DEAR DR. DONOHUE: Will you please say a few words about the prognosis and treatment of cervical cancer? My daughter, 45, was told at a recent checkup that she has a few cells of this kind, and she is reacting as if she has received a death sentence. Since it was caught early, should her outlook be more cheerful? — J.B.
ANSWER: All women are indebted to Dr. George Papanicolaou, who developed the Pap smear for the early detection of cervical cancer. The cervix, by the way, is the necklike projection of the uterus into the vagina. It was the site for the most common cause of cancer death in women before the Pap smear came into wide use. That was in the early 1940s. Since then, deaths from cervical cancer have been cut in half, with about 4,200 deaths occurring annually and 12,200 new cases detected each year. Most of the deaths are in women who did not have Pap smear testing.
I’m not clear what you mean by “a few cells of this kind.” If the cells obtained on a smear show low-grade changes, a woman’s chances of having cervical cancer are close to zero. Follow-up smears are the only treatment needed. If the cells show high-grade changes, the doctor will perform a colposcopy. Colposcopy is an examination of the cervix with an instrument that has a magnifying lens so suspicious areas can be readily seen and biopsied. Results determine what the next steps should be. However, at these stages — long before the cancer has spread — it is still quite curable.
Your daughter can trust her doctor to take the appropriate steps depending on the results of her Pap test. She does not face a death sentence. If she has any questions about her diagnosis, she should call her doctor for an explanation of her test results.
The booklet on cervical cancer and Pap smears deals with these issues in detail. Readers can obtain a copy by writing: Dr. Donohue — No. 1102W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: My husband and I are both 28. We have one child, a son. My husband felt a lump in his testicle and saw our family doctor. It turned out to be cancer. He was operated on. The doctor discussed many things with us, but we never discussed the prognosis.
We need to know: What’s the usual life span of someone who has had testicular cancer? — L.R.
ANSWER: If your husband had a seminona, one of the common varieties of testicular cancer, and if it was in its early stages, your husband’s chances of living a long, full life are very high, over 95 percent.
Your husband’s story is something that all young men should take to heart. Testicular cancer is a cancer of young men, most often males between the ages of 15 and 35. The earliest sign is a small, painless lump in the testicle.
DEAR DR. DONOHUE: I am a 55-year-old man who finally bit the bullet and had a colonoscopy. My doctor had badgered me to have one for the past five years. I don’t have cancer. I don’t have polyps. I do have diverticulosis. I didn’t know I had it before the scope exam. I’ve never had even a twinge of pain. What is this, and what do I need to do about it? — H.L.
ANSWER: A diverticulum is a small, balloonlike protrusion of the colon lining through the muscle wall of the colon and onto its outer surface. By “small,” I mean that diverticula range from 0.2 inches to 0.4 inches (0.5 cm to 1 cm) in largest diameter, around the size of a pea. Their cause appears to be a lack of fiber in the diet.
In places where the diet has lots of fiber, diverticulosis is rare. In North America, it’s rampant. Fiber keeps undigested food from drying out. Dried food residue requires powerful contractions of the colon muscle to push it along. Those contractions also push the colon lining through the colon wall, creating a diverticulum.
Diverticulosis is frequently a silent affair, not causing any troubles. Diverticulitis, on the other hand, is an inflammation and infection of diverticula. That is quite painful. It produces abdominal pain on the left, lower side of the abdomen, often with nausea and vomiting. The diverticula also can burst and release bacteria into the abdominal cavity, a serious situation. Severe diverticulitis must be treated in the hospital with IV fluids and IV antibiotics.
To prevent diverticulosis from becoming diverticulitis, increase your fiber intake. Fiber is the indigestible coverings of many fruits, vegetables and grains. White flour is refined wheat — wheat without its outer coat, the bran. Bran and other sources of fiber draw water into undigested food and make it easily pushed along the entire length of the colon.
We’re supposed to get 25 to 35 grams of fiber a day. Beans, whole-grain cereals, whole-grain breads, dates, prunes, unskinned apples and pears are examples of fiber-rich foods. If you cannot get enough fiber from foods, then commercial products such as Fiberall, Metamucil, Citrucel and FiberCon can provide it for you.
The booklet on diverticulosis provides more details on this common condition and its complication — diverticulitis. To order a copy, write: Dr. Donohue — No. 502W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: My doctor’s nurse studied my ears with great interest the last time I was there. I asked what she was looking at. She said I had a crease in my earlobes, and it’s a sign of heart disease. I looked in a mirror. I do have a crease. Does it mean I have heart disease? — J.K.
ANSWER: Right in the area where an earring is worn, some people have a transverse crease. At one time a fuss was made about it being a sign of heart disease. If it is, it’s not a reliable sign. I have those creases too.
DEAR DR. DONOHUE: My husband and I have started walking every evening. It’s our way of staying in shape. I like it. My husband actually listens to what I have to say when we walk. There is one thorn in my side, however. My husband insists that I don’t walk correctly, and he is constantly giving me ways to change my walking style. It’s extremely irritating. I have been walking the way I walk since I was an infant. Is there really a special way to do so? — R.C.
ANSWER: Most people develop a walk natural for them, and there’s nothing wrong with that. Some general pointers about the proper walking style are worth incorporating into your walking pattern.
Keep your head erect with eyes focused about 20 feet in front of you. Your arms should be bent at the elbow. When the right foot hits the ground, the left arm should be in front of your body, and vice versa when your left foot hits the ground. The heel of the foot should strike the ground first, and the liftoff should come from the toes.
Older people tend to shorten their walking stride in an attempt to keep both feet always on the ground. This gives them more balance and stability. They should try to take a little longer stride and use their arms for balance and stability as I described above.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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