Your column on early detection is so right on! My husband had perfectly normal blood tests and a clean physical exam on 1/13/06 and on 2/10/06 was diagnosed with advanced localized pancreatic cancer. He started not to feel great for about a week and when we were at the doctor for a problem I was having on 2/3/06, the doctor notice my husband was jaundice and sent him for some tests and our journey began. There was no way to detect this was happening. My husband has an identical twin brother and after Jacks diagnosis the surgeon who we had gone to see with the hope that his cancer had been caught early enough for the "Whipple surgery" told us to make sure his brother was checked. Unfortunately Jack is not operable at this point but we are still hopeful. It took his brother about a month to start the process and sure enough, in early May he had the "Whipple surgery" done at the Mayo Clinic in Jacksonville and is currently recovery and should be OK. He never would have known about his tumor had Jacks surgeon not said anything. He goes for regular checkups as did Jack but there was no way to test for this type of cancer. There are many cancers that can be caught with early detection and yet the insurance companies make it difficult to go for diagnostic or preventative services. I know this opens a whole other can of worms, but I know you would not be surprised that a lot of people avoid checkups, etc because of insurance issues. It is a wonderful thing that our government offers so much aid around the world and yet in our country so many people can't afford health insurance or appropriate medical care. Thankfully, we are insured and my husband is receiving wonderful care. I shudder to think what would happen to him if we did not have the insurance.

Sent by Amy Wile | 12:38 PM ET | 08-31-2006

Sorry to disagree with you, but this is too common a misconception. "Get tested, everybody!" This motto has also its undesirable effects. They are well documented in this book published by the University of California Press, Should I be Tested for Cancer? Maybe Not and Here's Why.

Thanks anyway for your blog, full of insights. Bon courage!

Sent by Garard | 3:06 PM ET | 08-31-2006

What is amazing to me is that many women don't get their annual mammograms or practice monthly breast self-exams, even at the urging of their doctors. Some women who detect a breast lump are told to wait a few months for re-evaluation. Often women who experience abdominal discomfort and bloating are thought to be experiencing women's problems and don't get the workups necessary to rule out gynecologic cancers. New research is even showing that breast cancer survivors are not doing their breast self-checks.

I think the message here is: we need to be our own advocates for health care, doctors are not infallible, denial does not serve you in the end, be in tune with your body and, as you say, don't procrastinate. Get those tests today.

Sent by Elm | 3:30 PM ET | 08-31-2006

I'm kind of a poster child for mammograms, which is ironic because I was pretty cavalier about them myself, having read the various studies suggesting that early detection doesn't necessarily equate to good outcomes, etc. To make a long story short(er), I had a routine mammogram in December 05, my first in 4 years, which found a small not too threatening cancer. THAT led my surgeon to order a breast MRI, which found the much more threatening cancer in the opposite breast, which had already spread to the nodes, and which might not have been found for a long time as it often doesn't even show up on mammograms. And though this doesn't really qualify as "caught it early" it was earlier and maybe early enough to stop it from metastizing. Hers to mammograms, diligent surgeons, and breast MRIs!

Thanks again for the blog, Leroy. Always thinking good thoughts for you.

Sent by Leigh | 3:32 PM ET | 08-31-2006

I had a little red bump on my hand that hadn't been hurting but annoyed me. I finally asked my primary care doctor about it and she sent me to the dermatologist. While that one was "only" a basal-cell carcinoma, we did a full body check — thankfully. I had a large melanoma in the middle of my back.

It's interesting that now that people know that I've had both types of cancer, I get asked to look at spots and moles on others. I rarely give advice beyond, "get yourself to the dermatologist and have him/her check it out." I'm not a doctor. I don't have that expertise. I only know what they looked like on me.

Sent by Dawn | 3:35 PM ET | 08-31-2006

I am just reaching my five year mark free of colorectal cancer. Your questions about screening everyone for CA so it would be caught early provoked this response.

