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Putting tests to the test In the previous issue of A Slice of Orange (January 2009), we listed the basic tests every adult needs. Each of these tests is crucial because they help screen for serious conditions that may be completely curable or more easily treatable when caught early, like some forms of cancer. In this issue, we discuss some of these tests in more detail, if only to convince you to go have a medical checkup at least once a year, even if you’re feeling well. Some of the tests you need to do annually – such as cholesterol and blood sugar tests – are just simple blood tests. The other tests, however, need a bit more of your participation and/or preparation.
Breast self-examination (for women only; monthly starting at age 20) The best time to perform the breast selfexamination (BSE) is a few days after your period has ended, when your breasts are not tender. Women who do not menstruate anymore should try to perform BSE on the same day each month. Stand before a mirror and check carefully for differences in size, nipple appearance or skin dimpling between the left and right breast. Still in front of the mirror, you should check your breasts with your arms at your sides, overhead, on your hips and while you are bent slightly forward. After observing, you should also check both breasts with your fingers. An easy way to do this is in the
shower because it’s easy to feel for lumps under moist skin. Raise your right arm and with soapy hands, check your right breast with the second, third and fourth fingers of your left hand. Use small circles and follow an up-and-down pattern. Make sure you go through the entire breast, from the nipple to the outer margins. Repeat the procedure for the other breast. Report any suspicious findings to your doctor. You can also ask your doctor to teach you how to do the BSE properly. Pelvic examination (for women only; annually) The pelvic exam is a complete physical exam of a woman’s reproductive organs. It helps your doctor evaluate the size and position of the vagina, cervix, uterus and ovaries. A pelvic exam is done to help detect certain
cancers in their early stages, infections, sexually transmitted diseases (STDs) or other related problems. You might want to urinate before the exam so you can be more comfortable. A female nurse usually stays in the room with you during the exam; if it will make you more relaxed, you may request a partner or friend to stay in the room with you. Breathing deeply and carrying a simple conversation with your doctor may help you relax. You will be asked to lie on your back on the exam table with your feet raised and supported by stirrups. Your
A Slice of Orange is a newsletter designed to help clarify basic health information and offer juicy tips on uplifting your health.
Editorial team Alvin Delfin Christine Llenes Orange de Guzman, MD
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doctor will use a small instrument called a speculum to open the vagina so that the walls of the vagina and cervix can be seen clearly. The speculum will be warmed with water or lubricated with a vaginal lubricant, such as KY Jelly, before being inserted. Your doctor will look for damage, growths, inflammation, unusual discharge or discoloration. A Pap smear can be done at this time (see “Pap smear/test” below). The pelvic exam is not just about the Pap smear and speculum. Your doctor also needs to check your external organs – he or she will check your vulva and the opening of the vagina for signs of irritation or infection, including warts and other abnormalities. Your doctor will use his or her gloved fingers to feel the uterus, ovaries and nearby structures for swelling or other abnormalities. Your doctor will also need to press down on your abdomen while his or her other hand is inside your vagina. At another part of the exam, your doctor will insert one gloved finger into your rectum and one into the vagina. This maneuver should not be painful; it will only make you feel like you are moving your bowels. Alert
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your doctor if you feel pain during any part of the exam. Pap smear/test (for women only; every 1 to 3 years in sexually active women or starting at 21 years old) Having regular Pap smears is one of the best ways to detect cervical cancer, which is the second most common cause of cancer-related disease and death in women. A Pap smear is a microscopic examination of cells taken from the cervix, which can detect certain viral infections like the human papillomavirus (HPV) infection. Early treatment of these conditions can prevent cervical cancer before it develops fully. Women who have cervical cancer may not know it because it doesn’t cause symptoms, so Pap smears are definitely valuable. The best time to have a Pap smear is when you are not menstruating. A Pap smear, which is usually part of a pelvic exam, should only take about a minute or so. When your doctor has a clear view of the walls of the vagina and cervix using a speculum (read “Pelvic examination” above), a sample of cells will
