Thyroid Cancer

May 6, 2021

A 28-year old male came for an Ultimate Assessment at Preventicum.  He was concerned about his general wellbeing and had found it challenging to access care locally due to the coronavirus pandemic.  He was feeling very tired and had been experiencing longstanding night sweats.  His full blood count and inflammatory markers were normal, but during ultrasound examination of his carotid arteries he was noted to have an abnormal looking lymph node in his neck.  An urgent letter was shared with his local hospital where he was being investigated for a mouth ulcer.  The lymph node was biopsied, and he was later diagnosed with a medullary carcinoma (cancer) of the thyroid gland.  This led to surgery to remove the thyroid gland and 50 additional lymph nodes to clear the cancer and reduce the risk of spread.  He is currently recovering from this procedure and is grateful to have discovered this through his Preventicum assessment and to have had the chance of curative surgery.

CANCER 30 GENE PANEL

Overview

All of us have a 1 in 2 lifetime risk of cancer, but some common cancers – breast, melanoma, pancreatic, prostate and ovarian – are known to occur more frequently in families, passing from one generation to the next. This is because certain gene mutations can be inherited.

Perhaps the most commonly talked about are the BRCA 1 and BRCA 2 genes, where mutations can indicate increased risk of developing breast, melanoma, pancreatic, prostate and ovarian cancers.

The 30-gene Pan Cancer Panel test from Everything Genetic, examines BRCA1 and BRCA2 and an additional 28 genes which can also indicate risk in the areas of uterine, colorectal (bowel) and stomach cancer.

Why have this test?

Knowing you have a genetic mutation enables you to make sure you have the appropriate regular screening and investigations. Many mutations are known to be hereditary; if you have a mutation, there is a 50% chance that your siblings and children will have it too.

What genes are tested?

Genes APC, ATM, BAP1, BARD1, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4*, CDKN2A(p14ARF), CDKN2A(p16INK4a), CHEK2, EPCAM*, GREM1*, MITF*, MLH1, MSH2, MSH6, MUTYH, NBN, PALB2, PMS2*, POLD1*, POLE*, PTEN, RAD51C, RAD51D, SMAD4, STK11, TP53.

What does the test involve?

This test is a simple saliva test that you can do in the clinic on the day of your assessment, or in your own home of you prefer – we do not need a blood sample. If you choose to add this test after your health assessment, you will receive a kit in the post with clear instructions on taking your sample, together with all the paperwork you need to sign and post to Everything Genetic.

How long does reporting take?

Once your sample is received at the US laboratory, it will be sequenced, and your genes analysed. A report is then generated, usually within 5 weeks of the laboratory receiving your sample.

How will I get my results?

Your Preventicum doctor will explain the process in your consultation, and you will also have a counselling session with a consultant (usually the day after your Preventicum assessment) so you understand this fully before consenting for the test.

Once your genes have been analysed, you will be sent your results from Preventicum. If there are any positive findings you will also be contacted by a Consultant Geneticist to discuss these, the implications, and next steps. If the results are negative but you still wish to discuss these further, a consultation can be arranged at no extra charge.

Discussing your results with a geneticist and Preventicum doctor will help you to:

  • Understand your risks
  • Monitor your health
  • Consider your lifestyle or diet
  • Protect your family

MUSCULOSKELETAL MOVEMENT SCREEN AND STRENGTH & CONDITIONING COACHING

Overview

Preventicum have partnered with Pure Sports Medicine (PSM), world-class sport and exercise medicine specialists to offer a musculoskeletal movement screen together with strength and conditioning coaching. PSM’s team will work with you to prevent, diagnose, treat and manage any injuries, bringing a multi-disciplinary, team-based approach to your health management.

Why have this test?

  • If you have an existing injury such as back or joint pain.
  • You want to improve or start a new exercise regime.
  • You are trying to improve your lifestyle.

What are the benefits of this screen?

  • Helps you to prevent injury and become injury resistant
  • Improve your ability to resist ailments
  • Improve and optimise your performance in your chosen sport

What can I expect?

This hour-long session starts with a specialist musculoskeletal physiotherapist consultation to determine injuries, exercise history and video gait analysis. All sessions are tailored to the individual and look at relevant lifestyle factors with a clinical assessment of any injuries.

Following this, you will meet a strength and conditioning coach for a full body movement screen and in-depth strength assessment, using a mix of gym equipment, clinical tests, and hand-held strength testing for specific muscle groups.

You will leave with a management plan including any recommendations for further treatment and a letter from your physiotherapist, detailing your findings from the day will be included in your Preventicum final report.

ESSENTIAL

Consultation with a Preventicum doctor
Lasting up to 50 minutes, you will have the opportunity to discuss your current health, medical and family history and any concerns you may have.

Detailed physical examination with a Preventicum doctor
An examination of the eyes, ears, mouth, throat, heart, lungs, musculoskeletal system, nervous system, gastrointestinal system and skin. In men we examine the groin, testes and prostate* (over 50) and in women we perform a breast examination and gynaecological examination and smear if required.*
*With consent and chaperone if requested.

