The most important in brief:
- For almost 50 years, Germany has had a statutory cancer screening program with selected studies.
- Early detection measures can increase the success of medical treatment and thus the chances of cure.
- However, in individual cases the tests can also have disadvantages such as false alarms, overlooked malignant tumours or unnecessary cancer diagnoses.
- Therefore it is very important to inform yourself in advance exactly about the advantages and disadvantages of the corresponding tests and to discuss them with the treating physician.
- Weigh all arguments carefully before you decide on a cancer screening test.
Doctors and health experts assume that about half of all cancers could be avoided if people were to maintain a healthier diet and lifestyle.
In connection with malignant tumours, prevention and early detection are key words. The earlier a cancer is diagnosed, the sooner the right therapy can be started and the better the chances of cure.
The term “cancer prevention” is familiar to most people. Basically, this is about early detection measures of various cancer diseases or their precursors.
In Germany, tests are part of the statutory early detection programme:
- Prostate cancer
- Colorectal cancer
- skin cancer
- Cervical cancer and
- breast cancer.
Since the early 1970s, every patient has a legal right to early cancer detection measures. This claim was revised in 2013 by the Register and Early Cancer Detection Act.
Further details on the implementation are regulated by the “Guideline of the Joint Federal Committee of Health Insurance Funds and Doctors“: Here it is precisely defined which examinations are to be performed by which doctor, at which intervals and at what age.
The examination includes:
- Anamnesis with specific questions about existing complaints and changes.
- inspection of the outer genital.
- scanning the outer genital.
- Cheft examination of the prostate (from the rectum.)
- tach examination of the local lymph nodes.
- Reported findings and subsequent medical consultation.
The examination includes:
- Anamnesis with specific questions about the given complaints or changes.
- inspection of the cervix.
- “Pap smear”: smear and cytological examination.
- report of findings to the patient and subsequent consultation.
The breast examination for early detection of breast cancer is intended for women over 30 years of age and is performed once a year.
The investigation includes:
- Anamnesis talk with concrete questions about given changes in the female breast.
- palpation of breasts and lymph nodes.
- Medical instructions for self-examination of the breast.
From the age of 50, in addition to the palpation examination, an x-ray examination of both breasts is performed as part of the mammography screening. This is carried out until the end of the 70th year of life at intervals of two years.
The mammography screening includes:
- Written invitation of the patient to a certified screening facility.
- The invitation also includes important information on the screening.
- Written anamnesis.
- mammography: X-ray of both breasts.
- Double diagnosis of the X-ray images (two independent physicians).
- report of findings to patients within one week.
If a finding with a corresponding suspicion arises, the patient is invited again for further diagnostic clarification. The screening examination facility takes care of this.
Basically, a distinction is made between the following types of skin cancer:
- Malignant melanoma (black skin cancer)
- basal cell carcinoma (white skin cancer) and
- Spinocellular carcinoma (white skin cancer).
The screening examination shall include:
- Anamnesis talk with questions about the existing complaints or changes.
- Visual inspection of the entire body and skin, including hairy body skin folds and the head.
- Report of findings.
In the context of colorectal cancer screening, the study includes the following measures:
- examination for concealed blood in stool
- intestinal endoscopy
- From 50 to 54 years of age: an annual examination for hidden traces of blood in the stool.
- from the age of 55: first colonoscopy. Ten years after the first colonoscopy, a second colonoscopy examination may be required.
- If you do not want to perform a colonoscopy examination, you have the option of taking a new stool blood test.
Recommended cancer screening for men
- men over 35 years of age: one total skin inspection every two years.
- Men from the age of 45: an annual genital and prostate examination with anamnesis interview and palpation of the lymph nodes and prostate.
- Men from the age of 50 to the age of 54: an annual rectal and colon examination, including a Hämmokkult test for blood in stool.
- men over 55 years of age: a colonoscopy twice every ten years (colonoscopy) or alternatively every two years a hemmococcult test.
Recommended cancer screening for women
- Women from the age of 20: once a year a genital examination with anamnesis talk about menstrual disorders, smear, discharge and cytological examination.
- Women from the age of 30: once a year a breast examination with anamnesis talk about possible complaints or breast tissue changes. The breast and the lymph nodes are palpated during the preventive examination.
- Women aged 35 and older: one skin inspection every two years.
- Women from the age of 50 to the age of 54: once a year a colon and rectum examination with a Hämmokkult test for traces of blood in stool.
- Women from the age of 50 to the age of 69: mammography screening every two years (x-ray examination of the breast).
- Women aged 55 and over: colonoscopy twice every ten years or a hemmococcult test every two years.
Further statutory cancer screening programs are offered under the term “Cancer Prevention Plus”. Depending on the respective medical institution or medical practice, these are individual service packages. In most cases, these early detection programs include examinations that are paid for and recommended by the health insurance companies.
