OB/GYN Articles and Women's Health Links
El Rio will provide important informational articles on OB/GYN and related
women's health articles in this section of our website. Please visit our Web site each month to learn more about
your OB/GYN health and choices in treatment.
Abnormal Pap
Smears
Pap smear screening is done to identify women that may be at risk for developing
cervical cancer later on in life. An abnormal results DOES NOT mean that you have cancer. An abnormal smear requires additional
evaluation to determine if you have a pre-cancerous condition called "dysplasia", which if left untreated, may develop into
cervical cancer. Dysplasia is caused by a virus called HPV (Human Papilloma Virus).
An appointment will be scheduled to perform a colposcopic evaluation of
your cervix. During this exam we will use a magnifying instrument (colposcope) to look for signs of dysplasia on your cervix.
A small biopsy is taken to confirm the diagnosis. The biopsy is relatively painless and may cause some cramping sensation.
When we receive the biopsy report, we will contact you and discuss the treatment
options available. If the biopsy does not find dysplasia, then a repeat Pap smear is usually performed in six months.
In cases where mild or moderate dysplasia is found, cryotherapy is used to remove the abnormal cells from your cervix. Cryotherapy
entails placing a cold metal probe against your cervix for three to five minutes. It usually causes mild menstrual-like
cramping, which subsides after the procedure is over.
For more advanced dysplasia (moderate to severe), we remove the involved
area of the cervix with a wire loop procedure called LEEP. This procedure is also done in the office using local anesthesia.
We have pamphlets available in our office which thoroughly explain dysplasia and its treatment.
Emergency
Contraception
Emergency Contraception (EC) is used to prevent pregnancy after having sex
without using birth control or after the method used has failed (i.e. broken condom).
The most commonly used method of EC is "Plan B" a Progesterone pill
that must be taken within 72 hours of having unprotected sex. Common side effects include nausea, vomiting, bloating
and breast tenderness. These symptoms usually resolve within one to two days.
The risk of pregnancy is greatly reduced when EC is used, but is not 100%
effective. If you do not get a period within three weeks, you will need to have a pregnancy test performed. El Rio OB/GYN
Associates offers free pregnancy testing at any of our office locations.
Breast Cancer
Breast cancer is the most common form of cancer among women, accounting
for 30 percent of cancers women get. Over the course of her lifetime, a woman's risk for breast cancer is one in eight. Each
year, there are approximately 180,000 new cases of breast cancer and 45,000 deaths from it. The chance of developing breast
cancer increases dramatically with age. Only lung cancer causes more cancer deaths among women.
Breast cancer, is a disease in which cancer (malignant) cells are found
in the tissues of the breast. Each breast has 15-20 sections called lobes, which have many smaller sections called lobules.
The lobes and lobules are connected by thin tubes called ducts. The most common type of breast cancer is ductal cancer. It
is found in the cells of the ducts. Cancer that begins in the lobes or lobules is called lobular cancer. Lobular cancer is
more often found in both breasts than other types of breast cancer. Inflammatory breast cancer is an uncommon type of breast
cancer. In this disease, the breast is warm, red, and swollen.
The risk of breast cancer increases
above the normal risk with these factors:
- Having had cancer in one breast, which increases the risk for cancer in the
other breast
- Never giving birth or giving birth after age 30
- Early onset of menstruation (before age 12)
- Late menopause (after age 55)
- Family history of breast cancer, especially for mothers, daughters and sisters
of women with breast cancer prior to menopause
- Exposure to radiation
- Diet high in fat
- Obesity
- Diabetes
- Recent trauma
- Detection
Hereditary breast cancer makes up approximately 5% to 10% of all breast
cancer cases. The genes in cells carry the hereditary information that is received from a person's parents. Several genes
have been found to be defective in some breast cancer patients. Relatives of breast cancer patients who carry these defective
genes may be more likely to develop breast or ovarian cancer. Some defective genes are more common in certain ethnic groups.
Tests are being developed to determine who has the genetic defect long before any cancer appears.
Hormonal contraceptives may be another factor to consider. Research findings
suggest a link between contraceptive use and a slightly increased risk of developing breast cancer.
A doctor should be seen if changes in the breasts are noticed. The doctor
may suggest that you have a mammogram. A mammogram is a special x-ray of the breast that may find tumors that are too small
to feel. If a lump in the breast is found, the doctor may need to cut out a small piece of the lump and look at it under the
microscope to see if there are any cancer cells. This procedure is called a biopsy. Sometimes the biopsy is done by inserting
a needle into the breast and drawing out some of the tissue. If the biopsy shows that there is cancer, it is important that
certain tests (called estrogen and progesterone receptor tests) be done on the cancer cells.
