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Author Topic: The big C: how can they spot it early enough?  (Read 2610 times)

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Offline newbie76

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  • Posts: 238
The big C: how can they spot it early enough?
« on: July 06, 2009, 04:10:25 PM »
A friend of mine was diagnosed with testicular cancer a couple of years ago and subsequently lost a testicle. He told me they now regularly monitor his blood to see whether the cancer comes back.

This left me a bit puzzled as I didn't know cancer can be detected in the blood.

So the next question would be, for us poz that have blood tests every few months, does that mean that doctors can detect cancer sooner? Do they actually routinely check for unbalances which could mean cancer?

Which type of cancers can be diagnosed through a blood test?

I know that cancer is one of the biggest causes of death for HIV+ people now that the meds have put the virus under control, so I am quite keen in knowing if there are ways to catch them as early as possible.

Are there other screening tests the doctors should perform on a regular basis?

I am very ignorant on this subject so apologies if my questions sound silly.  :-[
25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Offline Luke

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Re: The big C: how can they spot it early enough?
« Reply #1 on: July 06, 2009, 04:19:42 PM »
Your routine blood tests wont detect cancer, but they can very often detect the changes that are indicative of something going on and needing to be investigated further. So whilst we have to live with the downside of being more susceptible to certain cancers, the level of scrutiny also means that they are more likely to be detected early.

Offline bocker3

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  • You gotta enjoy life......
Re: The big C: how can they spot it early enough?
« Reply #2 on: July 06, 2009, 06:23:05 PM »
The typical blood tests performed to monitor individuals with HIV are NOT going to detect cancers -- with the exception of leukemia, liver cancer or, maybe, lymphoma.  When a doctor is "screening" for cancer -- it is typically a fairly specific test that detects certain proteins that cancer cells MAY give off.  An abnormal result would NOT indicate cancer, but would indicate doing more tests -- i.e. scans, xrays, etc.
Think of the PSA test (prostate specific antigen) -- a high level, might indicate cancer, but it is more likely to indicate an enlarged prostate.  Another "cancer screenting" test is the CEA (carcinoembryonic antigen).  It is used to screen for things like colon cancer and as a marker for lung, breast, liver, pancreas and a number of other cancers.
It is definitely not routine to use blood tests in detecting cancer (with the exception of PSA -- which causes much controversy).  There are far better things to do like breast or testicular exams, colonscopy, etc.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline newbie76

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  • Posts: 238
Re: The big C: how can they spot it early enough?
« Reply #3 on: July 07, 2009, 11:16:07 AM »
Thank you both.

So my next question would be: do you guys get tests in order to early diagnose the types of cancers that mostly affect positive people on a regular basis at your clinic?

Or is this something that is left ot the individual?
25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Offline Luke

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  • Posts: 291
Re: The big C: how can they spot it early enough?
« Reply #4 on: July 07, 2009, 11:55:37 AM »
So my next question would be: do you guys get tests in order to early diagnose the types of cancers that mostly affect positive people on a regular basis at your clinic?

No.

Offline newbie76

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  • Posts: 238
Re: The big C: how can they spot it early enough?
« Reply #5 on: July 07, 2009, 12:54:28 PM »
No.

... and does this not make you feel vulnerable and generally scares the bejesus out of you? Because it does that to me!  :o
25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Online Miss Philicia

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  • celebrity poster, faker & poser
Re: The big C: how can they spot it early enough?
« Reply #6 on: July 07, 2009, 01:06:02 PM »
... and does this not make you feel vulnerable and generally scares the bejesus out of you? Because it does that to me!  :o

Is it more or less likely than being involved in a car accident?
"Iíve slept with enough men to know that Iím not gay"

Offline Luke

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  • Posts: 291
Re: The big C: how can they spot it early enough?
« Reply #7 on: July 07, 2009, 01:39:57 PM »
... and does this not make you feel vulnerable and generally scares the bejesus out of you? Because it does that to me!  :o

No. Why should it?

If I do get cancer, then chances are I would get it whether or not I was HIV-positive. Did you run around scaring the crap out of yourself about the possibility of getting cancer before you became HIV-positive? If not, why now?

I could have a stroke, I could have a heart attack or get run over by a bus tomorrow. I have better things to do than ruin my life looking over my shoulder all the time worrying about what could happen.

Offline newbie76

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Re: The big C: how can they spot it early enough?
« Reply #8 on: July 07, 2009, 03:47:41 PM »
I just think that because HIV+ people are more likely to die of cancer than the rest of the population, preventive tests and screening should perhaps be part of the routine for us, that's all.

After all, the earliest you spot it, the better chances you have to survive it.

Following your reasoning then, why bother exercising and eat healthy? Hell, we might never die of a heart attack and with some luck our cholesterol might never be too high. What about the flu jab? We shouldn't do that either in the autumn, chances are we won't get the flu, and so on...

