How useful is a colonoscopy, and are colonoscopies really necessary?

Hi Cai Shum, A colonoscopy is one of the investigative tools we have to examine the colon, rectum and in some cases the terminal ileum. The alternatives are a computed tomography scan of the colon (also known as a CT Colonography) and a barium enema. The key benefit of performing a colonoscopy is the ability to directly visualize the colonic lumen through a high definition lens and biopsy the lesion if necessary. This cannot be done with the other imaging options.

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Answered By

Dr Jason Lim

Colorectal Surgeon

Are there any alternatives to chemotherapy for breast cancer after a mastectomy?

First and foremost, I am sorry to hear about your diagnosis of breast cancer and I hope you are recovering well from your surgery. In the treatment of any cancer, it is always important to consider the stage of the tumour (how advanced it is, how much it has spread) and also certain features of the tumour which can affect how aggressive the tumour is (grade, hormone receptor status, HER2 protein status etc). From your question, I am assuming your cancer surgeon has performed a mastectomy (whole breast removal) with clear margins and has advised you to go for chemotherapy.

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Answered By

Dr Tzeyeong Teng

General Practitioner

What should I do about an abnormal PSA result at a health screening?

PSA testing is done for the early detection of prostate cancer. However, an abnormal PSA is not specific for prostate cancer alone. There are other causes of an abnormal PSA such as: Enlarged benign prostate (BPH) Urinary tract infections Recent ejaculation etc. The risk of prostate cancer depends on how abnormal the PSA is. For example, Risk of prostate cancer for PSA 4-10ng/ml—around 25%, Risk of prostate cancer for PSA 10-20, around 33-50%. The risk of cancer increases as the PSA increases. I would suggest that you see a urologist for further assessment.

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Human

Could I have throat cancer if I have a persistent sensation in throat?

I will give you my suggestions based on my experience at A&E (of which I had plenty at in the past). You mentioned that you are worried about your throat health. But yet it appears that you have not taken steps to reduce or stop the smoking, which increases your risk of: Acid reflux Throat and nasopharyngeal cancers. I would suggest you consider seeking smoking cessation help if you can’t battle your addiction alone. The reflux CAN cause throat irritation.

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Answered By

Dr Winston Lee

Aesthetic

Is nail clubbing a sign of cancer, and what should I do next?

I totally agree with Dr Theng. If you have further concern, talk to the doctor who have done the tests. If all the history, examination and investigation have been done, then the next thing you should focus on will be to stop smoking. No point worrying about something you create which will then lead to more worries. Stop especially if it has already caused clubbing of your nails. Good luck!

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Answered By

Dr Kelvin Chua

Aesthetic

How does Azacitidine help for Acute Myeloid Leukemia?

You need to ask these questions to your haematologist or oncologist, as they are beyond the scope of this QnA. AML is complicated in general, and the answer is never straight forward. For example, the correct treatment in your case may also depend on genetic and molecular sub-typing. Your haematologist will have access to all the necessary information and test results (which we do not possess), in order to give you the most appropriate advice to your questions.

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Human

When should I see a doctor regarding rectum bleeding if I’m worried about colon cancer?

Great question. Bleeding from the back passage is actually one of the most common questions that get asked by friends. In short, the answer is you should see a GP. He 'll be able to determine the source of the bleeding by examining your back passage, and if it' s unclear where the blood is coming from, or if your history is to be able to decide on the necessary further investigations. In your shoes, I would not be overly concerned. As you mentioned, pain and bleeding in your 20s is most commonly due to anal fissures, caused by passing hard stools.

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Human

Which should I do next for a basal cell carcinoma in Singapore?

A non-healing ulcer may be due to an underlying skin cancer like basal cell carcinoma. The 1st thing to do is to see your dermatologist to get it checked out. A skin biopsy can be done to confirm the if this is indeed due to a pigmented basal cell carcinoma. Once confirmed, surgical excision is the main treatment option. Mohs surgery is a form of surgery and this is indicated when 'tissue preservation' is important to minimize the size of the excison. Moh's surgery is performed by a dermatologist who specializes in the procedure.

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Answered By

Dr Colin Theng

Dermatologist

Which specialist should I consult for a high platelet count?

As Dr Taufiq explained, going to see your GP for an interpretation of the results would be a good first port of call. This is because there are many causes for abnormal blood tests, which need to be interpreted in the context of other factors (eg. any other existing medical conditions, health issues, etc). For example, reactive thrombocythemia is one of the most common causes of high platelet count. This can be attributable to infection, tissue damage, inflammation, iron deficiency, medication etc.

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Human

Do I need a colonoscopy for tailbone and anal pain to rule out cancer?

From the sounds of it, you're most worried about cancer (which I can understand, given your father' s colorectal cancer) so let's address that first. Dull pain near tailbone -> anal pain - could it be cancer?

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Human

How can one differentiate acne from basal cell carcinoma? (photos)

This is a really good question. Many a times, different kinds of skin problems can present in very similar ways. The best and safest way to get the diagnosis right is to see a doctor as soon as possible to get it assessed physically. You can see a general practitioner, a dermatologist or an aesthetic doctor depending on your preference. A skin biopsy may be required. I do not recommend getting advice or answer over the internet over this matter because basal cell carcinoma can be a serious condition if not discovered early. Thank you.

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Human

How likely am I to get breast cancer if my mother has it?

The causes of cancer are multi-factorial. For example, the following factors all play a role: Family history/genetics Lifestyle factors such as diet and exercise Body weight Smoking and alcohol Sleep habits Exposure to environmental cancer-causing chemicals The lifetime risk of getting breast cancer in a woman is about 1 in 8. If you have a mom who had breast cancer before the age of 50, the risk is approximately doubled, especially if you inherited a certain gene mutation on BRCA1 and BRCA2.

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Human

What are the chemotherapy regimens for relapsed leukemia?

There are different types of leukemias, and going into the treatment regime for each one is beyond the scope of this QnA. For example, there are 4 main types of leukemia alone: Acute myeloid leukemia (AML) Chronic myeloid leukemia (CML) Acute lymphocytic leukemia (ALL) Chronic lymphocytic leukemia (CLL) I’d advise speaking to an oncologist to discuss about your query, as he will be able to provide a much more helpful answer in the context of additional details.

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Human

How reliable is an elevated CA 19-9 as a cancer marker?

CA19-9 is a tumour marker for digestive tract related cancers; specifically for cancers of the pancreas and biliary system. Having said that, an elevated tumour marker does not necessary mean the presence of cancer, especially if it is just marginally raised. Since your CA19-9 level is almost double, it will be prudent for you to get a proper assessment soon. If the repeat CA19-9 level shows a down trending pattern or normalises spontaneously, then there is a good chance we are dealing with a benign condition. Please bring along all your recent test reports or scans during the assessment.

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Answered By

Dr Wai Leong Quan

Gastroenterologist

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