Patient Resource Archives

For Your Health – Not Just Pink: Key cancer screenings for men and women

As we begin our annual move toward fall and more normal routines of work, school and family, it can be a great time to make sure that all of us are up to date with our recommended cancer screening tests.

There’s probably no better reminder of this than the upcoming Breast Cancer Awareness Month in October. The pink ribbons we see on websites, cereal boxes and t-shirts symbolize the importance of breast cancer and of cancer screenings. One out of 4 cancers diagnosed in women is breast cancer, so take the step now to get breast cancer screenings scheduled.

And while October focuses on mammograms for breast cancer, this translates just as well to other key tests for colon, lung, cervical and prostate cancers.

Screening tests not only help find cancers earlier when they’re more treatable but some can also help prevent certain cancers from developing in the first place. Below are general recommendations for five cancers – four apply to women, three to men.

People with a family history of cancer may need to begin screening at earlier ages than most. So, it’s important for younger adults in particular to talk to their providers about their risk of cancer and when it’s best for them to start getting screened.

Breast Cancer (Begin age 40)

While there are still some small differences in the breast cancer screening recommendations from individual organizations, most are now unifying behind women starting mammograms at age 40, and getting them regularly every year or every other year.

Cervical Cancer (Begin age 25)

Screening for cervical cancer helps to both find cancer early, and to help prevent the disease by finding and treating pre-cancers. The American Cancer Society recommends that most women begin screening at age 25 with an HPV (human papillomavirus) test every five years. Nearly all cervical cancers are caused by HPV infections. If an HPV test by itself isn’t available, an HPV test plus Pap test every 5 years is recommended, or a Pap test by itself every 3 years.

Colon Cancer (Begin age 45)

Colon cancer screening is another that can help prevent cancer – as well as help find disease in earlier, more treatable stages. Most people should start screening at age 45, and there are a number of different tests to choose from. Colonoscopy is the most common test and usually only needs to be done every ten years. Home stool tests, such as a fecal immunochemical test (FIT) and stool DNA test, are quicker and easier than colonoscopy but need to be done more often.

Lung Cancer (Begin age 50, if history of smoking)

Yearly lung cancer screening is recommend beginning at age 50 for certain people who smoke or have quit in the last 15 years. It’s important to talk to a healthcare provider to see if you qualify for screening and then to decide if screening is right for you. Currently, screening is only recommended in people who’ve smoked the equivalent of 1 pack a day for 20 years.

Prostate Cancer (Begin age 50, or 40 – 45 in Black men and others at higher risk)

Most men should talk to a healthcare provider about prostate cancer screening starting at age 50. Black or African-American men and others at high risk because of their family history should have this talk at age 45 and maybe even younger. Compared to other types of cancer screenings, there can be a more subtle balance between the potential benefits and harms of screening for prostate cancer. So, it’s important to discuss the test with a healthcare provider and then decide if it’s right for you.

Cancer screening saves lives. And millions of us missed our regular screenings during the height of the coronavirus pandemic and still need to catch back up. So, make your health a priority and take some time this fall to check with your provider to see if you’re up to date with your tests and schedule any you may need.

It’s your health. Take control.

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Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention and the creator of the free prevention tool YourDiseaseRisk.com®.

For Your Health: The A to Zzzzz of healthy sleep

It’s that time of year when it can be pretty easy to lose a couple hours of good sleep. Even if we’re usually pretty good about keeping up with our regular bedtime routines, there can be a lot going on that can get in the way. Evening trips to the park or a late summer concert can keep us up later than usual.

Uncomfortably warm bedrooms can make it harder to get to sleep and stay asleep. And the kids in our lives may feel summer coming to a close, bringing some extra energy and disrupted sleep in anticipation of a new school year.

Occasionally missing out on a healthy night’s sleep is fine. But, when it happens regularly, it can be more of a concern and have a real impact on our health.

“Sleep is essential in maintaining good physical and mental health, as well as well-being,” said Yikyung Park, professor in the Division of Public Health Sciences at Washington University School of Medicine in St. Louis. “Getting too little sleep or too much sleep disrupts the circadian rhythm – our natural ‘body clock’ – which leads to many unfavorable responses in the body.”

