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Question

I just had a Pap test and was told to return for further tests.  Several of my friends recently had the same experience.  Is this because the test has changed, or should we be worried?

Question

I have heard that there is a test for Jewish women to determine if they have an increased risk of developing breast cancer.  Should I have myself tested?

Answer

No, on both counts.  There are several reasons why further testing may be necessary.  One possibility is that the slide your gynecologist sent to the lab does not contain a satisfactory sample for analysis.  After you have had a second Pap test, one of three determinations will be made: 1) the results are negative; 2) the results show the presence of cancerous or precancerous cells; or 3) the smear contains " atypical squamous cells of undetermined significance" (ASCUS).

     Roughly 5 to 10 percent of women tested are in the ASCUS category.  The presence of abnormal cells may be due to human papilloma virus (HPV).   This sexually transmitted virus can remain dormant and undetected for years.   Harmless to men and most women, HPV can cause cell abnormalities that may lead to cervical cancer.  For women with ASCUS, doctors usually perform a diagnostic procedure known as colposcopy, which is a biopsy and endocervical curettage.  This may be followed by cryotherapy to freeze the surface layer of the cervix, causing the cells to slough off.  Or, the area may be cauterized to get rid of abnormal cells.   It is wise to repeat the Pap test three times, at 4- to 6- month intervals, to make sure that these abnormal cells have been eliminated.   Although the condition can reappear, with proper monitoring it can be prevented from ever becoming cancerous.

     In general, if you notice any symptom that worries you, report it to your doctor.  Even if you have been given the all-clear sign, false negative Pap test results are not that rare and it pays to be doubly safe.

Answer

While many factors influence a woman's risk of getting breast cancer, heredity plays an important role.  Genes contain important information about each of our physical characteristics, from our hair color down to the shape of our toes.   Scientists have found that when some of these genes have mutations ( flaws, or differences from normal genes ), the chance of getting certain illnesses increases.

     Scientists have identified two genes, known as BRCA1 and BRCA2, that affect a woman's chances of getting breast and ovarian cancer, and a man's chances of getting prostate cancer.  Three specific mutations have been found to be more common among Jewish women whose ancestors lived in eastern and central Europe.   If you are a member of this group, known as Ashkenazi Jews, and other members of your family have had breast or ovarian cancer, you may be at risk.  Before you decide whether to be tested, consult your doctor or a genetic counselor.  So far, only slightly more than 2 percent of the Ashkenazi Jews tested were positive, and more research needs to be done to understand how genetic factors interact with other risk factors, including environment, diet, and age, to produce cancer.

     All women, even those who are not in a high-risk group, should examine their breasts frequently.  And if you are over 40, be sure to have regular mammograms.

Question

I know exercise is important but when is a working mother supposed to find the time for it?

 

NEWS UPDATE

The results of a study of 80,000 nurses, begun in 1980, show that vitamin B6 and folate ( folic acid) reduce the risk of heart attacks.   Earlier studies have shown that B12 is also beneficial.  So eat plenty of fruit, vegetables, beans, and whole grains for good heart health.

A new drug for asthma treatment has just been approved by the U.S. Food and Drug Administration.  Singulair is the first medicine developed for both adults and children as young as six years old that can be taken in pill form once a day to control day and night-time asthma symptoms.  And because it does not contain steroids and has no serious side effects, it is considered safe for children.

Answer

After a day of taking care of the kids, cooking, working, and a hundred other small things, the last thing most of us think of doing is exercising.   However, more and more studies indicate that exercise is important for your health.   Women who exercise regularly are less likely to suffer from stress, cardiovascular disease, non-insulin dependant diabetes mellitus, and osteoporic fractures.

     The American College of Sports Medicine and the Centers for Disease Control and Prevention recommend 30 minutes of moderate exercise a day.   Walking is good exercise.  If you are heading for work or the store and it's a mile or two away, walk there if you can.

     Of course, exercise is not just beneficial to women.  A recent study published in the New England Journal of Medicine of retired nonsmoking men demonstrated that men who walked 2 miles a day had a death rate that was almost half that of men who walked less than a mile a day.  So invite your man to join you!

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