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Most of us know someone who put off having an essential check-up, like a Pap smear, for several years – and then, when they finally got around to it, was diagnosed with cervical cancer. Those stories should serve as a warning to most of us, but still we keeping putting off those vital tests.

You may not have a regular doctor – perhaps you use whoever's on duty at your local clinic, or the nearest government hospital. Perhaps you visit a large private practice with a number of different doctors.

But that's no excuse for missing some of the vital tests which monitor your health, and which could well save your life. Here's a guide to the tests and examinations you need, and when you need them.

Tests That Could Save Your Life
1. A pelvic examination with Pap smear and STD screening
You need it because:
Cervical cancer is one of the diseases which most often lead to death among South African women. Also, sexually transmitted diseases (STDs) like gonorrhoea and chlamydia are often asymptomatic, but, if left untreated, can lead to pelvic inflammatory disease and problems with fertility.

What it involves:
You can see your GP for this test, but a gynaecologist is preferable. The doctor examines your vagina for evidence of infections, as well as any discharge you might have. He'll also examine your cervix to see whether you have any irritation or infection in that area. Then your uterus, Fallopian tubes and ovaries are palpated through your abdomen, for abnormalities or signs of infection.

For the Pap smear, cells are scraped off the cervical opening and sent for analysis at a laboratory. This is a painless procedure. Another sample can be taken to test for chlamydia and gonorrhoea.

What the results tell you:
A Pap smear picks up changes to the cervical cells. These changes are an early warning system for cervical cancer.

When you need this test:
You should have your first Pap smear as soon as you become sexually active, or by no later than the age of 18. Thereafter (if you're in a monogamous sexual relationship), you need a test every two to three years until age 65.

If you have more than one sexual partner, you should be tested yearly. If your test results are inconclusive or abnormal, you should be tested yearly until you have three consecutive normal tests.

2 . Clinical breast examination
You need it because:
Breast cancer kills women indiscriminately, and most women aren't diligent about breast self-examination. They also (mistakenly) believe breast cancer is painful, so t hey ignore any painless lumps they find. However, any growth in your breast must be investigated immediately.

What it involves:
Your doctor will check your breasts and armpits, feeling the tissue for lumps or swollen glands.

What the results tell you:
Any lumps which are found may indicate benign conditions such as a blocked milk duct or a sebaceous cyst, but can also identify breast cancer. If something's found, follow-up investigations may include a mammogram, ultrasound, fine needle aspirate (FNA) of the lump, or other tests.

When you need this test:
If you're in your 20s or 30s, have a clinical breast examination every three years; once you hit 40, it should be a yearly thing.

3. Screening mammogram
You need it be cause:
The older you get, the greater your chances of contracting breast cancer. Screening mammograms have been shown to significantly reduce deaths from breast cancer in women aged 40-69.

What it involves:
Be warned – this isn't a comfortable procedure, because the breast is compressed between two plates while low-dose X-rays are beamed in to the tissue. Some women have compared it with slamming your breast in the fridge door!

What the results tell you:
Mammograms can detect tiny tumours you can't feel during self-examination. They can also find micro-calcifications – small calcium deposits which sometimes indicate the presence of breast cancer.

When you need this test:
From age 40, you need a mammogram everyone to two years, and yearly after age 50. If there's a history of breast cancer in your family, you m ay need more frequent screening – discuss this with your doctor.

4. Fasting blood sugar test
You need it because:
Diabetes mellitus has become an epidemic in South Africa – and most people who suffer from it haven't yet been diagnosed. Uncontrolled diabetes can lead to heart disease, nerve damage, vision loss and a host of other complications.

What it involves:
You stop eating and drinking for nine to 12 hours, and then have a blood test. It's easiest to have the test first thing in the morning, so you can fast while asleep!

What the results tell you:
The test determines whether you have abnormally high levels of sugar in your system – which, in turn, indicates whether your body's metabolising food correctly.

When you need this test:
Regardless of your age, you should have the test done if you experience blurred vision (that's not cleared up by wearing glasses), excessive thirst and/or urination, unexplained fatigue, or unexplained, sudden weight loss. If you're over 45, have it as a routine test every three years.

5. Whole body skin check
You need it because:
Malignant melanoma – the most serious form of skin cancer – is often fatal, unless caught early enough. And while black skin's less susceptible to cancer than white skin, there's still a risk of contracting this dangerous disease, particularly if you spend a lot of time in the sun.

What it involves:
A dermatologist examines every inch of your skin for suspicious moles or other growths.

What the results tell you:
If you catch skin cancer early, it's highly treatable. Anything suspicious can be dealt with before it gets out of hand.

When you need this test:
If you have a family history of skin cancer or spend a lot of time in this sun, see a dermatologist yearly, no matter what your age. Otherwise, start at age 35 and go annually thereafter.

6. Colonoscopy
You need it because:
Colo-rectal cancer is highly curable if caught early enough – but it's a fairly common cancer and is fatal if left untreated.

What it involves:
You'll have to eat a special diet and use laxatives or a bowel-cleaning solution for a few days before the procedure. You'll be sedated and then a gastro-enterologist will insert a flexible tube into your rectum and scrutinise your colon via a tiny camera that's connected to a monitor.

The procedure's painless, but is clearly unpleasant – which is why you're given sedation.

What the results tell you:
Colonoscopies are the best way to find suspicious growths (polyps) inside the colon before they become cancerous. These polyps can be surgically removed and biopsied to determine whether they're benign or malignant – which means great accuracy of diagnosis.

When you need this test:
Most people generally have this test at around age 50, but if you notice any blood in your stool or a marked change in your bowel habits, you may need one earlier. Discuss your options with your doctor.

Meanwhile, remember, the health of your bowel has a lot to do with what you eat. Avoid refined, processed foods and choose high-fibre, low-fat fresh ones – there's a definite link between an unhealthy diet and certain cancers of the digestive system.

General Check-Ups
It's a good idea to get into the habit of seeing your doctor at least once yearly for a check-up, no matter how young and healthy you are. Your doctor can check basics like your blood pressure and pulse, and ask the right questions to determine whether you're at risk of heart disease, stroke, diabetes and other lifestyle diseases.

He may decide to do a glucose test and/or a cholesterol test, based on your lifestyle and family history, in which case you'll have to fast overnight and visit a laboratory first thing in the morning to have blood extracted for testing.

A general check-up is a simple, quick procedure, but could pin-point a condition you never realised you had. It's also a good time to discuss any general problems you may be having, such as with your weight, sleeping patterns and mood.

Dental check-ups
Everyone, including children aged three upwards, should see the dentist regularly – every six months is the suggested frequency. Children and young adults tend to have more problems with tooth decay and cavities, whereas from about your 30s, gum disease becomes a real threat to your oral health, and isn't as easy to detect as a cavity.

Your dentist also checks for a variety of oral cancers, so there's more to the dental check-up than having your teeth professionally cleaned and polished.

Eye examinations
Changes in your vision may be gradual as you get older, and your body and brain start to accommodate your vision loss, however small. For this reason, it's advisable to have your eyes checked yearly, regardless of your age, even if you think you have perfect vision – you'll be amazed at how much more clearly you see the world if the optometrist finds you need glasses!

More importantly, however, your optometrist will be able to pick up any cataracts growing over your eyes once you hit your 40s, and will also perform screening for glaucoma (excessive pressure in the eye that can damage the optic nerve and cause blindness).

Future breakthroughs
Two new, promising tests are currently being researched. One aims to detect ovarian cancers and the other, bladder cancers – both of which are very difficult to diagnose in the early stages, when they're treatable. These tests are undergoing clinical trials and may be available in the next few years.

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