Whole Body Cancer Screening – Female (Rs 125, 000)
Chest Xray| Carcinoembryonic antigen (CEA)| Full Blood Count (FBC)| Mammography| Cancer Antigen (CA 15-3)| BRCA1 & BRCA2| Pap Smear| Cancer Antigen (CA 125)| Cancer Antigen (CA 19-9)| PET Scan| Gastroscopy| Colonoscopy| Alpha-fetoprotein (AFP)| Liver Function Test (LFT)| Consultation
| Age Group (yrs) | Frequency |
| Above 40 | Every 3 years |
Chest X-ray For Female
Chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-ray produces images of the heart, lungs, airways, blood vessels and the bones of the spine and chest for both female and male.
An x-ray (radiograph) is a non-invasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging to detect any lung pathologies.
Carcinoembryonic antigen (CEA) Test
A CEA test measures the level of carcinoembryonic antigen (CEA) in your blood or other body fluid, as an indicator of whether cancer is growing and spreading or diminishing with treatment. You may be tested before treatment to set a baseline level, then again during and after treatment.
What is CEA?
While in the uterus, an unborn baby produces CEA, but healthy adults produce little or none of this protein. Smokers may have elevated levels, as well as people with cancer.
Most commonly, CEA tests involve taking a blood sample, a simple procedure where blood is withdrawn from one of your veins via a needle into a syringe or test tube. Less often, fluid may be collected from other parts of your body, depending upon the type of cancer and where a tumor may be located. Fluid may be extracted from along the peritoneum, the pleural space surrounding your lungs, or next to your spinal cord.
A blood test requires no preparation on your part. You may experience slight discomfort from the needle and soreness and bruising afterward. Before both the spinal and abdominal procedures, you may be asked to go to the bathroom. The cerebrospinal fluid test may cause soreness and pain in the back, where the needle was inserted, and occasionally a headache afterward. Although generally considered safe, both the abdominal and pleural fluid tests carry a small risk of tissue damage and infection—as well as possible blood loss for the pleural test.
Full Blood Count (FBC)
A full blood count (FBC) is a common blood test that your doctor may recommend to:
⦁ Help diagnose some blood cancers, such as leukemia and lymphoma
⦁ Find out if cancer has spread to the bone marrow
⦁ See how a person’s body is handling cancer treatment
⦁ Diagnose other, noncancerous conditions
A FBC measures the amount of 3 types of cells in your blood:
⦁ White blood cell count. A white blood cell count, also called a leukocyte count, measures the total number of white blood cells in a sample of blood. These cells protect the body from infection by attacking invading bacteria, viruses, and other foreign materials in the body. Some white blood cells can also attack cancer cells.
⦁ White blood cell differential. A white blood cell differential measures the number of each type of white blood cell. There are 5 major types of white blood cells, and each type plays a different role in protecting the body. Your doctor can learn valuable information about your health by measuring the levels of these cells:
⦁ Neutrophils
⦁ Lymphocytes
⦁ Monocytes
⦁ Eosinophils
⦁ Basophils
⦁ Red blood cell count. Red blood cells carry oxygen throughout your body. A red blood cell count, also called an erythrocyte count, measures the number of red blood cells in a sample of blood. There are several ways to measure red blood cells. Two of the most common are:
⦁ Hematocrit (Hct), the percentage of your blood that is made up of red blood cells
⦁ Hemoglobin (Hgb), the amount of the protein in red blood cells that carries oxygen
⦁ Platelet count. A platelet count measures the number of platelets in a sample of blood. Platelets help to stop bleeding by forming blood clots.
The amounts of each of these types of cells have a normal range. Your health care team will note this range on your FBC lab results. A range is used instead of a specific number because a normal amount is different for each person.
Mammogram
Mammography is an x-ray that checks for breast cancer in women. The images that it produces are called mammograms. These images may show small tumors that cannot be felt. Mammograms may also show other irregularities in the breast.
