The Best Tests For 1993

By Dr. W. Gifford Jones

Let's start 1993 with a bet. I'd wager that no-one could guess what happened to my wife and me a few days ago. Here's the only clue. It was a "His" and "Hers" situation. You're wrong if you thought we bought "His" and "Hers" towels. Or "His" and "Hers" cars. We weren't looking for space and arranging "His" and "Hers" vacations. Instead we left home one morning for the most unromantic of appointments, with a colonoscopy clinic. This procedure and several others are considered the top best tests in 1993.

We subjected ourselves to colonoscopy even though we were both symptom-free and felt well. Cancer of the large bowel is now one of the major malignancies. It can be in an advanced stage before symptoms appear. This is why every year increasing numbers of people die from this disease.

Routine colonoscopy can prevent deaths by detecting and removing pre-cancerous polyps long before symptoms appear. But unfortunately this procedure will never be as popular as the Pap smear.

You have to be well motivated to have a flexible colonoscope inserted a few feet into the bowel when you have no rectal bleeding, pain or abnormal bowel movements. In addition laxatives and copious amounts of water must be taken for 24 hours before the examination to ensure a totally clean bowel.

I confess I'd rather have been in Philadelphia. During the preparation and the procedure I admit wondering why the Creator hadn't designed our anatomy a bit better! But the short indignity was better than dying from an undetected tumour.

Unfortunately there are not enough colonoscopists to screen everyone. But if you live in an area where it's available don't turn it down when suggested by your doctor. Ideally colonoscopy should be done by 40 years of age and then repeated every five years. The risk is minimal, about one chance in 4,000 of bowel perforation.

Women need regular Pap smears. Some physicians suggest one a year, others recommend one every three years. This test diagnoses pre-malignant changes in the cervix (the opening into the uterus) and could end deaths from this disease. Pap smears should be started in the late teens. It's particularly important for women who have multiple sexual partners.

A blood pressure check is mandatory every few years. It's appalling that over 20 per cent of North Americans suffer from hypertension. This increases the risk of stroke, heart attack, kidney failure and damage to the retina , the back part of the eye.

Mammography can be another life-saver since it detects breast cancers that cannot be felt. There is some debate about when it is most cost effective in detecting early breast cancers. Some believe annual screening should start at age 40 and be repeated every one to two years. Others suggest routine screening starting at age 50. The small risk of radiation must be balanced against the big risk of missing an early curable malignancy.

Baseline tests can save considerable worry. For instance, it's comforting to know that when a chest film reveals a questionable lesion late in life that it was known to be there 20 years previously and hadn't changed in size. Or that an abnormality in an electrocardiogram was also present earlier and hadn't changed.

Patients continue to die simply because they failed to get these tests done. I recall a young female patient who had studied piano for 15 years and was about to make her debut. She noticed increased vaginal discharge and for the first time sought medical help. Examination revealed an inoperable cervical cancer. She died shortly after giving her recital. Patients you've seen for just a few minutes are never forgotten when a terrible tragedy could have been prevented.

Recently I lost a friend whose life might have been saved if the "nicotine patch test" had been available 30 years ago. If you're still smoking ask your doctor about it.

One patch "Habitrol" delivers a tiny trickle of nicotine into the circulation every day for three months to counteract the agonizing withdrawal symptoms of giving up smoking. Don't cheat and smoke a cigarette while using the patch as this delivers a double dose of nicotine which could cause cardiovascular problems.

If you pass this test and never smoke again you've accomplished more for your health than all the other tests combined. Smoking causes 30 per cent of all cancers, 30 per cent of heart disease and 90 per cent of lung problems.

An ounce of prevention will always be worth a pound of cure. That's why it's prudent to agree to tests that have proven their worth. You might even arrange a "His" and Her" rendezvous in 1993. And then celebrate when both tests are negative. How's that for romance?

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod