[joevandyk]

I hope this is an appropriate place to ask.

Say I am eating well, exercising consistently, getting enough sleep.

For a male in his 40s, what are the best bang-for-the-buck ways to detect cancer before it becomes life-threatening?

[doctoring]

Whole body MRI is fairly available in major metro areas, though not cheap and not very sensitive or specific.

The Galleri blood test screens for a range of cancers (sensitivity varies by cancer) and is ~$900, although you need a doctor to order it. You also may not technically be within the intended use population unless you have some risk factors (e.g. you are older than 50, or have family history of cancer).

Colonoscopy is a good idea, given the rising rates of colon cancer among younger adults.

[somenameforme]

The actual stats on the efficacy of early detection are extremely surprising. This [1] is a random study, among many, about breast cancer screening. Breast cancer mortality rates have been trending downward sharply, and this correlated with a sharp rise in screening. People naturally assumed this was causal, but oddly enough the exact same reduction in mortality has also been observed in people who have not participated in early screening at all. So it seems that generally better treatments are the main reason.

The 'paradox' of genuinely higher survival rates with early detection is explained by the fact that the survival rates are measured from the time of diagnosis. If a person with undiagnosed cancer is diagnosed after 7 years with said cancer, and then dies the following year, then he is considered to have had 1 year of survival. By contrast if somebody is diagnosed at year 1 and then dies 7 years later from the cancer, then they are considered to have 7 years of survival. They lived exactly the same length with cancer, but the survival times after diagnoses are markedly different.

This applies for most cancers. In my prior readings on this topic, the one screening that had a statistically significant effect on life expectancy was a certain type of colonoscopy, but even in that case the effect was quite small, something like 3 months IIRC. I think the overall take away is that outside of healthy living, do what makes you feel most comfortable. Even if they may not be highly effective, screenings would provide some people significant mental comfort. If you're one of them, more power to you. If you're fine without, then that's also great.

[1] - https://www.sciencedaily.com/releases/2018/09/180912133536.h...

[BessS]

Don't ignore weird lumps and bumps, but the #1 bang for your buck is getting a colonoscopy

[soared]

Find a primary doctor you like and stick with them. Do your check ups, talk with them, communicate anything odd.

Go to a dermatologist and get a mole map. Get your tests done on schedule when you should be.

Don’t smoke cigarettes, or work in a high risk job around carcinogens.

[cgijoe]

Talk to your doctor, and ask to be screened for all common cancers. A colonoscopy is in your future (I just had one). Also ask for a Prostate-Specific Antigen (PSA) Test. Also look into the HPV vaccine.

[timr]

Don't do this. Nearly all cancer tests are overly sensitive, and not great at detecting the cancers you care about (the ones that will progress).

If you run out and get a bunch of random cancer tests, you are basically ensuring that you will get unnecessary and painful treatment for a finding that probably wouldn't have harmed you in the first place.

It's not a satisfying answer, but it's true. The reason most cancers are found late is because there's no effective alternative.

[fhsm]

Yes. You are correct. Patent is providing bad advice about PSA

https://www.bmj.com/content/362/bmj.k3519

Colo , when appropriate , is good but not as a general interest test:

https://jamanetwork.com/journals/jama/fullarticle/2529486

[Take8435]

Agreed. For more see https://www.npr.org/sections/health-shots/2018/08/18/6395885...

[bigDinosaur]

HPV vaccine has to be the biggest bang for buck. To anyone reading this, you should get it at any age because you likely haven't been exposed to all the strains that e.g. Gardasil-9 protects you from. You should also get it if you're male despite it being initially known as the cervical cancer vaccine because HPV causes oral cancers and you also don't want to potentially be a carrier.