Further supplementary examinations or alternative procedures are also included: The attending physician can invoice these directly to the patient of the patient as so-called “individual health service” (iGeL).
Whether the additional cancer screening programmes are necessary should be discussed in detail with the doctor in advance from case to case.
Extended cancer screening programs for men and women
For the early detection of malignant tumours in the abdominal cavity, “cancer screening plus” includes sonography (ultrasound examination) of the abdomen (usually the kidneys, bladder and liver).
For early detection of skin cancer, the entire skin surface is examined with a special magnifying glass, the so-called dermatoscope.
A laboratory examination for traces of blood in the urine should provide information about a possible kidney or bladder carcinoma. In addition, a general blood test is often offered as part of extended cancer screening:
The kidney and liver values as well as the blood fat values are determined here. The blood is also tested for certain tumour markers. For example, a bladder tumour screening test (NMP 22) is designed to effectively help detect bladder carcinoma at an early stage.
The expanded cancer screening for women
This expanded offer includes various sonographic examinations of women, such as transvaginal ultrasound. This vaginal sonography is intended to detect corpus carcinoma (cervical cancer) or ovarian carcinoma (ovarian cancer) at an early stage.
A so-called breast sonography, i.e. an ultrasound examination of the breast, is also part of the extended range of cancer screening services.
In addition, a laboratory test for chlamydia can be carried out to ensure fertility and to protect miscarriages or premature births. A test for human papillomaviruses, the so-called HPV test, is also offered. If this test is positive, there may be an increased risk of cervical cancer.
The advanced cancer screening for men
The extended range of early detection services for men often includes a transrectal sonography examination (TRUS) of the prostate as well as a blood test using a so-called PSA test. This test is intended to provide indications of a possible prostate carcinoma. As part of the early detection of testicular cancer, an ultrasound examination of the testicles can also provide additional safety.
In the following, the most common cancers in men, their symptoms and the measures for early detection are presented in more detail.
Early detection means that male persons are examined by a doctor even though they do not show any symptoms of disease. The aim of the medical examination is to detect malignant tumours at an early stage. If the tumour is still locally restricted to the prostate, the treatment options are significantly better.
Information on the disease
Prostate cancer is one of the most common cancers in men. Every year, more than 60,000 men in Germany are diagnosed with prostate cancer.
In general, the tumour in this disease grows quite slowly and does not lead to death in most patients. However, if the tumour has spread, it can no longer be cured. Around 11,000 men die every year from prostate cancer.
With advancing age, the risk for this disease also increases. Men under the age of 40 are hardly ever affected by prostate cancer. The average age of onset of the disease is 69 years. If there is a family history, the risk of developing the disease increases even more.
Precaution and early diagnosis
Early detection measures are often summarised under the umbrella term “cancer prevention”. However, this is misleading, because cancer screening does not prevent the development of a disease, but merely detects it earlier.
Many diseases, not just cancers, can often be prevented by a healthy lifestyle, a varied diet and lots of exercise. This is a central component of prevention and prevention.
For the early detection of prostate cancer, two examination methods are used in particular:
- Rectal palpation examination (this is an integral part of the statutory health insurance benefit) and:
- blood test (PSA test – this is usually a self-payer test).
DRU – digital rectal examination:
From the age of 45, males are entitled to the benefits of the statutory cancer screening programme once a year. If a family history exists, participation is already possible from the age of 40. This examination does not entail any additional costs for the patient.
During the examination, the form and consistency of the prostate is scanned for possible changes via the anus. Hardening on the surface or irregular lump formation can indicate cancer.
The digital rectal examination is completely uncomplicated and can be performed by any urologist or family doctor within a few minutes.
It should be noted, however, that only a small proportion of the tumours that may be present can be detected. Some tumours are not palpable because they are located in another, possibly non-palpable area of the prostate or because they are too small.
The PSA test for the early detection of prostate cancer:
This test is recommended from the age of 45. How often the PSA test should be repeated depends on the test result. The statutory health insurance does not cover the cost of the test. It must therefore be paid for privately by the patient.
PSA is the prostate specific antigen, a protein produced only in the prostate gland. An increased value indicates changes in the prostate gland. This can be caused by cancer, an enlarged prostate or inflammation. Blood is taken from the patient to determine the PSA level. The test result is available a few days later.
early detection of prostate cancer – the advantages:
- tumors can be detected early. This also increases the chances of cure.
- tumors can be detected at such an early stage that they can possibly even be removed by a gentle surgical procedure.
- In some circumstances, the tumour detected early may not need to be treated at all, but only actively monitored.
Possible disadvantages of early prostate cancer detection:
- In the context of early detection, tumors can be detected that currently require no further treatment. However, the diagnosis of cancer and the consequences of any subsequent treatment that may be necessary can become a real burden for those affected.
