MDNews - Greater Boston

IRMA ALARCON, MD, DISCUSSES CERVICAL CANCER DETECTION Q: What is the importance of Pap tests in early detection of cervical cancer? A: Once the leading cause of cancer deaths among U.S. women, cervi- cal cancer has decreased in incidence and mortality over the past 40 years. This good news is due to Pap tests, which can iden- tify cervical precancers before they become cancerous and when treatment is most effective. Of all the cancers of the female reproductive organs, only cervical cancer benefits from such a simple, dramatically effective screening test. Q : W h o i s m o s t a t r i s k f o r cervical cancer? A: All women are at risk, but it occurs most often in women older than age 30. Each year, about 12,000 women in the United States get cervical cancer, and about 4,000 women die from it. Other things can increase a patient's risk, such as smoking history, having HIV, using birth control pills for a long time (five or more years), having given birth to three or more children, and having several sexual partners. Q: W hat role does t he huma n papillomavirus (HPV) play in the development of cervical cancer? A: HPV is the main cause of cervical cancer. HPV is a common virus that is passed from one person to another during sexual intercourse. At least half of sexually active people will have HPV at some point in their lives. HPV usually shows no symptoms, so patients cannot tell if they have it. For most women, it goes away on its own; however, there is a chance that over time it may cause cervical cancer. Q: What is HPV vaccine? A: In the United States, two vaccines are currently available to protect patients against the types of HPV responsible for most cervical, vaginal and vulvar cancers. Both are recommended for 11- and 12-year-old girls, as well as for females 13–26 years of age who were not vaccinated at a younger age, or who did not receive a complete series of HPV vaccines. These vaccines also can be given to girls as young as 9 years of age. Females should receive the same vaccine brand for all three doses, if possible. It is important to note that women who are vaccinated against HPV still need to have regular Pap tests to screen for cervical cancer. Q: When should women stop screen- ing Pap tests? A: Recommendations are for patients to have their first Pap test when they are 21. If test results are normal, they can wait three years for their next one. HPV tests are not recommended for screening women under 30. Patients can stop being screened at age 65, as long as they have had normal Pap test results for many years or if they no longer have a cervix due to surgery for fibroids or other benign conditions. Dr. Alarcon is accepting new patients at 830 Oak St., Suite 105W, Brockton. Please call 508-897-4760 to refer a patient. LUCY LOMAS, MD, ENCOURAGES WOMEN TO CARE FOR THEIR HEALTH Q: Aside from pregnancy, what is the most common women's health issue that brings people to see you? A: Patients most often want to develop a reproductive plan. I work with my patients to determine which options are best for them at this point in their lives. Q: W h at a re t he primary concerns for maintaining good women's health? What are the most common fears or misconceptions patients have around their care? A: I believe guaranteeing access to health care for all women is the first step to ensure their well-being. Once women are provided with access, we can work on reducing fears and anxieties they may have. Some women find it difficult to discuss their reproductive concerns or are worried about whether they will have a healthy pregnancy. I also see women experiencing pelvic pain or who have fibroids and cysts that have gone undiagnosed. These can be the root of deeper fears that, once the medical condition has been diagnosed, can be cleared away. Q: Can you describe a typical well visit with a new patient — what you look for, ask about or want them to share? A: I generally take a thorough history to find out when their last pelvic exam was, the most recent Pap smear and its results, reproductive concerns, pregnancies, and what their menstrual cycles are like. I want each patient to feel comfortable sharing her past experiences and why she is choosing a new physician. Q: How have women's health ser- vices changed or advanced in the last few years? A: We have better technology for early detection of breast, ovarian and uterine cancers, which can mean everything to a patient facing those diagnoses. Treatment options are becoming more varied, as well. Q: What are some of the things most women put off or don't address that you, as a physician, wish they would? A: Self breast exams, mammograms and their annual pelvic and Pap smear. These are the basic diagnostic tools we use to provide early intervention. Q: Do you think that women are well-versed in the aspects of their care? How can the medical community better communicate and educate all populations about their health care? A: I do think there are inconsistencies in the communication of women's health care and concerns that we see from one patient to the next. Some women come in with textbook knowledge of their health, while others have had limited exposure to resources. If we continue to dialogue with our patients and encourage primary care providers, insurers and even pediatricians to begin these conversations early, we could see a significant change in the discussions we have with patients. Q: If there is one thing you would insist all women do for their own health, what would that be? A: The one thing I would encourage all my patients to do is to take charge of their health care and make it a priority. Dr. Lomas is accepting new patients at 21 Bristol Drive, Suite 203, South Easton. Please call 508-565-3411 to refer a patient. For a complete list of our physicians, visit www.steward.org/doctorfinder. COV ER FE AT UR E WO M EN C A R I N G FO R WO M EN 8 | Greater Boston MD NEWS ■ M D N E W S . CO M

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