hospital gown. You will have an EKG depending on your age, your blood pressure and heart rate will be taken. Then they will start an IV line so it is ready to be hooked up when you go into the procedure room. Once you are ready you will be taken in for your colonoscopy. The doctor will review your medical history and reason for colonoscopy. The nurses will hook up your IV and give you sedation. Then the procedure starts but you will be unaware of what is happening. This is not a general anaesthetic, it is conscious sedation. You will be able to respond to staff but you will not remember a thing. Next you will wake up back in the recovery room. It takes 20 minutes or so to fully be aware of your surroundings. You will be hooked up to a monitor and nurses will make sure you are ok. They will call your contact person to come pick you up. You may not drive yourself since you had been sedated. The staff will inform your of your colonoscopy results and will give you a printed copy and send a copy to your doctor. Once you are fully awake you may get dressed and go home.

If you are uneasy with the whole idea, remember that colonoscopies save lives! Polyps can be removed during the procedure so they never turn into cancer. If there are any lesions viewed they can be removed in further surgery or can be treated with medications. The worst part of the whole thing is drinking the prep. You will not have any pain from the colonoscopy nor any memory of it.

Colon Cancer Screening

 Your risk of developing cancer in your lifetime is about 45%. A cancer diagnosis is not a death sentence. Some types of cancer are highly survivable and an early diagnosis can help make surviving a reality. Getting screened for cancer can make a huge difference in the outcome, so let's talk about screening tests.

About 69 persons in Canada are diagnosed with colon cancer every single day. Most colon cancer happens to older adults, aged 50 and over but this is trending to more young people being diagnosed now.

In Manitoba, screening for colon cancer for most people starts at age 50. If you have a Manitoba Health number, the Colon Check program will mail you a FIT test for you to do at home. This is a Fecal Immunochemical Test and is sent to you once every two years until age 74. Instructions are in the package, and you collect a small amount of stool on a swab and mail it in. You will receive your results by mail in a week or two, and your doctor will also get results. This is an easy, non invasive screening program. If your result is normal nothing further is needed until the next FIT test is due.

If your FIT result is abnormal you will be referred for a colonoscopy. The wait time is short, about a month. You will have an appointment for a review and then a colonoscopy will be scheduled within a week or two. If you have symptoms that include persistent abdominal pain, change of bowel habits lasting at least 2 weeks, or have visible blood in your stool you should contact your doctor for referral for testing even if you are not due for a FIT test.

If you are under 50 and have a personal history of Inflammatory Bowel Disease (Crohn's Disease or Ulcerative Colitis), Familial Adenomatous Polyposis (FAP) or Lynch Syndrome, have a sibling, parent or child diagnosed with colon cancer under age 60, or have two or more relatives diagnosed at any age you are at increased risk of developing colon cancer. In this case you should be screened with a colonoscopy every 5 to 10 years. Note that Irritable Bowel Syndrome does not increase your risk of colon cancer.

You can reduce your risk of colon cancer by being screened with a FIT test and if necessary by colonoscopy. Also eating healthy by limiting highly processed foods, alcohol and not smoking. The next post will discuss the process of getting a colonoscopy - its not as bad as you think!