To prepare for your mammogram:
⦁ Consider scheduling the test within the 2 weeks after your menstrual period ends. Women’s breasts are least tender during this time.
⦁ Discuss any breast symptoms you are experiencing. Mention if you are pregnant or breastfeeding. In both cases, your doctor will probably recommend postponing this test.
⦁ Avoiding caffeine for a week before the test
⦁ Taking an over-the-counter pain medication on the test day
⦁ Don’t use deodorant, antiperspirant, powder, lotion or perfume before your mammogram as they leave residue on the skin that could create spots on the x-ray.
⦁ Tell the technologist if you have:
⦁ Breast implants
⦁ Previous breast surgery (You may be asked to point out any scars.)
⦁ Any area of concern in your breast
This helps the technologist better perform the mammogram. And it helps the radiologist read your mammogram more accurately.
If you had previous breast surgery, the technologist may tape small markers to your skin at the scar site. This will show the radiologist where you have the highest risk of recurrence.
If you have had a mammogram before, bring copies of the images to share with the radiologist
During the test
⦁ At the testing facility, you’re given a gown and asked to remove neck jewellery and clothing from the waist up. To make this easier, wear a two-piece outfit that day.
⦁ For the procedure itself, you stand in front of an X-ray machine specially designed for mammography. The technician places one of your breasts on a platform and raises or lowers the platform to match your height. The technician helps you position your head, arms and torso to allow an unobstructed view of your breast.
⦁ Your breast is gradually pressed against the platform by a clear plastic plate. Pressure is applied for a few seconds to spread out the breast tissue. The pressure isn’t harmful, but you may find it uncomfortable or even painful. If you have too much discomfort, tell the technician.
⦁ Your breast must be compressed to even out its thickness and permit the X-rays to penetrate the breast tissue. The pressure also holds your breast still to decrease blurring from movement and minimizes the dose of radiation needed. During the brief X-ray exposure, you’ll be asked to stand still and hold your breath.
After the test
⦁ After images are made of both your breasts, you may be asked to wait while the technician checks the quality of the images.
⦁ If the views are inadequate for technical reasons, you may have to repeat part of the test. The entire procedure usually takes less than 30 minutes.
⦁ Afterward, you may dress and resume normal activity.
Cancer Antigen (CA 15-3)
Cancer antigen 15-3 (CA 15-3) is a protein made by a variety of cells, particularly breast cancer cells. The protein moves into the blood, where it can be measured.
CA 15-3 levels are higher than normal in most women with breast cancer that has spread to other parts of the body (called metastatic breast cancer). Not all types of breast cancer will cause CA 15-3 levels to rise, as some types of cancer cells don’t over-produce the antigen.
CA 15-3 is a tumour marker. It is used to check how breast cancer treatment is working and look for cancer that has come back, or recurred after treatment.
CA 15-3 is not measured for early stage breast cancer because the levels of this protein are rarely higher than normal at this stage.
BRCA Genetic Test for Female
A BRCA genetic test looks for changes, known as mutations, in genes called BRCA1 and BRCA2. Genes are parts of DNA passed down from your mother and father. They carry information that determine your unique traits, such as height and eye colour. Genes are also responsible for certain health conditions. BRCA1 and BRCA2 are genes that protect cells by making proteins that help prevent tumors from forming.
A mutation in a BRCA1 or BRCA2 gene can cause cell damage that may lead to cancer.
Women with a mutated BRCA gene have a higher risk of getting breast or ovarian cancer.
Men with a mutated BRCA gene are at a higher risk for getting breast or prostate cancer.
Not everyone who inherits a BRCA1 or BRCA2 mutation will get cancer. Other factors, including your lifestyle and environment, can affect your cancer risk.
If you find out you have a BRCA mutation, you may be able to take steps to protect your health.
What is it used for?
This test is used to find out if you have BRCA1 or BRCA2 gene mutation. A BRCA gene mutation can increase your risk of getting cancer.
Why does one need a BRCA genetic test?