In most countries around the developed world, women have to -or at least are offered- screen periodically to spot early cervical cancer. I am just wondering why HIV+ people are not offered routine tests to look out for the cancers that are more likely to affect us.


25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Offline Assurbanipal

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  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: The big C: how can they spot it early enough?
« Reply #9 on: July 07, 2009, 04:08:12 PM »
I just think that because HIV+ people are more likely to die of cancer than the rest of the population, preventive tests and screening should perhaps be part of the routine for us, that's all.

After all, the earliest you spot it, the better chances you have to survive it.

Following your reasoning then, why bother exercising and eat healthy? Hell, we might never die of a heart attack and with some luck our cholesterol might never be too high. What about the flu jab? We shouldn't do that either in the autumn, chances are we won't get the flu, and so on...

In most countries around the developed world, women have to -or at least are offered- screen periodically to spot early cervical cancer. I am just wondering why HIV+ people are not offered routine tests to look out for the cancers that are more likely to affect us.




Actually there's been some recent studies that have suggested that you can do too much cancer screening.
 - Some cancers grow so slowly that one dies of old age first
 - Some cancers actually go away on their own

In my father's case he probably would have died of old age if they had not operated for a very small lung cancer (instead he died as a result of complications of surgery after a long miserable decline on a ventilator).

We like to think that if only we do the right screening anything can be prevented.  But screening has a cost in both dollars and effect on patient health.  It doesn't always improve people's lives or health...
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Luke

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  • Posts: 291
Re: The big C: how can they spot it early enough?
« Reply #10 on: July 07, 2009, 05:43:50 PM »
I just think that because HIV+ people are more likely to die of cancer than the rest of the population, preventive tests and screening should perhaps be part of the routine for us, that's all.

After all, the earliest you spot it, the better chances you have to survive it.

Following your reasoning then, why bother exercising and eat healthy? Hell, we might never die of a heart attack and with some luck our cholesterol might never be too high. What about the flu jab? We shouldn't do that either in the autumn, chances are we won't get the flu, and so on...

In most countries around the developed world, women have to -or at least are offered- screen periodically to spot early cervical cancer. I am just wondering why HIV+ people are not offered routine tests to look out for the cancers that are more likely to affect us.

Why do you automatically equate cancer with death? Are you not understanding that, in the developed world, cancer is already being picked up earlier in those living with HIV than in the population as a whole? That is as direct consequence of the amount of monitoring you already get.

As for this extrapolation that we may as well not bother exercising and eating healthily, that is just bizarre. They are proactive steps you can take to improve your health - but they wont stop most cancers.
« Last Edit: July 07, 2009, 05:47:11 PM by Luke »

Offline GNYC09

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  • Posts: 702
Re: The big C: how can they spot it early enough?
« Reply #11 on: July 07, 2009, 07:46:21 PM »
I just think that because HIV+ people are more likely to die of cancer than the rest of the population,

newbie76, I don't believe it's the case that HIV+ people are more likely to *die* of cancer although it is the case that we're more likely to be afflicted with *some* types of cancer. (Source: http://www.annals.org/cgi/content/full/148/10/728).  That said, that's no reason to pack it in and abandon healthy living. There is research that shows that regular exercise decreases your chance of getting cancer.  This can be coupled with cancer self-exams. I hope this helps.

Offline newbie76

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  • Posts: 238
Re: The big C: how can they spot it early enough?
« Reply #12 on: July 08, 2009, 01:39:07 PM »

As for this extrapolation that we may as well not bother exercising and eating healthily, that is just bizarre.

I never claimed that we might as well stop excercising and eating healthy. I was just taking to extreme your rather odd reasoning that because we might never get cancer than why bother screening for it, which is what I think you were getting at. Please correct me if I am wrong.
25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Offline newbie76

  • Member
  • Posts: 238
Re: The big C: how can they spot it early enough?
« Reply #13 on: July 08, 2009, 01:43:47 PM »
newbie76, I don't believe it's the case that HIV+ people are more likely to *die* of cancer although it is the case that we're more likely to be afflicted with *some* types of cancer.

Why do you automatically equate cancer with death? Are you not understanding that, in the developed world, cancer is already being picked up earlier in those living with HIV than in the population as a whole? That is as direct consequence of the amount of monitoring you already get.

Sorry I need to quote you again...

Yes, you are right cancer doesn't always equal death, but the more you wait, the harder it is to survive it, at least I think we can agree on this.

