- The Washington Times - Monday, June 5, 2006

It has been Dr. Elmer Huerta’s dream to have a clinic bearing a sign that says: “Only for people without symptoms.” As the director of the Cancer Preventorium at the Washington Hospital Center’s Washington Cancer Institute, he encourages people to go for a checkup before they become sick. When he worked as an oncologist, he became frustrated when he realized how many of his patients’ conditions could have been prevented.

“If you intervene early and find conditions earlier, then you provide better quality of life,” Dr. Huerta says. “You give more years to people, and you save a lot of money.”

Prevention is the key to saving many lives. Getting a yearly physical exam and knowing family history of disease can greatly increase people’s health and might even save their lives.

Many physicians only run medical tests when patients have symptoms, says Dr. David Sandmire, co-author of “Medical Tests that Can Save Your Life: 21 Tests Your Doctor Won’t Order … Unless You Know to Ask.” Dr. Sandmire is an associate professor at the University of New England in Biddeford, Maine.

Unfortunately, once a person shows signs of illness, the disease often is in such a late stage that it can’t be treated effectively, he says.

Dr. Sandmire’s book lists 21 tests he says the public should understand. Then, after researching their family medical history, they can discuss the procedures with their doctors. Some of the tests in his book include blood glucose tests for type 2 diabetes, blood tests for HIV and the c-reactive protein test for coronary heart disease risk.

In a standard 15-minute doctor visit, the time crunch makes it possible to overlook an important topic.

“I’m not suggesting to have all these medical tests done on everyone,” Dr. Sandmire says. “I want to inform the layperson how to determine if they are at risk for a certain condition. If they are at risk, they should be an advocate for themselves.”

Colonoscopy for colorectal cancer and precancerous polyps, another test in Dr. Sandmire’s book, should be performed on adults by age 50, or earlier if the family has a history of colorectal cancer, says Dr. Stan Benjamin, chief of gastroenterology at Georgetown University Hospital in Northwest.

Colon cancer begins its life in the colon as a polyp. Five percent of the United States population will end up with colon cancer, making it the fourth most common type of cancer, he says. It is the second-leading cause of cancer-related death. Lung cancer is the first.

The colonoscopy allows doctors to identify precancerous lesions so they can be removed.

“It is unquestionably a test that could save your life,” Dr. Benjamin says. “There is no other cancer that is truly preventable other than colon cancer. That is why you should have your colonoscopy.”

An abdominal ultrasound for an abdominal aortic aneurysm is another potentially lifesaving test, says Dr. David Deaton, chief of endovascular surgery at Georgetown University Hospital.

Abdominal aortic aneurysms have no symptoms. If the aneurysm begins to rupture, it usually is too late to save the person, he says. The mortality rate is 70 to 80 percent.

“It’s like how a bridge fails,” Dr. Deaton says. “If it goes out, it goes out so suddenly that people will run their car off the end of the bridge. It’s a catastrophic failure.”

If an aneurysm is found, the aorta can be replaced through surgical or minimally invasive procedures. Having discovered it, the mortality rate drops to 1 to 2 percent, he says.

Anyone with the suspicion of pancreas problems could discuss having an endoscopic ultrasound or endoscopic retrograde cholangio pancreatography with their physician, says Dr. Patrick Jackson, assistant residency program director at Georgetown University Hospital .

Jaundice and abdominal pain are signs of pancreatic cancer. The symptoms, however, may not appear together.

“The only people who survive pancreatic cancer are those who are picked up early,” Dr. Jackson says. “If you have abdominal pain, you ought to go see your primary care physician, and let them help guide you through figuring out the abdominal pain.”

Genetic tests, such as BRCA1 and BRCA2 for breast and ovarian cancer risk, and the Hereditary Non-Polyposis Colon Cancer test, can be helpful when considered with a family medical history, says Beth Peshkin, senior genetic counselor at Lombardi Comprehensive Cancer Center at Georgetown University Hospital.

Fewer than 10 percent of breast cancers are attributable to inherited factors, she says. Cancer is usually developed through the combination of genes and environment. Further, even with a gene mutation that indicates elevated risk, it doesn’t mean the person will get cancer.

Genetic tests, however, usually provide life-changing information, she says. Patients should be ready to hear the test results and be willing to take preventative steps.

“You have a piece of information that you didn’t have before,” Ms. Peshkin says. “Most people choose to get tested because they want to do something proactive.”

For people with busy schedules, a one-stop shop might be the way to address many health concerns, says Dr. Craig Cheifetz, medical director of the Inova Executive Health Center in Falls Church.

The center partners with corporations to provide comprehensive health screenings for their executives. Individuals also can pay for the screening themselves for around $2,000, which varies depending on a person’s specific needs. One person goes through the program per day.

A concierge nurse takes the patient through a list of tests, such as blood work, hearing tests, vision tests, lung function tests, a chest X-ray, an electrocardiogram, an exercise treadmill test with a cardiologist, flexibility testing and body fat analysis. The visit also involves taking an hourlong health history and physical exam. The patient submits a three-day food diary to a nutritionist who makes dietary recommendations.

“Northern Virginia has a lot of people who spend a lot of time working, but don’t spend a lot of time working on their health,” Dr. Cheifetz says. “This way you can go to one place that does it all.”

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