by Dr. Steven Garner, MD

Dear Dr. Garner,

I hope you can help me. Three years ago, my husband died, and since that time, I have been very lonely. We used to have a vibrant life together. Now I spend most of my evenings alone in the house and rarely go out.

I don’t believe I’m depressed. I think I am lonely. My daughter is telling me that it’s a sin to behave the way I am without seeking help. She says God gave us our bodies, and we must treat them well. She says I am not taking good care of my body by prolonging my loneliness.

Is it true that loneliness can make you sick on top of being unhappy?

Lonely Lady in Astoria

Dear Lonely Lady,

Before I answer your question, I would like to acknowledge loyal Tablet reader and St. John’s legend, Jack Kaiser, and his lovely wife Connie. It was a pleasure sitting with them last week at Carnesecca Arena, where St. John’s won a thriller in overtime.

Your daughter is absolutely right. Loneliness can cause many harmful physical effects to the body. It has been linked to illnesses such as diabetes, high blood pressure, alcohol and drug abuse, difficulty concentrating, poor memory, heart disease, strokes, depression, suicide and sleep disruption.

Lonely people feel alone and unwanted. I am concerned that you may also have a component of depression. Before I continue, I want to stress the importance of seeing your doctor for evaluation of possible depression, which can be serious. Being lonely is not necessarily about being alone but feeling as if you don’t have enough social contact. For example, a child attending an out-of-town college may feel lonely despite being surrounded by numerous classmates. It is also the quality of relationships rather than quantity.

Loneliness affects the health of the elderly more than other ages. There is a direct association between being lonely and having ill health. Studies with fruit flies show that they die sooner when they are isolated.

It is not unusual to feel isolated occasionally; however, these feelings usually subside within a few months. When they persist for months and increase in intensity, intervention is necessary. It sounds to me that you are at this point.

I am sorry to hear about the loss of your husband. It is important at the time of such a loss to have a connection to other people to help ease the isolation and sadness that you feel. There are things that you can do to try to alleviate loneliness such as:

• Being positive. When you are happy, you project confidence. This is helpful in making new friends.

• Try to improve your social skills. This includes being a good listener. There are numerous books and information, either online or in your library, to help develop these skills.

• Get out of the house. Select an activity that you like. It could be something such as bird watching. Here you will meet people with similar interests and increase the likelihood of developing new friends.

• Make a commitment, such as at church or elsewhere as a volunteer. The opportunity to help others improves your self-esteem and helps eliminate feelings of isolation.

• Try to understand why you feel lonely. When did it start? What worsens your loneliness? Write down some causes of your loneliness and think about what you can do to improve it. People who are lonely often have a component of anger. Resolve to become a more calm, friendly person.

In 1984, a questionnaire asked people to tell how many close confidants they had. At that time, it was an average of three. A repeat survey in 2004 found the most common answer was one. It is the quality of the confidant that is important rather than the quantity. One close friend can help cure loneliness.

Persistent loneliness has a detrimental effect on your health and indicates that something in your life needs to be changed. With the right approach, you can cure your loneliness. Speak to your physician to get further help. You should also be evaluated for depression.

by Dr. Steven Garner, MD

Dear Dr. Garner, 

I am constantly under stress. I never feel relaxed. I feel this at work and at home. My eating habits have become crazy, and I know I must be hurting myself. I am 49 years old and an otherwise healthy person, but I don’t know for how long.

Please give me your ideas on what is going on.
Anxious in Astoria

Dear Anxious,

Before I address your issue, I would like to wish all our readers a happy and healthful summer.

With the summer and vacation time here, it is a good time to relax and take stock of the year ahead. My wife and I will be traveling to Manchester, Vt., as we do every summer, with the Grisafis and the Carneseccas.

We also look forward to enjoying our “empty city” in the summer and meeting old friends such as the Paluszeks for dinner.

I hope all of our readers can take advantage of the longer daylight hours to walk, exercise and “smell the roses.”

Getting back to your question, stress can be as severe a risk factor for heart attacks as smoking.

The way people react to stress may be determined by genetics. The genes that control stress usually keep people functional and keep the stress in check.  If these genes fail or mutate, a person may experience either too much or too little stress. Some stress is good, as it can keep us alert and safe, but when it controls your life, or becomes overbearing, it can be a major problem.

I would like to review, how to recognize the signs of stress and then how you can develop methods to lessen the stress that you experience.