I believe most people spend a lot of time thinking about being embarrassed during colonoscopy, so they procrastinate (there is also the cost). From my own experience, having a colonoscopy is no big deal. The nurses and physicians are professional and caring. I can tell you I would much rather have a colonoscopy than radiation and chemo.

Sent by Rosemarie Raedy | 4:07 PM ET | 09-01-2006

I had cancer a year ago. I think it's gone now, thankfully. It's really hard to deal with when you know it's in your body. I was constantly scared. Like a little kid outside alone on a dark night scared.

I had a tumor, which was removed. I remember waking up from the surgery thinking "good, it's gone." I didn't mind the recovery process because I wasn't scared anymore.

Sent by Dale Jorgenson | 4:15 PM ET | 09-01-2006

Well, I agree with you, of course. We all wish our cancers had been caught earlier, and I imagine we all encourage others to get tested regularly. However — sometimes the tests just don't work! Or maybe it's just human error in reading the tests. I have had yearly mammograms since my 4oth birthday, which was 21 years ago. Last August, I had a mammogram and also had a breast exam by my doctor. Supposedly, neither showed any sign of cancer. In November, I found a large lump in my breast. It was already Stage III and had spread to the lymph nodes. Obviously, that cancer had been growing there for years. Why wasn't it caught? I try not to be cynical when I hear people preach about how important tests are, but JEEZ! And now, with one breast left, I have a hard time placing much trust in my doctor's assurances that there is no sign of cancer there. I do breast self exams, but if a doctor could miss it, I'm not too confident that I'd do better!

Sent by Doris | 5:02 PM ET | 09-01-2006

The issue of insurance is very important in the early detection of cancer. Sometimes we have to be our own best advocate for the testing, and the medical insurance companies are reluctant to authorize the test needed

I cannot emphasize enough the importance of self body checkups and exams by your doctors, and they aren't always on the ball either. My thyroid cancer was discovered during a health appraisal by a nurse practitioner. When she called in her mentor MD, the MD checked me and then rather cavalierly told me that 80% of Thyroid lumps are benign and that perhaps I should check again in a year. Given the fact that on my health appraisal information sheet my father and brother both deceased due to cancer, I was incredulous! I pressed for a nuclear medicine scan to verify the lumps and a biopsy, and this MD refused!! I got the distinct impression that it was an insurance issue for the test, and I work at a HMO whose entire thrust is for preventative medicine. I work at the HMO where my insurance is, and I told the MD that I would get a physician in my department to write a referral for a scan. When the MD still hesitated, I got dressed and walked out of the exam room. Fortunately, the nurse practitioner had the good sense to grab me and handed me the referral for a scan and a biopsy.

We can talk all we want about early detection, but if we aren't able to get the medical people to listen to us and work with us, then early detection is not early detection. Sometimes we have to be almost "ugly" to get the testing done to diagnose cancer.

After my surgery and iodine therapy I totally examined my husband and sons for any lumps, spots, moles and we do this annually. I totally agree with you Leroy that once cancer is in the house that is one nasty houseguest to be rid of.

Thank you for the blog. I think of all of us cancer survivors and pray that we have "just another day" for the rest of our lives

Sent by Emily V. | 5:08 PM ET | 09-01-2006

It is hard to put yourself back into that pre-cancer state of mind that it will not happen to you. I was diagnosed at age 38 with breast cancer. I thought women in their 30s rarely got breast cancer which is certainly not the case. My doctor had recommended a baseline mammo four months prior and I told him he was making me feel old. After all, I wasn't even 40 yet! Unfortunately, my delay may be the reason the cancer spread to lymph nodes. Ill never know, but try not to beat myself up too much about it. Women who are diagnosed with breast cancer are routinely referred for a colonoscopy, no matter what age now. And in my new "enlightened" state, I am happy to have any and all diagnostic tests recommended to me. I've learned my lesson. Now knowing the colon cancer is very curable if caught early, I recommended to my 46 year old husband that he go for his first. You know, we can go together. He won't. I guess he believes it won't happen to him

Sent by June | 5:12 PM ET | 09-01-2006

I couldn't agree with you more Leroy. My husband and I have said this many, many times. I have had four cancers total including the one I have now and the only tests I've had in the past 10 years were annual chest x-rays and blood work. My doctor feels that it's not necessary to do scans and tests if there isn't a problem presenting itself. The truth be known, I know it's the insurance companies that will not pay for the preventative screenings. They only cover the most common cancers, breast, colon, and lung. I have esophageal/stomach there is not preventative screening for this so one has to look for symptoms and by that time its progressed too far. It's ridiculous to me too.

