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Health care:?It’s all about prevention

February 23, 2012
Times Leader
By SCOTT McCLOSKEY, For The Times Leader

Routine medical examinations such as mammograms, colonoscopies and prostate exams are extremely important for Baby Boomers, as that’s the age we start seeing more illnesses related to those tests and screenings, according to local doctors. While the guidelines for each of these examinations differ, they all are geared toward the same result — catching a disease early. For example, cancer screening increases the chances of detecting certain cancers early, when they are most likely to be curable, according to the American Cancer Society. Dr. William Mercer of Wheeling said it’s extremely important to consult your own personal physician when making choices about medical exams or testing, because it is vital to look at the whole person and their medical and family history while making these decisions. “If we have a frail elderly, some of these screening tests are not worthwhile,” said Mercer. “Again, running a battery of tests, you have to know what that person’s general health is — because I have seen complications from these tests, they are not benign, but they have made a huge difference I feel in diagnosing cancers early.” Some guidelines set by the American Cancer Society for cancer screenings include: ? Yearly mammograms and clinical breast examinations are recommended for women age 40 and over and continuing for as long as a women is in good health. Women in their 20s and 30s should get a clinical breast exam every three years. Some women, because of their family history, a genetic tendency, or certain other factors, should be screened with MRI in addition to mammograms. Breast self-exam is recommended for women starting in their 20s. Women should talk to their doctor about their history and whether they should have additional tests at an earlier age. ? For screening of colorectal cancer or polyps — beginning at age 50, both men and women should follow one of the following testing schedules after consulting with their doctor about their history and which test is best for them: a flexible sigmoidoscopy every five years, or colonoscopy every 10 years, or double-contrast barium enema every five years, or a CT colonography (virtual colonoscopy) every five years. However, if any of the three tests other than colonoscopy come back positive, a colonoscopy should be done. ? The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. It is recommended that starting at age 50, men should talk to their doctor about the pros and cons of testing, so they can decide if testing is the right choice for them. If you are African American or have a father or brother who had prostate cancer before the age of 65, you should have this talk with your doctor starting at age 45. If you decide to be tested, you should have a PSA blood test with or without a rectal exam. How often you are tested will depend on your PSA level. Mercer said the U.S. Preventive Services Task Force recently came out with new guidelines on the PSA blood test for prostate screening. He said the organization is saying it may not necessarily be the best test for healthy men in their 50’s and 60’s because it sometimes can result in additional anxiety and testing which could prove to be unnecessary in some cases. Mercer said this has caused “some debate” within the medical community. “What their saying is, ‘discus it with your physician.’ Mercer said he is still recommending the PSA test, but is “discussing it with the patient instead of just doing the test.” “I still think it is beneficial, it’s a guide. ... I think the question is maybe more for the baby boomers, the 50’s, the 60’s, do we still do it ... right now I think most officials are still recommending it,” he added. He said a patient’s family history also plays an important role in how aggressive patients are tested. “I don’t think there is any doubt that colonoscopy ... has really made a big difference,” said Mercer. “We really stress to our patients, ‘Let’s get that colonoscopy,” he added. “Another thing that we really do recommend is the mammograms — I feel they make a huge difference,” he added.



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