The idea of starting the year with a clean slate, particularly a clean bill of health, is appealing. We run through five health tests that might be worth considering.

The type 2 diabetes, or HbA1c, test

A relatively new test, the HbA1c test looks at ‘glycated haemoglobin’ in your body, averaged over the last three months, to determine if you have diabetes, prediabetes or healthy levels of HbA1c.

With 1.2 million Australians living with diabetes, a further 500,00 suspected of having undiagnosed diabetes and with the condition projected to grow to 3.5 million by 2033, it’s a real spectre on the health horizon. Someone can live with diabetes for 7 years before any symptoms become apparent, causing damage to the body in the meantime.

Take the 2-minute AUSDRISK diabetes assessment to learn if you might be at risk and need to book in for a test.

The skin cancer, or melanoma, test

Australians have the highest rates of skin cancer in the world, and melanoma is the third most common cancer in Australia, and two-thirds of Australians will be diagnosed with skin cancer by the time they’re 70.

A visit to the doctor or skin specialist to check spots and for other symptoms is your first port of call. If required, the doctor may perform a biopsy to test for any suspected skin cancer.

Bowel cancer screening

Every year 17,000 Australians are diagnosed with bowel cancer, but the good news is that bowel cancer is one of the preventable cancers, meaning with changes to diet and lifestyle, the dangers can be reversed or mitigated.

Of those diagnosed with bowel cancer, 93% are aged over 50. If detected early, 9 out of 10 bowel cancer cases can be successfully treated. And in a stroke of further good fortune, the Australian government runs a free bowel screening test program, sending a testing kit to your house, no less, which you can conduct and return at your own convenience.

Cholesterol test

Cholesterol is no good for the old heart and brain, so if you’re over 45 you want to check that out – particularly if high cholesterol and heart disease run in the family. For those under 45, other risk factors include smoking, excess weight, diabetes, high blood pressure renal failure, or being of Aboriginal or Torres Strait Islander descent.

A cholesterol test involves taking a blood sample and looking for LDL-C, a bad cholesterol (there are good ones too) which collects in the walls of blood vessels.

STI and related tests

No, young people do not escape testing. If you are sexually active you might want to consider testing for chlamydia, syphilis, or gonorrhoea, as well as the three H’s: human papillomavirus, HIV and hepatitis.

STIs are on the rise in Australia and often symptoms will be missed. If not detected and treated the health effects can be significant. More detail on how these tests work can be found here.

While GPs are often the first port of call for someone concerned about a medical condition, and where test referrals are made, it’s the pathology lab where a diagnosis is determined.

‘There are plenty of health conditions out there of concern,’ says Victorian pathologist, Dr David Clift ‘but the good news is that a lot of these conditions are preventable and treatable.’

‘Certainly, the five conditions mentioned here are preventable. If you haven’t had a test ever or for a while and have concerns, it’s good to know with Australia’s leading-edge pathology sector that you can have a simple test and set your mind at ease for the coming year.’

The post 5 health tests to start 2019 on the right footing first appeared on Know Pathology Know Healthcare.

Anatomical Pathologists make diagnoses of skin cancer  – much of their work involves analysing biopsies for melanoma and determining suitable treatment.

We spoke to three anatomical pathologists to get their insights on skin cancer and sun safety.

Dr Penny Yarrow

As an Anatomical Pathologist and a mother of two, Dr Penny Yarrow has spent many years teaching the value of Slip, Slop, Slap.

“With kids, I think it’s crucial to set good examples at a young age. I have a daughter and a son who have been taught to wear hats and sunscreen since they were toddlers. They are both very wary of sun burn as a result.”

Throughout her career, Penny has diagnosed thousands of skin cancers and melanomas in people of all ages.

”Skin cancer isn’t just a threat to older adults, it is a multi-generational health issue, affecting grandparents, parents and even teenagers. Much of the sun damage to our skin that causes skin cancers in later life occurs during our teenage years so it’s essential that we teach our kids to be sun smart throughout childhood and adolescence.”

Dr Nick Musgrave

Nick Musgrave has experienced skin cancer both in the lab and in his personal life.

”I’ve had more skin cancers than the average Anatomical Pathologist! Being fair skinned and growing up in Queensland has its consequences and it’s taught me that prevention is critical.”

Nick is a strong advocate for skin checks, particularly for those with a genetic predisposition to skin cancer.

”Anyone with lots of freckles and moles or with a family history of skin cancer should get a professional skin check once per year. In Queensland, 2 out of 3 people will have skin cancer before the age of 70 so it’s important to be aware of your risk.”

While the statistics are concerning, Nick is encouraged by advances in pathology which have helped improve treatment of melanoma.

“Thanks to BRAF mutation testing, we can identify a patient’s genetic blueprint and guide targeted therapy for melanoma.

Genetic testing has had a dramatic improvement on the prognosis for patients who have melanoma that’s already spread. With advances in genetic testing, the hope is that melanoma will become more of a chronic disease than a fatal one.”

Dr David Clift

When David Clift was growing up in the 1950s, people had less knowledge of sun safety.

“It was very common for people to get plenty of sunburns, peeling and even blistering burns so it is no surprise that melanoma rates have doubled in the last 20 years and we are seeing 80% of all melanomas on 50+ year old Australians, who grew up not using sunscreen”, he says.

David has noticed that a greater public awareness of skin cancer has helped to improve patient outcomes.

“During the summer months in the lab, we see a much larger volume of skin cancer cases. People are showing more skin and noticing new moles that were never there before. Rather than ignoring it, they’re going to their doctor and getting treatment early and that can save their life.”

A keen sailor, David is always careful to protect himself on the water.

”Skin cancer is very common on the neck and ears so I always wear a hat with a legionnaire scarf to protect those areas.”

The post How do anatomical pathologists protect themselves in the sun? first appeared on Know Pathology Know Healthcare.

When examining a patient’s skin for problematic lesions, moles or blemishes, doctors may take a biopsy or remove a suspect mark. This sample is then sent to a pathology lab where it is examined by a pathologist to determine if cancer is present.

Cancer Council estimates that two thirds of Australians will be diagnosed with skin cancer by the age of 70. Basal cell carcinoma is the most common form of the cancer, accounting for 70 percent of non-melanoma skin cancers.

Fortunately, as Jackman points out, non-melanoma skin cancers are mostly successfully treated.

However, it is important that Australians are vigilant about skin cancer checks. A suspicious mark may turn out to be harmless but if it does turn out to be cancer it is important to get fast treatment. This is particularly important for cases of the more dangerous type of skin cancer, melanoma, which caused over 1500 deaths in 2015.

The only way to accurately diagnose what type of cancer is present or if a blemish is benign is via pathology testing. An anatomical pathologist will examine the sample removed by a doctor and provide data on the type of cancer as well as ‘staging’ the cancer. This denotes the thickness of cancer and whether it is likely to have spread to another area of the body.

The 5 year survival rate for melanoma is 90%, and early detection is key to this.

“WEAR SUNSCREEN” Tweeted Jackman, we’d like to add “GET CHECKED”.

http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3303.02015?OpenDocument

The post Not just a pretty face: Hugh Jackman’s photo tells of skin cancer danger first appeared on Know Pathology Know Healthcare.

1. Skin cancer check

Skin cancers make up 80% of newly diagnosed cancers and will affect two thirds of Australians before the age of 70. As with all cancers, catching the disease early is important for the best outcome. About 90% of skin cancers are caused by sun exposure so summer is the perfect time to be thinking about your skin.

Ask your doctor to check your skin, particularly if you haven’t been checked before or have moles and blemishes you are concerned about. Your doctor may take a biopsy of any suspicious marks and pathology testing will reveal if cancer is present.

2. Diabetes check

Type 2 diabetes is a growing problem in Australia. It is more likely to affect people over 45, but cases in younger people including children are on the increase.

Fortunately, an HbA1c blood test is a simple way to diagnose diabetes and an oral glucose tolerance test can assess if someone is ‘pre-diabetic’ and therefore at high risk of developing Type 2 diabetes.

Risk factors for diabetes are; family history, age (55 or older), high blood pressure, being overweight and having polycystic ovarian syndrome for women. Symptoms vary from fatigue, persistent hunger and / or thirst to leg cramps, headaches and blurred vision. It is important for anyone concerned about symptoms or in a high risk category to talk to their doctor about testing.

3. Bowel cancer screening

If you’re turning 50 this year, you should receive a bowel cancer screening kit in the post. The free screening program uses a Faecal Immunochemical Test to look for blood in a faecal sample taken by patients at home. This doesn’t diagnose cancer but a positive test means further investigation is needed to find the cause of bleeding.

If you are over the age of 50 and haven’t been tested, speak to your doctor. Bowel cancer is the second biggest cancer killer in Australia but if caught early up to 90% of cases can be treated successfully.

4. Cervical cancer screening

The new cervical screening test is due to be implemented in December 2017 but if you are a woman who had your last pap test 2 years ago or more, you should continue as normal and arrange a pap test under the current program.

