6 ways your primary care doctor can help you prevent cancer

When it comes to spotting — and even stopping — cancer, your primary care physician (PCP) plays a critical role.

Whether they’re providing a referral for screening, checking out an unusual mole or addressing any concern that’s out of the ordinary, PCPs do much more than conduct your annual check-up or address minor ailments.

"Screening is the best way to catch several types of cancer early, and that's one of our roles in primary care," said University of Chicago Medicine primary care doctor Laurence Gordon, DO*, who explained the ways he and other PCPs can help.

1. Monitoring your overall health over time

Most PCPs have known their patients for several years, making them well-informed about a person’s health status and their family history of cancer.

Routine and recurring tests to measure blood pressure, heart rate and weight — as well as physical exams and blood tests — give your PCP a wealth of important data at each visit.

Gordon is always on the lookout for unexplainable fatigue and weight loss, which are possible symptoms of cancer. As a PCP, he focuses on the whole person, often recognizing when a patient feels off.

“Once you get to know a patient, you pick up on what isn’t normal for them,” Gordon said.

2. Encouraging healthy behaviors

Your PCP can help address the habits that increase your risk for diseases such as lung, liver and skin cancer. They’ll provide guidance on quitting tobacco, limiting alcohol use and using protective sunblock, among other steps.

They also will take stock of your diet to make sure you’re eating foods known to lower cancer risk — such as vegetables, fruits, beans, nuts and whole grains — and that you're getting enough physical activity.

Your PCP will ensure you’re up to date on protective vaccines, including:

• A shot to prevent infection from human papillomavirus (HPV). Young people vaccinated against HPV can be spared some of the deadliest and hard-to-treat cancers, including cancers of the cervix, vagina, vulva, penis, anus, mouth and throat. The U.S. Food and Drug Administration has also approved use of the vaccine for people ages 27 to 45.
  
  
• A Hepatitis B vaccine that protects you against the virus that causes liver cancer.

Based on your risk factors, your PCP may seek to reduce your chance of developing certain cancers with preventive medication, such as tamoxifen and raloxifene (for breast cancer) or aspirin (for prostate and colorectal cancers).

3. Advising timely cancer screenings

As the cornerstones of healthcare, PCPs keep close track of the latest research on who should receive which cancer screenings — and when to get them. Among the tools they may suggest:

• Breast cancer screening: Begin receiving mammograms at age 40 and talk to your doctor about the best screening plan.
  
  
• Colorectal cancer screening: Adults over 45 should generally have a colonoscopy every 10 years. Ask your PCP if a simpler stool test is an option.
  
  
• Cervical cancer screening: Any woman or transgender male who has a cervix (lower part of the uterus) and is age 21 and older needs to get screened for cervical cancer. Guidelines vary by age and if you are at normal or high risk for cervical cancer. Learn more about cervical cancer screening, Pap tests, HPV tests and pelvic exams.
  
  
• Lung cancer screening: If you’re between 50 to 80 years old, you have a minimum 20 pack-year history (pack-years are determined by the number of packs smoked per day multiplied by the number of years you smoked) and you smoke or quit within the past 15 years, you may be recommended for an annual low-dose CT scan.
  
  
• Skin cancer screening: If you have a history of skin cancer or any suspicious moles or lesions, your PCP may recommend an exam or refer you to a dermatologist. Skin cancer, including melanoma, is very treatable when caught in the early stages.
  
  
• Prostate cancer screening: Depending on your risk factors, screening for prostate cancer can start at age 40; your PCP will discuss if a prostate specific antigen (PSA) blood test is right for you. (Some patients have elevated PSA levels that aren’t due to cancer, and unnecessary prostate biopsies carry their own risk.)

4. Exploring family history and genetic testing

Sharing your family’s cancer history with your PCP is a critical component when assessing your hereditary cancer risk. “We look for patterns in your family to determine whether you might benefit from earlier or more frequent screening,” Gordon said.

Based on that information, as well as medical factors and lifestyle influences, your PCP may refer you to a genetic counselor who specializes in cancer risk counseling.

Once a patient’s risks are determined, a counselor can help design a personalized risk reduction plan that may include one of several blood tests to detect mutations for certain cancers, such as the mutated BRCA genes linked with breast and other cancers.

5. Answering your questions and concerns

PCPs play an important role in addressing your cancer queries, from clarifying your cancer risk to explaining why a mole looks abnormal. It’s OK to ask any question, large or small.

“A good PCP believes in educating the patient,” Gordon said. If you are diagnosed with cancer, your PCP can review your treatment options, help you navigate the healthcare system and provide supportive care.

6. Connecting you with specialists and coordinating your care

If they suspect cancer, your PCP will get you to the necessary specialist at the right time. You may need several different procedures for the diagnosis and treatment; these can be coordinated by your PCP to avoid any delays or confusion.

“Depending on the type of cancer, you may be overseen by your PCP and not an oncologist,” Gordon said.

Because cancer can have a profound impact on a person’s life, PCPs also help patients with long-term planning. They can discuss how cancer may impact you and your family, and assist you with any issues that lie ahead.

“We are there to do our best at guiding you through everything,” Gordon said.

 

* Dr. Gordon is a UChicago Medicine Medical Group physician. UChicago Medicine Medical Group is comprised of UCM Care Network Medical Group, Inc. and Primary Healthcare Associates, S.C. UChicago Medicine Medical Group providers are not employees or agents of The University of Chicago Medical Center, The University of Chicago, UChicago Medicine Ingalls Memorial or UChicago Medicine South Loop.