SavantMD: Health and Wellness » Dr. Chan

Health and Wellness Tip: Cervical Cancer and Pap Smears

SavantMD — Fri, 29 Jan 2010 06:07:45 +0000

Why and how often should women get pap smears? Watch the wellness tip below from Dr. Savant to find out and learn more from Dr. Chan about Cervical Cancer and Pap Smears.

• About Dr. Savant

Cervical Cancer and Pap Smears

SavantMD — Sat, 23 Jan 2010 01:59:58 +0000

Some of my patients wonder why it is important for them to get pap smears. I explain that pap smears, or Papanicolaou tests are important in helping us detect early, pre-cancerous changes in the cervix, thus allowing for the possibility for early treatment if necessary.

Watch the video below, or Read More.

Cervical cancer is a slow progressing disease. The normal cells go through several pre-cancerous stages before becoming cancer. This process usually takes several years. More importantly, only some of the women with pre-cancer of the cervix will develop actual cancer. For most women, the pre-cancer changes will remain stable or go away without any treatment. Since it is impossible to predict which women will end up with cervical cancer, the best approach is to have regular follow-up with your doctor and get regular evaluation with pap smears.

Pap smears are tests performed to retrieve a sampling of cells from the cervix in order to diagnose pre-cancer or cancer. The goal is to prevent cervical cancers by finding and treating the pre-cancers before they have a chance to progress further. It is recommended that women get a pap smear every year beginning at age 21, or starting three years after the first sexual encounter, whichever comes first.

Your doctor may choose to recommend different intervals between pap smears once you begin testing, especially if you are 30 years old or older and have had a number of normal pap results in a row. If you are unsure about when you should get your next pap smear, definitely talk to your doctor.

Pap smears can also be used to detect the presence of HPVs, or human papillomaviruses. HPVs are a group of viruses that are sexually transmitted and can cause infections to the cervix. It is a common infection among sexually active women and usually does not cause any symptoms. HPV infection has been determined as the most important risk factor for the development of cervical cancer. Fortunately, most HPV infections clear on their own without treatment within months to a few years, and only a small proportion progress to cancer.

Helpful Resources
• American Cancer Society: Cervical Cancer – Prevention and Early Detection

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Besides getting regular pap smears, there are other things you can do to help avoid cervical cancer. These include decreasing your chance of catching HPVs by delaying sex until an older age, limit your number of sexual partners, and avoid having sex with someone who has multiple other sexual partners.

It is also important to practice safe sex by using condoms. Even though condoms do not completely prevent HPV infections, they still decrease the risk significantly and also protect against other STDs such as HIV. Avoid smoking, since that has been linked to increased risk of cervical cancer. Lastly, consider getting the HPV vaccine. There are currently two HPV vaccines that are approved by the FDA: Gardasil and Cervarix. The main thing to keep in mind about these vaccines is that they do not treat HPV infections and do not prevent all HPV infections. Therefore it is important to continue with your pap smear testings even after getting the vaccine.

Source American Cancer Society: Cervical Cancer – Prevention and Early Detection
• About Dr. Chan

Breast Cancer and Mammograms

SavantMD — Tue, 29 Dec 2009 00:08:42 +0000

Breast cancer is the second most frequent cause of death due to cancer in women in the United States. About one in eight women will get breast cancer during their lives. Even though most cases occur after menopause, about 25% (or 1/4) of breast cancer is found in women younger than 50 years of age.

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Risk factors for developing breast cancer include: being a carrier of the BRCA1 or BRCA2 gene mutations, family history of breast cancer (especially with two or more first-degree relatives with breast cancer), older age at the birth of first child, late menopause (age 55 or older) and younger age at the start of periods (younger than age 12). But the most important risk factor of all is age, with increasing risk as one gets older.

Currently, a mammogram is the screening test of choice for breast cancer. It is the most studied breast cancer screening test that is available, and there is evidence supporting its role in reducing the number of breast cancer related deaths (particularly in women aged 50 to 74 years).

The goal of mammograms is to find breast cancer while it is still at an early stage, when it is more likely to be cured completely.

There are potential side effects of mammograms. They include results that are falsely positive (leading to unnecessary treatment of lesions that otherwise would not have an impact to one’s health), radiation exposure (although the dose of x-ray per test is extremely low), and procedure-associated pain.

The American College of Obstetricians and Gynecologists recommends screening mammograms every one to two years for women ages 40 to 49, and yearly thereafter. The American Cancer Society recommends yearly mammograms beginning at age 40.