BRCA testing is not recommended for most people. But you may want this test if you think you are at a higher risk of having the mutation. You are more likely to have a BRCA mutation if you:
⦁ Have or had breast cancer that was diagnosed before age 50
⦁ Have or had breast cancer in both breasts
⦁ Have or had both breast and ovarian cancer
⦁ Have one or more family members with breast cancer
⦁ Have a male relative with breast cancer
⦁ Have a relative already diagnosed with a BRCA mutation
The test checks for the three most common BRCA mutations. But there are more than 1000 BRCA mutations, so a negative result may not rule out an increased risk of cancer.
What happens during a BRCA genetic test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Will I need to do anything to prepare for the test?
You don’t need any special preparations for BRCA testing. But you may want to meet with our consultant first to see if the test is right for you. Our consultant may talk with you about the risks and benefits of genetic testing and what different results can mean.
You should also think about getting genetic counselling after your test. Our consultant can discuss how your results may impact you and your family, both medically and emotionally.
Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
What do the results mean?
Most results are described as negative, uncertain, or positive, and typically mean the following:
⦁ A negative result means no BRCA gene mutation was found, but it doesn’t mean you won’t ever get cancer.
⦁ An uncertain result means some kind of BRCA gene mutation was found, but it may or may not be linked with an increased cancer risk. You may need more tests and/or monitoring if your results were uncertain.
⦁ A positive result means a mutation in BRCA1 or BRCA2 was found. These mutations put you at a higher risk of getting cancer. But not everyone with the mutation gets cancer.
It may take several weeks to get your results. If you have questions about your results, talk to your health care provider.
Is there anything else I need to know about a BRCA genetic test?
If your results show you have a BRCA gene mutation, you can take steps that may lower your risk of breast cancer.
These include:
⦁ More frequent cancer screening tests, such as mammograms and ultrasounds. Cancer is easier to treat when it’s found in the early stages.
⦁ Taking birth control pills for a limited time. Taking birth control pills for a maximum of five years has been shown to reduce the risk of ovarian cancer in some women with BRCA gene mutations. Taking the pills for more than five years to reduce cancer is not recommended. If you were taking birth control pills before you took the BRCA test, tell your health care provider how old you were when you started taking the pills and for how long. He or she will then recommend whether or not you should continue taking them.
⦁ Taking cancer-fighting medicines. Certain drugs, such as one called tamoxifen, have been shown to reduce the risk in women with a higher risk of breast cancer.
⦁ Having surgery, known as a preventive mastectomy, to remove healthy breast tissue. Preventive mastectomy has been shown to reduce breast cancer risk by as much as 90 percent in women with a BRCA gene mutation. But this is a major operation, only recommended for women at very high risk for getting cancer.
You should talk with your health care provider to see what steps are best for you.
Pap Smear Test
Screening tests can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer. Most guidelines suggest beginning screening for cervical cancer and precancerous changes at age 21.
A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase the risk of cervical cancer.
Pap test. During a Pap test, your doctor scrapes and brushes cells from your cervix, which are then examined in a lab for abnormalities.
HPV DNA test. The HPV DNA test involves testing cells collected from the cervix for infection with any of the types of HPV that are most likely to lead to cervical cancer.
Preparing for your appointment
Make an appointment with your doctor if you have any signs or symptoms that worry you.
What you can do
⦁ Be aware of any pre-appointment restrictions, such as not eating solid food on the day before your appointment.
⦁ Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.
⦁ Write down your key medical information, including other conditions.
⦁ Write down key personal information, including anything that increases your risk of STIs, such as early sexual activity, multiple partners or unprotected sex.
⦁ Make a list of all your medications, vitamins or supplements.
Cancer antigen 125 (CA125)
Cancer antigen 125 (CA125) is a protein found on most ovarian cancer cells that is secreted into the blood stream and can be measured. CA125 can also be found on other normal and cancerous cells in the body.
