What to Ask on your Yearly Physical Examination

Routine blood work and a physical exam should be done annually for both men and women.  These tests can help your doctor look for things like hypertension, anemia, infections, cholesterol levels, liver and kidney function, blood sugar levels and thyroid function. We recommend you specifically ask for cholesterol levels, TSH (thyroid), ferritin and liver enzymes if they have not previously been done.  Depending on your individual health and treatment plan, your doctor might also test your hormone levels.

During your first visit at the clinic, we recommend you bring in any screening bloodwork that you may have had done before you have arrived at the clinic.  We will review findings and recommend any additional testing that may need.

Women’s Health Screenings
There are some annual tests that are specific to women’s health.  An exam is recommended yearly and includes a breast exam and pelvic exam to check your uterus and ovaries for problems such as cysts, physical abnormalities and growths.  At this time you will also get a Pap test and often the doctor will screen for STDs.    Many national organizations recommend starting Pap exams at age 21 and repeating these tests at least every 2 years.  The Pap test looks for cellular changes on the cervix that might become cervical cancer if left untreated.  

For Pap exams I refer out to Options for Sexual Health, a Program of the BC Cancer Agency (604-731-4252) which has drop in clinics in the evenings. You can request to have your results forwarded to the clinic.  OFSH can be used for information regarding contraception and to be fitted for a contraception device.

Breast cancer is the second most common cancer among women, and mammograms are recommended every 1-2 years for women over the age of 50.  A baseline mammogram at age 50 is recommended and can be self- booked through the Screening Mammography Program of BC (part of the BC Cancer Agency).  To arrange an appointment, call 604-775-0022 or toll free 1800 663 9203.  The centre is located at BC Women’s Health Centre, Block F2 easily accessed through Parking entrance #3 at Heather and West 29th.  You may request that your results be forwarded to the clinic/Dr. Doan.

Clinical breast exams and self-breast exams are recommended routinely.  This is when you check for lumps, changes in size or shape of the breast, or any other changes in the breast or armpit.  

Potential harmful effects of screening mammography include false negative and positive results, overdiagnosis, overtreatment and radiation exposure. If you would prefer not to do mammograms, there are other types of screening, including breast thermography. Breast exams can be done at the clinic and please talk to us about more information about breast thermography.

Men’s Health Screenings
Prostate cancer is the second most common cancer in men.  There are two tests your doctor which are commonly used to screen for prostate cancer.

The prostate-specific antigen (PSA) test is a blood test for men that can be added to your routine screening bloodwork.  This test is commonly recommended starting at age 50 for average risk.  If African American or family history of prostate cancer, it may be best to start at age 40.  A high PSA level does not always mean that a man has prostate cancer.  IT may be elevated with other types of prostate problems or interfering factors with the test itself.  It is important not to test PSA directly after a digital rectal exam, or within two days of ejaculation, horseback riding or biking.  In addition, high or low blood sugar and certain medications can interfere with the test.  Commonly if the PSA is initially or slightly elevated with no other symptoms or signs of concern, we repeat the PSA in 2-3 months.

A Digital Rectal Exam (DRE) is where the doctor inserts a gloved, lubricated finger into the rectum to feel the prostate for asymmetry, lumps, enlargement or anything else unusual.

Bone Health
Healthy Bones are essential for aging well and quality of life.  The National Osteoporosis Foundation recommends testing postmenopausal women, all women over the age of 65, all men over the age of 70 and men between 50-69 with a high risk factor profile.  The first 5 years post-menopause is the time of most bone loss.  If you have higher risk factors (history of smoking, previous fractures, use of corticosteroids, amenorrhoea or anorexia) it may be a good idea to screen early.  

Colon Health
If you are 50 or older, getting a colorectal cancer screening test could save your life.  Screenings will help detect both polyps, which can turn into cancer as well as colorectal cancer at an early stage.

The frequency of routine colonoscopies is every 10 years, unless advised more frequently by your gastroenterologist.  If you have a parent that was diagnosed with colon cancer, it is recommended that you start getting screened 10 years prior to their age at diagnosis.  

Other Screening Tests
Skin: If you notice changes in moles, or other skin issues it is a good idea to have someone have a look at it.  If you have a mole that you think is suspect, taking a picture annually of it will help you track changes.  Make an appointment with a dermatologist if you are concerned.

Thyroid:  If you have thyroid disease, it is recommended you get a yearly screening thyroid ultrasound.  Thyroid cancer is one of the few cancers that has increased in incidence over recent years and occurs in all age groups from young children thru seniors.  An ultrasound can check for thyroid size, masses or nodules and follow-up screening can monitor for number, size and stability of nodules if you have them. Thyorid cancer is usually high treatable when found early.

Sexually Transmitted Diseases:  Depending on your risk factors, we also recommend screening tests for sexually transmitted diseases.  These risk factors include having unprotected sex, sexual contact with multiple partners, a history of STDs.  Many infections often do not cause symptoms.  Getting tests can put your mind at ease and get you (and your partner) treated.

Naturopathic Physicians in BC have access to Lifelabs. This means that if you have a test you want done, we now have the ability to give you a requisition that you take directly to Lifelabs and the results come to the clinic.  Currently you as the patient pay for the test and work continues to be done by our Association about this.

Your lab results are now available online.  You create a password, and then you yourself have access to any labs that you have recently had done. You can print them out and bring them to the clinic for review.

I believe in prevention.  Make sure to schedule an appointment with your physician today to talk about screening exams that can make a difference in your life.