The following are symptoms of  overwhelming stress:
• Impatience or edginess
• Poor concentration
• Headaches and heart palpitations
• Depression
• Chest pains
• Excessive intake of caffeine, cigarettes or alcohol
• Frequent colds – (immune system is actually impaired)
• Generalized  feeling of anxiety
• Feeling exhausted
• Sleep problems – (A new study out last week shows that people who are prone to anxiety often have dramatic worsening of their stress with sleep deprivation. They anticipate problems at an increased rate, contributing to their anxiety).

If you have more than four of the above 10 symptoms, there is a good chance you are suffering from excessive stress and need to address the issue.

There are several home remedies for stress. When it interferes with everyday functioning, professional help should be sought. There are many psychiatrists and analysts who specialize in this, and I would be happy to give you a referral.

What can be done about stress?
• Aerobic exercise is one of the most important things you can do – walking is a great way to perform this task.
• Get outside when possible – a little sunshine can go a long way.
• Aroma therapy is something to try. Sit in a warm bath with some drops of lavender oil.
• Deep breathing exercises can really work to drain the stress away.
• Try some of the herbal teas, such as chamomile, valerian root or ginseng.
• Massage is a great relaxer.
• Learn to say no – stress is often caused by over commitments – you can only do so much, and trying to say yes all the time can be a big negative for you at work.
• Psychoanalysis and psychiatry may be necessary for resistant cases.
• Keep a stress diary – write down all the times you feel the most stress and why. Sometimes just writing it down can help you deal with the stress. Also, at night, if something is bothering you and preventing your sleep, write the problem down and agree not to think about it until morning.
• Sometimes pills are necessary, both to help with sleep as well as stress. It is very important to be closely monitored as these can become habit forming.

Stress can be harmful to your health and also prevent you from enjoying the good things in life.  I urge you to discuss the situation with your doctor.

Once again, a great summer to all, and I’ll be back with new columns in a little while.

by Dr. Steven Garner, MD

Dear Dr Garner,
I am a 72-year-old woman, who is in good shape and likes to exercise every day.
The problem is, that my knees and hips start to hurt when I jog (got bad rheumatism). I have no problem walking, but cannot jog without feeling a lot of pain.
My friend tells me that walking is just not that good to stay in shape and that it is no good even for weight loss.
My question to you is whether walking is a waste of time, or something that I should be doing as part of my daily fitness program.
Jogging or Walking dilemma in Williamsburg

Dear Jogging,
I am frequently asked this question. There is a common misconception that walking is an inferior form of exercise compared to jogging.
In many people’s mind, including mine, it turns out that not only is there nothing wrong with walking, but when all things are considered it is actually superior to jogging as an exercise regimen.
It is important to understand the goal of your exercise program to evaluate what is the best form of workout for you.
Obviously, if you are training for the marathon, walking would not be the best choice, but if you want to keep your body toned, avoid heart problems, keep up good mental health, and generally stay in good shape, the answer is different.
Jogging or walking is not a great way to lose weight.
Study after study shows that the best way to lose weight is to eat less.
While you may be able to lose some calories while jogging or walking, a person’s appetite is actually stimulated by the workout, and the jogger or walker tends to eat more afterwards losing much of the caloric benefit.
It is true that you can lose more calories jogging than running, but not that much more, particularly if you are walking up a slight incline. In addition, the appetite is stimulated more after jogging than walking which further reduces the weight loss benefits of jogging.
The overwhelming advantage of walking instead of jogging is that you are far less likely to have an injury.
Jogging presents hazards to your hips, knees, and ankles, particularly if you already have some arthritis, which seems to be the case in your situation.
It is important to talk with your doctor regarding your decision to walk or jog, particularly if you are over 50, or have underlying heart disease. Starting to jog suddenly may be too much of a strain on your heart and your doctor may have you walk instead.
Some studies show that jogging may provide the same exercise benefit of walking in half the time, but newer research shows that prolonged exercise is most useful to good health, particularly the heart and your blood vessels.
Walking can strengthen bones, tone muscles, and help the cardiovascular system, to the same extent as jogging and with less risk to the other parts of the body.
Both jogging and walking add bone mass and help to prevent osteoporosis.
Studies show that jogging more than 25 miles a week, however, does not add further benefit in preventing or treating osteoporosis.
The pounding of the foot on the pavement or grass while running causes damage to heels, shins, knees, hips, and even the back.
Walking has been shown to be better for the spine than jogging, as it puts less stress on the discs with less likelihood of disc herniation.
Walking is better for the feet than jogging, as there is much less chance of experiencing stress injuries.
To get the most out of walking, make sure your posture is good, with maximum benefit derived from “walking tall”, holding your stomach muscles in, and ribcage up.
It is recommended that we should exercise 30 minutes a day for at least 5 days per week.
The good thing is that the walking can be divided into smaller periods, with exercise throughout the day from common situations such as walking up a flight of stairs instead of taking the elevator, or getting off the bus a stop early to get extra walking in.
This may not seem like a lot of exercise, but it adds up in the course of a year.
In summary, jogging and walking both provide good exercise. Both improve our quality of life and make us feel better throughout the day.
I believe that when risks and benefits of both are considered, that walking is best for our health.
Be consistent, and get at least 30 minutes of walking in each day.
You will be more likely to continue your workouts and less likely to suffer serious injury to your body.
To boost the health benefits of walking, try adding an incline to your course.  It does not have to be very steep, but about 10 degrees can do wonders with your exercise program.
I hope that this helps to settle your dilemma, and that you forge ahead with a daily exercise program made up of the simplest and best form of exercise — walking.