Poor quality sleep and short sleep (less than 7 hours a night) – have been linked to accidents, weight gain, weakened immune function, depression, diabetes, high blood pressure, heart disease and some cancers.

“Sleep also plays an important role in brain health, such as learning and memory. Poor or short sleep is associated with cognitive decline, dementia and Alzheimer’s disease,” Park added.

As important as healthy sleep is, 35% of adults in the U.S. don’t get the generally recommended 7 or more hours each night. And around 15% of adults have trouble falling asleep, with women much more likely to have this issue than men, people with lower incomes more likely than those with higher incomes, and those in rural communities more likely than those in larger metro areas.

Sleep quality also varies significantly by race and ethnicity, Park said. African Americans, multiracial non-Hispanics, American Indians/Alaska Natives and Native Hawaiians/Pacific Islanders are more likely to experience short sleep than other groups. Such differences in sleep quality can be caused by a number of factors – from stress and discrimination, to demands of family and jobs, to building and neighborhood conditions that can make it harder to get to sleep and stay asleep.

While we can’t control everything that might impact the quality and amount of our sleep, there are steps we can take to try to get as good a night’s sleep as possible. Park recommends:

Going to bed and waking up at the same time every day.
Going to bed only when you feel sleepy.
Putting away electronics at least 30 minutes before bed. If you need to have your phone, put it in silent mode if possible.
Avoiding large meals, caffeine, and alcohol within a couple hours of bedtime.
Getting regular physical activity, but not too close to when you want to get to sleep.
Limiting exposure to bright light in the evenings.
Keeping the bedroom at a comfortable temperature.
Using eye masks or a white noise machine or app if light or noise are issues in your home or neighborhood.

“Finally, if you have high blood pressure, diabetes, a history of heart disease or stroke, and snore, gasp, choke or have silent pauses in breathing during sleep, or have excessive daytime sleepiness or fatigue, you may consider getting obstructive sleep apnea screening,” Park added.

In sleep apnea, you stop and start breathing many times during the night, and it can increase the risk of a number of serious conditions. Fortunately, it is also treatable. So, reach out to a healthcare professional if you have questions about sleep apnea or other sleep issues.

Taking steps to improve the amount and quality of sleep can be pretty simple. But it can take some time to put them into practice regularly. Start with one or two – and build slowly from there. Even small changes can have a big impact on sleep health, which can help us feel better, and improve our overall health and wellness.

It’s your health. Take control.

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Colon cancer surgery: what to expect and how to prepare

When it comes to colon cancer, surgery is the most common treatment. Types of colon cancer surgery depend on the stage of the cancer and where the cancer is in the colon. For early-stage colon cancers and young-onset colorectal cancer, surgeons may recommend minimally invasive surgery. For more advanced colon cancers, surgery may be performed to remove parts of the colon or to reconnect healthy parts of the colon. All types of colon cancer surgery involve the removal of nearby lymph nodes where the cancer may have spread.

How to prepare for colon cancer surgery

Prior to your surgery, there are steps you can take to prepare.

A week or more before your surgery:

Make a list of all your medications and any allergies you have.
Fill any prescriptions you will need after surgery.
Ask your surgeon about when you should stop taking your medications. Don’t stop taking your medications without speaking to your surgeon.
Ask your surgeon if it’s safe to take ibuprofen or aspirin.
Arrange for family or friends to help care for you while you’re in the hospital and after you go home.
Plan for a caregiver to drive you home after you are discharged from the hospital.

24 hours before your surgery:

Don’t eat any solid foods and only drink clear liquids.
You may be advised not to eat or drink anything (including water) after midnight.
Ask your nursing team about the specific eating and drinking guidelines you’ll need to follow the night before surgery.
Your colon must be completely empty before the procedure. Follow your surgeon’s “bowel prep” instructions. You may need to use laxatives and/or enemas to get all the stool out of your colon.

