Whenever I tell people I'm a student, one of the next questions is inevitable: what degree/major? I tell them cytotechnology. Then most people give me a confused look. Some can tell it has something to do with cells, but usually I end up giving a quick explanation. Even I hadn't heard of the area eighteen months ago, so I understand completely. There's only about 25,000 cytotechs in the US, so not very well known.
So here it is: whenever someone gets a routine cancer screen done (the Pap smear, mostly), they put that cellular material onto a slide or into a vial of fixative solution and send it to the pathology department of the hospital (or for smaller hospitals and clinics, either to a larger hospital or private lab). The sample is put onto a slide if it hasn't already been done, stained, and sent to us, the cytotechs. We techs screen the slide for anything unusual: not just cancer, but also infections and wrong hormonal patterns. If we diagnose anything as pre-malignant, we send those slide(s) to the pathologists, who do the final diagnosis and sign-out. We are essentially decreasing the pathologist's workload (believe me, they have a lot). We also have a quick stain and a microscope on a cart that we take to accompany the docs on fine needle aspirations, or FNAs (sticking a hollow needle into a mass to sample it) to make sure they get adequate samples, and to tell them what kind of fixatives to use and procedures they should do based on what we see.
On another important note, I must make myself sound really dorky here: I read Reader's Digest (what? young people read that?). A lot of the articles I see pertain to cancer and its treatment. Problem is, a lot of times, they tend to almost argue against its treatment. One recent article pondered how necessary it is to treat carcinoma in situ, or CIS (basically cancer, but not invasive), because they don't know how many cases actually progress into cancer. Another lamented about the number of cancer survivors that come down with another type of unrelated cancer due to their past chemotherapy and/or radiation. And their health section more often than not talks about cancer-fighting/preventing foods. Some of these make sense (chemo is a carcinogen,radiation alters normal cells too, and the antioxidants in raw fruits/veggies bind with damaging, potentially mutation-causing oxidants in your system). Then there's the articles like the first I mentioned. Being a cytotech-in-training, it sometimes baffles me that someone would choose not to treat something that is a shade away from something deadly for lack of statistics. No, we healthcare providers don't know how many cases end up as cancer, but withholding treatment to conduct that sort of study would be grossly negligent on our behalf.
Anyways, on to the real point of today's post. If there's anything I learn in every course, it's this: if a cancer screening test exists and you fall into the correct age/gender group, you should probably be getting it done as recommended. Why, you say? I am so glad you asked. Sorry, gents: if I have to be specific, I'm mainly going to concentrate on Paps, as they're the most well-known cancer screening test. (That doesn't mean tune out, of course.)
- It's the only thing that's going to catch a pre-malignant condition before it actually becomes cancer. Pre-malignant conditions (or dysplasias) generally don't have any signs. By the time symptoms begin showing up, such as pain/bleeding/weight loss/etc., you already have invasive cancer. (An exception to this is lymphoma/leukemia; for the most part, if you have a hard TENDER lymph node, it's only inflamed, but if you have a hard PAINLESS node, it can be bad and may need checked.)
- Treatment for dysplasia is much simpler than treatment for cancer. A lot of low-grade dysplasias actually go away on their own, and no treatment is required; just close monitoring. Mid- to high-grade dysplasias are treated with a biopsy. The reason being is that, once you take out the bad tissue, generally normal tissue grows in to replace it. Once you get into cancer, you begin thinking about (in women) a hysterectomy, radiation, and/or chemotherapy (the last two of which are toxic). Plus, there is no chance that dysplasia can metastasize, as it isn't invasive; even if you surgically remove a tumor, it may have already shed bad cells into your bloodstream, which can lodge in your pulmonary capillaries, liver, etc., and create a new tumor.
- Costs of screening are low, especially compared to cancer treatment costs. A Pap is around $60 if you are uninsured. From what I've noticed, many insurance companies pay for the whole cost of preventative screening (not the 80% business like at the chiropractor). Why would you not? It's also not inconvenient. Paps need done once a year for your first three; then, if those were normal, your doc may have you come in every three years until a certain age. Exceptions are if you're already in the certain age group (chance of cancer goes up with age), are hi-risk HPV positive or in another hi-risk category, or have had an abnormal test in the recent past. On the other hand, some of the immunohistochemical tests pathologists have to perform to figure out what type of cancer is present cost upwards of $1000 a pop, and they usually perform a panel (at least two) to tailor your treatment to the type.
- If you have symptoms, then by all means get yourself checked.* There are many cancers that are very biologically aggressive. For example, one type of lung cancer (highly associated with smoking, BTW), by the time of diagnosis, has usually already metastasized to at least one other body site and has an expected life span of six WEEKS. Surgery just shortens that scarily short number, so all they can do is give you chemo. Which only increases your life span by about a week.
- You are not too young. Some types of cervical cancer can occur in your twenties. I recall one case in particular from the teaching file where the girl was only nineteen when she was diagnosed.
*Notice I say 'symptoms', not 'symptom.' I'm not promoting hypochondria, because then you'll get unneeded testing, spend monies, and get mad at me. The best way to do it is to use your best judgement. At the same time, if one symptom makes you suspicious, then by all means get a test.
In conclusion, I feel like I have given a bevy of good reasons. I will continue to share info I think you need to know, or isn't discussed/represented much. Cancer is always a horrible diagnosis to get, and luckily we have most of these tests so preventing and treating it is as effective as possible.