 by Dr. Steven Garner, MD

Dear Dr. Garner,
Last week, I had the worst pain of my life.
While I am a man and have never been pregnant, the feeling I had is what I imagine my wife felt during the delivery of our daughter.
It turned out to be kidney stones.
Foremost on my mind, is whether I should expect a recurrence anytime soon.
Kidney stones and moans in Midwood

Dear Kidney Stones,
You have endured what is known to be the most painful affliction of humans aside from pregnancy.
The kidney stone is actually a small rock that forms in the kidney. It can either stay in the kidney or move further down a tube (ureter), which leads from the kidney to the bladder. This tube carries urine from the kidney to the bladder for excretion.
The problem arises, when a stone gets stuck somewhere in the tube causing severe pain, and blockage of the kidney.
While anyone can form a stone, some are more likely than others to develop it.
These include:
• Males
• Caucasians
• Those overweight
• Those with kidney infections
•. Those who have family members with kidney stones
• Those who have had a kidney stone before
• Those who eat a lot of meat and eggs
• Those who do not drink enough liquid
The kidney stones occur most frequently in the spring. Some believe this be due to the fact that we become dehydrated, as we go outdoors for physical activity after the long winter. Getting enough fluid is an important part in prevention of stones.
The symptoms of a kidney stone include:
• Severe pain in the side and back below the ribs
• Pain that spreads to the belly
• Pain that comes in waves
• Pain on urination
• Cloudy or foul smelling urine
• Fever and chills
• Urge to urinate
What causes the kidney stone?
The stone forms from different crystals in the urine that can come together, usually when one is dehydrated or has a lot of crystals. There are many different types of stones, and the cause is better understood once the type of kidney stone is determined. For example, stones made of calcium may be caused by drinking too much milk, or dairy products, or from taking too many supplements.
What can you do when you have a stone?
• Drink water to try to flush the stone out (This may take two to three quarts a day).
• Pain relievers may help.
• Try to remain active.
There are certain medicines that can dissolve stones which may work.
Certain stones may be treated with ultrasound waves, known as lithotripsy in which the stone is blasted by sound waves into little pieces and then flows out in the urine.
Lifestyle changes may help. These include:
• Eating a diet low in salt and animal protein
• Limiting the use of calcium supplements
Some simple tips to reduce recurrence are:
• Drink plenty of water all day to flush the crystals out of the urine.
• Drink less beer – in addition to dehydrating you, it contains crystals which can form stones.
• Eat less meat – they are high in certain crystals which can form stones.
With the proper lifestyle change, you can definitely reduce your chance of developing another kidney stone.

 by Dr. Steven Garner, MD

Dear Dr. Garner,
I am very scared. When I got up to go to the bathroom today, my urine looked bloody.
I never had anything like this before. It really doesn’t hurt. It is more the sight of it that bothers me.
I am 58 years old, and aside from smoking, I am fine with no problems.
Do you think I have cancer? I am afraid to even call my doctor for an appointment. I am hoping it just goes away.
Please help me. How worried should I be?
Red Urine in Red Hook

