Get in the Groove With Your Regular Screenings, Which Can Detect Health Problems Early

What do Elvis Presley, Johnny Cash and health screenings have in common? They are just a few of the topics patients might discuss with family physician, music lover and Luray record store owner David Switzer, MD, of Valley Health Page Memorial Family Medicine | Luray. In addition to sharing stories about his visit to Graceland, Elvis’ home in Memphis, and his passion for country, rock and even punk-rock music, Dr. Switzer never misses a beat when he reminds his patients that screenings can save lives because they pinpoint health problems early, when they are most treatable.

“There is a perception that your body is wired to tell you when there’s a problem, but the reality is that the body is wired to signal you when there is a serious problem,” notes Dr. Switzer, board certified in family medicine. “The whole idea of screening is to head things off before they become serious.”

Now a Believer

Don’t believe in the value of health screenings? Ask 62-year-old Luray resident Marion Muehlebach to share his story. Like many, he rarely visits the doctor and had never had a colonoscopy. “I don’t go to the doctor just to be going. I have to have a real reason,” he says. And although he felt fine, Muehlebach decided not to delay his colonoscopy any longer. “I had a feeling that I needed to see about this.”

He scheduled his first-ever colonoscopy for early February and was pleasantly surprised when he got a call from oncology nurse navigator Grace Nixon, RN, MSN, OCN. One of the team members collaborating on Valley Health’s Colorectal Cancer Screening Pilot Study, Nixon contacts patients to make sure they understand the process and have the resources they need to complete their screenings.

“She walked me through everything step by step,” Muehlebach continues. “Grace told me what I needed to buy and what I needed to do.” That included drinking the required bowel prep drink, which Muehlebach gulped “to get it over with.” She also called him following the procedure to check in on how he felt.

When Muehlebach went to Page Memorial Hospital for his colonoscopy, the surgeon spotted trouble in the colon—three polyps, and one was precancerous. “If [Muehlebach] had waited another two or three years, the one polyp almost certainly would have become cancerous,” Nixon says.

All of the polyps were removed during the procedure. “One of them was a centimeter big,” Muehlebach says. “They caught it before it had gotten a hold into my body. I was anxious and relieved at the same time.”

Muehlebach, now a believer in the importance of screenings and taking an active role in his own health care, will get a follow-up colonoscopy in three years and has also scheduled a checkup with his primary care physician. “I’ve had a hernia for a long time and I don’t want something disastrous to happen,” he says. “This has encouraged me not to take any more chances.”

Essential Tests Save Lives

Evidence-based screenings can give you peace of mind. “And even if you get a positive result, problems caught and addressed early can potentially improve your outcome and save your life,” says Dr. Switzer. “The screenings we recommend in the Valley Health Medical Group—such as colorectal cancer screening—have met very high standards, demonstrating they find problems not just early but early enough that addressing them makes a difference.”

Here are some common conditions that screenings can help identify:

• Colorectal cancer. This type of cancer is the second leading cancer killer of adults, after lung cancer, and many adults age 45 to 75 aren’t up to date with this screening. That’s unfortunate because screenings identify colon and rectal cancers before they become dangerous and can even find precancerous polyps, as in Muehlebach’s case.
  Colon cancer screening usually entails a colonoscopy, in which a physician inserts a flexible tube with a video camera into the colon via the rectum. In some cases, it’s the most appropriate tool, but there are also noninvasive alternatives.
  You may be able to collect a stool sample at home and return it to your doctor’s office or a lab. Dr. Switzer emphasizes that the screening that works best is the one that you actually do. “If you agree to a colonoscopy in the doctor’s office and then walk out and say, ‘I’m not going to bother with that,’ then that’s not going to be an effective screening tool for you,” he says. “It is completely fair to ask, ‘Is there an alternative that I could use?’ Sometimes the answer is no, but a lot of times the answer is yes.”
• Cervical cancer. Most women age 21 to 65 should get a Pap smear every three to five years, or as recommended by their healthcare provider, to screen for cervical cancer. A Pap smear is sometimes recommended for women over 65, but your provider will give you guidance if this is the case. Most women who have had a complete hysterectomy with cervix removal for a reason besides cancer don’t need this screening.
• Breast cancer. Women between 40 and 74 are encouraged to have a regular mammogram to screen for breast cancer. Factors like denser breasts may make mammography less reliable, so all women, regardless of age, should discuss their breast cancer risk—including family history—with their doctor.
• Lung cancer. If you’re between 50 and 80 and a smoker—or a former smoker who quit less than 15 years ago—your doctor may suggest a low-dose CT scan to screen for lung cancer. “There is an amount of smoking history that is used as a threshold,” Dr. Switzer says. “Typically, it’s 20 pack years of smoking or more, meaning that you smoked the equivalent of one pack a day for 20 years. If you’ve smoked two packs a day for 10 years, that’s also 20 pack years.”
• Prostate cancer. Screening recommendations for prostate cancer are more nuanced. Men between 55 and 69 should talk to their doctor about the pros and cons of a prostate-specific antigen-based (PSA) screening, which may reduce the risk of death from prostate cancer in some men.
• Skin cancer. Depending on your personal and family history, a skin cancer screening might be appropriate. This visual exam can be done during a routine physical or by a dermatologist.
• Osteoporosis. One in four women over age 65 is affected by osteoporosis, which weakens bones. You could be feeling spry—until you slip and fall, breaking a wrist, a hip or even your spine. A bone-density test can assess your bone health. Osteoporotic bones can then be strengthened with calcium and vitamin D supplementation or perhaps medication.
• Elevated blood pressure. Nearly everyone who visits their primary care provider gets their blood pressure checked. “If you have elevated blood pressure persistently, you are at increased risk for heart attack and stroke,” Dr. Switzer says. “We have interventions that reduce your risk. It’s important to get your blood pressure checked, because 99.9 percent of the time, elevated blood pressure has no symptoms whatsoever.”
• Other conditions. Your provider may also give you a blood test to check for high cholesterol, another sneaky condition. And depending on your health history and lifestyle, you may get a blood test to screen for diabetes, or your doctor might recommend screenings for infectious but treatable diseases like HIV and hepatitis C. Additionally, an ultrasound screening for abdominal aortic aneurysm may be recommended for men 65 to 75 who ever smoked.

During the COVID-19 outbreak, many patients have delayed scheduling routine medical care and preventive screenings, but Dr. Switzer emphasizes it’s safe to get care at Valley Health hospitals, clinics and practices. “We now know more about COVID transmission, have extensive sanitizing protocols in place, vaccination is more widespread, and all our employees are screened daily. In fact, scheduling your screening sooner rather than later can prevent serious problems.”

It’s easy to put off health screenings, especially if they make you nervous. But screenings can help you outsmart disease. “Fear usually stops us from doing what we need to do,” Muehlebach says. “But I would rather have peace of mind than worry that something’s fixing to get me.”

“That healthcare screenings save lives is one thing all physicians agree on,” adds Dr. Switzer. That’s music to the ears of everyone who values lifelong good health.