The day of surgery and your hospital stay

When you arrive at the hospital for your surgery, you will be escorted to the pre-operation (pre-op) area to prepare for the operation. A nurse will take your vital signs and will insert an IV to administer fluids, including antibiotics to decrease the risk of infection, anesthetic medications and pain medications.

You’ll also meet with an anesthesiologist who will review your medical history, speak with you about your safety during surgery, go over the type of anesthesia you’ll receive and answer any questions you may have. Your family and/or friends will then go to the waiting room, where they will remain throughout the procedure.

Once the surgery is over, you will be taken to the recovery room. You will stay in recovery anywhere from one to two hours for observation and for the anesthesia to wear off. Then, you will be transferred to your room once you’re in stable condition.

You may stay in the hospital for two to five days after surgery. Depending on whether you have minimally invasive surgery or open surgery, your hospital stay may be shorter or longer. While you’re in the hospital, your nurses will teach you and your caregivers how to care for yourself during the recovery process.

Discharge and going home

Right after surgery, you will need to be on a clear liquid diet. This diet continues for the rest of that day. The day after surgery, you will get back to a regular diet. A dietitian will be available to help you while you’re in the hospital. Additionally, your nurses and physical therapists will help you move around and will teach you deep breathing and leg exercises. These exercises will help you regain mobility and improve your circulation.

Before discharging you from the hospital, your surgeon will write your prescriptions and give you written discharge instructions. Your surgeon will review these with you before you leave. Because medication and anesthetic can slow your reaction time and thought processes, make sure you have someone to drive you home.

Recovery at home

Once you’re home, you will be encouraged to steadily increase your activity level. Avoid strenuous activity – walking helps to prevent blood clots and keep your lungs clear, though you can climb steps and engage in light activity as soon as you feel up to it. Don’t take baths or submerge yourself in water until your incisions have healed.

Your surgeon will schedule a follow-up appointment after your surgery, but it’s a good idea to contact your surgeon right away if you experience any of the following:

Nausea/vomiting
Fever
Diarrhea
Wound is red, more painful or has drainage
No bowel movement within a few days of returning home

The Siteman approach to colon cancer surgery

With expert physicians, skilled support staff and the latest technology, we ensure that our colon cancer surgery patients receive the comprehensive care they need.

Our surgeons were the first in the region to perform laparoscopic colectomy for cancer. They use minimally invasive and robotic techniques whenever possible, making the recovery process easier while keeping risks down.

Our colon cancer specialist team

The multi-disciplinary colon cancer specialist team at Siteman comprises outstanding Washington University medical oncologists, radiation oncologists, surgeons, gastroenterologists, radiologists and others. The diverse expertise of our specialists allows them to create individualized treatment plans for all colon cancer patients.

While many colon cancers may be treated with surgery alone, some are treated with a combination of surgery, chemotherapy and radiation. Not all colon cancer patients will undergo the same course of treatment, so it’s important to have a team of providers across a wide range of disciplines.

You’ve been diagnosed with colon cancer. Now what?

If you’ve been diagnosed with colon cancer, you may be experiencing a wave of emotions including fear, anger and sadness. 50Siteman providers are here to support you every step of the way throughout your cancer journey. With our exceptional physicians, psychology services and survivorship care, we are committed to caring for your body, mind and wellness, even after treatment ends.

If you are experiencing symptoms of colon cancer and are concerned about your risk, please make an appointment with your primary care provider. If you have been diagnosed with colon cancer and would like a second opinion from a colon cancer specialist at Siteman, please call 800-600-3606.

Ask the Doctors: How to Check Yourself for Testicular Cancer

Testicular cancer is most common among men ages 15-35. In fact, it is the most common type of cancer for men in this age range. Men can play an important role in detecting testicular cancer through self-examination. Despite the ease and benefit of performing a self-exam, not many men know how to check for testicular cancer, or how to talk to a doctor about sensitive men’s health issues. To help start the conversation, Washington University urologist Zachary Smith, MD, answers some of the most frequently asked questions about performing a testicular self-exam.

Testicular Cancer: Frequently Asked Questions

What is testicular cancer?