Dear Red Urine,
Before addressing your question, I would like to bring our readers up to date on the Ask the Doctor TV Show.
We will be returning early September, for all new shows in season number 17.
For those who need an extra “fix” of the show, I will be doing an Ask the Doctor session at the Health Fair that my good friend, Dr. Emil Baccash, organizes each year at the Virgin Mary Church, 216 Eighth Ave., Park Slope – 11215, at 1 p.m. on Sunday, May 6.  It will be great to see who can come.
Bleeding in the urine is known as hematuria (hē-mə-t(y)ur-ē-ə\).
There are two types of hematuria. In one type, the urine looks normal and a microscope is required to detect the blood cells.  In the second type, there is bleeding that changes the color of the urine, and is known as gross hematuria.
In some cases the bleeding may go away on its own. An example of this is urine in the blood that comes from strenuous exercise.
It takes very little blood to cause the urine to change colors. It usually isn’t painful and there may be no other symptoms present.  Blood can come from any part of the urinary system, which includes the kidneys, bladder and ureter (tubes that carry urine from the kidneys to the bladder), and in men, the prostate, as well.
Some causes of blood in the urine include:
1. Urinary tract infections – The symptoms present include an urge to urinate, pain or burning with urination and a peculiar smell to the urine.
2. Bladder or kidney stone – The stones can cause either gross or microscopic blood in the urine, and usually has pain associated with it.
3. Enlarged prostate – There may be difficulty urinating, whether gross or microscopic blood is in the urine. Infection of the prostate known as prostitis can cause the same signs and symptoms.
4. Kidney diseases – Certain infections can cause the kidney cells to inflame. With the swelling of the kidney, the blood vessels become swollen as well, and blood can leak into the urine.
5. Cancer – yes, the dreaded “c” word can be a cause, although not that common.
6. Kidney injuries – this usually happens as a result of a car accident, fall, or sports injury.  There can be      microscopic blood or bright red bleeding in the urine.
7. Medication – aspirin, penicillin, heparin blood thinners, and certain anti-cancer drugs can cause blood in the urine.
8. Strenuous exercise can cause gross or microscopic bleeding.
9. Certain medications or food can cause the urine to change colors.  Examples of this are beets, berries, and rhubarb.  There is no blood in the urine in this instance.
It is important to see your doctor at once should you see any evidence of blood in the urine.
To help diagnose the problem, your doctor, may order urine tests, as well as a CT scan, sonogram, or MRI, to get a good look at the whole urinary system, including the kidneys, bladder, and ureters.
Sometimes the doctor will use a mini camera that goes directly into the bladder to determine if there are any tumors, infection, or pre-cancerous growth.
The treatment for hematuria will depend on the underlying condition.  An example would be treating an infection of the kidneys with antibiotics.
Sometimes no treatment is necessary and the condition resolves on its own.
The bottom line is that your bleeding is most likely not caused by cancer, but you do need to have the problem checked out.  Best of luck  and please keep me informed of your condition.

by Dr. Steven Garner, MD

Dear Dr. Garner,
I had been having trouble with my vision so I went to see my ophthalmologist. She said I have cataracts that need to be removed. I am a little nervous about the surgery.  
Could you tell me more about this condition and why I got it?  I am in good condition otherwise.
Clouded Eyes in
Clinton Hill