And your second sentence is exactly my question: how is cancer already picked up earlier in those living with HIV than in the rest of the population?? What are the tests that you personally get in order to get cancer picked up early? I just want to make sure that in my clinic are actually doing the necessary tests to pick up any abnormality.
25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Offline Luke

  • Member
  • Posts: 291
Re: The big C: how can they spot it early enough?
« Reply #14 on: July 08, 2009, 01:45:23 PM »
I never claimed that we might as well stop excercising and eating healthy. I was just taking to extreme your rather odd reasoning that because we might never get cancer than why bother screening for it, which is what I think you were getting at. Please correct me if I am wrong.

Then you are reading things into what I said which weren't there. I was simply pointing out that there is no point in living with an irrational fear of what may never happen.

Offline Scotian

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  • Posts: 37
Re: The big C: how can they spot it early enough?
« Reply #15 on: July 08, 2009, 05:25:37 PM »
In another thread GSOgymrat suggested a link                                   http://psychcentral.com/lib/2007/what-is-catastrophizing/
... it's worth reading.

Early after my diagnosis, 'catastrophizing' was a major issue with me and with the help of a psychologist( or as others call it 'cognitive therapy') it helped turned turned things around after several months.
Give me an issue ---HIV ---med side effects----aging--disclosure---finances---general health---relationships  etc etc and I can imagine all sorts of horrible outcomes ....that will never happen.
Now, I do some deep breathing  and self talk to break the' catastrophizing loop' in my brain. For me, I use a simple visiaul process...say I'm worried about getting cancer --I capture that thought and visualize hitting the 'delete' button on a computer keyboard ...or at the very least put it in a folder of "future worrying". I also try to be grateful for the extraordinary health care system and meds I have access to. In other words,  stay off the 'pitty pot'  as much as possible.
Also, I have found two books by Eckart Tolle invaluable in maintaining some sanity: The Power of Now and  A New Earth.
Good luck.

Offline SouthSam7

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  • Posts: 428
Re: The big C: how can they spot it early enough?
« Reply #16 on: July 08, 2009, 09:25:49 PM »
You all are referring to a study with some data almost 20 years old (1992Ė2003).  I wish the researchers had specified if their sample was on ARVs or not.  I suspect they were not, or they were perhaps on monotherapy for some of the study (1992). 

It also does not take into consideration that many HIV+ people are more susceptible to certain cancers not because they have HIV, but because they have (or had) anal sex or heterosexual unprotected sex.  Anything that exposes you to HPV can give you anal or cervical cancers.

It would be interesting to know the long-term cancer risks of the powerful ARVs most of us are on (does being HIV make you at risk for cancer or is it the meds, or neither?). 

As for exercising, eating right and taking care of yourself, I firmly believe that I am in better health now that I'm HIV+ since I watch what I eat, work out, don't do drugs, go to the doctor and get enough sleep.  Before I knew I was HIV+, I was a drugged-out mess.  I'm much better off now.

I just think that because HIV+ people are more likely to die of cancer than the rest of the population, preventive tests and screening should perhaps be part of the routine for us, that's all.

After all, the earliest you spot it, the better chances you have to survive it.

Following your reasoning then, why bother exercising and eat healthy? Hell, we might never die of a heart attack and with some luck our cholesterol might never be too high. What about the flu jab? We shouldn't do that either in the autumn, chances are we won't get the flu, and so on...

In most countries around the developed world, women have to -or at least are offered- screen periodically to spot early cervical cancer. I am just wondering why HIV+ people are not offered routine tests to look out for the cancers that are more likely to affect us.




Offline GNYC09

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  • Posts: 702
Re: The big C: how can they spot it early enough?
« Reply #17 on: July 08, 2009, 09:32:03 PM »
hi newbie76, I honestly don't know which tests can be done to catch cancer in its early stages besides testicular or breast self-exams.  I think rectal exams also but am not sure.  Maybe somebody with more info/experience can chime in...

Offline bocker3

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  • Posts: 3,358
  • You gotta enjoy life......
Re: The big C: how can they spot it early enough?
« Reply #18 on: July 08, 2009, 10:19:09 PM »
The best "screening" you can do for cancers is to know your body.  You can do testicular exams yourself.  If you have a history of HPV infection (anal warts, in particular) you might ask your doctor about anal pap smears -- but just like in cervical pap smears -- there are many more "false alarms" than real cancers detected.

The fact that HIV+ might have higher rates of some cancers does not mean most will.  Many HIV- folks have very infrequent doctor visits -- the fact that most HIV+ see their doctor's more frequently probably mitigates a bit of the "increased" risk.  Cancers are not usually picked up via screens that were not indicated by something (like a lump, or some other physical indication).

Like a number of said, it is easy to panic about some "studies" -- one has to be realistic -- you are probably in more mortal danger from driving to work than from this "increased" risk of cancer.  Seriously!

Try to not let HIV and the fear it can cause consume your ability to enjoy life.

Hugs,
Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

 


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