August 2014

preventioncouple 163x170.jpgPrevention, Screening and The Real Story

Medical journals, newspapers and TV news reports publish story after story about advice that people can wait longer periods of time to have cancer screening tests. These articles often suggest that regular screening and preventive testings can be postponed for years, or even entirely avoided for both men and women.

Sadly there is another truth, one not often seen or presented as part of these stories. In recent years you may well remember reading stories regarding the practical risks and lack of benefits now being attributed to yearly routine cancer screening tests. The Annual Pap Smear was a regular event. Most women would go annually to see their primary care medical doctor or their gynecologist for a pap smear, breast exam and referral for their annual mammogram. Now the media tells us that prestigious medical committees or organizations are publishing studies that tell women that it is perfectly acceptable to put off these exams for two, three or even five years.

While it is hard to argue with studies done by major organizations and experts, is it really the right thing to do for you? In recent years the medical professionals, have told women that breast-self exam is useless, mammography and pap smears may lead to expensive and even unnecessary painful and even dangerous post testing, false positive and bring more fear into the lives of women who participate. Each of these articles almost always contain a statement of how putting off these routine procedures can save dollars. The assumption is that it reduces health care costs, but with health care organizations making record profits, and since health care costs have not really dropped significantly, I often question where the money saved actually goes?

As a physician I want to listen to and value these studies. Most of these studies at least on the surface appear to be well done and offer some value. However, my practical reality of day-to-day medical practice and years of experience in dealing with people and not just numbers, leaves me screaming inside as to the damage these new recommendations could end up doing.

These new recommendations are heavily influencing women to postpone some potentially life saving procedures, I am very uncomfortable with this outcome. My patients specifically come to me to take care of their needs and help them not only prevent but also catch early problems that would ultimately if undiagnosed, create misery, confusion and true risk to their life and well-being. They want to trust of my expert advice and I will only give the very best advice to them, since I feel they deserve this.

I have actually started writing this article nearly 100 different times. Each time I see an article telling the world that it is okay to live in a bubble, to not worry about real risks and problems and to accept being talked out of taking care of them selves. I have no statistics to offer to prove my point or to assure my patients that I am more correct than these major academic organizations. I am not a prestigious teaching physician. I am not the head of a well-known hospital or medical center. I am in a sense a lone practitioner who simply takes the very best care of and sincerely cares about his patients as unique, valuable and deserving individuals.

I have no great words of wisdom to offer, I simply have more than 42 years of medical practice experience on the front line working with women. The vast majority of my patients choose to prevent and not to live in fear of having life changing medical conditions such as cancer of the breast, uterus, ovaries, vulva or any other organ or bodily system take over their life.

I feel fortunate that, here on the front line, I do not see a great deal of cancer or other lethal health problems in my patients, yet cancer and other major health problems are not at all uncommon.

What I do see is that the great majority of women with breast cancer often have found it by themselves. They often did so when they detected a lump in their breast that was not previously present. How do I know this, because it is the most common way we as physicians see breast cancer’s detected. The difference between those caught early which are 100% curable and those caught late which ultimately require radical mastectomies, chemotherapy and radiation is the fact that most of the women with early tumors found their cancers either randomly or during monthly breast-self exams. The other group of early cancer patients are those who did come in for yearly breast exam and/or mammography.

I cannot imagine how any articles could say that it is better to wait,. But unfortunately they do and this not only makes me angry, but it makes me question what the underlying intent of these studies and subsequent articles are. Are they to protect women or to protect the insurance companies profits? No one can tel me that waiting until cancer is in an advanced stages saves anyone any money or in fact suffering, anxiety or pain either.

I have practiced medicine long enough to know, and as my professor of Statistics told me on my first day at UCLA School of Public Health, “Tell me what you want me to prove and I will design the study to prove exactly what you want to prove for you and anyone reading it.” While I hate to say things like this, since most medical practitioners and academic organizations are honest and really care about their patients, the truth is studies are paid for by someone and as we have just seen in our last presidential election, truth is often in the eye of the person with the dollars.

I have added an article to this month’s HolisticGynPS.Com newsletter that would at first glance appear to be out of place, a story regarding the decrease in the death rate from ovarian cancer done in England. Ovarian Cancer Deaths Fall By 20%, England.

Why should we, here in America, care about what is happening in England? The answer lies in a short statement mid-way through this article, “.. the fall in deaths could be because we are getting better at detecting and treating ovarian cancer.” The author cites improvements in scanning procedures, surgery and chemotherapy treatments. The decrease in deaths in England, is occurring because they are getting better at detecting and treating ovarian cancer, not because they are delaying detection.

The takeaway here is that in order to prevent deaths from ovarian cancer we must first detect it while it is early enough. How can ovarian cancer or breast cancer for that matter, be detected if we are telling women to stay home, stop self exams and wait longer and longer to come in to their doctor to be seen, screened and checked?

Cancer is always time sensitive! Even if it may take years for some cancers to develop, during this time the cancer will likely go unrecognized until one of two things happens, 1) the woman develops signs and symptoms which could mean that her cancer has advanced, or 2) the woman or her doctor finds it early enough to start treatment before the woman’s life and well-being are at risk.

