Seeking guidance on cancer screening tests

foana

foana

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A clinic in Thailand (Healthlab) quoted me for a cancer screening panel, and I'm trying to work out whether a 39 yr old male really needs the whole thing. Any advice on what's genuinely worth doing before I go deeper into peptide research?

Blood work (ตรวจจากเลือด)

1. AFP, or alpha-fetoprotein

Marker for liver cancer – มะเร็งตับ

350 บาท (ราคา)

2. CEA, or carcinoembryonic antigen

Markers for colon and digestive tract cancer – มะเร็งลำไส้และระบบทางเดินอาหาร

400 บาท (ราคา)

3. CA 125 (for women) — cancer antigen 125

Marker for ovarian cancer – มะเร็งรังไข่

700 บาท (ราคา)

4. CA 15-3 (for women) — cancer antigen 15-3

Marker for breast cancer – มะเร็งเต้านม

700 บาท (ราคา)

5. PSA (for men) — prostate specific antigen

Marker for prostate cancer – มะเร็งต่อมลูกหมาก

700 บาท (ราคา)

6. CA 19-9, or cancer antigen 19-9

Markers for pancreatic and digestive cancer – มะเร็งตับอ่อนและระบบทางเดินอาหาร

700 บาท (ราคา)

7. NSE, or neuron-specific enolase

Marker for lung cancer – มะเร็งปอด

1,500 บาท (ราคา)

8. the H. pylori test, or helicobacter pylori

A bacterium tied to stomach cancer – เชื้อที่เกี่ยวข้องกับมะเร็งกระเพาะอาหาร

800 บาท (ราคา)

9. the lymphoma panel

Screening for lymphatic cancer – มะเร็งต่อมน้ำเหลือง

5,500 บาท (ราคา)

⸻

Stool work (ตรวจจากอุจจาระ)

1. the ColoTect DNA test

A DNA-based bowel cancer screen – ตรวจ DNA มะเร็งลำไส้

6,900 บาท (ราคา)

2. the faecal occult blood plus inflammation test

Occult blood and inflammation in stool (a bowel cancer screen) – ตรวจเลือดแฝงในอุจจาระ

2,000 บาท (ราคา)
 
foana said:

A clinic in Thailand (Healthlab) quoted me for a cancer screening panel, and I'm trying to work out whether a 39 yr old male really needs the whole thing. Any advice on what's genuinely worth doing before I go deeper into peptide research?

Blood work (ตรวจจากเลือด)

1. AFP, or alpha-fetoprotein

Marker for liver cancer – มะเร็งตับ

350 บาท (ราคา)

2. CEA, or carcinoembryonic antigen

Markers for colon and digestive tract cancer – มะเร็งลำไส้และระบบทางเดินอาหาร

400 บาท (ราคา)

3. CA 125 (for women) — cancer antigen 125

Marker for ovarian cancer – มะเร็งรังไข่

700 บาท (ราคา)

4. CA 15-3 (for women) — cancer antigen 15-3

Marker for breast cancer – มะเร็งเต้านม

700 บาท (ราคา)

5. PSA (for men) — prostate specific antigen

Marker for prostate cancer – มะเร็งต่อมลูกหมาก

700 บาท (ราคา)

6. CA 19-9, or cancer antigen 19-9

Markers for pancreatic and digestive cancer – มะเร็งตับอ่อนและระบบทางเดินอาหาร

700 บาท (ราคา)

7. NSE, or neuron-specific enolase

Marker for lung cancer – มะเร็งปอด

1,500 บาท (ราคา)

8. the H. pylori test, or helicobacter pylori

A bacterium tied to stomach cancer – เชื้อที่เกี่ยวข้องกับมะเร็งกระเพาะอาหาร

800 บาท (ราคา)

9. the lymphoma panel

Screening for lymphatic cancer – มะเร็งต่อมน้ำเหลือง

5,500 บาท (ราคา)

⸻

Stool work (ตรวจจากอุจจาระ)

1. the ColoTect DNA test

A DNA-based bowel cancer screen – ตรวจ DNA มะเร็งลำไส้

6,900 บาท (ราคา)

2. the faecal occult blood plus inflammation test

Occult blood and inflammation in stool (a bowel cancer screen) – ตรวจเลือดแฝงในอุจจาระ

2,000 บาท (ราคา)
Click to expand...
I wish I could assist, but this might be better handled by someone with a different expertise. Wishing you the best as you look into things further!
 
