(Six months after surgery - I'm well so far, still doing chemo for the next three months. We'll see, we'll see.)
Still, one needs to be careful about taking one incident and generalizing from that. There is, for example, a very real possibility that performing an ionizing-radiation scan for every patient who presented with acid reflux would cause more cancer than it cured.
> Yeah, pancreatic cancer patient here. Mine presented as acid reflux, which my GP treated with Prilosec.
The fact that you walked in with pancreatic cancer and got told you have heartburn doesn't exactly argue for regular checkups.
Probably 99 out of 100 people with GP's symptoms (if not more) actually do have acid reflux. It therefore makes medical sense to assume that until additional symptoms indicate a different conclusion.
There has been a big push back recently against using an improvement in 5 year survival rate as an indication of success in the war on cancer. For example, if a new diagnostic test lets you find out you have cancer earlier, but you still end up dying at the same age you would anyway, the 5 year survival rate would go up, with no real benefit to you. In fact, there could be lots of real negatives, like anxiety and an increase in other tests and procedures that don't actually improve your lifespan or quality of life.
The conclusion: "Although 5-year survival is a valid measure for comparing cancer therapies in a randomized trial, our analysis shows that changes in 5-year survival over time bear little relationship to changes in cancer mortality. Instead, they appear primarily related to changing patterns of diagnosis."
According to http://www.clinchem.org/content/47/4/624.full
> CEA as a Marker for Colorectal Cancer
> screening
> In screening for colorectal cancer, the aim should be to detect disease at either Dukes’ A or B stage. Malignancy detected at more advanced stages is unlikely to be more treatable than that detected through the usual course of events. Using an upper limit of normal of 2.5 μg/L, Fletcher (19) calculated that CEA has a sensitivity of 36% and a specificity of 87% in screening for Dukes’ A and B colorectal cancer. These findings, combined with the low prevalence of this malignancy in unselected populations, render the positive predictive value of CEA unacceptably low and thus of little value in screening healthy subjects. For the present, therefore, we must rely on fecal occult blood and endoscopy to screen for colorectal cancer (20).
What does 36% sensitivity and 87% specificity mean? Imagine that you test ten thousand 40-year olds and twenty-five of them do actually have colon cancer (this is more or less consistent with statistics telling that 0.23 of them will be diagnosed with colon cancer before turning 50). You will get a true positive result in 9 cases (out of 25) and a false positive in 1297 (out of 9975). So only 0.7% of the positive cases are real, and you missed two thirds of the cancers.
It's perhaps unintuitive, but more testing isn't always good. The benefits need to outweigh the risks, and it isn't always the case. There are ongoing debates about who should be screened for various types of cancer, for example, and the "right" answer changes over time - as we find ways to reduce false positives, as we find better treatments, as we better understand the diseases, etc.
It's tempting to do more tests because it feels like you're doing something. You don't want to get sick later and feel like you could have prevented that. But that's an irrational form of thinking. All that we can do is make the best choice now, given our current information. As GP's links mention, the best choice we have now often seems like "avoid tests that aren't clearly needed."