Sent by Ruth White | 5:29 PM ET | 09-01-2006

My father has had polyps removed a number of times during colonoscopies. It's routine. Turns out I had been talking to a new doctor who told me I should have my first one when I was something like 10 years younger than the age my father was for the first one. I was in my mid-thirties and was 10 years overdue. I got the colonoscopy and sure enough they took out two polyps — one would have become cancer. I've gone regularly since.

Sent by Geoff | 5:30 PM ET | 09-01-2006

Early detection, sort of an oxymoron, once the cancer is detected its already later than wed like. I had my first colonoscopy three years ago and was told no cancer, no polyps and no worries. Come back in ten years. About a year ago I started feeling a general malaise that none of my doctors could discover a cause for, my cardiologist said, "its not your heart, its actually better than it was five years ago" my endocrinologist said, "your diabetes is well controlled" my pulmonologist said," your lungs look okay but lets treat you for asthma until we find something else." My primary care doc said," lets do an old fashioned physical" and part of that is an occult blood test that came back positive, so another colonoscopy and VOILA!! I have colon cancer, A TUMOR!! A week later they removed 2 feet of my ascending colon, 17 lymph nodes and a small piece of my liver. They got all of the cancer, I hope, and now Im cancer free. I asked the doctor who did both colonoscopies how this could happen and he said "I don't know how we missed this cancer three years ago, but I'm going to have a colonoscopy more than every ten years like the guidelines recommend." All of my doctors said the same thing, and you of all people, know how cancer can sneak up on you. So now my mantra is like the democrats in Chicago, "Test early and test often!"

The doctors may say I'm cancer free but I know that it can strike again and I can tell you, cancer treatment ain't for sissies. Being a sissy myself, I KNOW and I don't want to do it again.

Sent by John Clark | 5:35 PM ET | 09-01-2006

I'm not sure if the treatment or the cancer is going to kill my daughter's boyfriend. Is it all worth it? He is only 19. Where did the quality of life go?

Sent by Leah Wellman | 11:59 AM ET | 09-05-2006

I have just completed breast cancer radiation and am so exhausted. The radiation was a snap but the side affects can be very painful. My eyes are so very sore and tired and my eyebrow bone is painful. I went to the optometrist and my eyes are healthy. My daughter-in-law who is very well informed about alternative health care told me to check my occipital bone on the back of my head and if it was sore to massage it because that is where the liver symptoms show up. I did and have been massaging it for a day and the eye and eyebrow bone pain are almost gone and I feel so much better. I guess I am surprised that my radiation oncologist did not know about this and have some information to hand out about it. I was more or less a number at radiation therapy except for two of the therapists. They treated me with some kindness and compassion. I am still very new at this journey in my life and have enjoyed reading your messages.

Sent by Lucille Thares | 1:58 PM ET | 09-05-2006

Dear Mr. Sievers,

Good luck with your cancer treatments it is a hard road, but one that we can cross. I have adinocarcenoma, a deadly lung cancer that attacks non smokers. Nine in ten victims of this are gone within a year of diagnosis. I told them I'd kill it, and I did. It did, truthfully, come back, but I control it with a growth inhibitor pill, diet and tai chi. You are so right once cancer is in us, it will always be there fighting to beat us down. But don't let it, Mr. Sievers. You and I and countless others can kill this parasitic enemy. Change your diet to a high antioxidant diet, for one thing. You can do a lot, along with the conventional methods, to make it work. There are books and information on the internet for every type of cancer.

Sent by Leslie Imholt | 2:08 PM ET | 09-05-2006