The single largest downside of broad screening panels is false positives — and that risk is especially pronounced at 39, when the odds of a genuine positive are extremely small. The same reasoning applies to whole-body CT or MRI. Generally speaking, cancer becomes far more frequent as people get older, aside from a handful of exceptions, with incidence climbing every additional decade from roughly 50 through 90.

Suppose a test has a 1% false positive rate — that would actually be outstanding, better than most — and your real likelihood of cancer is 1 in 10,000. In that scenario, for every 1 genuine positive you would see 100 false positives. So if you received a positive result, the overwhelmingly probable explanation is that you do not have cancer at all; it is simply a false positive.

On its own, that is not catastrophic. But if you are prone to anxiety — plausible, given you are contemplating these tests at your age — the strain could be substantial. Add to that the expense and worry of follow-up testing, which may even involve invasive biopsies, all to determine whether something is actually there.

For many cancers, catching and treating them early raises the odds of cure or long-term remission. That is not necessarily true across the board, and for some it is not even established. So there is a real possibility of discovering a cancer, treating it, and the only lasting difference being that you spent 10 years aware of having cancer, endured surgery, radiotherapy, chemo, or all of them, and ultimately did not live longer than if it had never been detected early.

Most men who develop the most common cancer in men end up dying with prostate cancer from another cause, not from the cancer itself. I am not claiming screening for it is unwise — only that the picture is complicated.

There is substantial money to be made screening healthy people for cancer, and that money can lead clinics to offer screening the evidence does not support. Enormous research effort goes into figuring out which screening programs, at which ages, actually make sense, and it is genuinely complex. Based on what I see in the research, there is a real possibility that large-scale metabolomic tests or circulating DNA tests, interpreted with AI, will eventually become accurate enough to be truly useful and catch most cancers early from a blood draw. But as far as I know, nothing available yet is good enough to overcome the false positive problem, which generates a great deal of extra testing and anxiety potentially for no benefit.

Some cancers are worth screening for, particularly when additional risk factors are present — skin, bowel, breast, cervical, and others. I am not up to date on current clinical practice here, so this may be incomplete, and it may vary between countries. The easiest way to learn whether you should undergo screening that has proven benefit for your age group is simply to ask your doctor.
 
Is concern what's driving this? From what you've said, it sounds like peptides are the reason.

Whether it's good or not isn't something I can say. Asking your doctor is the right move, I agree.

When I was in my twenties, strong family history led my doctor to send me for cancer screenings along with genetic testing. These days, yearly MRIs are what I'm supposed to get. At one point there was a change, and a biopsy was done on it (benign). The biopsy itself was rough, because it was MRI guided and the lido wore off partway through.

Thinking back, I know that at the time I felt relief at learning it wasn't genetic related. But honestly, my life wasn't improved or changed much by it. Had I never gone, my life would have been the same so far.
 
If you're only getting these tests because you're beginning peptide use, that seems like too much. Still, it would be wise to talk it over with your primary care physician or another medical professional. Family medical history, any symptoms you have now, and your current medical condition all ought to factor into decisions about cancer screenings.

Are you looking into glp medications, or something different? The guidance would probably be different if growth hormones are what you're considering…
 
Wow, that's quite a bit of screening! I wish I had solid advice for you, but I don't.

Is your worry about cancer due to it running in your family, because of peptide use, or are you simply after a baseline?

I understand the family history side.

Cancer tends to hit my family. My mom and every one of her sisters had died by 61, and my brother died at 60. At this stage of my life I've outlived all of them, though not by a lot.

Testing like that would make me far too anxious.

For me, where I am now, each year is extra and I've grown fairly fatalistic; when I'm called, I'll go home...in the meantime, ride on
 
lessthanhalf said:

The single largest downside of broad screening panels is false positives — and that risk is especially pronounced at 39, when the odds of a genuine positive are extremely small. The same reasoning applies to whole-body CT or MRI. Generally speaking, cancer becomes far more frequent as people get older, aside from a handful of exceptions, with incidence climbing every additional decade from roughly 50 through 90.

Suppose a test has a 1% false positive rate — that would actually be outstanding, better than most — and your real likelihood of cancer is 1 in 10,000. In that scenario, for every 1 genuine positive you would see 100 false positives. So if you received a positive result, the overwhelmingly probable explanation is that you do not have cancer at all; it is simply a false positive.

On its own, that is not catastrophic. But if you are prone to anxiety — plausible, given you are contemplating these tests at your age — the strain could be substantial. Add to that the expense and worry of follow-up testing, which may even involve invasive biopsies, all to determine whether something is actually there.