- The recognized tumor may no longer be curable under certain circumstances. Thus the affected persons are burdened with the knowledge of an inevitable fatal disease.
- The test result may be indicative of a tumor, although in fact none is present.
- The test procedure may overlook a possible malignant tumor.
The symptoms of the disease
There are no characteristic symptoms indicating malignant prostate cancer. The affected person does not notice anything of the disease at first. The symptoms often only become noticeable when cancer cell growth is so advanced that the tumour expands to the urethra and forms metastases (daughter tumours) outside the prostate – especially in the bones.
The following symptoms can be observed:
- Increased urge to urinate, especially at night
- Harmful urination problems
- urinary retention (inability to deliver urine)
- Interrupted or weak urine flow
- Painful ejaculations
- blood traces in seminal fluid or urine
- Pain in the prostate
- Intensive pain in the area of the lower back, pelvis, hips and thighs (sciatic pain)
- Reduced ejaculation
In most cases, these symptoms conceal a benign enlargement of the prostate gland. Nevertheless, a doctor should be consulted as soon as the first symptoms appear in order to clarify the symptoms and monitor their course.
You can do this yourself:
A healthy lifestyle and diet can provide effective protection against many diseases, including cancer:
- Be sure to maintain a healthy body weight. Avoid frequent consumption of fried food and beverages rich in sugar. On the other hand, eat fresh vegetables and fruit every day.
- Be active and move. Even a moderate exercise load of 45 to 60 minutes, around four to five times a week, is sufficient to prevent illnesses. In this context, it does not matter whether you prefer swimming, dancing or hiking. It is important to do what you enjoy doing yourself. Become more active in your everyday life: take the stairs instead of the elevator or go shopping by bike.
- Without cigarettes. Nicotine is an important risk factor for the development of numerous diseases such as respiratory or cardiovascular diseases, but also many cancers.
- Enjoy alcohol only in moderation.
- Supplements such as vitamin D, vitamin E and selenium do not provide protection against prostate cancer.
PREFERE Study – The prostate cancer study
This randomized study was planned and established by radiation therapists and urologists in collaboration with pathologists, biometrists and quality of life researchers. In particular, the value of the recommended therapy methods for low-risk prostate cancer should be investigated. The aim of the study was therefore to evaluate the current treatment options for early forms of prostate cancer.
It was supposed to be a “milestone study”, which unfortunately ended in a disaster: Due to a much too small number of participants, the German Cancer Aid Foundation and the private and statutory health insurers have decided to stop funding the study.
A total of 7600 participants should be collected by 2017. Unfortunately, this target could not be reached by far, because after three and a half years there were only 343 participants.
Lung cancer- the second most frequent type of cancer in men
In Germany, lung cancer is one of the most frequently occurring tumor diseases. Approximately 34,690 men contract it every year. Smoking is considered the most important cause of this type of cancer.
Information about the disease
- Lung cancer is the second most common form of cancer in men and the third most common form in women.
- The main risk factor is nicotine and tobacco consumption.
- The symptoms of the disease are rather unspecific and often only become noticeable in the advanced course of the disease.
- There are four stages of lung cancer.
- The therapy options include chemotherapy, radiation and surgery.
In most cases, lung cancer originates from the cells of the bronchi (lower respiratory tract). For this reason it is often referred to as bronchial carcinoma. In lung cancer, doctors distinguish between small cell and non-small cell diseases:
Small cell carcinomas grow very quickly and also form metastases (daughter tumours) in neighbouring body organs within a very short time. About twenty percent of all lung carcinomas are small cell diseases. The non-small-cell form is therefore much more common: Approximately eight out of ten patients are affected.
Risk factors and causes of lung cancer
- The main risk factor for the development of cancer is smoking. Approximately nine out of ten lung cancers can be attributed to smoking. Passive smokers also have an increased risk of developing the disease.
- Environmental factors such as fine dust. Air pollution caused by exhaust gases from diesel vehicles is also an important risk factor.
- Dangerous pollutants and substances in the workplace. Workers in mining, construction and metal processing are particularly at risk. Even the smallest asbestos particles can lead to scarring of the lung tissue and inflammatory processes. In the long term I can develop a lung carcinoma from these pollutants.
- Genetic influences such as family predispositions.
Symptoms of the disease
In the early stages of the disease, lung cancer causes hardly any discomfort. The first signs of lung cancer only become apparent at an advanced stage. Smaller tumours can often only be discovered by chance, for example if the lung is x-rayed for another reason.
In addition, the symptoms of the disease are not always definitely associated with lung cancer, but can also be indicative of other diseases.
For this reason, a doctor should always be consulted for the following symptoms in order to clarify the exact cause of the complaints:
- long-lasting cough (longer than three weeks)
- Longer lasting sputum with and without blood admixture.
