In my previous thirty-two columns for the West Texas County Courier Newspaper, I have discussed issues of vital medical importance to the general public. I have taken none of those journalistic pieces as seriously, however, as what I am about to tell you. Four minutes of your time here may add forty years to your life, as we slam the screen door on cancer and infectious disease, allowing only what is good and pure and healthy to bridge the mesh.
Let’s let the sunshine in on screening procedures for some common cancers. Foremost among them, we turn our attention to breast cancer. On October 2, 2003, I discussed this uninvited guest in some detail. Years pass, words are wasted, and we are left with an ill-timed knock at the door. Monthly self-examination and an annual breast exam by a physician might have canceled delivery. Mammography conducted every year after age 40-50 would certainly be more efficacious than do-not-call lists.
When cervical cancer comes a calling, we have only ourselves to blame. A failure to seek an annual Pap smear starting at age 18 or at the onset of sexual activity ups the ante in a game of Russian roulette. It becomes useless here to rant and proselytize on the subject, as I did in my piece on February 9, 2006. A door blown open requires much more than simple hinges. If we had only taken the time to heed our health care providers, those three consecutive, normal, annual Pap smears would have not only increased the screening interval to every three years, but would have provided more security and peace of mind than double locks.
Colons and prostates are our friends, that is, when we cater to their needs. When the pizza boy comes a knocking, we leave him a tip. Such attention to detail in an encounter with a complete stranger makes little sense, when, on the contrary, we abuse and neglect those old chums who have kept us going for a half century. After age 50, annual examination of the stool for blood and sigmoidoscopy every 3-5 years or colonoscopy every 10 years can provide a pat on the tummy more potent than surgery, chemotherapy, or radiation. The welcome mat to prostate cancer prevention is a little more controversial. While some physicians recommend no screening, others slide back the latch and peep favorably through the crack at yearly rectal examination and prostate-specific antigen (PSA) testing at age 45 for African-Americans and those with a strong family history and at age 50 for all others.
On December 2, 2004 and on December 29, 2005, I discussed adult vaccines and immunizations, respectively. In the meantime, a revolving door policy in the medical community has fed doubts as to our coming or going. Some simple instructions will now go far to extending our warranties. While influenza and pneumococcal immunizations are messengers of hope for the 50-65-and beyond age groups and those with HIV, splenectomy, organ transplant, or on chemotherapy, other vaccines target a restrictive customer calling list. Hepatitis A (for travelers to endemic areas), meningococcal (for use in outbreaks), and smallpox (for laboratory workers directly exposed) immunizations fall into the latter category.
Finally, accidents will happen, and, rather than trust a friendly voice behind a closed portal, we must proactively assume a defensive stance. Such is the case with tetanus and hepatitis B prevention. The former vaccine mandates initiation in childhood with boosters every 10 years. Hepatitis B immunization, on the other hand, is reserved for all young adults and for IV drug users, health care providers, and those with chronic liver disease.
Some simple guidelines will ensure unbruised derrieres, as the screen door swings back on our golden years.
© 2007, Albert M. Balesh, M.D. All rights reserved.
