Breast cancer is the most common cancer among women with one in eight women being diagnosed with it during their lifetimes. Pikeville Medical Center has the advanced capability to diagnose it in its earliest stages, when its most effectively treated.

Pikeville Medical Center recommends the following breast cancer screening protocols for women:

Breast Self-Exams
Adult women of all ages are encouraged to perform breast self-exams at least once a month.

Clinical Breast Exams
Your Ob/Gyn provider will conduct a physical exam of your breast during your annual women’s health screening as a check for lumps or other changes.

Mammograms
Regular mammograms are the best test doctors have to find breast cancer early. Women ages 40 to 44 should have the option to start receiving annual mammograms. Women ages 45-54 should get mammograms every year. Women aged 55 and older may switch to receiving a mammogram every other year, or they may continue yearly screening.

Pikeville Medical Center provides women access to leading-edge 3-D mammography technology with the ability to detect up to 65 percent more invasive breast cancers than that of standard mammography equipment.

Ultrasounds
Pikeville Medical Center offers a testing option as a supplement to a routine mammogram for women with dense breast tissue through our Automated Breast Ultrasound System 2.0, by GE. Discuss this option with your doctor.

Most cases of cervical cancer occur in women who were never screened or inadequately screened. Cervical cancer is diagnosed in women at an average age of 50 years old although it can be diagnosed in women in their 30s and 40s. Early detection and routine screenings are an important step in fighting the disease.

There are two screening tests that can help prevent or detect cervical cancer. Pikeville Medical Center’s OB/GYN physicians and many of our Family Practice physicians are able to provide these important screenings.

Pap Screenings

Pap smears look for precancerous cells of the cervix that may progress to cervical cancer if not treated appropriately. Women should begin getting pap smears at age 21 every three years. Beginning at age 30, pap smears are recommended every three years or every five years if also screened for HPV. Screenings are typically continued until age 65, but based on your medical history you may require additional screening.

HPV Screenings

HPV screenings look for high risk types of HPV that can lead to pre-cancerous changes and cancers of the cervix and vulva. HPV screenings are often done together with a Pap smear although they can be done as a stand-alone test. Pikeville Medical Center also offers vaccination against HPV with the Gardasil vaccine that can help prevent cervical cancer and genital warts.

According the American Cancer Society, lung cancer is the second most common cancer in both men and women (excluding skin cancer) as well as the leading cause of cancer death. Early detection and the ability to begin treatment as soon as possible is therefore very important.

Low-Dose CT Scans

The screening test recommended for lung cancer is low-dose computed tomography, more commonly known as a low-dose CT scan. Low-dose CT scans are advised for men and women who:

• Have a 20 pack-year* or more smoking history, and
• Smoke now or have quit within the past 15 years, and
• Are between the ages of 50 and 80

*A pack-year is smoking an average of one pack of cigarettes per day for one year. As an example, a 20 pack-year history can therefore equal a person smoking one pack a day for 20 years, or a person smoking two packs a day for 10 years.

Excluding some types of skin cancer, colon/colorectal cancer is the third leading cause of cancer-related deaths in the U.S. This type of cancer can, however, be effectively treated when detected early. There are a variety of screening options, and it is recommended that all men and women ages 50 to 75 be routinely tested. Some sources indicate for screenings to begin as early as age 45.

Colonoscopy

Colonoscopy is considered the most sensitive colon cancer screening test, allowing the physician to view the entire colon and rectum during the procedure. This screening further allows the physician to remove any abnormal tissue or polyps during the course of the exam. A colonoscopy is recommended every 10 years for those in the age range identified above.

Other Screening Options:

• Stool Tests
• Flexible Sigmoidoscopy
• CT Colonography

Pikeville Medical Center recommends that you talk to your primary care provider about the pros and cons of each test, which test is best for you and the frequency of your testing schedule.

Other than skin cancer, prostate cancer is the most common cancer in men in the U.S. Approximately one man in eight will be diagnosed with it in his lifetime.

PSA Test

The most effective test used to screen for prostate cancer is a prostate specific antigen or PSA test. PSA is a substance produced by the prostate. A PSA test measures the level of PSA in in a man’s blood with high PSA levels being a possible indicator that a prostate issue is present.

Before receiving a PSA test, men should talk to their Family Medicine providers about the benefits and risks of a prostate cancer screening using this schedule as a guideline:

• Age 50 for men who are at average risk of prostate cancer and who are expected to live at least 10 more years.
• Age 45 for men at high risk of developing prostate cancer. This includes African American and men who have a father or brother (first-degree relative) who were diagnosed with prostate cancer when younger than 65.
• Age 40 for men at even higher risk, which include those with more than one first-degree relative who had prostate cancer at an early age.

Genetic tests look for changes in DNA that are associated with a high risk of inherited cancer. Testing helps inform individuals of cancer risk, including breast, ovarian, uterine and melanoma. Genetic counseling is performed before testing to develop a plan of action, which may include surgery, preventative therapies and frequent screenings.

Candidates May Have:

• Personal or family history of cancer
• Family history of cancer diagnosed at a young age
• Multiple family members with the same type of cancer
• Family member with more than one cancer diagnosis
• Family member with a rare type of cancer
• Family history of a genetic alteration associated with a hereditary cancer syndrome

Genetic Tests Available:

• BRCA1 (breast, ovarian, prostate)
• BRCA2 (breast, ovarian, prostate, pancreatic)
• MSH2, MLH1, MSH6 (colon, uterine, ovarian)
• APC (colon with multiple polyps)
• CDKN2, CDK4 (melanoma, pancreatic)
• P53 (breast, bone, brain, leukemia)
• RBI (retinoblastoma)
• RET (medullary thyroid, parathyroid, pheochromocytoma)