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December 11, 1998     Cape Gazette
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December 11, 1998

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38 - CAPE GAZETTE, Friday, Screenings Continued from page 33 digital rectal exam of the prostate gland and a blood test called prostate-specific antigen (PSA). Neither of these tests alone is considered an excellent screening tool, but together they offer the best exam that is currently avail- able to screen for prostate cancer. An abnormal prostate gland exam or high PSA level does not auto- matically mean an individual has prostate cancer. As with other screening tests, it usually means an individual has prostate cancer. As with other screening tests, it usually means referral to a urolo- gist for examination and probably an ultrasound and biopsy of the prostate gland. Many providers recommend yearly rectal exams and a PSA for all men starting at age 50. Some may recommend starting screen- ing at an earlier age if an individ- ual is at higher risk because of a family history. The exact recom- mendation for screening any indi- vidual should be discussed with a health care provider. Cervical cancer Cervical cancer is detected in 16,000 new patients each year and about 4,500 women die annually from this disease. The incidence of invasive cervical cancer has greatly decreased over the past 30 years due to improved early detec- tion programs. Risk factors for cervical cancer include early onset of sexual intercourse, multiple sexual partners, history of infec- tion with the human papilloma virus, HtV infection and smoking. Cervical cancer and cervical dys- plasma, a precancerous condition, generally cause no initial symp- toms so early detection with screening is very important. The main screening test for cer- vical cancer and cervical dyspla- sia is the Pap smear. The Pap smear is generally considered to be an excellent screening test, however, an abnormal Pap smear does not automatically mean an individual has cancer. As with most screening tests, it usually December 11 - December 17,1998 means that a more accurate test is needed. In the case of an abnormal Pap smear, a colposcopy is gener- ally recommended which is a magnified examination of the cervix. It is strongly recommend- ed that all women have regular Pap smears after the age of 18, or after becoming sexually active. Pap smears should generally be done every year, but occasionally can be done less frequently, de- pending upon individual risk fac- tors and age. Individuals should discuss the actual frequency with their health care provider. Skin cancers Skin cancers are very common with more than 800,000 new cases diagnosed each year. Most of those - 95 percent - are basal cell and squamous cell cancers, which are generally considered very treatable and are rarely metastic, only causing approximately 2,000 deaths per year. However, local tissue destruction may cause dis- figurement or even functional im- pairment if these tumors are not detected and treated early. Risk factors for these cancers include light complexion, includ- ing light eyes and hair, poor abili- ty to tan, and substantial cumula- tive lifetime sub exposure. Malig- nant melanoma is less common than these cancers but is more deadly. There are only 35,000 new cases each year but about 7,000 deaths per year from malig- nant melanoma. Risk factors for this disease include light skin, pre- cursor lesions, such as atypical moles and some congenital moles, increased number of common moles, family or personal history of skin cancer, excessive sun ex- posure and frequent "sunburns in childhood. Early detection of skin cancer generally reduces the severity of the disease. Early detection should reduce the degree of dis- figurement caused during excision of basal cell and squamous cell cancers and reduce the incidence of death as well as disfigurement from melanoma. Identifying and removing precancerous lesions, like atypical moles, may actually prevent cancer by removing the lesion before it becomes a cancer. Primary prevention is also pos- sible by reducing modifiable risk factors such as sun exposure. This can be done by wearing protective clothing or applying appropriate sunscreen preparations. The most effective way is to avoid pro- longed sun exposure, especially between 10 a.m. and 3 p.m. in the summer months. Wearing sun- screen is not as effective in avoid- ing sun exposure completely but is certainly helpful, especially sunscreens which are formulated to block ultraviolet (UV) rays, in- cluding UVA and UVB. Most on- 1.y block UVB. Screening for skin cancer in- volves periodic total body skin ex- aminations by a clinician and a self skin examination. The recom- mendations for these exams vary depending on individual risk fac- tors. A clinical skin exam could be done yearly as part of a routine physical exam for all adults over age 40 and every three years for all adults age 20 to 30. Also, indi- vidual should be aware of the con- cerning features of skin lesions which include irregular borders, color variability, asymmetrical le- sions, nonhealing lesions and le- sions that frequently bleed. Any lesion that is concerning should be &apos;evaluated by a health care provider and a biopsy may be done if indicated. In general, the key to cancer screening is to identify and treat cancer as early as possible to im- prove longterm survival. More important is the prevention of can- cer by identifying and treating precancerous conditions and by reducing modifiable risk factors such as avoiding tobacco use and eating a healthy diet that is low in fat and high in fiber. Editor's note: Dr. Greg Bahtiar- man is a family practice physician at Bayside Health AAssociation. For more information, call 645- 4700. I FITNESS CENTER REHOBOTH BEACH Enjoy Working Out in an Oceanfront Gym Without Oceanfront Prices? Free or low-cost prescriptions available A new publication may help people whose medication is too expen- sive for their budgets. The Cost Containment Research Institute in Washington, DC has just published a 32 page booklet, "Free & Low Cost Prescription Drugs," which provides information on how and where to get free and low-cost prescription drugs. "Many major drug companies provide free or low cost medication, but rarely, if ever, publicize the programs," said Heather Kerrigan, di- rector of the institute. "We've published an A to Z listing of all the drugs that are available to certain qualified groups for free or at very low cost, directly from the manufacturer." Consumers may receive a copy by sending $5 to cover the cost of priming, postage and handling to Institute Fulfillment Center, Prescription Drug Booklet #: PD-372, P.O. Box 462, Elmira, N.Y. 14902-0462. Consumers may also get the information from the institute's Web site <>. Michael L. Cahoon, D.M.D. Oral and Maxillofacial Surgery is pleased to announce the opening of his practice at 750 Kings Highway Kings Way Professional Building Suite 107 Lewes, DE 19958 302-644-4171 302-644-4314 (Fax) Accepting New Patients UDAY A. JANI, M.D. Internal Medicine Board Certilled Appointments also available evenings and Saturdays.