- Unclear febrile diseases
- breast pain
- Respiratory distress
- Difficulties swallowing and hoarseness
- Loss of weight
- Decrease in performance, exhaustion and exhaustion
- Bone pain
- Swollen lymph nodes, especially above the clavicle.
No early detection of lung cancer is possible until now
Due to the late occurrence of disease symptoms and the diagnostic ambiguity, physicians have been searching for a reliable early detection method for lung cancer for many years.
If it were possible to detect this form of cancer earlier, the treatment options and the chances of cure would also be much better.
Colorectal cancer – the third most common cancer in men
Around 33,100 male patients develop bowel cancer every year. With advancing age, the risk of developing bowel cancer increases more and more.
Information on the disease
This is a malignant change of the intestinal mucosa. This occurs mainly in the rectum and colon.
Measures for early detection of colorectal cancer
The aim is to detect malignant tumours as early as possible and thus to treat them more easily and effectively. Colonoscopy is one of the main early detection methods. It enables the removal of precancerous lesions during the examination. This also significantly reduces the risk of colon cancer developing.
Overview – the most common cancers in men
- Prostate cancer
- Lung cancer
- Colorectal cancer
- renal cancer
- urinary bladder cancer
- Oral sinus and pharyngeal cancer
- pancreatic cancer
- skin cancer
- oesophageal cancer
- Testicular cancer
- throat cancer
- Thyroid cancer.
Prevention in connection with cancer is a central keyword and can be prevented best by an active and healthy lifestyle. This allows some of the risk factors responsible for the development of cancer to be positively influenced and even avoided.
Your gynaecologist can only ensure that a possible cancer is detected as early as possible. This also increases the chances of a cure.
The goals of cancer screening:
- Detect malignant tumors in time and treat them successfully
- Secure and maintain the best possible quality of life for patients
- Decrease the mortality rate from cancer significantly.
In this context, it should not be forgotten that no cancer screening method is perfect and error-free. In individual cases, the advantages and disadvantages should therefore always be carefully considered.
The Early Detection of Breast Cancer
In medical jargon, this form of cancer is also referred to as “breast cancer”. It is the most common cancer in women. About every ninth woman is affected by breast cancer. There are many different causes and risk factors for the development of this type of cancer. For this reason, it is of great importance to detect the disease early, treat it adequately and thus fight the tumour effectively.
In principle, every woman can develop breast cancer. However, women themselves can make a significant contribution to keeping the risk of breast cancer as low as possible and, in the event of a disease, to detecting the tumour at an early stage. The number of fatal breast cancers has been falling steadily for several years now.
One reason for this development lies in better early detection measures: Although these measures cannot prevent cancer, they can detect malignant tumours at a very early stage. The earlier therapy is started, the greater the chances of being able to cure the cancer.
The survival rate for breast cancer patients today is over 80 percent according to current statistics.
- Women from the age of 20: Doctors recommend to palpate the breast once a month. You will find exact instructions for this below. The earlier young women develop a routine for this, the finer their feeling for malignant changes in the breast tissue will become.
- Women between 30 and 49 years of age and over 70 years of age: The mammary glands and lymph nodes in the collarbone, sternum and armpits are scanned once a year. The size and shape of the breast and nipples are also checked. During the examination, the nipple is also gently squeezed to see if any fluid is leaking.
- Women between the ages of 50 and 69: This age group is invited in addition to the medical tactile examination every two years in writing for mammography screening.
In the case of a hereditary predisposition, the early detection measures are somewhat different: In women whose families have had a high incidence of breast cancer at a young age, an ultrasound and palpation examination is carried out every six months at the age of 25. Magnetic resonance imaging is also recommended to these high-risk patients once a year. From the age of 40, these women should undergo mammography once or twice a year.
Short overview – Methods for early detection of breast cancer
- Pushbutton examination by the physician.
- Sonography (ultrasound examination).
- magnetic resonance therapy.
Most malignant tumours are detected during regular medical palpation and breast palpation. The mammography examination can also be used to detect smaller tumours.
The moreover one for the diagnosis of cancer of the breast still further methods and possibilities are available:
- Biopsy (this is rarely used).
If the suspicion of malignant breast cancer has been confirmed, the next step is to carefully determine whether metastases have already formed in other parts of the body and organs.
When is an ultrasound examination recommended?
In case of abnormalities, a sonography is recommended for women who have not yet reached the age of 40. The ultrasound examination is used as a diagnostic measure after the medical tactile examination: This allows the exact causes of chest pain or other complaints to be clarified. If necessary, a mammography can be performed afterwards.
Women over the age of 40 should additionally take advantage of the ultrasound examination. First a mammography is performed on these women. Sonography is intended as an additional supplement, for example if the women have dense breast tissue.
The health insurance will only cover the costs for the sonography if there is an abnormality and the ultrasound is necessary from a medical point of view.