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be obtained from the cervix and sent to the lab. Most women don’t feel anything during the test, except for a bit of pressure or a small pinch. Testicular examination (for men only; annually in males aged 15 to 40 years) The testicular exam is a complete physical of your groin and genital organs (penis, scrotum and testicles) by a doctor. Your doctor will feel the organs and check for lumps, swelling, shrinking or other abnormalities. A lump or swollen testicle may indicate testicular cancer, which is one of the most common cancers in men younger than 35 years old. If found early and treated, testicular cancer is very easily curable. Your health professional will inspect your abdomen, groin and genital area (penis, scrotum, testicles). If a mass is found in a testicle, your doctor will place a strong light behind the testicle to determine whether the lump is a solid tumor or not. Your doctor will also need to check the lymph nodes in your groin and along your inner thigh for
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signs of enlargement. The testicular exam may be mildly uncomfortable, especially if your testicles are painful or swollen. Testicular self-examination (for men only; monthly) A testicular self-examination (TSE) is useful in the detection of cancer of the testicles. The best time to examine testicles is during or after a warm shower or bath. It is normal for the left testicle to hang a bit lower than the right. Also, it is common for one testicle to be larger than the other one. To start the TSE, support each testicle with one hand and examine it with the other hand. Gently roll each testicle between the thumb and fingers; it should feel firm and smooth. You will feel a ropelike structure at the back of the testis – that is the epididymis, which is part of normal anatomy. Report any lumps or nodules to your doctor. Your doctor can also teach you how to do a TSE properly. Mammogram (for women only; annually starting at age 40) A mammogram is a special x-ray exam of the breast to detect tumors that are too small to be felt during a routine breast exam. It is the most helpful radiological way to find breast changes
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early, helping to improve the chances of breast cancer survival. To minimize discomfort during your mammogram, try to schedule it about a week after your period starts. A technician will place your breast between two radiographic breast supports. The supports will be pressed together, gently flattening the breast. Mammography should not be painful; you will feel uncomfortable only for a few seconds when the breast is pressed, which is necessary to get a clear image. Tell the technician if the pressure is unbearable. Two x-ray views (from two different angles) are usually taken of each breast. Digital rectal exam (annually) Men and women need to have a digital rectal exam (DRE) every year to screen for colon problems. The rectal exam also detects prostate abnormalities such as benign prostatic hyperplasia and prostate cancer in men. During a DRE, your doctor inserts a lubricated, gloved finger inside the rectum to check for abnormalities that can be felt in the area. The prostate lies just in front of the rectum so it’s easy to check for surface irregularities during a DRE. The procedure is painless; you will only feel a temporary urge to move your bowels, but this is expected.
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When examining your skin – which you should do monthly – look out for the ABCDEs of possible skin cancer.
• Asymmetry: Normal moles or freckles are symmetrical. In skin cancer, spots will not look the same on both sides. • Border: Check for lesions with blurry or jagged edges. • Color: Moles that have more than one color or hue need to be evaluated by a doctor. • Diameter: Show your doctor moles that are larger than 6 mm in diameter (the size of a pencil eraser). • Elevation: Be wary of moles that are raised with an uneven surface.
A slice of trivia Cryptorchidism is another term for which male condition? Hint: Men with a history of cryptorchidism need to have testicular exams more often. Freshen up on your researching skills, e-mail us the answer at orange@activelink-consult.com and win a prize! From those with the correct answer, 20 people will be randomly chosen to win a gift pack from ActiveLink. We’ll include the answer in the next issue of A Slice of Orange.
Answer to last issue’s question: The all-important Pap smear is actually a nickname of sorts; the longer term is the name of its Greek inventor. What is ‘Pap’ short for? Pap smear is short for Papanicolaou test, which was
invented by and named after Georgios Nicholas Papanikolaou (or George Papanicolaou, 1883–1962). He was born in Greece and was a pioneer in cytology. In this issue, read about why the Pap smear is so important in women’s health.
Looking to enhance your corporate healthcare benefits? E-mail us at benefits@activelink-consult.com. The information in this newsletter is not intended as a substitute for professional medical care. Consult a doctor for all matters relating to your health, particularly for symptoms that may require diagnosis or medical attention. © 2009 ActiveLink
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The Orange wants to he ar from you! Dying to ask us your health related questio ns? Itching to share your pe rsonal health tips? Want to sugg est topics for future issues? Feel free to contac t us. You can e-m ail our team at orange@activ elink-consult.c om.