ASK THE DOCTOR
03/18/1997
ASK THE DOCTOR
03/18/1997
BY DR. ERIC ANDERSON
c.1997 Medical Tribune News Service
Q: Is it true that breast self-exams don't benefit women?
A: No. Since I graduated from medical school in 1958, I've had 20 to 30
patients come to me because they'd found lumps in their breasts. Many
of those lumps turned out to be malignant and most of them were caught
early by the patient because she'd learned how to examine her breasts
properly.
A recent study published in the Journal of the National Cancer Institute
revealed that an intensive program to teach 133,000 women in China how
to examine their breasts failed to reduce cancer deaths over five
years. I discount this study for two main reasons: the study was
conducted in Chinese women, so the results can't necessarily be
generalized to all women; and five years is too short of a time frame
to rule out any benefit from breast self-exam.
Breast self examination is easily learned. It doesn't cost anything,
doesn't hurt and doesn't have side effects. It is a useful adjunct to
mammography.
Q: My husband and I are planning to conceive a child in the near future.
Are there any steps I can take to prepare for a healthy pregnancy?
A: First of all, any current health problems should be addressed
promptly because it's difficult to pinpoint the exact moment you become
pregnant.
Both you and your husband should exercise and eat well, avoiding toxins
like alcohol, tobacco, unnecessary medications and, of course, illicit
drugs.
Both of you also should try to stay away from germs: That means shunning
incompletely cooked meats and avoiding not only people with the flu and
other viruses but even ill animals. Women shouldn't handle soiled cat
litter because it can harbor germs that cause toxoplasmosis _ an
infection to avoid if you are pregnant or trying to conceive.
It's helpful for women to have a test done for anemia because pregnancy
can worsen the condition. And if you haven't been vaccinated against
rubella, you should either be vaccinated against the disease before you
become pregnant or try to avoid the disease during pregnancy.
Different races can have different potential genetic problems so you'll
want to discuss your family background with your doctor.
You also should start taking a multivitamin that contains folic acid as
that may cut down on some birth defects.
That said, don't become so concerned about danger that you lose the
thrill and pleasure of the greatest experience in life _ having a baby.
Dr. Anderson is a charter diplomate of the American Board of Family
Practice. A former president of the New Hampshire Academy of Family
Physicians, he now practices part-time for a large medical group in San
Diego and writes regularly on medical matters.
Do you have a health question that you would like the Medical Tribune
News Service to address? If so, please send it by e-mail to
jstenson@jobson.com. Dr. Anderson cannot respond to questions
personally. Please note that the information contained in this column
is not intended to replace the medical advice offered by your
physician.
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