If it is possible to detect breast cancer in time, the treatment options and chances of recovery are very good. Tumours that can be detected by palpation are often two to three centimetres in size, but the chances of cure are still around 65 percent.
In the case of smaller, malignant tumours discovered by sonography or mammography, the chances of recovery are often over 90 percent.
When is an MRI examination recommended?
Magnetic resonance therapy – also called magnetic resonance imaging – is an examination method in which the female breast is represented by magnetic fields in layers using an imaging method.
The MRT examination is intended as an additional supplement. Women with a hereditary predisposition are offered the MRI examination method in specialised clinics and centres. It is also frequently used to plan further treatment, for example when a tissue sample has been used to diagnose breast cancer precursors.
In principle, an MRI is not performed as part of the early detection of breast cancer, except for women with a family history. The MRI examination is also not suitable as a substitute for mammography.
Before taking advantage of this examination, you should check with your health insurance company to see whether or not the costs will be covered.
Tactilography – Early detection of breast cancer in all age groups by visually impaired women
“Discovering hands” trains visually impaired and blind women to become medical-tactile examiners (MTU´s). They are used for the early detection of breast cancer because their special tactile skills and their exceptionally fine sense of touch can improve the examination over the long term.
From a scientific point of view, tactilography has already shown demonstrable success: The trained MTU´s were able to feel around 30 percent more malignant tissue changes than doctors.
The tactile examination of the breast tissue takes between 30 and 60 minutes. With the help of special and patented adhesive strips attached to the breast, the examiners orient themselves. According to a standardized procedure, the breast is systematically scanned down to all tissue depths.
Of course the tactile breast examination takes place under medical responsibility. This means that the result of the examination is then discussed with the treating doctor.
According to the current fee regulations, this examination method costs around 46 euros. Some private and statutory health insurance companies cover the costs. Please ask your insurer beforehand
Coverage of costs – who bears the costs of the individual examination methods?
Examinations that are planned as part of the statutory cancer screening measures are covered by the health insurance fund. They are therefore free of charge for you.
MRI and sonography examinations may not belong to the agreed service repertoire of statutory cancer screening and must therefore be paid for privately.
The symptoms of breast cancer
If you notice any of the following changes in your breast, you should have the cause of them clarified by a doctor as soon as possible:
- Hardening or knot formation on the breasts
- (painless) nodes or hardenings in the armpits
- Changes in shape, color or size of your breasts
- Changes in the skin surface of the breasts, such as curvatures or redness
- retractions of the nipple
- Separation of fluid from the nipple (possibly even with blood)
- Painful or exciting breasts that feel different than during menstruation
- Unexplicable weight loss.
The different treatment options
A careful and early diagnosis enables a tailor-made breast cancer treatment. Depending on the degree of the disease, the doctor can put together an individual therapy concept.
The first therapeutic step is usually the surgical removal of the malignant tumour. This can be followed by further treatments:
- Radiation therapy: The aim of this therapy is to destroy malignant tumour cells and the smallest daughter tumours that may remain in the operated breast or lymph node area. Thanks to the latest medical technology and modern irradiation equipment, radiation therapy can be used effectively but gently.
- Chemotherapy: Here certain drugs, so-called cytostatic drugs, are administered that attack the remaining cancer cells and thus eliminate them. In concrete terms, these cytostatic drugs are cytotoxins that stop the growth of cancer cells and thus prevent their further proliferation.
- Hormone therapy: Hormone therapy is preferred, especially for hormone-sensitive tumours, due to its better tolerability. If, sooner or later, the tumour no longer responds to this therapy, this is referred to as hormone resistance. In this case, chemotherapy must be used.
- Antibody therapy: This form of treatment is one of the targeted therapeutic measures for breast cancer. Antibody therapy recognizes the surface structures of malignant tumor cells and binds them. This stops the growth of malignant cancer cells. The tumour cells are thus targeted by the antibodies. In contrast to cytostatic drugs, the antibodies are directed only against the cancer cells and largely spare healthy body cells.
Breast implants after breast cancer
If the female breast can no longer be preserved by the operation, plastic surgery offers very good possibilities for reconstruction. This is possible both with the patient’s own body tissue and with implants.
Ideally, patients should inform themselves about the subsequent reconstruction options prior to breast cancer surgery. Each woman must decide for herself individually whether or not artificial breast reconstruction is an option for her. After all, not every patient is concerned about postoperative reconstruction. Many women do not define their own femininity by their breasts, for others the loss of the breast is a great psychological burden.
In this case, reconstruction would be a great help in coping with the disease.
Hyperthermia – what is that?
Hyperthermia is the overheating of the entire body or individual areas of the body. In cancer therapy, the body temperature is artificially increased to around 40 to 44 degrees Celsius: This can be achieved by electromagnetic waves such as microwaves or radio waves, by ultrasound or by infusing a heated fluid.