For many cancers, catching and treating them early raises the odds of cure or long-term remission. That is not necessarily true across the board, and for some it is not even established. So there is a real possibility of discovering a cancer, treating it, and the only lasting difference being that you spent 10 years aware of having cancer, endured surgery, radiotherapy, chemo, or all of them, and ultimately did not live longer than if it had never been detected early.

Most men who develop the most common cancer in men end up dying with prostate cancer from another cause, not from the cancer itself. I am not claiming screening for it is unwise — only that the picture is complicated.

There is substantial money to be made screening healthy people for cancer, and that money can lead clinics to offer screening the evidence does not support. Enormous research effort goes into figuring out which screening programs, at which ages, actually make sense, and it is genuinely complex. Based on what I see in the research, there is a real possibility that large-scale metabolomic tests or circulating DNA tests, interpreted with AI, will eventually become accurate enough to be truly useful and catch most cancers early from a blood draw. But as far as I know, nothing available yet is good enough to overcome the false positive problem, which generates a great deal of extra testing and anxiety potentially for no benefit.

Some cancers are worth screening for, particularly when additional risk factors are present — skin, bowel, breast, cervical, and others. I am not up to date on current clinical practice here, so this may be incomplete, and it may vary between countries. The easiest way to learn whether you should undergo screening that has proven benefit for your age group is simply to ask your doctor.
Click to expand...
Thanks for laying that out so thoroughly. What you said makes sense.
 
myopicmystic said:

Is concern what's driving this? From what you've said, it sounds like peptides are the reason.

Whether it's good or not isn't something I can say. Asking your doctor is the right move, I agree.

When I was in my twenties, strong family history led my doctor to send me for cancer screenings along with genetic testing. These days, yearly MRIs are what I'm supposed to get. At one point there was a change, and a biopsy was done on it (benign). The biopsy itself was rough, because it was MRI guided and the lido wore off partway through.

Thinking back, I know that at the time I felt relief at learning it wasn't genetic related. But honestly, my life wasn't improved or changed much by it. Had I never gone, my life would have been the same so far.
Click to expand...
Peptides are the sole reason for this. I have no symptoms that point to cancer, and I'm in good health.
 
Grogu said:

If you're only getting these tests because you're beginning peptide use, that seems like too much. Still, it would be wise to talk it over with your primary care physician or another medical professional. Family medical history, any symptoms you have now, and your current medical condition all ought to factor into decisions about cancer screenings.

Are you looking into glp medications, or something different? The guidance would probably be different if growth hormones are what you're considering…
Click to expand...
I'm certainly going to move forward with growth hormones. When I talked to the clinic, peptides were the main thing I brought up. They came back with this list and a price quote. To be honest, it does feel like too much, so I'm leaning toward just getting a standard blood panel that checks vitamins, hormones and how my organs are working.
 
FarmgirlRebel said:

Wow, that's quite a bit of screening! I wish I had solid advice for you, but I don't.

Is your worry about cancer due to it running in your family, because of peptide use, or are you simply after a baseline?

I understand the family history side.

Cancer tends to hit my family. My mom and every one of her sisters had died by 61, and my brother died at 60. At this stage of my life I've outlived all of them, though not by a lot.

Testing like that would make me far too anxious.

For me, where I am now, each year is extra and I've grown fairly fatalistic; when I'm called, I'll go home...in the meantime, ride on
Click to expand...
Sure, having a baseline might ease my mind a bit, but I can't really push back against lessthanhalf's solid point about false positives when you're young.

As far as I know, there's no cancer in my family history. I think what's really worrying me is the warnings tied to GH related peptides.

Thanks to everyone for the responses.
 
I didn't mean to suggest that screening as a whole is worthless. The same problems I raised earlier still hold, but at least for the tests below there's proof of a benefit in overall survival. Whether that benefit justifies the expense, worry, and procedures is usually something each person has to weigh for themselves.

I'm not sure which country you're in — your profile says thailand, though I can't tell whether that's where you live permanently. Take the US as an illustration: screening programs there for men (and separate ones for women) are established and shown to improve outcomes for colorectal cancer beginning at 45, for lung cancer in smokers beginning at 50, and for prostate cancer beginning at 50 — although with prostate cancer the screening benefit is less clear — and sometimes for skin cancer, depending on where you are and what your risks are.
 
foana said:

Grogu said:

If you're only getting these tests because you're beginning peptide use, that seems like too much. Still, it would be wise to talk it over with your primary care physician or another medical professional. Family medical history, any symptoms you have now, and your current medical condition all ought to factor into decisions about cancer screenings.

