Whole Body Cancer Screening – Male (Rs 75, 000)
Chest Xray| Carcinoembryonic antigen (CEA)| Full Blood Count (FBC)| PSMA Scan| Low Dose CT| Prostate-Specific Antigen (PSA)| Cancer Antigen (CA 19-9)| Gastroscopy| Colonoscopy| Alpha-fetoprotein (AFP)| Liver Function Test (LFT)| Consultation

Male Whole Body Screening

Male whole body screening is vital for cancer detection because it allows early identification of potential risks and abnormalities, increasing the chances of successful treatment and improving overall health outcomes.

Chest X-ray

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.

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Most commonly, CEA tests involve taking a blood sample, a simple procedure where blood is withdrawn from one of your veins via a needle into a syringe or test tube.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.

Prostate Specific Membrane Antigen (PSMA) PET SCAN

PSMA-PET scans are the most sensitive scans available for detection prostate tumours. This means that they are able to see small tumours where other types of scans miss them.

Australia is a world-leader in PSMA-PET scans. Unlike most other countries, PSMA-PET scans are commonly used by Australian men with recurrent prostate cancer. These scans can also be used by men who have been diagnosed with high-risk or metastatic prostate cancer.

The long name of this scan is gallium-68 PSMA PET-CT. There are two parts to the scan – an x-ray component (CT) and a PET scan.

CT scan: The CT scan uses x-rays taken in different directions to make a 3D image of the body.

PSMA-PET scan: PET scans use a radioactive dye to light up specific regions in the body. PSMA-PET scans look for areas of the body where the PSMA protein is found, showing the presence of prostate cancer cells. PSMA stands for prostate specific membrane antigen –  a protein found on the surface of prostate cancer cells. Gallium-68 refers to the radioactive part of the PET scan.

By combining the results from the CT and PET scans into one image, we can see the location of prostate tumours in the body.

When are PSMA-PET scans currently used?

These scans are used by some men with prostate cancer, despite being expensive.

They are useful for men:

⦁ who have been treated for localised prostate cancer but their PSA is rising (recurrent prostate cancer)
⦁ who have metastatic prostate cancer at the time of diagnosis
⦁ who are diagnosed with high-risk prostate cancer that appears localised (no tumours see in CT or bone scans).

Low Dose CT scan (LDCT)

A low-dose CT scan is a special kind of X-ray that takes multiple pictures as you lie on a table that slides in and out of the machine. A computer then combines these images into a detailed picture of your lungs.
A study on early detection of lung cancer found that the low-dose cancer screening test can reduce mortality for those at high risk.

Doctors use a low-dose computerized tomography (LDCT) scan of the lungs to look for lung cancer. If lung cancer is detected at an early stage, it’s more likely to be cured with treatment.

By the time lung cancer signs and symptoms develop, the cancer is usually too advanced for curative treatment. Studies show lung cancer screening reduces the risk of dying of lung cancer.

Prostate-Specific Antigen (PSA) test

The PSA test is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It’s normal to have a small amount of PSA in your blood, and the amount rises slightly as you get older and your prostate gets bigger. A raised PSA level may suggest you have a problem with your prostate, but not necessarily cancer.

What could affect the PSA level?

Prostate specific antigen (PSA) is produced by healthy cells in the prostate, so it’s normal to have a small amount of PSA in your blood. The amount rises as you get older because your prostate gets bigger.
Prostate problems, such as an enlarged prostate, prostatitis or prostate cancer, can cause your PSA level to rise – but lots of other things can affect your PSA level too, including the following.

⦁ A urine infection – You may have a test for a urine infection as this can raise your PSA level. If you have an infection, you’ll be given treatment for this. You’ll need to wait until the infection has gone – around six weeks – before you have a PSA test.

⦁ Vigorous exercise – You might be asked not to do any vigorous exercise in the 48 hours before a PSA test.

⦁ Ejaculation – You may be asked to avoid any sexual activity that leads to ejaculation in the 48 hours before a PSA test.

⦁ Anal sex and prostate stimulation – Receiving anal sex, or having your prostate stimulated during sex, might raise your PSA level for a while. It might be worth avoiding this for a week before a PSA test.

⦁ Prostate biopsy – If you’ve had a biopsy in the six weeks before a PSA test, this could raise your PSA level.

⦁ Medicines – Let your GP or practice nurse know if you’re taking any prescription or over-the-counter medicines, as some might affect your PSA level. For example, some medicines used to treat an enlarged prostate, known as 5-alpha-reductase inhibitors such as finasteride (Proscar®) or dutasteride (Avodart®), can reduce your PSA level and give a false test result.

⦁ Other tests or surgery – If you’ve had any tests or surgery on your bladder or prostate, you may need to wait up to six weeks before having a PSA test.

⦁ Urinary catheters – If you have a catheter to drain urine from your bladder, you may need to wait up to six weeks after it has been put in before having a PSA test.

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.

Gastroscopy

What is a gastroscopy ?

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?

1. 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.

2. During the procedure

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.

3. 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 of Colonoscopy

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.