By Katherine Hobson

The government estimates that more than 15,000 women died last year from ovarian cancer.

But routine screening of women with no symptoms isn’t recommended by the United States Preventive Services Task Force, American Congress of Obstetricians and Gynecologists or other professional groups, even for women at high risk for the disease. That’s because the benefits of the available tests — a transvaginal ultrasound and a blood test that detects an antigen called CA-125 — haven’t been shown to outweigh their risks (such as complications from unnecessary surgery), or to reduce the number of deaths.

Despite that evidence, a new study finds that when presented with a scenario of a woman coming to her annual check-up, a significant percentage of physicians surveyed would screen for ovarian cancer.

Some 28.5% of the 1,088 primary-care docs? — OB/GYNs, family physicians and general internists — surveyed said they “sometimes” or “almost always” offered or ordered ovarian-cancer screening tests for low-risk women. when the vignette involved a woman at medium risk of the disease, that proportion jumped to 65.4% of physicians.

About a third of physicians reported believing that ultrasound or CA-125 blood testing is an effective screening test for ovarian cancer, the study found. It’s unclear why that is, and more research is needed to discover why, says Laura-Mae Baldwin, an author of the study and professor of family medicine at the University of Washington.

“We know that in medicine we have an enthusiasm for screening,” she says. “We want to find diseases before they can cause harm.”

The study also found that physicians were more likely to say they’d order screening for patients who requested it — even if the doctor herself didn’t believe screening was effective.

In that scenario, physicians may be trying to maintain a relationship with the patient, or they “may lack confidence in explaining why the test is more harmful than beneficial,” says Baldwin. she says there’s an important role for clinical tools that could accurately illustrate the level of risk faced by a particular woman and also illustrate the harms and benefits of the test.

The study is published in the Annals of Internal Medicine.

There are limitations to the research: doctors were reporting how they’d react to the scenarios presented to them, not discussing actual patients. and while there was a 62% response rate to the initial questionnaire sent to physicians, the results may not generalize to the doctors who didn’t respond, the authors write.

Untreated hypertension may lead to heart attack or stroke.  Even without noticeable symptoms, unsuspecting victims of high blood pressure may experience significant health effects.  Paramus Health Officer, Judith Migliaccio reminds us that because hypertension can be treated, early detection is necessary for good management.  Healthy eating and daily physical activity can have beneficial results.  For that reason, Paramus residents will be offered several opportunities in January to have their blood pressure checked by the Borough nurses.

Hypertension screening will be offered along with blood testing for diabetes at Borough Hall on Wednesday, January 11th from 1:00 to 3:00 p.m.  on this date an appointment is necessary and can be made by calling the Board of Health.  Residents are invited to drop in to the Board of Health without an appointment on the fourth Friday of the month, January 27th, from 9:30 to 11:00 a.m. A decrease in daily physical activity along with an increase in the consumption of high calorie foods has resulted in an epidemic of diabetes in our country.  other risk factors for diabetes include being over age 40, being overweight or having a known diabetic as a close relative.  Consistent high blood sugar may result in increased thirst and urinary frequency or change in vision.

The Board of Health offers an opportunity for blood glucose testing on January 11th from 1:00 to 3:00 p.m.  A simple finger stick yields immediate results and anyone with an elevated response will be advised to see their own physician.  For accurate test results, no alcohol may be taken 24 hours prior to testing and simple dietary rules must be followed by a 2 hour fast.  For complete instructions and an appointment please call the nurses office at 201-265-2100, Ext. 615 or 618. Board of Health President, Dr. Holly Driscoll encourages residents to take advantage of these valuable services offered to Paramus residents.

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Q I have reached my 79th birthday and have been diagnosed with pelvic prolapse, affecting mostly my bladder. however, my OB-GYN describes it as bladder, bowel and cervix.

Owing to my heart skipping occasionally, I went through an EKG and all stress tests and blood testing preparing me for surgery.

I was given approval for the surgery until my OB-GYN told me that she would not perform the necessary surgery as it would be a long procedure and she didn’t want to put my body through that much stress.

A pessary was ruled out because it did not work for me. so, for the time being, I have decided to live with the situation but am now asking your advice on whether I should get a second opinion or do nothing? what problems do you think I would encounter later on?

A Pelvic prolapse is a weakening of the muscles and ligaments of the pelvic organs with the end result being that the organs slip downward out of their normal position.

This is a rather common condition that affects almost 50 percent of all women who have had children.

Symptoms include loss of bladder and bowel control, an increased sensation of urgency to urinate with a sensation of being unable to fully empty the bladder, repeat infections and excessive vaginal discharge.

To document the diagnosis, there are bladder-function tests plus pelvic floor strength tests, ultrasound, MRI or cystoscopy.

Because there are several types of prolapse, I will explain them briefly. If the anterior vaginal wall and bladder fall, the condition is known as a cystocele.

If the posterior vaginal wall and rectum fall, the condition is known as a rectocele. If the uterus falls, a person has uterine prolapse. Small bowel protrusion through an area between the vagina and rectum is an enterocele.

Initial treatment might begin with medication. For example, menopause causes a decrease in estrogen levels in a woman’s body that results in a weakening of vaginal muscles.

Estrogen-replacement therapy can restrengthen those muscles; however, this therapy is not appropriate for all women. that decision must be left to each patient’s primary-care physician or gynecologist.

The next step might be physical therapy to include either biofeedback or electrical stimulation — then surgery. the procedure depends on what specific type of prolapse a person has.

I don’t know your full medical history and can only suggest you return to your surgeon with a list of questions.

Ask why the doctor has chosen not to perform the procedure after all your testing. Perhaps she found something in the test results that she failed to share with you.

Then, if you remain dissatisfied, ask for a referral to another specialist for a second opinion. Bring all your test results when you go.

Write to Peter Gott, c/o United Media, 200 Madison Ave., Fourth Floor, New York, NY 10016.

Last time I had a blood test every thing was fine apart from having slightly high liver enzymes. Apart from showing up on your blood test as being high are there any actual physical symptoms that show from having high liver enzymes?

No one blood test is 100% accurate.
It depend which enzymes where elevated.
The ALT enzyme is mostly made in the liver,
so it is the test they rely on most to see if
the liver cells may be damaged. The others
are made in other organs, also.

Many things can effect these blood tests:
exercising before the blood was taken,
having an intramuscular injection,
having muscle injury, and even some
medications.

It is best to have more blood testing done.
The doctor will compare them and also
see if these enzymes will return to a normal
level. if they stay elevated, then he may
do more blood tests to see if this is a liver
problem: like the liver functions tests and
the liver viral tests. if he suspect a liver
problem for certain, than an ultrasound
or Ct scan will show if inflammation has
developed in the liver because of liver
cell damage. (It would cause the liver
to enlarge in size)

Usually patients do not have symptoms when
the enzymes are elevated, unless it is a liver
problem. The first signs are usually things
that can be mistaken for other things:
like being tired or having flu like symptoms.
The real first sign of a liver or biliary problem
is Jaundice (yellowing of the whites of the eyes
and skin and possibly the darkening of the urine).

I hope this information has helped you. best wishes