Are you looking into glp medications, or something different? The guidance would probably be different if growth hormones are what you're considering…
Click to expand...
I'm certainly going to move forward with growth hormones. When I talked to the clinic, peptides were the main thing I brought up. They came back with this list and a price quote. To be honest, it does feel like too much, so I'm leaning toward just getting a standard blood panel that checks vitamins, hormones and how my organs are working.
Click to expand...

Since it seemed likely that HGH or other secretagogues were being considered, a smarter approach than running the full slate of cancer screenings might be to first establish where your overall health stands using blood work plus a physical exam. For example:

IGF-1

IGFBP-3

Fasting glucose

Hemoglobin A1c

Fasting insulin

Comprehensive metabolic panel (CMP)

Thyroid panel (TSH, Free T4, Free T3)

Lipid panel

ACTH

Morning cortisol

Prolactin

LH

FSH

Total testosterone

Estradiol

Complete blood count (CBC)

PSA (as appropriate)

Vitamin D

C-reactive protein (CRP)

Ferritin / iron panel
 
Grogu said:


I had a feeling that HGH or other secretagogues were on the table, so rather than all those cancer screenings, getting a baseline of your overall health through blood tests and a physical would probably be a better idea. Like these tests:

IGF-1

IGFBP-3

Fasting glucose

Hemoglobin A1c

Fasting insulin

Comprehensive metabolic panel (CMP)

Thyroid panel (TSH, Free T4, Free T3)

Lipid panel

ACTH

Morning cortisol

Prolactin

LH

FSH

Total testosterone

Estradiol

Complete blood count (CBC)

PSA (as appropriate)

Vitamin D

C-reactive protein (CRP)

Ferritin / iron panel

Click to expand...
Click to expand...
Appreciate it — many of those were already on my list, so this really helps
 
lessthanhalf said:

The single largest downside of broad screening panels is false positives — and that risk is especially pronounced at 39, when the odds of a genuine positive are extremely small. The same reasoning applies to whole-body CT or MRI. Generally speaking, cancer becomes far more frequent as people get older, aside from a handful of exceptions, with incidence climbing every additional decade from roughly 50 through 90.

Suppose a test has a 1% false positive rate — that would actually be outstanding, better than most — and your real likelihood of cancer is 1 in 10,000. In that scenario, for every 1 genuine positive you would see 100 false positives. So if you received a positive result, the overwhelmingly probable explanation is that you do not have cancer at all; it is simply a false positive.

On its own, that is not catastrophic. But if you are prone to anxiety — plausible, given you are contemplating these tests at your age — the strain could be substantial. Add to that the expense and worry of follow-up testing, which may even involve invasive biopsies, all to determine whether something is actually there.

For many cancers, catching and treating them early raises the odds of cure or long-term remission. That is not necessarily true across the board, and for some it is not even established. So there is a real possibility of discovering a cancer, treating it, and the only lasting difference being that you spent 10 years aware of having cancer, endured surgery, radiotherapy, chemo, or all of them, and ultimately did not live longer than if it had never been detected early.

Most men who develop the most common cancer in men end up dying with prostate cancer from another cause, not from the cancer itself. I am not claiming screening for it is unwise — only that the picture is complicated.

There is substantial money to be made screening healthy people for cancer, and that money can lead clinics to offer screening the evidence does not support. Enormous research effort goes into figuring out which screening programs, at which ages, actually make sense, and it is genuinely complex. Based on what I see in the research, there is a real possibility that large-scale metabolomic tests or circulating DNA tests, interpreted with AI, will eventually become accurate enough to be truly useful and catch most cancers early from a blood draw. But as far as I know, nothing available yet is good enough to overcome the false positive problem, which generates a great deal of extra testing and anxiety potentially for no benefit.

Some cancers are worth screening for, particularly when additional risk factors are present — skin, bowel, breast, cervical, and others. I am not up to date on current clinical practice here, so this may be incomplete, and it may vary between countries. The easiest way to learn whether you should undergo screening that has proven benefit for your age group is simply to ask your doctor.
Click to expand...
That was a really solid, well-informed reply. We may not see eye to eye on other topics, but on this one you made your point perfectly.

The one thing I'd tack on: broader screening is probably a major factor behind the improved cancer survival numbers we see these days. When a clinic picks up a false positive and then "cures" that person, those patients tend to show quite favorable 5-year cancer survival rates (since cancer was never actually present to begin with). Because of that, the same cancer treatment program can then claim its 5-year survival rates beat the ones from earlier eras (back when cancer was typically found only at advanced stages).
 
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