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If you feel something, say something. - (9/15/2020)

By Dr. Ron Gasbarro

George came into the pharmacy, looking surprised. ‘’Hey, Doc! I haven’t seen you in a monkey’s age! You been away or something? I heard you were sick.” This is a story the pharmacist has told countless times since he returned to work. Throughout the winter and into early spring, the pharmacist was having trouble with his right ear. Pharmacists have a supernatural ability to ward off most viral infections simply because they are bombarded with sick patients who need medication. However, this “ear trouble,” although relatively mild, felt like a blockage of the Eustachian tube – the short pipe that links the sinus area to the middle ear. Befuddled, he went to his doctor for a diagnosis.

After two rounds of an antibiotic, a steroid regimen, a decongestant, and a thorough earwax removal, the pharmacist’s problem persisted. “I remember saying to my doctor, ‘I just want to make sure it isn’t cancer.’” Finally, the pharmacist got a cat scan to visualize the inside of his neck. There is was: a golf-ball-sized tumor right next to the voice box. “Throat cancer! My mind rushed through a series of scenarios from my family to my work to my own death.” However, his oncologist predicted that this particular growth was “very, very” treatable. “We caught it early!” the doctor said. 

There are two words you never want to hear from your oncologist: inoperable and metastatic. Early detection offers the opportunity to detect cancer expeditiously, with an increased chance for treatment and cure. Screening both healthy and high-risk populations is a wise move for most adults. For example, The American Cancer Society urges people at average risk of colorectal cancer (CRC), with no family history of CRC or inflammatory bowel disease, to start regular screening by age 45. Some cancers, such as breast or ovarian, tend to “run” in some families. Family members must be closely monitored because they have a greater likelihood of developing a malignancy at a younger age than is the norm.

Does early detection decrease cancer death rates? Early detection has proven its worth: since 1950, researchers have observed a 70% decline in cervical cancer incidence and deaths due to the simple Pap smear. Overall, cancer mortality has plummeted 27% since 1991, with approximately 2.6 million fewer cancer deaths, stated the American Cancer Society in 2019. The decline in cancer mortality is largely the result of advances in early detection and treatment. Such breakthroughs have saved people from some of the deadliest forms of cancer, principally breast, cervical, colon, prostate, and lung. 

Everyone knows someone who has or had cancer. According to the Centers for Disease Control and Prevention, one in 10 American adults has had such a diagnosis at some point. Most of them lived! Yet, whatever your age or family history, if you have a lump or a bump or an unusual dump, check it out with your healthcare provider. And, if your doctor or nurse says it is “nothing,” and the abnormality persists, keep on it. As the pharmacist says, “I thought it was earwax buildup. Good thing I kept hounding people for an accurate diagnosis until I found out it was a cancer that could have killed me!” The pharmacist went through eight weeks of chemotherapy and radiation and their inevitable side effects. He lost a fair amount of weight but survived intact and was ready to go back to work. Not everyone is so lucky. 

For 90% of the population, any physical or mental abnormality is likely not cancer but something not as dramatic. Whatever the case may be, if you feel something, say something! 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.

Illustrations by Wojak


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