Wednesday, May 30, 2007

Common Medical Questions

Patients often ask common and straight forward questions,and physicians try to give answers that are sound. But often we don't have scientific evidence for answering questions. I always look for studies and proof that what I am doing and saying to patients, has basis in up-to-date facts. Here are some common questions where we DO have science to back up the answers.

Q: Are Statin drugs safe for treatment of high cholesterol (hyperlipidemia)?

A: When scientists looked at Statin drugs alone (not in combination with other drugs) they were as safe as placebo except for causing increased liver enzymes. The same number of patients stopped the Statin drug for side-effects as did the placebo group. (Statin drugs: Lipitor, Mevacor, Crestor, Pravachol, Zocor)

Keep in mind that these studies did not look at drug-drug interactions and most of the patients in the studies were younger, but we have good evidence that Statin drugs are safe for prolonged use and we know they are effective in reducing heart attacks and strokes.

Q:Do herbal supplements relieve hot flashes and night sweats in women during menopause?
A: Herbal supplements (Black cohosh, botanical supplements, soy, Chinese herbs and red clover) did not relieve symptoms of menopause in women any better than placebo. The women studied were between 45-55 years old and the best relief of symptoms was from estrogen replacement therapy.

Q: What are the latest recommendations for ovarian cancer screening tests?
A: Unfortunately, there are no effective reliable screening tests for ovarian cancer. Most women who develop ovarian cancer have no known risk factors. A women with a mother or grandmother with ovarian cancer is considered at higher risk. For these women there are two tests which can be helpful in early detection.
1. Ca-125 blood test -unfortunately it is not specific for ovarian cancer and is usually used to track response to treatment.
2. Trans vaginal ultrasound - this tests visualizes the ovaries to look for tumors, but when they screened 1048 high risk women, only 6 of 13 who had cancer showed up on ultrasound.

As you can see, when your doctor says there are no good screening tests at this time, she is accurate. Hopefully, time and research will help develop such a test.


georgia said...

I have had 2 bouts of ruptured ovarian cysts. The first was so painful I was at the ER for 6 hours and had a CT scan and trans vag ultrasound. Is this to be of concern. The second bout was 2 years later a little less painful. Is there any link between this and cancer?
thank you

Toni Brayer MD said...

For individual medical advise, you should consult your physician. It would be irresponsible of me to attempt any diagnosis of your condition.

For general knowledge - there is no link between ovarian cysts (which are common) and ovarian cancer.

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