At the moment, women are tested using a ‘smear’ technique where a sample of cells is collected from the cervix using a spatula or brush, these are smeared onto a slide and examined under a microscope for abnormalities. The new test is different. Sample collection is the same but the test looks for the virus that leads to cervical cancer, Human Papilloma Virus (HPV). This early detection technique means women will be tested every 5 years once the new scheme is in place.

5. That thing you’ve been ignoring

Whether it’s a change in bowel movements, frequent headaches or feeling constantly tired despite getting enough sleep, ongoing symptoms should not be ignored. Studies show that many people put up with symptoms linked to serious conditions including cancer¹.

Pathology testing can help your doctor to find the cause of persistent symptoms or to give you the all clear if something is worrying you. If it is something more serious, early detection could save your life, or change it for the better, like some of our supporters.

References:

¹https://www.independent.co.uk/life-style/health-and-families/health-news/stiff-upper-lip-stoicism-keeps-people-with-cancer-symptoms-away-from-gp-10001784.html

The post The 5 pathology tests you should have this year first appeared on Know Pathology Know Healthcare.

Men’s Health Week takes place in June each year; it was started in the US in 1994 to increase awareness of preventable health problems and encourage early detection and treatment of disease among men and boys.

This month we take a look at the broad role pathology plays in some conditions affecting men.

Heart disease

The biggest killer of men in Australia is heart disease. The Heart Foundation says 98 Australian men have a heart attack every day with 1 in 7 dying. Heart disease has a number of risk factors that are modifiable and pathology can help to identify risk and measure improvement by use of cholesterol testing.

Total cholesterol testing measures levels of high density lipoproteins (HDL or ‘good’) cholesterol, low density lipoproteins (LDL or ‘bad’) cholesterol and triglycerides in the blood.

A person’s total cholesterol score will show whether they are at greater risk of developing heart disease and having a heart attack. High ‘bad’ cholesterol and triglycerides can cause the arteries to harden and narrow. Having a blood test to find out cholesterol levels is highly recommended, particularly for men over 45. Changes in diet can help lower ‘bad’ cholesterol and reduce risk and follow-up pathology results can monitor improvement.

Although younger men may be less likely to worry about heart health, cholesterol testing is also advisable for those under 45 who are in high risk groups. Men with heart disease in their family, who are overweight or have diabetes are all at increased risk and recent research has also drawn a link between mental health and heart disease.

Melanoma

Men are more likely to suffer from melanoma than women and more likely to die from the disease.

Research suggests that, as well as other biological differences, men develop melanoma more on their backs and chests, whereas it is more common on the arms and legs in women. Back and chest areas are harder to see meaning the cancer may go unnoticed longer in men. It is also more difficult for someone to apply sunscreen to their own back when it is exposed to the sun. As men may be less likely to seek help with sunscreen application, this places them at further risk.

Pathology is crucial for melanoma diagnosis which is done via a biopsy of a lesion removed from the skin.

Testicular cancer

The most common cancer in men aged 18-39 is testicular cancer, according to Cancer Council. Diagnosis of testicular cancer starts with a physical examination and may then include laboratory tests for tumour markers, such as AFP (alpha-fetoprotein), hCG (human chorionic gonadotropin) and LDH (lactate dehydrogenase). An ultrasound may also be used to distinguish between cancer and other possibilities such as infection.

Should these tests indicate testicular cancer is likely, diagnosis is confirmed by removing the testicle, which is then biopsied.

A biopsy performed while the testicle is still in situ risks spreading the cancer so the testicle is removed in cases where cancer is strongly suspected. This also acts as the first stage of treatment and further treatment may not be needed if the cancer is detected early.

Once testicular cancer is diagnosed, blood tests to monitor tumour markers can also help doctors to assess the patient’s response to treatment.

Sexually transmitted infections

With research showing that sexually transmitted infection (STIs) rates continue to rise, STI screening is an essential part of men’s health.

In terms of everyday human activities, sex is one of the easiest ways to spread infection and although many men feel that they are in a low risk category for STIs, screening is important to rule out ‘silent’ infections and protect sexual partners.

Chlamydia has raised concern recently as rates are high amongst Australians on the dating scene, including over 50s. Around 50% of chlamydia cases in men have no symptoms and diagnosis can only be made using pathology testing of either a urine sample or a cell sample collected from the urethra (or the cervix in women).

The infection is easily spread and when left untreated can damage fertility in women and can even lead to men becoming sterile in some cases.

Other infections which can be passed on through sex, such as herpes, can increase the risk of contracting more serious diseases like HIV. A sexual health check can help identify any suspect lesions which can then be swabbed to collect a cell sample for pathology testing.

The post Men’s health: much more than ‘man flu’ first appeared on Know Pathology Know Healthcare.