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News18
7 days ago
- Health
- News18
Breast Cancer: What's The Right Age To Start Mammography?
Last Updated: According to experts, women should begin annual mammogram screenings at the age of 40. However, this may vary depending on individual risk factors Breast cancer cases are rising rapidly among women in India. Every year, around 20 lakh women are diagnosed with breast cancer, and nearly 1 lakh lose their lives to the disease. The best way to detect and treat breast cancer early is through a mammogram — an X-ray test that helps spot cancer even before symptoms appear. But when should women start getting mammograms, and how often should they be done? Dr Laura Dean, a diagnostic radiologist at the Cleveland Clinic, has shared some important insights. When Should Women Start Getting Mammograms? According to Dr Dean, the most widely accepted recommendation is that women should begin annual mammogram screenings from the age of 40. However, this can vary based on individual risk factors. Women at a higher risk may be advised by their doctor to start screenings earlier. Recently, the US Preventive Services Task Force suggested getting a mammogram every two years from the age of 40. But in the US, where breast cancer cases are higher, annual screenings are still encouraged. Dr Dean says early detection through yearly mammograms can save more lives, with strong evidence supporting this approach. Do Men Need Mammograms Too? While breast cancer is more common in women, men can also develop the disease — although rarely. Dr Dean clarifies that this guidance mainly applies to women. However, men should still perform regular self-examinations. Any noticeable lump, swelling, or change in the chest area should be reported to a doctor immediately. Even individuals who have undergone breast removal are not completely free from the risk. Who Should Get Screened Early? Certain women need to start screening before 40. Dr Dean recommends that all women consult a doctor by the age of 30 to assess their risk. Early mammograms may be advised if there's a family history of breast cancer, gene mutations such as BRCA, dense breast tissue, or any underlying health conditions. In such cases, doctors may recommend starting screenings earlier than usual. Why Are Mammograms So Important? Globally, breast cancer claims over 6.85 lakh lives every year. In the United States, it is the leading cause of cancer-related deaths among women aged 35 to 54. Regular mammograms are the first line of defence against this deadly disease. Dr Dean stresses that screening allows for early detection, which can significantly improve chances of survival. A mammogram can identify unusual changes in breast tissue, prompting further tests like diagnostic mammograms or biopsies to confirm if it is cancer. Catching the disease early allows for timely treatment, potentially saving lives.
Time of India
7 days ago
- Health
- Time of India
Why it's tough to detect prostate cancer
Former US president 's health was a matter of intense focus while he was in office due to his episodes of forgetfulness and verbal slip-ups. But amid the speculation over his alleged cognitive decline, a far more serious illness was silently progressing inside his body. Tired of too many ads? go ad free now Biden, 82, was diagnosed with prostate cancer last week, and the disease has already metastasised to his bones. His condition has been characterised by a Gleason score of 9, near the top of the 6-10 scale used to grade prostate cancer severity. 'While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive, which allows for effective management,' his office said. Usual, But Unexpected Delayed diagnosis, experts say, is common in people who skip regular health check-ups or overlook clear signs of the disease. However, they add that late detection in someone as high-profile as Biden, who was president of the US until Jan this year and, therefore, was regularly monitored by a team of doctors, is unexpected and concerning. While some have questioned whether Biden's cancer could have been detected earlier, experts stress that his doctors were likely following standard protocol. Specialists note that prostate cancer is usually easy to detect early through a simple blood test — Serum PSA (Prostate-Specific Antigen). 'Early detection is possible in 99% of cases through PSA testing,' said Dr Amrendra Pathak, senior urologist at Sir Ganga Ram Hospital, Delhi. However, PSA screening isn't routinely recommended for men over 70, as the risk of overdiagnosis and unnecessary treatment may outweigh the benefits, according to reports on Medium, the online publishing platform. Leading medical bodies — including the US Preventive Services Task Force and the National Comprehensive Cancer Network — recommend discontinuing routine PSA testing after a certain age, unless the patient is in exceptionally good health. Tired of too many ads? go ad free now Given Biden's age and prior treatment for an enlarged prostate, the absence of a PSA test during his 2024 physical appears to be in line with the guidelines. A Tricky Customer Even with regular screening, however, prostate cancer can evade early detection. In some cases, the disease is metastatic from the outset, leaving no window for early diagnosis. In others, it may progress rapidly between PSA tests or fail to trigger elevated PSA levels at all. Studies also show that roughly 15% of men with prostate cancer may have normal PSA levels, especially since what is considered a 'normal' range increases with age. Dr Manav Suryavanshi, senior consultant and head of the urology division at Amrita Institute of Medical Sciences, Faridabad added: 'PSA is a critical marker, and in men who are predisposed to prostate cancer — due to family history, genetic mutations like BRCA1/2, or ethnicity — stricter and more frequent screening protocols are essential. In most clinical cases, if these protocols are followed rigorously, prostate cancer is usually detected at an early, localised stage where treatment is not only effective but also potentially curative. ' In early stages, when the disease is localised to the prostate, it can be cured by surgically removing the gland. But doctors say if it reaches a locally advanced stage, that is, if it spreads outside of the prostate gland into nearby tissues, multimodal therapy including surgery, radiotherapy, and hormonal treatment is required. Prostate cancer in India is on the rise, with nearly five lakh new cases being reported every year, said Dr Harit Chaturvedi, chairman, Max Institute of Cancer Care. The burden is expected to rise further due to population growth, increasing life expectancy, and an aging male population in the country.