Telling women to wait for years, to not go in for regular check ups, while an early or worse advanced cancer might be allowed to grow, can only suggest that, “the inmates are running the asylum.” To me waiting seems to be a fool’s delight, it may make some people very happy and believe that this saves lots of money, but others will not fare so well. True we might spend more money offering preventive services and we are likely to get lot’s of normal test results, to which I say, Hurray!!!, For every woman I have ever known hearing the words, “Everything is normal, you are safe” almost always rings joyful in their heart and soul.

Everyone out there can believe what they desire. Too many times this doc has heard from specialists, “Sorry! It is just too late to do her any good!” This is a message I would like to never ever have to hear again. I invite my patients to come to see me or go to another doctor every year and get checked. Don’t just go for a pap smear and mammography, do make sure to also get your blood pressure checks, look for an unexpected anemia, check for skin cancers, check for blood in your stool, get a complete yearly exam and know that you are working to prevent diabetes, heart disease and cancers. Stop listening to those who can tell you that you can wait. It would be a horrible shock to be told by specialists that you did not come in soon enough.

This might ultimately break the system, but truthfully, if you care about the system why not elect representatives who can help fix this already broken system? Let’s find people who can support and improve early detection, believe in the benefits of screening and early treatment, rather than simply leave more and more lives hanging in the wind. Health issues are always time sensitive!

midlifewalking141x170.jpgMoving 6,000 or more steps a day -- no matter how -- adds up to a healthier life for midlife women. That level of physical activity decreases the risk of diabetes and metabolic syndrome (a diabetes precursor and a risk for cardiovascular disease), showed a study published online this month in Menopause, the journal of the North American Menopause Society.

To read the full article Daily Steps Add Up for Midlife Women's Health, click here.
sick136x170.jpgWhen you wake up feeling under the weather, the last thing you’re capable of doing is thinking clearly. But if it’s a weekday, the decision you have to make—call out or head in—is as stressful and confusing as the time you had to figure out what to do with your boss’s Facebook friend request.

To read the full article 5 Times You Should Call in Sick to Work, click here.
birthcontrol155x170.jpgA dramatic new study with implications for next month’s presidential election finds that offering women free birth control can reduce unplanned pregnancies -- and send the abortion rate spiraling downward.

To read the full article Free Birth Control Cuts Abortion Rate Dramatically, Study Finds, click here.
ovariancacouple146x170.jpgDeaths from ovarian cancer among women in England have fallen by 20% over the last ten years, says a new report from the National Cancer Intelligence Network released on 20 November.

To read the full article Ovarian Cancer Deaths Fall By 20%, England, click here.
womandreaming170x156.jpgWith the book "Fifty Shades of Grey" still flying off the shelves, women are discovering the power of sexual fantasy, some for the first time.

To read the full article More Women Harness Power of Fantasy, click here.

If your goal is to lose weight, no one will tell you to drink more soda. But Pepsi Special, a new fiber-infused soda from Pepsi-Cola, has been marketed as being able to block fat and reduce hunger. And some nutritionists are calling foul.

To read the full article Can Soda Help You Lose Weight?, click here.
itchyscalp130x170.jpgGive your dry skin the moisture it craves.

Flaky, itchy, dry skin can plague you all year, and it’s often worse in winter. But whenever it happens, you only want relief, and you want it fast.

To read the full article 6 Quick and Easy Dry Skin Relievers, click here.
feelinggoog140x170.jpgWhat words would you associate with being old? I asked a few people recently, and here are just some of the words they used: fuddy-duddy, not fresh, decrepit, sad, wrinkly, tired, stiff, brittle, unhappy, invisible, obsolete, diminished, fat, fragile, cranky, and marginalized.

To read the full story Are Your Thoughts Making You Old?, click here.
healthreforminsurance150x170.jpgPresident Obama's re-election guarantees that the health reform law will continue rolling out.

A WebMD survey after the election found that many readers want to know what impact the law will have on their health care costs.

To read the full story Will Health Reform Cost Me More?, click here.
affordablecare170x130.jpgOne Big Winner in Tuesday's Vote: Health Reform

One of the biggest winners Tuesday night was health reform. Now that President Barack Obama has won a second term and kept a Democratic majority in the Senate to back him up, Republicans have lost any chance at repealing his biggest domestic initiative.

To read the full story One Big Winner in Tuesday's Vote: Health Reform, click here.
ObamaHealthReform122x170.jpgNow that President Barack Obama has won a second term, the Affordable Care Act is back on a fast track. Some analysts argue that there could be modifications to reduce federal spending as part of a broader deficit deal; for now, this is just speculation. What is clear is that the law will have sweeping ramifications for consumers, state officials, employers and health care providers, including hospitals and doctors.

To read the full story A Consumer's Guide to Health Reform, Post-Election, click here.
testiculartrauma170x170.jpgGenital Harm More Common Than Dental Injuries, Study Shows

Think twice before making fun of your friend for going to the hospital after getting hit in the crotch with a soccer ball.  According to a study published in the Journal of Urology, these accidents are more common than you’d imagine.

To read the full story Genital Harm More Common Than Dental Injuries, Study Shows, click here.