Dear Clouded,
You might be surprised to learn that cataract surgery is actually the most common surgical procedure performed in America.
Let’s start with the basics: What is a cataract? Cataracts form when the lens of the eye becomes cloudy. More than half of Americans ages 65 and older have a cataract, and it is thought that nearly everyone will develop one if they live long enough.
The lens of the eye works much like a camera lens, focusing light onto the back of the eye on a structure called the retina.  The lens also adjusts the eye’s focus, letting us see things clearly both up close and far away. The lens is mostly made of water and a substance known as a protein.
As we age, some of the protein may clump together and start to cloud a small area of the lens.  This is a cataract, and over many years, it may grow larger and cloud more of the lens, making it harder to see.
Therefore, the main symptoms of a cataract are cloudy, blurred and dulled vision, which cannot be corrected by wearing stronger glasses or contact lenses. You may find the need for a brighter light to read. Increased sensitivity to glare may also be a problem.
There are also several types of cataracts; the most common is called a nuclear cataract, because it affects the inside of the lens. Another common form is a cortical cataract in which the outside of the lens becomes cloudy.
Risk Factors
Why do some people get cataracts at an earlier age than others?
Smoking greatly increases the chance of getting a nuclear cataract, the most common type in the United States. To lower the risk for cataracts, simply stop smoking.
Diabetes is another risk factor for developing cataracts.  Keeping blood sugar under tight control and maintaining a normal weight can slow this.
Many studies suggest that exposure to ultraviolet light is associated with cataract development, so it is advised to wear sunglasses and a hat to lessen exposure.
An interesting study, conducted in Iceland in 2005, suggests that airline pilots have a higher risk of developing cataracts than non-pilots. It is thought this is due to exposure to cosmic radiation. A similar theory suggests that astronauts, too, are at increased risk from cosmic radiation.
People who use steroids are also more prone to cataracts.  Some eye care experts believe that a diet high in antioxidants, such as beta-carotene (vitamin A) selenium and vitamin C and E, may slow down the development of cataracts. While this is not proven, it is always good to get as many of these vitamins in their natural form, in food, as opposed to pills. Heavy alcohol consumption is a risk factor as well.
Now that we have reviewed the symptoms and some possible causes, what are the treatments available?
Effective Treatment
Cataracts are a curable eye condition. The surgery performed is rapid, safe and nearly always completely successful.  Nine out of 10 people who have cataract surgery regain very good vision.
A cataract needs to be removed only if it interferes with one’s vision enough to prevent him/her from driving, reading or other essential activities. After the surgery, an artificial lens is implanted in the eye so that people no longer need to wear “Coke-bottle” glasses.
Remember, however, that just having a cataract does not mean you need immediate surgery. When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, appropriate lighting or magnification.
Many people consider poor vision an inevitable fact of aging, but cataract surgery is a simple, relatively painless procedure to regain regular vision.
I urge you and any of our other readers who are exhibiting signs of vision problems to check with your doctor to determine the cause. If cataracts are to blame, find out how your quality of life can be improved with this surgical procedure.

by Dr. Steven Garner, MD,

Dear Dr. Garner,

I am 35 and in good condition except for a problem I have been having lately.

Whenever I get upset or worried about something my bowels go haywire. I have pain and diarrhea and I feel a little depressed.

My doctor feels it is due to irritable bowel disease.

Is there a way to know for sure? He has sent me for a zillion tests with everything coming back negative.

My worrying has made the condition worse. I have this fear that it will turn into cancer.

Please help me. It is really getting me down.

Irritable Bowel in Bensonhurst

Dear Irritable Bowel,

Irritable bowel syndrome (IBS) is a common problem that affects the intestines, causing cramping, belly pain, bloating, and change in bowel habit. Despite the severity of the symptoms, irritable bowel syndrome does not cause damage to the bowels.

It does not cause cancer or other diseases such as Crohn’s disease or ulcerative colitis.

Most symptoms will actually improve as the person with the disease gets a better understanding of what causes it for him or her and what treatments are effective.

The diagnosis is difficult to make as there are no specific signs for irritable bowel syndrome. It is diagnosed by a process of elimination. IBS may include other bodily symptoms such as constantly feeling tired and depressed.

To make a diagnosis of irritable bowel syndrome, a person should have belly pain and discomfort, lasting about 12 weeks a year.  In addition, you must have two of the following:
1. A change in the frequency or consistency of your stool.
2. Straining to empty your bowel.
3. Mucous in your stool.
4. Bloating and abdominal distention.

Using these criteria, your doctor can help decide whether or not your symptoms are due to irritable bowel syndrome or something more serious.  The following might be the sign of a more serious condition:
1. Onset of IBS symptoms after age 50
2. Weight loss
3. Rectal bleeding
4. Fever
5. Diarrhea that awakens you from sleep

To evaluate your condition, your doctor may perform the following:
1. Colonoscopy through which your doctor can examine the entire colon.
2. CT scans to help rule out all the causes.
3. Lactose intolerance test as you may not have enough of the enzyme to digest a type of sugar found in dairy products.
4. In addition, your doctor may order blood tests to rule out diseases such as celiac disease.

Simple Lifestyle Changes
Here are some simple lifestyle changes you can make:
1. Increase the fiber in your diet. This can help reduce constipation, however, it can also increase the amount of gas and cramping that you experience. Gradually increase your fiber over a period of weeks.

Avoid problem foods. Chocolate, high-fat foods, milk products, and large amounts of alcohol can trigger symptoms. The best way to understand what your particular problem foods are is to keep a food diary.  When you have bad days, review the diary to see what you ate and avoid those foods in the future.
2. Avoid chewing gum or drinking through a straw which can lead to swallowing air and cause more gas.
3. Eating smaller meals may help to control diarrhea.
4. Substituting yogurt for milk may help reduce symptoms.
5. Drink plenty of liquids.
6. Avoid caffeine.
7. Exercise regularly.

