The Sunshine Coast nurse and mother of two was diagnosed with bowel cancer in 2018 at just 38 years old.

“We are lucky that we live in a country where we have these tests available, so people really need to take part in screening, and listen to their body if something isn’t right.”

Ms Kriel was referred for a colonoscopy when she experienced stomach cramps and bloating.

“They removed two polyps from my bowel and pathology testing confirmed there was cancer present in one of them, it was so small a CT scan would have missed it. My surgeon said I am an ‘unlucky, lucky person’ because I was healthy and had no risk factors for bowel cancer, so I was lucky that the cancer was caught early.”

A study published in the May edition of The Lancet showed bowel cancer cases in people under 50 have risen in the last 10 years.¹

Pathology Awareness Australia ambassador, Dr Nick Musgrave is an anatomical pathologist who specialises in gastrointestinal pathology:

“With the data showing an increase in bowel cancer in younger Australians, anyone with symptoms should talk to their doctor. However, cancers can develop over several years and at the early stages may have few or no symptoms. That’s why it is important people take part in the screening program from the age of 50, to have the best chance of catching cancer early,” said Dr Musgrave.

Bowel cancer is Australia’s second biggest cancer killer, yet the 5-year survival rate for stage I bowel cancer is 99% and stage II is 89%.

For stage IV bowel cancer (metastatic cancer) the 5-year survival rate is just 13%.²

Ms Kriel’s cancer was at stage I and had not spread. She had surgery to remove half her bowel but was able to avoid radiation and chemotherapy after surgery.

“My bowel will never be the same, but chemotherapy is very gruelling and I was really worried about this when I was first diagnosed because it would mean prolonged illness and being away from my family. The psychological toll and financial burden of a cancer diagnosis and treatment is huge, especially for a younger person, you have your mortality thrown in your face.”

Despite this, a report released this month by the Australian Institute of Health and Welfare (AIHW) ² shows bowel cancer screening participation rates are worryingly low, just 41% in 2016-2017. And the participation rate was very poor (30%) in the younger age group, 50-54 years.

Dr Musgrave has called the numbers “astounding”.

“When you consider that bowel cancer in its early stages has a high survival rate but with late stage bowel cancer the survival rate is pretty dreadful, it is astounding that more people are not having the test. This is one of the cancers that we are able to screen for, so we must do everything we can to reduce the risk of having advanced disease,” said Dr Musgrave.

Under the National Bowel Cancer Screening Program, Australians aged 50-74 are sent testing kits in the mail to collect a faecal sample that is then posted to a pathology laboratory to be examined.

“I’ve turned 50 this year myself, and I know there’s an ‘ick’ factor with the test, but some people make too big a deal of having to sample their own faeces and may not realise that the test is actually pretty simple,” said Dr Musgrave.

“We know that participation rates for both cervical and breast cancer screening are much higher. The bowel cancer test is free of charge, is non-invasive and you don’t need to leave the house to collect your sample, when you weigh that against the potential impact of advanced cancer the number of Australians getting tested is far too low.”

Sally hopes her story will raise awareness of bowel cancer and encourage more people to take part in screening:

“I’m sure if we offered to turn back time for every bowel cancer patient to have early screening and an early diagnosis – they would take the opportunity in a heartbeat. The later the diagnosis, the more invasive the treatment needs to be, and the lower the survival rate.”

References

2. https://www.thelancet.com/journals/langas/article/PIIS2468-1253(19)30147-5/fulltext
3. https://www.aihw.gov.au/reports/cancer-screening/national-bowel-cancer-screening-program-monitoring/contents/table-of-contents

The post Low screening rate “astounding” in light of increased bowel cancer cases first appeared on Know Pathology Know Healthcare.

Congratulations, you just had your first pathology test, but certainly not your last. The testing of blood, urine and tissue continues throughout a person’s life-cycle.

And it’s a good thing too. Pathology tests are there to pick up on any health concerns nice and early, when they are at their most treatable.

Whatever stage of life you’re at – from being freshly minted to being longer in the tooth – pathology tests are there to help you monitor the inner workings of your body for optimal health.

We run through five tests everyone is likely to have through their lifetime.

