Examine Thyself!

May 3rd, 2015

Most of us see a primary care physician once or twice a year for a complete physical exam. However, many conditions can develop during the time in between exams.  I strongly advise my patients to make sure they know how to do self-exams for certain conditions and to get into the habit to examine ALL your body parts at least once a month.  Get to know your body and be familiar with your unique features.  The best time to do this would be just before you get in the shower where we all usually have a large mirror.

Here are some recommendations:

• Skin.  Skin cancer is the most common cancer in the US.  You want to examine every inch of skin.  Don’t forget your lips, and fingernails.  Melanomas can develop in these places, especially if you are African American or Latino.  Examine your moles.  Do they look different?  Are they growing larger in diameter (>5 mm) or growing outward from the skin?  Do they have different colors?  Are the borders looking irregular?  Do they bleed or itch?  If your answer is “yes” to any of these, you should get the mole checked out.  I have some patients who take pictures of their moles with their cell phones and save the images on their computer so they have a record of what each mole looks like year after year.
• Breasts.  Breast cancers can develop over a few months.  Detecting cancers early generally lead to improved survival.  If you don’t know how to examine your breasts, you can refer to this link from the American Cancer Society.  You can also ask your primary care physician or gynecologist at your next visit.
• Testicles.  The United States Preventative Services Task Force (USPSTF) recently recommended against routine testicular exams by medical providers.  They changed their standing because testicular cancers are relatively rare and they were concerned guys weren’t going for their annual exams because they were afraid or embarassed at this particular exam.  However, this does not mean you should not examine your own testicles.  Here is a link to the American Cancer Society website to learn how to do it.
• Genitals.  If you are sexually active, you need to check the skin in the genital area at least once a week, or more frequently if you have a new partner or have multiple partners.  Genital warts caused by HPV (human papilloma virus), herpes, syphilis, and chlamydia can start with skin irritation but can rapidly progress to the entire body if untreated.
• Mouth.  Oral cancers are more common in alcohol and tobacco users, particularly people who chew tobacco or smoke cigars or cigarettes. There are some virus such as Epstein Barr virus that can increase your risk for mouth cancers.  Typically, mouth cancers look like discolored ulcers that don’t seem to go away in the mouth and can sometimes bleed.  If you find one, you should see a dentist or primary care doctor immediately.  Bad breath or foul odors in the mouth could indicate cavities or gum infections.
• Feet.  You should examine your feet at least once a month.  Diabetics should check once every week because they are at high risk for foot infections that won’t heal.  You want to look to see if there are callouses, fungal infections, splinters, or infections around the toenails.  Do your feet smell?  That odor could be caused by foot fungus.  You may need to buy an anti fungal powder and change to breathable socks.  If you see callouses, that could indicate that your shoes are not fitting properly.  Warts are common, especially in people who shower at the gym or use a local pool.  By finding a wart early, you can prevent spread to other parts of the foot and your family.  These can easily be cured with over-the-counter treatments or by visiting your primary care provider.
• Eyes.  How is your vision in both eyes?  How is your peripheral vision?  Many diseases of the eye develop very gradually and can be difficult to notice until it’s too late.  The situation is also complicated by the fact that we have two eyes and that we often unconsciously compensate with the better eye.  I recommend covering one eye and holding a newspaper in front of you about 14 inches away (if you wear glasses or contacts, you are allowed to wear them for this test).  If you start noticing a large difference, you may need to see your eye doctor.