Hyperthermia is not primarily concerned with killing cancer cells. The temperatures required for this would also massively damage healthy body tissue and pose a danger to the patient. Rather, the aim of this treatment method is to make tumour cells more sensitive to chemotherapy or radiotherapy and to natural degradation processes.
Various research studies are currently dealing with the question of which tumours in which disease stage should be considered for hyperthermia treatment. In the case of blood cancer diseases, for example, this treatment method is not used.
Directions – possible additional therapies
The following additional therapies can also be used for treatment. Health disadvantages are generally not to be expected:
- Hypnosis before surgery: This is intended to reduce pain, anxiety and nausea.
- Exercise and physical training
- Yoga: This improves the quality of life and reduces anxiety, depression and stress. Yoga can also improve symptoms of fatigue (fatigue syndrome).
- A treatment with acupuncture may also be used to relieve symptoms such as fatigue, vomiting and nausea.
The Mistletoe Therapy
If mistletoe therapy is used in conjunction with chemotherapy, a significant improvement in symptoms such as anxiety and fatigue, depression, pain and nausea can be observed.
In some cases, a drop in white blood cells could also be observed. Nevertheless, orthodox medicine not only takes a critical view of this treatment method, but also rejects it in some cases. There are repeated claims that mistletoe therapy can even stimulate the growth of cancer cells:
However, it has not yet been possible to substantiate these allegations with any lasting scientific evidence.
The Different Risk Factors in Breast Cancer
Non-influenceable risk factors
- Gender plays an important role in the development of breast cancer: men can also develop breast cancer, but much less frequently than women.
- Age is also a major risk factor. Approximately four out of five women have exceeded 50 years of age when diagnosed with breast cancer.
- Hereditary predisposition also plays an important role in the development of breast cancer. If the mother, sister or other close relative was already affected by the disease, the risk of developing the disease increases significantly.
Invigorable risk factors
- Sporting women who do a lot of exercise have a lower risk of disease.
- Nicotine and alcohol increase the risk of developing breast cancer. Therefore, alcohol should only be consumed in very small amounts. Smoking should be avoided at all costs.
- A high-fat diet has several negative effects on health: It promotes the development of diabetes, cardiovascular disease and stroke. In addition, frequent consumption of animal fats such as high-fat meat, butter or sausage increases estrogen levels. A high oestrogen level also increases the risk of breast cancer. A healthy and balanced diet with many fresh vegetables and fruits not only helps to avoid obesity, but also reduces the risk of breast cancer.
- Overweight is also a high risk factor in the development of breast cancer. The reason for this is the hormonal balance: In fatty tissue, certain hormones are produced which cause an increase in the oestrogen level. The female sex hormone finally stimulates the mammary glands to divide cells. If mistakes are made, cancer can result. Especially after menopause, too high a body weight seems to be crucial when it comes to the risk of developing breast cancer. The disease risk for estrogen-dependent malignant tumours increases particularly markedly.
- Conceptional drugs such as the contraceptive pill but also hormone therapy against menopausal symptoms significantly influenced the interaction of the two female hormones progesterone and estrogen. These two factors also significantly increase the risk of breast cancer. In comparison to the hereditary predisposition or age of the woman, however, this risk factor is significantly lower.
A tight-fitting bra increases the risk of developing breast cancer?
Many women ask themselves whether tight bra underwiring and tight support straps can damage breast tissue, because the myth that wrongly fitting and tight bra straps cause breast cancer persists.
But the wrong bra size is first and foremost uncomfortable and not harmful to health. Dr. Susanne Weg-Remers is head of the Cancer Information Service at the German Cancer Research Centre in Heidelberg. She says quite clearly: “Brassieres do not influence the breast cancer risk at all. It doesn’t matter whether the bra fits exactly, is too small, has a temple or not”
Step by step instructions – the self-examination of breasts
Test the appearance of your breasts carefully in the mirror:
- Put your hands on your hips and look forward. Take a close look at your breasts and examine them for visual abnormalities.
- Lift your hands over your head and check if the burst warts and the skin move evenly. Look carefully for any curvatures, skin retractions or other conspicuous changes. Also a clearly visible difference in size between the two breasts as well as strong redness should be noticed attentively.
Systematic breast palpation while lying down:
- Scan the breasts one after the other from left to right or from outside to inside. The best way to do this is with the flat fingertips. Work from the sternum to the armpit and from the lower end of the breast to the clavicle.
- Nodes are generally one to two centimeters tall before it is possible to palpate them. They feel firm and cannot be moved. Likewise, the nodules usually do not hurt. When palpating, pay attention to the lymph nodes in the armpit area.