Vital observations
Height, weight, BMI, resting heart rate, blood pressure

Over 45 blood tests and urine analysis
Including a full blood count, comprehensive cholesterol profile, liver and kidney function tests, bone profile, iron studies, inflammatory markers, thyroid function in women, HbA1c (diabetes test), vitamin D, and PSA on men over 50 years.

Ultrasound examinations
We scan the carotid arteries, abdominal aorta, liver, gallbladder, biliary tree, pancreas, kidneys, spleen, bladder, uterus and ovaries in women and the prostate in men.

Echocardiogram
A non-invasive ultrasound examination using high-frequency sound waves to create detailed pictures of your heart. We look at the structure and function of your heart including the valves and can record dynamic changes within this moving organ to see how the heart is managing blood flow around the body.

Resting electrocardiogram (ECG)
ECG is used in diagnosing many electrical heart abnormalities and can help to show if there is the possibility of significant coronary artery disease.

Spirometry (lung function test)
Spirometry is used to determine lung function and to help to detect lung disease.

Body Composition Analysis
The InBody 720 provides a detailed, highly accurate map of body composition, including visceral fat, using 30 impedance measurements.

Audiometry (hearing test)
This test measures the sensitivity of your hearing across a range of different frequencies.

Tonometry (glaucoma/eye test)

Results consultation
The opportunity to go through your results from the day with your Preventicum doctor and discuss further management and referrals as needed. Please note that some of the results take slightly longer to analyse and will be available in your final report.

Preventicum Lifestyle Prescription
A bespoke lifestyle prescription covering the key areas of nutrition, sleep, exercise, relaxation and environment, to help you optimise your health and wellbeing.

Follow-on consultation
This 20-minute virtual follow-on consultation will take place 6 months after your assessment or at a time of your specification.

For more information, please see our brochure.

ELITE

Consultation and physical examination with a Preventicum doctor
Lasting up to 60 minutes, you will have the opportunity to discuss your current health, medical and family history and any concerns you may have. Your doctor will also carry out a physical examination of the eyes, ears, mouth, throat, heart, lungs, musculoskeletal system, nervous system, gastrointestinal system and skin. In men we examine the groin, testes and prostate* (over 50) and in women we perform a breast examination and gynaecological examination and smear if required.*
*With consent and chaperone if requested.

Vital observations
Height, weight, BMI, resting heart rate, blood pressure.

Over 50 blood tests and urine analysis
Including a full blood count, comprehensive cholesterol profile, liver and kidney function tests, bone profile, iron studies, inflammatory markers, thyroid function, HbA1c (diabetes test), vitamin and mineral profile including vitamin D, and PSA on men over 50 years.

Magnetic Resonance Imaging (MRI)
MRI scans of your brain, heart, central arteries and organs of the abdomen and the pelvis as well as a whole spinal scan including your cervical, thoracic and lumber spine. Our two, state-of-the-art MRI scanners are equipped with ‘in-bore’ technology, ambient lighting and a choice of music or film to create an immersive audio video visual experience.

Ultrasound examinations
We scan the carotid arteries, abdominal aorta, liver, gallbladder, biliary tree, pancreas, kidneys, spleen, bladder, uterus and ovaries in women and the prostate in men.

Exercise Stress Echocardiogram
Preventicum are the first UK clinic to introduce this test as part of a screening health assessment. Stress echocardiography uses specialist ultrasound imaging combined with the exercise stress test to show how well your heart muscle is working to pump blood to your body, and it is most often used to detect a decrease in blood flow to the heart from narrowing of the coronary arteries. The test assesses heart function and structure, and can diagnose underlying heart disease.

Resting electrocardiogram (ECG)
ECG is used to diagnose electrical heart abnormalities and can help to show if there is the possibility of significant coronary artery disease.

Spirometry (lung function test)
Spirometry is used to determine lung function and to help to detect lung disease.

Pure Sports musculoskeletal movement screen and strength & conditioning coaching
A consultation and movement screen with a specialist musculoskeletal physiotherapist at Pure Sports (on-site) to determine injuries, exercise history and gait analysis. A sports coach will then take you through an in-depth strength assessment using a mix of gym equipment, clinical tests, and hand-held strength testing for specific muscle groups.

Body Composition Analysis
A detailed, highly accurate map of body composition, including visceral fat, using 30 impedance measurements.

Audiometry (hearing test)
This test measures the sensitivity of your hearing across a range of different frequencies.

Tonometry (glaucoma/eye test)

Radiologist consultation
A results consultation with one of our highly experienced consultant radiologists. A virtual tour viewing hundreds of your MRI scan images, including a video of your beating heart and you will be given a USB of your images to take away on the day.

Results consultation
The opportunity to go through your results from the day with your Preventicum doctor and discuss further management and referrals as needed. Please note that some of the results take slightly longer to analyse and will be available in your final report.

Preventicum Lifestyle Prescription
A bespoke lifestyle prescription covering the key areas of nutrition, sleep, exercise, relaxation and environment, to help you optimise your health and wellbeing.

Follow-on consultation
This 30-minute virtual follow-on consultation will take place 6 months after your assessment or at a time of your specification.

For more information, please see our brochure.