Babies | Heel prick test

‘Hey, I didn’t ask for this!’ This is true, sorry fresh baby, but the heel prick test is very important. Taken 48-72 hours after birth, the heel prick test is looking for several conditions:

• Phenylketonuria (PKU) – a condition in which the liver can’t breakdown the amino acid phenylalanine (a building block of protein) and if left untreated can lead to intellectual disability
• Hypothyroidism – the thyroid helps regulate your metabolism. An underactive thyroid doesn’t produce enough hormones and can significantly impact intellectual development and a baby’s growth
• Cystic fibrosis – this condition leads to the production of too much mucus, which clogs the lungs and pancreas, preventing them from functioning properly
• Medium Chain Acyl CoA Dehydrogenase (MCAD) Deficiency– this condition results in inability of the body to completely break down fat. If untreated, it may be life-threatening during common childhood illnesses
• Congenital Adrenal Hyperplasia-an altered ability of the adrenal gland to produce hormones that may affect the baby’s metabolism, response to infection, ability to regulate salt levels and sex characteristics
• Various metabolic disorders – involving amino acid, organic acid and fatty acid oxidation, these disorders can have serious and even fatal effects if not treated

All ages | Full Blood Examination

The no-frills, all-rounder of the blood testing world, the full blood examination (FBE) or full blood count (FBC) is an exam you might have at various stages and for various reasons:

• Anaemia – a low red blood cell count may indicate anaemia
• Various organ diseases – a high red blood cell count may indicate heart, lung or kidney disease, low numbers of white blood cells may indicate liver or spleen disorders
• Leukaemia – high levels of white blood cells may point to leukaemia
• Eclampsia – a high haematocrit count may indicate eclampsia
• Iron deficiency – smaller sized red blood cells may indicate iron deficiency

Middle-age | HbA1c or type 2 diabetes test

Anyone around middle-age will want to speak to their doctor about whether they should be having this test, with diabetes growing at enormous rates across the world.

If you are over 35, have a waist circumference over 100cms (95 for some ethnic groups), or exercise less than 2.5 hours a week, you will want to seriously consider this test.

A person can go for seven years without showing any symptoms of diabetes, during which time it can be causing serious damage to your kidneys, heart, eyes and extremities.

Later middle age: cholesterol

By the time you’re past the half-way mark of life, there’s a good chance you’ve dispatched your fair share of cheeses, lasagnes and choc-tops and might want to check your cholesterol.

The cholesterol test looks for several types of lipids:

• Low-density lipoprotein (LDL) cholesterol – also known as ‘bad cholesterol’, a high level of LDL cholesterol is linked to heart disease and stroke
• High-density lipoprotein (HDL) cholesterol – this good cholesterol helps clean your arteries from fatty build-ups. High is good.
• Triglycerides – high triglycerides can be a pointer to cardiovascular disease or diabetes.

Older age: urine and stool tests

Examining poo and wee is not just for children and comedians. A lot can be determined about someone’s health by looking at urine and stool samples.

Technically these are two types of tests that we’ve briefly outlined below:

• Urinalysis– like the FBE, a lot can be determined by a urine test, or urinalysis. Conditions which can be picked up through a urine test include urinary tract infections (UTIs), kidney disorders, liver disease, or diabetes.
• Bowel cancer screening – for Australian citizens between the ages of 50 and 74, the federal government sends a free bowel cancer screening test kit for a stool sample to be taken at home. If caught early, 90% of bowel cancer cases can be successfully treated.

Of course, the above list of tests is by no means comprehensive. There are a multitude of pathology tests performed every day to help detect medical conditions and to help monitor the treatment of those who already have medical conditions.

Medical scientist and Pathology Awareness Australia ambassador, David Nielsen explains the importance of pathology testing through the life cycle.

‘A lot of people’s experience with medicine is usually with a doctor at the local GP clinic or at a hospital.

‘But there is a whole world of medical diagnosis going on behind the scenes in pathology labs. Every year there are 500 million tests conducted in Australia,’ said Mr Nielsen.

‘And while pathology accounts for just 3% of the annual healthcare budget, 70% of medical treatment decisions rely on pathology.’

The post From cradle to grave: five pathology tests you will likely have through your life 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.