A CA125 test may be done:
⦁ if the doctor suspects there may be cancer
⦁ to find out if cancer treatment is working
⦁ to find out if cancer has come back (recurred) after treatment
This test is not recommended as a screening test for ovarian cancer because CA125 can be normal in many women with early-stage ovarian cancer and it may be higher than normal in non-cancerous (benign) conditions and other cancers.
How is a CA125 test done?
A CA125 test is a blood test that measures the amount of CA125 protein in the blood. A sample of blood is taken by inserting a needle into the vein in your arm. No special preparation is needed.
What the results mean?
An increased CA125 value can occur in both cancers and non-cancerous conditions.
Cancers
The CA125 blood levels can be increased in ovarian cancer and other cancers including:
⦁ uterine
⦁ fallopian tube
⦁ pancreatic
⦁ breast
⦁ colorectal
⦁ lung
⦁ stomach
A decrease in the CA125 level during treatment usually means that the cancer is responding to treatment.
If the CA125 level stays the same or rises during treatment, it may mean that the cancer is not responding to treatment.
A high CA125 level after treatment is complete may mean that the cancer has come back (recurred).
Non-cancerous conditions
The CA125 blood level may be increased in non-cancerous conditions including:
⦁ menstruation
⦁ pregnancy
⦁ endometriosis
⦁ pelvic inflammatory disease
⦁ non-cancerous ovarian cysts
⦁ uterine fibroids
What happens if the result is abnormal?
The doctor will decide whether further tests, procedures, follow-up care or additional treatment are needed.
CA 19-9 Test
What is a CA 19-9 test?
This test measures the amount of a protein called CA 19-9 (cancer antigen 19-9) in the blood. CA 19-9 is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body.
Healthy people can have small amounts of CA 19-9 in their blood. High levels of CA 19-9 are often a sign of pancreatic cancer. But sometimes, high levels can indicate other types of cancer or certain noncancerous disorders, including cirrhosis and gallstones.
Because high levels of CA 19-9 can mean different things, the test is not used by itself to screen for or diagnose cancer.
It can help monitor the progress of your cancer and the effectiveness of cancer treatment.
What is it used for?
A CA 19-9 test may be used to:
⦁ Monitor pancreatic cancer and cancer treatment. CA 19-9 levels often go up as cancer spreads, and go down as tumors shrink.
⦁ See if cancer has returned after treatment.
The test is sometimes used with other tests to help confirm or rule out cancer.
Why do I need a CA 19-9 test?
You may need a CA 19-9 blood test if you’ve been diagnosed with pancreatic cancer or other type of cancer related to high levels of CA 19-9. These cancers include bile duct cancer, colon cancer, and stomach cancer.
Your health care provider may test you on a regular basis to see if your cancer treatment is working. You may also be tested after your treatment is complete to see if the cancer has come back.
What happens during a CA 19-9 test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Will I need to do anything to prepare for the test?
You don’t need any special preparations for a CA 19-9 blood test.
Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
What do the results mean?
If you are being treated for pancreatic cancer or other type of cancer, you may be tested several times throughout your treatment. After repeated tests, your results may show:
⦁ Your levels of CA 19-9 are increasing. This may mean your tumor is growing, and/or your treatment is not working.
⦁ Your levels of CA 19-9 are decreasing. This may mean your tumor is shrinking and your treatment is working.
⦁ Your levels of CA 19-9 have not increased or decreased. This may mean your disease is stable.
⦁ Your CA 19-9 levels decreased, but then later increased. This may mean your cancer has come back after you’ve been treated.
If you do not have cancer and your results show a higher than normal level of CA 19-9, it may be a sign of one of the following noncancerous disorders:
⦁ Pancreatitis, a noncancerous swelling of the pancreas
⦁ Gallstones
⦁ Bile duct blockage
⦁ Liver disease
⦁ Cystic fibrosis
If your health care provider suspects you have one of these disorders, he or she will probably order more tests to confirm or rule out a diagnosis.