Recommendations for mammograms include a screening mammogram once between
the age of 35 to 40. From age 40 to 50, a mammogram should be done every two years. From age 50 and on, a mammogram should
be done every year. Any woman who notices a lump in her breast or any of the other symptoms mentioned previously should see
her doctor as soon as possible. Tests can be done to tell if cancerous cells are present.
Estrogen and progesterone receptor tests may tell whether hormones affect
the way the cancer grows. They may also give information about the chances of the tumor coming back (recurring). The results
help a doctor decide whether to use hormone therapy to stop the cancer from growing. Tissue from the tumor needs to be taken
to the laboratory for estrogen and progesterone tests at the time of biopsy because it may be hard to get enough cancer cells
later, although newer techniques can be used on tissue that is not fresh.
The chance of recovery (prognosis) and choice of treatment depend on the
stage of the cancer (whether it is just in the breast or has spread to other places in the body), the type of breast cancer,
certain characteristics of the cancer cells, and whether the cancer is found in the other breast. A woman's age, weight, menopausal
status (whether or not a woman is still having menstrual periods), and general health can also affect the prognosis and choice
of treatment.
How to Examine Your Breasts
It is normal to have some lumpiness or thickening in the breasts. By examining
your breasts once each month, you will learn what is normal for you, and when any changes do occur. Some women find that doing
a daily or weekly self-exam works better for them. They learn their breasts at all phases of their menstrual cycle. The more
you examine your breasts, the better you can learn what is normal for you. Your "job" isn't just to find lumps, but also to
notice if there are any changes:
- In the shower -- With your fingers flat, move gently over every part of each
breast. Use your right hand to examine the left breast and your left hand to examine the right breast. Check for any thickening,
hard lump or knot.
- In front of a mirror -- Check your breasts with your arms at your sides.
Then raise your arms overhead. Look for any changes in the shape of each breast, swelling, dimpling or changes in the nipples.
- Lying down -- To examine your right breast, put a pillow under your right
shoulder. Place your right hand behind your head. Keeping the fingers of your left hand flat, press gently in small circular
motions around an imaginary clock face. Begin at the outermost top of your right breast for 12 o'clock, then move to 10 o'clock,
and so on, until you get back to 12 o'clock . Each breast will have a normal ridge of firm tissue. Then move in one inch toward
the nipple. Keep circling to examine every part of your breast, including the nipple.
Repeat the procedure on the left breast with a pillow under the left shoulder
and your left hand behind your head. Finally, squeeze the nipple of each breast gently between the thumb and index finger.
Any discharge, clear or bloody, should be reported to your physician immediately. Continue to perform breast self-examination
monthly.
Self-Care and Preventive Procedures
Eat a low-fat diet of 25 percent or less of total calories as fat. Focus
on fresh fruits and vegetables, whole grains and so on. Eat vegetables that contain a substance called sulforaphane, which
may help protect against breast cancer. Examples are broccoli, cabbage, cauliflower and Brussels sprouts. Avoid unnecessary
X-rays. Wear a lead apron when you have dental X-rays and other X-rays not of the chest. Don't smoke. Stop smoking if you
do. Breast feed your babies. This may reduce your risk for breast cancer, especially before menopause. Limit foods that are
salt-cured, smoked and preserved with nitrites and nitrates. Examples are hot dogs, bacon, smoked sausage and ham. Limit alcohol.
Umbilical
Cord Blood Banking
The cord blood that remains in the umbilical cord after your baby's birth
has the potential to save lives. There are special cells in the baby's blood called stem cells. These stem cells have the
potential to become virtually any type of human tissue.
You can now opt to save these valuable stem cells for future medical needs
of your baby or immediate family. The process is called cord blood banking, which requires freezing the stem cells obtained
from the umbilical cord at the time of delivery. The process is painless, since the blood is drawn from the umbilical cord
attached to the placenta after the baby is born, and takes only a few minutes of the doctor's time to collect.
The frozen stem cells act as an insurance policy for your family should
there be a medical need for them in the future. Most people associate the use of stem cell transplants with leukemia patients
that otherwise would have required a bone marrow transplant to obtain these important stem cells. Stem cells are also being
used in patients with sickle cell disease and other anemias. They may also be useful in treating some immunodeficiencies and
genetic disorders of metabolism. Future research will surely find other uses for stem cells, such as growing your own skin
in case of burns requiring skin transplants.
If you are interested in banking your newborn's cord blood, you must make
arrangements prior to delivery. We have information pamphlets in our office regarding the company that stores the blood here
in Tucson, along with the costs associated with the collection and storage of the blood.
For additional information, call 1-888-CORD BLOOD or visit the cord
blood registry website at www.cordblood.com.