Testicular cancer (TC) is—just as it sounds—cancer that forms in the testicle itself. This does not include any tumors or cancer of the other scrotal contents or penis. It is a relatively rare cancer, with only about 9,000-10,000 cases per year in the United States. Fortunately, it is very curable in most situations, even if advanced, and there are only approximately 400 deaths per year in the U.S.

Why should I check myself for testicular cancer?

The goal of testicular self-examination is to find TC early. Compared to other tumors, it has a more rapid growth rate. Early detection decreases a man’s likelihood of the disease spreading and requiring more extensive treatment. While the data is mixed on the absolute benefit of self-examination, since TC is a very treatable disease for most men, it is generally felt that this is an easy and low-risk test to detect tumors early and potentially help men avoid more aggressive treatment.

How do I perform a testicular self-exam?

The examination is best performed in a warm environment, so the scrotum and muscles can relax and hang free. It is often recommended to be done in the shower.

Check each testicle one at a time.
Gently roll each testicle between the thumb and the other fingers
Palpate the entire surface of the testicle, checking for any hard lumps, bumps, or irregularities

Note that the testicle itself (the oval shaped body) is the portion we are generally concerned about. The epididymis (the tube-like structure on the back of the testicle), is a normal part of the anatomy and may often have some asymmetry. Similarly, the spermatic cord (the blood vessels and tubes that the testicle hangs from) may feel different from person to person and is of low risk for cancer. Any change in shape, contour or firmness of the testicle itself should be noted and raise concern.

What should I do if I feel something?

If you feel anything concerning, you should reach out and make an appointment to see your doctor as soon as possible. It is important to make sure that the office knows the reason for your visit. Do not leave the reason for your visit nondescript. That way, the appointment may be scheduled in a time-sensitive fashion. Abnormalities in the testicles are often something for which men delay medical evaluation for a number of reasons. However, there is no reason to be embarrassed, as this is very routine for doctors. This is what we are here for. Early evaluation could make a profound impact on the extent of treatment required if the abnormality turned out to be TC.

How often should I check myself?

It is generally recommended to perform self-examination monthly. Monthly exams help to reduce the chance of missing a tumor. Routine examination also allows a man to be more familiar with what “normal” feels like. This makes it more likely you will be able to detect something “abnormal.” It is easiest to remember to do this monthly if you choose the same day each month (like doing the exam in the shower on the first day or the last day of the month).

What does testicular cancer feel like?

It is important to know that most cancerous tumors are not painful. So just because you “feel fine” or it “doesn’t hurt” doesn’t mean that a lump is fine. If there is any question, seek evaluation. Also, while it is generally easiest to be seen by your primary care physician, since you have an established relationship with them, you can also always reach out to a urology office, where you would generally be seen very soon for any testicular lump. Here at Washington University and Siteman Cancer Center, we specialize in treatment of TC and have the experience and knowledge to walk you through the diagnosis from start to finish.

To make an appointment with a Washington University urologist, please call 314-862-8200 or fill out the online appointment form.

To learn more about testicular cancer treatment at Siteman Cancer Center, please call 1-800-600-3606.

Under 50? What you need to know about colon cancer risk and prevention

In recent years, doctors have noticed an unsettling trend: an increase in the number of people under the age of 50 who are being diagnosed with colon or rectal cancer. While this trend is alarming, there is good news: colon cancer can be prevented entirely or at least caught early, when it’s easier to treat.

Much of the world became painfully aware of this trend when Hollywood’s Chadwick Boseman died tragically at the age of 43 from colon cancer. For many, the question became: what can I do to keep this from happening to me and my loved ones?

How can I prevent colon cancer?

In order to ensure that you can go on to live a longer and healthier life, you must be aware of your family history and be on the lookout for key symptoms. Washington University colorectal surgeon Radhika Smith, MD, who treats colon cancer patients at Siteman Cancer Center, emphasizes the importance of knowing family history of colorectal cancer.

“If anybody in their family has a history of malignancies, especially at a young age, that really should prompt them to seek medical attention. This will allow them to ensure that there’s nothing with their family genes that could increase their risk,” she said.