Positron Emission Tomography (PET) Scan
PET scan is a type of test that create 3 dimensional (3D) pictures of the inside of your body.
The PET scan uses a mildly radioactive drug to show up areas of your body where cells are more active than normal. It’s used to help diagnose some conditions including cancer. It can also help to find out where and whether cancer has spread.
It usually takes between 45 and 60 minutes. You will be in the department for at least an hour beforehand. This is because you have an injection of a radioactive liquid (radiotracer) before the scan.
PET scans are often combined with CT scans to produce more detailed images. These are called PET-CT scans.
A PET scan can help to:
⦁ show up a cancer
⦁ find out how big it is and whether it has spread (stage a cancer)
⦁ show whether a lump is cancer or not
⦁ decide the best treatment for your cancer
⦁ show how well a treatment is working
After you have had treatment for cancer, a CT scan may show that there are still some signs of the cancer left. But this may not be active disease. It could be scar tissue left over from cancer killed off by your treatment. A PET scan can show whether this tissue is active cancer or not.
PET scans are sometimes used to look for cancer in the lymph nodes in the centre of the chest.
Preparing for your PET scan
For most PET scans, you need to stop eating for about 4 to 6 hours beforehand. You can usually drink unflavoured water during this time.
You might have instructions not to do any strenuous exercise for between 12 and 24 hours before the scan.
Call the number on your appointment letter if not eating is a problem for you, for example if you’re diabetic. You might need to adapt your diet and sugar control and your appointment time could change.
Some people feel claustrophobic when they‘re having a scan. Contact the department staff before your test if you’re likely to feel like this. They can take extra care to make sure you’re comfortable and that you understand what’s going on. Your doctor can arrange to give you medicine to help you relax, if needed.
At the hospital
Your radiographer might ask you to change into a hospital gown. You have to remove any jewellery and other metal objects such as hair clips, coins, belts and a wired bra. Metal interferes with the images created by the scanner.
You have an injection of radiotracer about an hour before the scan. You have the injection through a small plastic tube in your arm (cannula). It’s only a small amount of radiation.
You need to rest and avoid moving too much during this hour. This allows the radiotracer to spread through your body and into your tissues.
The radiotracer is a radioactive sugar. The one commonly used is called FDG (fluorodeoxyglucose). Cancer cells are very active when they are growing and reproducing in a specific area. They need energy to grow. So, active cancer cells take up the FDG which then shows up brighter on the scan.
In the scanning room
Your radiographer takes you into the scanning room. The PET machine is large and shaped like a doughnut.
You have most scans lying down on the machine couch on your back.
Once you’re in the right position, your radiographer leaves the room. They can see you on a TV screen or through a window from the control room. You can talk to each other through an intercom.
Having the PET scan
The couch slowly slides backwards and forwards through the scanner. The machine takes pictures as you move through it.
The scan is painless but can be uncomfortable because you have to stay still. Tell your radiographer if you’re getting stiff and need to move.
It’s not particularly noisy but you’ll hear a constant background noise. In most places the radiographer will be able to play music for you.
When it’s over, your radiographer will come back into the room and lower the couch so you can get up.
After your PET scan
Your radiographer removes the cannula from your arm before you go home.
You can then eat and drink normally.
The radiation in the radioactive tracer is very small. Drinking plenty of fluids after your scan helps to flush the radiotracer out of your system.
The radioactive tracer gives off very small levels of radiation that go away very quickly. As a precaution, you should avoid close contact with pregnant women, babies and young children for 6 hours after the scan.
You need someone to take you home and stay overnight if you’ve had medicine to help you relax (sedative). For the next 24hours you also shouldn’t:
⦁ drive
⦁ drink alcohol
⦁ operate heavy machinery
⦁ sign any legally binding documents
Most airports have sensitive radiation monitors, which may pick up the trace of radiation following your test. If traveling abroad within a week of your scan, it’s a good idea to take your appointment letter with you.