If using products that stop diarrhea or constipation, the medication should be used sparingly with the lowest possible dose. If your symptoms include pain or depression, your doctor may recommend an antidepressant. These medications relieve depression as well as control the spasms. Some doctors may use antibiotics.

Several new medications recently approved for IBS are:
• Lotronex. Doctors who use it must be familiar with its complications. Lotronex works by controlling the nerves that supply the bowels.
• Zelnorm relieves pain, bleeding and constipation but its major side effect is diarrhea.
• Celexa, an anti-depressant, may help those who are anxious.
• Amitiza works by increasing fluids that the body makes in the bowel to help with the passage of food.

Some people have had success with acupuncture, herbal medication, hypnosis and yoga.

In summary, irritable bowel syndrome is common and may occur in up to 20% of adults in the United States. Those most at risk are women younger than 50, and people with a family history of irritable bowel syndrome.

IBS can be successfully managed, but cannot be cured. The symptoms vary in frequency.  Some people can go for weeks or months without symptoms, and others experience symptoms daily. The most important thing to do is rule out the more serious causes of bowel discomfort such as cancer, Crohn’s disease or ulcerative colitis. This can be done by visiting your family physician.  While the cause of IBS remains a mystery, simple treatments can be successful.

by Dr. Steven Garner, M.D.

Dear Dr. Garner

My husband and I are totally confused with the changes in when to get mammograms and PSAs. We have been diligent about the tests, but now hear they’re no longer recommended. 

What is your opinion?

Confused Couple
In Canarsie

Dear Confused,

You are not the only ones confused. Many doctors feel the same way.

The confusion is the result of two government task forces. One reviewed mammograms and the other reviewed the PSA test, which detects a chemical in the blood that may increase with prostate cancer.

Their conclusions have caused much angst in the medical community, as well as the public in general.

First let me address the PSA changes that were recommended last week.  I was just discussing them with my good friend and loyal Tablet reader, Dr. Antonio Mascatello.

The panel recommended that routine screening with the blood test for PSA, no longer be performed.   They felt that the test caused useless anxiety among men. They argued that many men have prostate cancer and never die from it, because it grows slowly.

They also noted that due to the PSA test results, men were subjected to biopsies and treatment that often left them incontinent and impotent.

I totally disagree with this recommendation. The PSA has been shown to save lives in several large studies.  The test allows a man to be proactive about his health. The key to success in having the exam is to do it in conjunction with a doctor you trust. PSA may be high in cases where there is a benign condition, such as an enlarged prostate, constipation and infections.  The result must be carefully evaluated to ensure that the patient is fully informed of options available.

It is true that prostate cancer can be aggressive, or may never cause a patient any harm. This is why many doctors merely follow the patient without doing any further tests or work-up.

I think most men would like to have an idea of the functioning of their prostate gland, rather than to be totally in the dark about possible early cancers.

Let us not kill a test which may save thousands of lives, just because there is confusion in interpreting the result. Hopefully, we will have more accurate tests as time goes by, but at the present, at least this one, non-invasive blood test is available to provide an early warning signal for men to protect against this disease. Have your husband follow up with his doctor to determine what is best for him. There is no one size fits all approach to prostate health.

As far as mammograms, there is no doubt in anyone’s mind that mammograms save lives. The government committee argued in its report that there were false results from the mammograms, which subjected a women to unnecessary biopsies and possible harmful effects.

I could not disagree more with their conclusion that women between the ages of 40-50 should not get routine yearly mammograms. Breast cancer for women in their 40s tends to be more aggressive than in older patients.  Why would we not want to discover these cancers as early as possible?

Recent studies from Sweden have shown a significant drop in deaths from breast cancer with routine screening of women in their 40s.

The American Cancer Society and the American College of Radiology continue to recommend mammograms beginning at age 40, and then yearly.  It is important to check with your doctor, as the screening should be tailored to one’s family history. If there is a strong history of breast cancer (mother or sister) then the screening may begin even earlier and may include tests such as an MRI, that not everyone will require.

The committee also recommended against self-breast exam. Again, I strongly disagree. The self-breast exam allows a woman to become familiar with her breasts and makes her a partner in the health care process. We have seen many cancers detected through self exams, which, if not performed, would have delayed diagnosis and possibly reduced chances for full recovery.