It is important to be aware of your family history when it comes to taking charge of your health. At the same time, it is just as important to keep an eye out for signs of potential problems.

“Colorectal cancer doesn’t frequently strike young people. However, when you experience symptoms, you never want to ignore them,” says Smith. “You always want to have them evaluated. Make sure that you’re protecting yourself and doing all you can to give attention to any underlying issues you might have.”

Identifying symptoms is essential for effective treatment for colorectal cancer.

It is also important to note that certain genetic syndromes create hereditary risks for colorectal cancer, including Lynch syndrome and FAP. Additionally, Crohn’s disease and ulcerative colitis may potentially increase risk.

What symptoms should I look out for?

When it comes to identifying symptoms prior to diagnosis, it can be a bit tricky. This is because there are routine issues (such as constipation and diarrhea), and then there are alarm symptoms.

“If you have run-of-the-mill constipation, you should address it with changes in the food you eat, fiber supplements, and be sure to take in 64 ounces of an uncaffeinated beverage. If that doesn’t fix it, then you should go see a provider,” says Smith. “Most young people don’t know how to really fix constipation, so engaging a doctor is important.”

Because many young people eat low-fiber diets, they experience constipation, which then becomes their norm. This is why it’s important to stay on top of your health from a young age. It will allow you to be able to identify potential issues in the future.

Constipation can, of course, be just that – constipation. However, it also can be a sign of a larger issue. Here are some symptoms that may be more concerning:

Rectal bleeding
Change in stool caliber
Weight loss
Constipation or diarrhea
Abdominal pain
Fatigue or tiredness

How do I speak with my provider about my concerns?

It can feel uncomfortable to bring up colorectal health concerns with your provider. While this might be the case, doing so is the only way to be proactive when it comes to your health.

“At the end of the day, you just need to remind yourself that every provider at Siteman and at Washington University really just wants to help people,” says Smith. “You won’t feel any sort of judgment. You just need to be honest about the symptoms you’re experiencing. Most of the time, you will simply need to make minor changes in your diet. This can have a huge impact on your overall bowel function and improve your quality of life. But in some rare cases, this may also save your life.”

Early intervention can prevent many problems down the road. All you need to do is take charge of your health and be honest with your provider.

If a larger issue does happen to arise in the future that needs to be addressed, there are many effective treatment options. These colon cancer treatments and colon cancer surgeries can prolong and improve your quality of life.

At what age should I have my initial colon cancer screening?

Siteman recommends that you have your initial screening at age 45, but there are some factors that can lower that recommendation. If you have a first-degree family member who has had colorectal cancer, you should get tested 10 years before the age of their diagnosis. In this case, you should be tested at 5-year surveillance intervals following your initial screening. However, if you experience any symptoms, you should get screened, regardless of your age.

Smith underlines the importance of symptom surveillance.

“If you have any symptoms that concern your doctor, even if they’re minor, you should get a colonoscopy. Then you can go forward with a clean bill of health, knowing this is your baseline. If you have a departure from that baseline down the road, you’ll know it’s time for more medical attention.”

What healthy practices can I bring into my life to avoid future colon risks and issues?

Looking out for symptoms and establishing a relationship with your provider are key elements to taking charge of your health. Additionally, there are many healthy habits that you can adopt before and after symptoms arise. These include:

A high-fiber diet with low amounts of processed foods and smoked meats
Exercise
Normal weight
Avoiding excessive amounts of alcohol
Avoiding tobacco
Knowing your family history so that you can be on a proper colorectal surveillance program

Learn more

Your Disease Risk — Find out your risk of colorectal cancer and other diseases and get personalized tips to help prevent them.
8IGHTWAYS® to Prevent Colon Cancer — Seventy-five percent of all cases could be avoided by things you can do or start doing now. Use these eight tips as a guide to lowering your risk.
The Young-Onset Colorectal Cancer Program at Siteman is one of the first in the country to focus exclusively on providing care for colorectal cancer patients under 50 while addressing concerns that are especially important to younger people.

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