Possible risks
A PET scan is a safe test for most people. But like all medical tests it has some risks. Your doctor and radiographer make sure the benefits of having the test outweigh these risks.
Pregnancy
Pregnant women should only have the scan in an emergency. There’s a risk that the radiation could harm the developing baby. Contact the department beforehand if you’re or think you might be pregnant.
Breastfeeding
If you’re breastfeeding, let the department know a few days before your appointment. They will let you know if you need to stop breastfeeding for a length of time after having the radioactive drug. You might need to store enough expressed milk for at least one feed.
Radiation
Exposure to radiation from the radiotracer during a PET scan slightly increases your risk of developing cancer in the future. Talk to your doctor if this worries you.
Bruising and swelling
You might get a small bruise around the area where they put the needle in. There’s is a risk that the radioactive tracer will leak outside the vein. This can cause swelling and pain in your arm but it’s rare.
Allergic reaction
Rarely, people have an allergic reaction to the radioactive tracer. This most often starts with weakness, sweating and difficulty breathing. Tell your radiographer immediately if you feel unwell.
Getting your results
Your scan will be looked at by a specialist doctor and you should get your results within 48 hours. You won’t get any results at the time of the scan.
Waiting for results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact them if you haven’t heard anything after 48 hours.
Gastroscopy for Female
A gastroscopy is a test that looks at the inside of your food pipe (oesophagus), stomach and the first part of your small intestine (small bowel).
A doctor or specialist nurse (endoscopist) does the test. They use a long flexible tube which has a tiny camera and light at the end. This tube is called a gastroscope or endoscope.
You may also hear this test called an oesophagho gastric duodenoscopy (OGD).
Why you might have a gastroscopy
You might have a gastroscopy to find out the cause of symptoms such as:
⦁ abnormal bleeding
⦁ indigestion
⦁ low levels of iron (iron deficiency anaemia)
⦁ difficulty swallowing
How you have a gastroscopy for Female?
Preparing for your test
You might have blood tests beforehand to check your blood levels and how well your blood clots.
Tell your doctor if you’re taking medicines to thin your blood such as warfarin.
Your doctor will tell you if you need to stop taking these or any other medicines for a while before your gastroscopy.
You can’t eat for 6 hours before the test, but you might be able to drink sips of water up to 2 hours beforehand. Your doctor or nurse gives you written instructions about this before your appointment.
Talk to your doctor if not eating could be a problem for you. For example, if you have diabetes.
What happens?
Most people have a gastroscopy as an outpatient, which means you go home the same day. The test takes up to 15 minutes. But expect to be in the hospital for several hours.
First you meet your nurse who asks you about your medical history and any allergies you might have. They may check your blood pressure and heart rate.
Your nurse or endoscopist explains the procedure and asks you to sign a consent form. This is a good time to ask any questions you might have.
Some endoscopy units may ask you to change into a hospital gown, but you can usually have the test in your own clothes.
Usually, you’re awake when you have the test, but you can choose to have medicine to relax you. These make you drowsy (sedation).
If you have any false teeth or wear glasses you need to remove them for the test. Your nurse puts a plastic guard in your mouth to protect your teeth from the gastroscope.
Having the test awake
- Your endoscopist sprays the back of your throat with local anaesthetic to numb it and make it easier to swallow the tube. This may make you cough; your eyes may water and it may taste bitter.
- You then lie on your left side.
- It takes a few minutes for your throat to go numb. Your endoscopist passes the gastroscope into your mouth and down your throat to the oesophagus. The tube is slightly bigger than a pen and will be uncomfortable but shouldn’t be painful.
- They ask you to swallow as the tube goes down. They can see the images from the gastroscope on a television screen. They may put a small amount of air into the tube to help them see your oesophagus, stomach and duodenum. This might make you feel like burping.
- Your endoscopist takes samples (biopsies) through the gastroscope of any abnormal areas. This shouldn’t be painful.
At the end of the test, your endoscopist gently removes the gastroscope.