The Star
25-05-2025
- Health
- The Star
What Joe Biden's prostate cancer diagnosis can teach us
The recent announcement of former US President Joe Biden's diagnosis with Gleason grade 9 advanced prostate cancer has drawn global attention to a disease that affects millions of men worldwide. Prostate cancer is the most commonly diagnosed cancer among men in the United States, with over 288,300 new cases and approximately 34,700 deaths annually. In Malaysia, prostate cancer ranks as the third most common cancer among men, but late presentation remains a significant concern. Globally, around 10–20% of men present with advanced-stage prostate cancer at diagnosis. In Malaysia, this percentage is notably higher, with many men first seeking care when the disease has already spread. Advanced prostate cancer frequently metastasises (spreads) to the bones. Some men with advanced disease may have no symptoms until the cancer burden becomes substantial, often presenting as bone pain in the lower back or hips. For many, the first signs prompting evaluation are urinary difficulties, including frequency (urinating more often than usual), urgency (the feeling you need to urinate) or a weak stream, although it's important to note that not all urinary symptoms are caused by cancer. This raises an important question: why are more men not being diagnosed earlier? The fact that a high-profile figure such as a former US president may not have undergone regular screening is both surprising and concerning. Thoughts about screening If you're a man – or someone who cares about one – this is a good moment to stop and think. Have you ever talked to a doctor about prostate cancer screening? If you're in your 50s or older, or in your 40s with a family history of prostate cancer, this is the recommended time to consider it. And if you're a partner, friend, daughter or colleague, asking something as simple as "Have you ever had a PSA test?" or "Do you think it's time to check on this?" could make all the difference. The primary tool for early detection is the prostate-specific antigen (PSA) test. This is sometimes combined with a digital rectal examination (DRE), particularly for men at higher risk. This examination allows doctors to feel for any hard or unusual areas in the prostate that might suggest cancer. However, PSA screening has long been a subject of debate. In 2012, the US Preventive Services Task Force advised against routine PSA screening due to concerns that it led to the detection and treatment of many low-grade prostate cancers that might never have caused any health problems during a man's lifetime or affected how long he lived. ALSO READ: Diagnosing prostate cancer too early might cause more harm than good This recommendation resulted in a decline in PSA testing and sparked debate over whether fewer screenings might contribute to later-stage diagnoses. In 2018, the Task Force revised its stance, recommending that men aged 55 to 69 engage in shared decision-making with their healthcare provider to weigh the benefits and risks of screening. Routine screening remains not recommended for men over 70, given the lower likelihood of benefit in this age group. While this cautious approach aims to avoid unnecessary treatment, it underscores the need for better risk stratification tools to catch aggressive cancers like the one diagnosed in Biden, while minimising intervention for slow-growing ones. How often then should men be screened? For those who choose PSA testing, screening is typically recommended every one to two years, depending on baseline PSA levels and personal risk, consistent with guidance from the American Urological Association and National Comprehensive Cancer Network. Understanding the risks To understand screening implications, we must look at the Gleason grading system, which scores prostate cancer from 6 to 10 based on microscopic appearance: Gleason 6 (Grade Group 1) This cancer is low-grade, slow-growing and often managed with active surveillance, i.e. a "watch-and-wait" approach that avoids immediate treatment and monitors the cancer closely through regular checkups and tests. (Grade Group 1) Gleason 7 (Grade Groups 2 and 3) This cancer carriers intermediate risk. Ttreatment may involve surgery or radiation. (Grade Groups 2 and 3) Gleason 8–10 (Grade Groups 4 and 5) There are high-grade, fast-growing cancers that need quick and often combined treatments like surgery, radiation or hormone therapy, to keep them under control. In localised high-grade prostate cancer, treatments that aim to cure (radical prostatectomy or radiation therapy with hormonal therapy) are employed. But once the cancer is advanced or metastatic, the treatment shifts focus to disease control with the therapies listed below, to ensure that patients tolerate therapy well and maintain a good quality of life. Treatment in advanced disease Thanks to advances in treatment, many men with stage 4 prostate cancer can live for years with well-controlled disease, and may ultimately pass away from other age-related health conditions. The main treatment for advanced prostate cancer is hormone therapy, also known as androgen deprivation therapy (ADT). This approach lowers testosterone, the hormone that fuels prostate cancer growth. Most men are able to tolerate therapy well with the main side effects reported being hot flashes, tiredness, weight gain, mood changes and a drop in sex drive, which are all symptoms related to the lowering of testosterone. In men, whose cancer has spread widely or to organs like the liver or lungs, doctors often add chemotherapy (such as docetaxel) to the hormone therapy. This combination has been shown to help men live longer. We now live in the era of precision oncology, where genetic testing is helping doctors tailor cancer treatment to the individual. In prostate cancer, checking the tumour's DNA (deoxyribonucleic acid) can reveal changes in genes like BRCA1, BRCA2 or ATM. These are found in about 10-15% of men with advanced prostate cancer, based on global data. These changes can make the cancer more responsive to a group of drugs called PARP inhibitors, including olaparib and rucaparib, which help slow disease progression in men with certain types of resistant prostate cancer. While international estimates guide current practice, data on how common these gene mutations are in Malaysian men is still limited, pointing to the need for wider access to testing and research in this region. The treatment options for advanced prostate cancer that no longer responds to hormone therapy are improving quickly. New pills that block the effects of testosterone – like enzalutamide, apalutamide and darolutamide – can help men live longer. Another newer option is radioligand therapy, which delivers targeted radiation to cancer cells using a special radioactive drug called Lu-177-PSMA-617. These treatments are now being used more often for men whose cancer has spread or no longer responds to standard therapies. Biden's diagnosis of Gleason 9 disease suggests a highly aggressive form, and the "advanced" designation implies either locally advanced or metastatic spread. His case underscores the importance of early detection, nuanced understanding of risk, and individualised treatment planning. In conclusion, prostate cancer remains a major health issue with varying presentations and outcomes. The diagnosis of a global figure may offer a moment to re-examine current screening practices, particularly for high-risk populations, and reinforce the need for personalised care based on tumour biology, grade, stage, and now, molecular profile (when available). Most importantly, it's a reminder: have the conversation. Early detection could save your life, or that of someone you love. Professor Dr Deva Mahalingam is a Malaysian medical oncologist and clinical researcher at Northwestern University in the United States. For more information, email starhealth@ The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
India Today
21-05-2025
- Health
- India Today
Joe Biden went a decade without prostate cancer screening, his office confirms
Former US President Joe Biden had not received a test for prostate cancer, known as a PSA, for more than a decade before he was diagnosed with an advanced form of the disease last week, a spokesperson said on latest comments from the former Democratic president's camp come amid questions from Republicans and some health professionals about why his cancer was not caught before reaching an advanced 82, has also faced broader questions about whether he and his allies withheld critical information from the American public about his ability to serve in the White House. A new book, "Original Sin," details widespread concerns about Biden's mental acuity amongst aides as he pursued reelection last year. "President Biden's last known PSA was in 2014," the Biden spokesperson said on Tuesday. "Prior to Friday, President Biden had never been diagnosed with prostate cancer."A PSA test, or prostate-specific antigen test, is a blood test that is used to screen for prostate health professionals consulted by Reuters expressed surprise at the diagnosis given that most prostate cancers are detected at an earlier stage and that presidents undergo thorough health others said it is not unusual to discontinue testing for prostate cancer in older patients because the test is less reliable in that age group. Prostate cancer has a much higher survival rate than most other 2012, the US Preventive Services Task Force recommended against PSA-based screening for prostate cancer in men of all ages. The task force reversed the recommendation in 2017, advising against screening for men older than who ultimately abandoned his reelection bid and left office in January, was in his early 70s at the time of his 2014 screening."It is very reasonable to discontinue PSA screening at age 72, regardless of health status, or significantly decrease the frequency of screening," said Dr. Scott Eggener, a urologic cancer specialist and professor of surgery at the University of office said he had been diagnosed on Friday with "aggressive" prostate cancer that had spread to his bones. Cancers that have spread, or metastasised, are considered stage 4, the most President Donald Trump and Vice President JD Vance are amongst the Republicans who have offered well-wishes to Biden while also raising questions about the timing and nature of his cancer received a PSA test as part of his latest annual physical exam, according to results released in Watch
The Age
21-05-2025
- Health
- The Age
Biden did not get a prostate cancer blood test for more than a decade
Washington: Former US president Joe Biden had not done a test for prostate cancer for more than a decade before he was diagnosed with an 'aggressive' form of the disease last week, a spokesperson said. The latest comments from the former Democratic president's camp come amid questions from Republicans and some health professionals about why his cancer was not detected in a PSA test (to measure prostate-specific antigen in the blood) before reaching an advanced stage. Biden, 82, has faced broader questions about whether he and his allies withheld critical information from the American public about his ability to serve in the White House. A new book, Original Sin, details widespread concerns about Biden's mental acuity among aides as he pursued re-election last year. 'President Biden's last known PSA was in 2014,' the Biden spokesperson said. 'Prior to Friday, President Biden had never been diagnosed with prostate cancer.' Some health professionals consulted by Reuters had expressed surprise at the diagnosis, given that most prostate cancers are detected at an earlier stage and that presidents undergo thorough health monitoring. Still, others said it was not unusual to discontinue testing for prostate cancer in older patients because the test was less reliable in that age group. Prostate cancer has a much higher survival rate than most other cancers. In 2012, the US Preventive Services Task Force recommended against PSA-based screening for prostate cancer in men of all ages. It reversed the recommendation in 2017, advising against the screening for men older than 70. Biden, who ultimately abandoned his re-election bid and left office in January, was in his early 70s at the time of his 2014 screening.
