Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Cancer Care

Santa Clara Medical Center

News & Events

Dr. Pan and Dr. Lee's Blog

Cancer screening and prevention

Jul 01, 2012

This month, I am going to try to answer a question that is frequently asked by my patients about early diagnosis: would a CA125 blood test have detected their ovarian cancer early? Similarly, many patients with non-ovarian cancer have asked if a CT scan done six or more months earlier would have detected their cancer when it was more treatable or curable.

These are excellent questions and concern the fundamental concept of cancer screening and prevention.

Before I attempt to answer though, let me outline some screening methods available today:

  • For breast cancer, mammogram screening is effective.
  • For colorectal cancer, fecal blood test and colonoscopy are effective.
  • For cervical cancer, Pap smear is an effective method.
  • For prostate cancer in men, a PSA blood test has experienced a lot of debate and controversy.
  • Recently, a low dose CT scan was shown to detect lung cancer in heavy smokers between age 55 and 74.
  • For patients with chronic hepatitis B, which may eventually cause cirrhosis and liver cancer, regular screening with an AFT blood test and ultrasound is advised.

For many other cancers there is still a lack of effective screening method.
Now, let us go back to the case of ovarian cancer screening. Studies have been done with hope to use the CA125 blood test as a screening test to detect ovarian cancer early but the result was disappointing. Why? Some patients without ovarian cancer have a CA125 level higher than the normal range (35 or lower). And only approximately half of patients with ovarian cancer have elevated CA125 while the other half show normal levels even when they have ovarian cancer. In the studies, women whose CA125 was elevated would be subjected to further screening with transvaginal ultrasound and surgery. Some patients with elevated CA125 were found to indeed have ovarian cancer, but about half of the women who went through further testing and surgery actually did not have ovarian cancer at all. These women did not benefit from the screening with CA125, but rather were harmed by the screening with this test with unnecessary further testing and procedures.

Some patients then asked me, "Well, if the test was done on me, it would have been effective in diagnosing my cancer early." That may be true for those patients whose CA125 was elevated at the time of their ovarian cancer diagnosis. But the question is how would we know which patient to test before they were diagnosed with ovarian cancer? It is easier to look back for one specific case, but screening is not meant for one or a few cases, it is for the whole population at risk. Therefore, a screening test must be very sensitive and specific. In the case of ovarian cancer, CA125 is neither sensitive nor specific enough as an effective screening test. 

I do not mean to seem pessimistic about cancer screening. We are on a long journey of fighting cancer and developing much more effective screening tests. With the current pace of scientific advances, medicine in the next two decades will be vastly different than what we know today. The future holds great promise. 
Before I close this blog I want to remind you that there is no better medicine for preventing cancer than regular exercise (though if you smoke, or drink alcohol heavily, or have other unhealthy habits, quitting is most certainly the best medicine). 30 minutes a day is a good goal, but start with five minutes of gentle exercise to get started; walking, taichi, yoga, or any physical activity like doing chores, gardening, etc., is effective. Then add a minute or two every day until you reach 30 minutes or more each day. Go to a gym if that’ what you need, but you can also save money by exercising at home, at work, anytime you get a minute or two. 

I hope this has been helpful to you and wish you all the best. 

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