- Finally, use your index finger and thumb to gently squeeze the nipples together and check for fluid secretion. You can discuss your personal palpation results with your attending physician at any time and ask for further examinations if necessary.
- This will help you to eliminate unnecessary worries that may have arisen during your self-examination.
Cervical cancer and screening
The most common cancer of the female genital organs is malignant tumours of the uterus. There are two types of cancer:
- Cancer of the neck of the uterus
- cancer of the uterine body.
In cervical cancer, malignant cancer cells form on the lower part of the uterus. In most cases, they develop from tissue changes at the exit of the cervix into the vagina, the so-called cervix. The medical term for this cancer is cervical carcinoma: women on average are 53 years old. The cause of this cancer is usually a certain viral infection of the genital area (HPV).
If this type of cancer is detected at an early stage of the disease, it can almost always be cured. However, the further the tumour spreads, the lower the chances of cure.
Early cancer detection studies can effectively detect such precursors of the disease. In this way, treatment can be started in good time and the tumour can be removed. The protective vaccination against the cancer-causing viruses, the so-called HPV vaccination, also reduces the risk of disease.
The symptoms of this cancer
Until a malignant cervical cancer develops from tissue changes, it can take years or even decades in most cases. These changes in the tissue are usually harmless and do not cause any specific symptoms.
However, if a cancer has developed, it manifests itself in the following signs and symptoms:
- Uncommon bleeding outside the monthly menstrual period, for example after sexual intercourse or during menopause.
- Uncommon and partially malodorous vaginal discharge.
- Unexplicable weight loss.
- Fatigue and signs of exhaustion.
- Pelvic and abdominal pain.
- Partially severe pain when urinating.
If cervical cancer causes concrete symptoms, the disease stage is often already quite advanced.
Caution should be exercised with regard to the symptoms: These signs and symptoms are not clear symptoms of cancer. In many cases there may also be another cause behind it. If you notice these symptoms, you should consult your doctor to determine the exact cause of the symptoms.
Cost absorption of the examinations
The regular check-up with a gynaecologist is the most important examination within the framework of early cancer detection. This also applies to women who have been vaccinated against the most important HP viruses. A protective vaccination cannot replace a preventive examination in any case, but is merely a supplement to the preventive programme.
Every woman in Germany from the age of 20 can have a preventive examination by a gynaecologist once a year.
The health insurance companies will cover the costs.
An HPV test may also be advisable to clarify the possibility of cervical cancer. This test involves taking a smear from the cervix and examining it more closely for human papilloma viruses. Women over the age of 30 can take the HPV test as a supplement to routine screening.
However, the costs for this are not covered by health insurance. The test must therefore be paid for privately.
HPV vaccination – what does it protect against?
This vaccination provides protection against HP viruses, which are considered the most common cause of cervical cancer. Infection with these pathogens can lead to dysplasia, i.e. changes in tissue that can lead to malignant cancer.
The “STIKO”, the “Standing Vaccination Commission” of the Robert Koch Institute, recommends vaccinating all adolescent girls between the ages of nine and 14 against the viruses before their first sexual intercourse.
The costs incurred for this are covered by health insurance.
Boys should also be vaccinated against HP viruses, at least that is what medical experts advise. If you are not infected with the pathogens yourself, you will not be able to infect your sexual partners with them later: This offers comprehensive protection against cervical cancer.
In addition, this vaccination provides the boys themselves with protection against cell changes that may lead to cancer and genital warts.
The treatment options
Which therapy method is the right one depends in particular on the size of the tumour. It also depends on whether the cancer has already spread to other parts of the body and organs.
If the tumour is still at a very early stage, a small operation on the cervix is sufficient in most cases.
However, if the tumour has already damaged surrounding body tissue, the entire uterus must be surgically removed (hysterectomy). The lymph nodes are also removed over a wide area. In such cases radiotherapy is also possible. Radiation therapy is also a sensible option if it is not possible to surgically remove the tumour. In some patients, this treatment method can be combined with chemotherapy.
Additional Treatment Methods
Malignant tumours such as cervical cancer can cause intense pain, especially in the advanced stages of the disease. In such cases, affected women receive individually adapted pain therapy.
Many women develop anemia as a result of cancer or chemotherapy. A blood transfusion may have to be administered in this case.
The Risk Factors of Cervical Cancer
- Cigarette consumption: In such cases, the body’s own immune defence can often be less effective in fighting the viruses.
Changing sex partners:
- Changing sexual partners: The more sexual partners a woman has, the higher the risk of developing cervical cancer.
Early start of sexual activity:
- Early onset of sexual activity: Young girls who have sexual intercourse before they reach the age of 14 have a significantly increased risk of HPV infection and consequently of developing cervical cancer.
Inadequate Genital Hygiene:
- Inadequate genital hygiene: Inadequate hygiene makes the female organism much more susceptible to infections and sexually transmitted diseases.