Having the test while drowsy
- You lie down on the couch.
- Your nurse puts a small plastic tube (a cannula) into a vein in your arm. They then inject the sedative into the cannula. It takes a few minutes for you to get more relaxed, this makes you drowsy. You are still able to follow instructions from your endoscopist and nurse.
- They give you oxygen through a small plastic tube with prongs that sit just inside your nostrils. They also put a clip on your finger to check your oxygen levels and heart rate.
- Your endoscopist then passes the gastroscope down your throat.
After your test
Your nurse or endoscopist will talk to you about how the test went, if they took any biopsies and when to expect the results.
You might have some bloating and discomfort lasting a few hours after the gastroscopy.
If you haven’t had sedation, you can usually go home shortly after having the test. You won’t be able to eat or drink until the local anaesthetic spray has worn off. This takes about an hour.
If you had sedation, you stay in the endoscopy unit for an hour or two to recover. You may not remember much (if anything) about the test. You’ll need a friend or relative to take you home and stay overnight.
For 24 hours after having sedation, you shouldn’t:
⦁ drive
⦁ drink alcohol
⦁ operate heavy machinery
⦁ sign any important documents
Possible risks
Gastroscopy is a very safe procedure but your nurse will tell you who to contact if you have any problems after the test. Your doctor will make sure the benefits of having a gastroscopy outweigh the possible risks.
Colonoscopy
A colonoscopy is a way for your doctor to see the entire large intestine. It can help find the cause of problems in a part of the intestine called the colon.
How a colonoscopy works
Your doctor places a thin, lighted tube through your anus and rectum up into the colon. Before the procedure, you get a sedative and pain medication to make you more comfortable. The colonoscopy tube has a small camera on it. It shows your doctor images of the inside of your colon as the tube moves through. The doctor can also take a small sample of tissue through the tube to examine later. Getting this type of sample is part of a test called a biopsy.
Who does my colonoscopy?
A doctor called a gastroenterologist, or GI doctor, usually does a colonoscopy. This type of doctor specializes in the digestive system. A surgeon may also do the procedure. Your team will also include a nurse and possibly an anesthesia specialist.
Getting ready for a colonoscopy
You will probably have your colonoscopy at a doctor’s office or hospital. Getting ready is important, because your colon needs to be as clean as possible. This will allow the doctor to see the colon well. So when you schedule your colonoscopy, you will get detailed instructions on how to prepare.
Here are some things to keep in mind:
⦁ Tell your doctor about all the medications you take, including any vitamins, herbs, or supplements. Be sure to ask if you should take them on the day of the test. If you take a blood thinner or daily aspirin, you might need to stop several days before the procedure.
⦁ Tell the doctor about any drug allergies or medical conditions you have.
⦁ You will need to avoid solid food for 1 to 3 days before the procedure. You may drink clear liquids up to a certain time. These may include fat-free bouillon or broth, black coffee, strained fruit juice, or gelatin.
⦁ You will need to take a laxative or give yourself an enema at a certain time before the colonoscopy. Your doctor’s office will tell you what to use. The laxative is a pill or a powder you mix with water before drinking. A laxative speeds up the process of waste leaving your colon and it will make you have more bowel movements than usual.
⦁ Arrange for a friend or family member to drive you home. You will be sleepy after the procedure.
⦁ You will be asked to sign a consent form before your colonoscopy. It will state that you understand the risks and benefits of the colonoscopy and agree to have it. Your doctor or nurse will explain the procedure before you sign the form, and you can ask questions.
Talk with your health care team about any concerns you have about the colonoscopy.
During the procedure
- You should expect the procedure to take about 30 to 60 minutes. When you get to the hospital or doctor’s office, you will change into a hospital gown. You will be in a private room with a sheet draped over your body.
- The nurse or anesthesia specialist will give you pain medication and a sedative. You will get this through an intravenous tube, or IV. The IV goes in a vein in your arm. You might feel a small sting from the IV needle when it goes in.
