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Keeping tabs on cancer
Rob Stewart
August 30, 2019

Despite improvements in cancer treatment, early detection of cancer is still the most effective method of preventing cancer from being fatal. The key question is how to successfully detect cancers early, and fortunately New Zealand has excellent programmes for managing this process.

Bowel cancer

Bowel cancer claims more lives in New Zealand than any other cancer, despite being curable 75% of the time if detected early. With such a great opportunity for successful removal it is unsurprising that a national Bowel Screening Programme is currently being rolled out across New Zealand, targeting those aged 60-74 years. Bowel screening involves taking a self-sample and sending this off for analysis. If there are no issues detected then you'll receive your result directly, however if there is anything that needs to be reviewed then your result to come to us, as your primary care provider, and we'll get in touch about next steps. The majority of our patients are within the Capital & Coast DHB, who are scheduled to start the Bowel Screening Programme in the first half of 2020. Those patients in the Hutt Valley and Wairarapa are already part of the programme, with MidCentral (North of the Kapiti Coast) starting later in 2019.

However, regardless of age, if you're aware of a history of bowel cancer or polyps yourself or in your family, and you're experiencing any of the symptoms such as rectal bleeding, a change in bowel habit, severe tummy pain, any lump in the tummy or weight loss and tiredness, then it would be worthwhile talking to your GP about getting a screening test directly so that any bowel cancer is caught early.

Cervical cancer

Previously a significant concern for women’s health in the past, this cancer of the lower part of the womb is one of the most preventable cancers. Deaths of cervical cancer have dropped by nearly two-thirds since screening started. Almost all cervical cancers are caused by the HPV virus which is sexually transmitted.  

Cervical cancer is detected by testing a cervical smear sample every few years for women aged 20 to 70 who have ever been sexually active. Cervical cancer is a slow moving cancer, so regular screening is necessary to ensure that any changes are detected. On the plus side, once it is detected early there is plenty of time to treat the cancer. The cervical screening process is managed by us as your primary care provider and overseen by the National Cervical Screening Programme. We acknowledge that the regular reminders for a fairly invasive procedure are not always appreciated, but the outcomes , is very good at picking up this slowly - growing foe. As long as you are registered with a medical practice, you will get reminders for this screening.

The fight against cervical cancer is also being bolstered by the fully funded HPV vaccine which is recommended for young people between 9 and 27 years old, as this is having significant success where deployed overseas (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194907/).

Breast cancer

Again, the idea of catching the cancer when it is as small as possible will increase the chance of survival. Mammography can help visualise these tiny lumps in the breast before they can be felt. Currently, mammography is recommended every two years by BreastScreen Aotearoa, New Zealand’s free national breast screening programme for women aged between 45 and 69 (reminders available). However, some types of breast cancers may grow more quickly than others, which means that self – checking of breasts during the two – year interval is also important. The symptoms to watch out for may include any lump, skin changes on the breasts such as thickening, dimpling, rash, change in breast size or shape, and nipple discharge.

Melanoma

While New Zealanders are very good at using sun protection to prevent this type of skin cancer, monitoring skin lesions carefully is another essential skill to have in order to win the war, as this cancer grows by months, even by weeks in some cases.  Check all of your skin, not just sun-exposed areas. Ask for help from another person if you need to, or use a mirror. If anything suddenly grows bigger, looks irregular, gets mottled with colours (brown, black, blue, red, white or light grey) or bleeds, talk to your GP immediately. A skin lesion that gets persistently itchy should also raise suspicion.

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