Low socioeconomic status:
- Low socioeconomic status: Statistics show that people with a low social status and low income are more likely to be infected with HP viruses than women from higher social classes.
Numerous pregnancies and births:
- Numerous pregnancies and births: Every pregnancy and every birth significantly increases the risk of infection with HP viruses and thus promotes the development of cervical cancer. This may be due to changes in the tissue during pregnancy, for example.
Oral long-term contraceptive use:
- Oral long-term use of contraceptives: In women at risk, long-term use of progestin and estrogen-based contraceptives may increase the risk of cervical cancer slightly.
Weak immune defense:
- Weak immune defence: A weak immune system can be caused by a disease such as AIDS or by taking certain drugs. However, a weakened immune system cannot fight HP viruses so effectively and therefore increases the risk of developing cancer.
According to the current state of scientific research, genetic factors play only a minor role in the development of cervical cancer.
Overview – the most common cancers in women
- breast cancer
- Colorectal cancer
- uterine body cancer
- Cervical cancer
- Lung cancer
- ovarian carcinoma (ovarian cancer)
- skin cancer
- urinary bladder cancer
- pancreatic carcinoma (pancreatic cancer)
- renal cancer
- Thyroid cancer
- cancer diseases of the throat and oral cavity
- oesophageal cancer
- throat cancer.
Food supplements for cancer – benefit or harm?
Many cancer patients ask themselves to what extent they can influence the course of the disease or support cancer therapy through a healthy diet and certain supplements.
The focus is often on certain trace elements and vitamins.
But what really helps in such a disease situation? What effects do vitamins have on cancer treatment? Can an excess even cause damage?
Healthy people, too, are very much concerned with these questions and are considering whether an extra portion of vitamins a day can reduce the risk of developing cancer.
In the course of a tumour disease, an undersupply of micronutrients can actually often occur. Older patients in particular often require an individually adapted diet and supplementation.
Patients can do this themselves
Cancer patients should be careful to eat a healthy, fresh and balanced diet. In particular, many fresh vegetables and fruits, but also eggs, dairy products, fish and lean meat should often appear on the diet.
Depending on the type and degree of cancer, it may also be necessary to replenish the body’s own nutrient and vitamin stores and thus strengthen the immune system. For this purpose, suitable preparations with a balanced nutrient mixture can be found in the pharmacy.
The attending physician can recommend and prescribe suitable supplements. Please do not use various dietary supplements on your own, especially if they are high-dose preparations. An experienced oncologist can clearly diagnose an acute deficiency and prescribe suitable preparations.
This is how healthy people can effectively prevent cancer
If you want to do something really good for your own health, you should pay attention to a healthy lifestyle and diet. Put together a varied and balanced diet, make sure you get enough sleep and, above all, exercise.
Avoid cigarettes and enjoy alcohol only in small amounts and very rarely. Avoid stress and treat yourself to sufficient breaths in everyday life: Even gentle sports such as yoga or autogenic training can effectively help you to switch off.
Your general practitioner can use a blood count to identify possible gaps in supply and nutrient deficiencies. With the appropriate dietary supplements you can then further reduce your cancer risk.
It is up to you whether or not you wish to participate in the statutory cancer screening examinations. There is therefore no obligation in Germany to participate in the screening and early detection programme.
Your Rights at a Glance:
- You can choose your doctor freely.
- You have a right to neutral information.
- You have the right to be comprehensively advised and informed by your attending physician.
- You have the right to privacy.
- You have the right to self-determination.
- You have the right to file a complaint.
- You have the right and entitlement to complete and adequate medical care.
- You have the right to proper documentation of the investigations.
- You have the right to inspect the documents at any time, i.e. in doctor’s letters, mammography images or the like. You can also request a copy of these medical documents and findings at any time.
- You have the right to a second opinion. However, it is essential that you check with your health insurance company in advance whether any costs that may arise are covered.
Summary – the health surveillance protocols in the range of health insurance services
Every legally insured citizen in Germany is entitled to participate in the free screening and cancer screening examinations. These examinations concentrate on diseases that can be treated very successfully if they are detected early.
These include, for example, malignant tumours. Since the 1970s, early cancer detection measures have been part of the fixed scope of services provided by the statutory health insurance funds (SHI).
This catalogue of services precisely defines:
- which diagnostic procedures may be used
- at which age the individual screening examinations can be taken up
- at which age the costs for cancer prevention are borne by the health insurance company
- at which time interval the early detection examinations should take place.
In addition, each person is free to participate in additional individual services provided by medical practices and clinics. However, if these unscheduled examinations are desired, they must be paid for by the patient himself.
In the individual medical practices there are special service catalogues for this, so-called “IGeL lists”. The attending physicians inform the patients in advance that the desired examinations may be an individual service that is not covered by the health insurance.
This post is also available in: German