- To start the procedure, the doctor blows some air through the small tube into your colon. This inflates the colon slightly so the doctor can see better. You might need to change your position during the procedure. This is to help the doctor move the colonoscopy tube or get a better view. If you are asleep, the doctor or nurse will help with this.
- If you have an abnormal growth, or polyp, in your colon, the doctor will remove it. Or they may take a small sample of tissue. This is not usually painful, and the doctor will stop any bleeding. If the growth is too large or complicated to remove during the colonoscopy, doctors may remove it later.
- During the procedure, you may feel discomfort from lying still for a long time. If you are awake, you may have some cramps. If so, tell your nurse. You can also take slow, deep breaths to relax.
There is a small risk that the tube used for a colonoscopy might puncture the colon. This is rare, but you might need surgery to repair it if this happens. Talk with your health care team if you have concerns about this.
After the procedure
You will stay at the hospital or doctor’s office until you are fully awake. You should not drive a vehicle, operate machines, or make important decisions the rest of the day. A friend or family member can drive you home.
You can expect to go back to normal activities the next day.
Contact your doctor immediately if you have:
⦁ Severe abdominal (belly) pain
⦁ A fever
⦁ Bloody bowel movements
⦁ Dizziness
⦁ Weakness
Alpha-fetoprotein (AFP) Test
Alpha-fetoprotein (AFP) is a protein normally made by the liver and yolk sac of a developing baby. AFP levels go down soon after birth. It is not normally found in healthy adults.
Why an AFP test is done
Your doctor may order an AFP test to help diagnose, monitor response to treatment and check for recurrence of the following cancers:
⦁ a type of testicular cancer called non-seminoma germ cell tumour
⦁ a type of ovarian cancer called germ cell tumour
In rare cases an AFP test may be used to help diagnose the following cancers:
⦁ bile duct
⦁ colon
⦁ stomach
⦁ lung
⦁ breast
⦁ lymphoma
⦁ pancreas
In the past, doctors used the AFP test to help them diagnose a type of liver cancer called hepatocellular carcinoma. But the AFP test can’t specifically identify hepatocellular carcinoma, so doctors no longer use it to diagnose liver cancer. Doctors may still order an AFP test to help diagnose some liver problems such as cirrhosis and hepatitis.
How an AFP test is done
It is measured with a blood test. No special preparation is needed. The blood sample is analyzed by special machines.
What the results mean
AFP may be found in the blood if you have one of the following non-cancerous conditions:
⦁ cirrhosis
⦁ hepatitis
⦁ a rare inherited disorder called ataxia-telangiectasia
It may also suggest that a person may have a testicular or ovarian germ cell tumour.
If someone with cancer had a high AFP level before treatment, lower AFP levels may mean that the cancer has responded well to treatment. Higher AFP levels may mean that the cancer is not responding well to treatment, is still growing, or has come back (recurred). A slight increase may not be significant. The doctor looks at trends in the increase over time.
What happens if a change or abnormality is found?
The doctor will decide if more tests, procedures, follow-up care or additional treatment is needed.
Special considerations for children
Liver function tests (LFTs)
Liver function tests (LFTs) check how well your liver is working. LFTs look for levels of enzymes and proteins made by the liver, or which are cleared by the liver. They include:
⦁ alanine aminotransferase (ALT)
⦁ aspartate aminotransferase (AST)
⦁ alkaline phosphatase (ALP)
⦁ gamma-glutamyl transferase (Gamma GT)
They might be raised if you have a blockage in your liver or bile duct, or if you drink a lot of alcohol.
LFTs also look at the amount of bilirubin in the blood. This is a chemical in bile.
Bilirubin can be raised if you have a problem with your liver or gallbladder. Bilirubin can cause yellowing of your skin and eyes (jaundice).
LFTs also measure albumin. This is a protein in the blood that can be low in some types of cancer. You can also have low albumin if you’ve been eating small amounts and are malnourished.