Recently, the U.S. Preventive Services Task Force (USPSTF) issued its new breast cancer screening guidelines, an update from those they issued in 2002. They recommend waiting until age 50 years to begin routine screening, and changing the screening interval from one to two years. These changes are made by the task force based on a review of previously published data of breast cancer screening tests, looking at evidence for screening in lowering cancer-related death rate as compared to its potential harm.

The important thing to keep in mind is that at this point in time, other organizations and expert groups, such as the American College of Obstetricians and Gynecologists and the American Cancer Society, have not changed their own guidelines based on the U.S. Preventive Services Task Force’s recommendations. The best thing to do to determine when you should begin mammogram screening and screening interval will be to consult your doctor.

Helpful Resources
• The American College of Obstetricians and Gynecologists: Mammography
• The American Cancer Society: Mammograms and Other Breast Imaging Procedures

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Your doctor may also recommend that you get a mammogram at other times. For example, when the clinical breast examination demonstrates an abnormal mass, or when you have complaints of any breast related symptoms. It is also possible that your doctor will recommend ultrasound or MRI of the breasts as additional evaluation tests. Bottom line is when in doubt, always talk to your doctor.
• About Dr. Chan

Pregnancy and Flu Vaccines

SavantMD — Mon, 26 Oct 2009 06:40:08 +0000

A lot of my expecting patients have been wondering about the flu season. Even though the majority of people infected with the flu virus will have uncomplicated illnesses (symptons that go away without treatment), more severe diseases causing superimposed pneumonia, preterm labor, sepsis and even death have been reported. Pregnant women are among the group of people with increased risk of developing these more severe complications of the flu.

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Because of this, the Centers for Disease Control and Prevention, or CDC, and The American College of Obstetricians and Gynecologists recommend the influenza (flu) vaccination for all women who are or will be pregnant during the flu season. If you fall into this category, this year, the recommendation is to receive both the seasonal and 2009 H1N1 vaccines.

It has also been shown that babies born to mothers who had a flu shot in pregnancy get sick with flu less often. So when you get the flu shot as an expecting mother, you are not only protecting yourself and your pregnancy, but also your newborn up to 6 months of age.

http://www.flu.gov/widgets/vaccinelocator.htmlBoth the seasonal and 2009 H1N1 flu shots can be received by pregnant women at any time during pregnancy. The important thing to remember is to choose the injection form of the vaccine (TIV or trivalent inactivated vaccine) and avoid the nasal spray form of the vaccine (LAIV or live attenuated influenza vaccine).

There are some concerns about the flu vaccines containing thimerasol, a mercury preservative. The truth is that the exposure to mercury from these vaccines is minimal and there is no evidence that it is harmful. So when the option of obtaining the thimerasol-free version is not available, it should not prevent you from getting vaccinated.

Helpful Resources
• The Centers for Disease Control and Prevention (CDC): H1N1 (Swine Flu)
• The CDC: H1N1 (Swine Flu) Resources for Pregnant Women

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The most common side effects after flu shots are mild. You might get sore, red and swollen where the shot was given. Some people might have headaches, muscle aches, fever, nausea or feel tired. These symptoms are usually self-limited (require no treatment) and should not last more than 1 to 2 days.

Both the seasonal flu vaccine and 2009 H1N1 vaccine are not recommended for people with severe egg allergy. So if that is something you have, make sure to talk to your doctor about other ways to stay healthy during the flu season.

Besides getting the flu shots, don’t forget the importance of behavioral prevention, for example: hand washing with soap and water, or alcohol-based hand rub, covering your nose and mouth when coughing or sneezing, and remaining home from work or school while infected with the flu. • About Dr. Chan

I’m pregnant. Should I get the flu shot?

SavantMD — Sat, 24 Oct 2009 20:38:20 +0000

Dr. Chan: Both the Centers for Disease Control and Prevention, or CDC, and The American College of Obstetricians and Gynecologists recommend the influenza (flu) vaccination for all women who are or will be pregnant during the flu season. If you fall into this category, this year, the recommendation is to receive both the seasonal and 2009 H1N1 vaccines. Learn More.

Is it safe to exercise during pregnancy?

SavantMD — Sat, 24 Oct 2009 20:34:26 +0000

Dr. Chan: Yes, it is safe to exercise during pregnancy. In fact, women who exercise regularly during pregnancy are found to have fewer pregnancy related symptoms, healthier pregnancies and easier deliveries. In terms of the type of exercise, there is little limits as to what one can do during pregnancy, but do practice common sense, and do not engage in activities that might increase the risk of injuries.