Annual Doctor Day offers good opportunity to seek preventive screenings
DALLAS – Sept. 2, 2003 – UT Southwestern Medical Center at Dallas physicians are hoping patients and their families will observe today’s national Take A Loved One to the Doctor Day on Sept. 16 by seeking preventive care and undergoing simple screenings that could detect potentially life-threatening diseases.
“Preventive medicine is looking at health in a different way,” said Dr. Greg Schneider, assistant professor of family practice and community medicine at UT Southwestern. “It’s emphasizing that we can have an impact on health long before a problem sets in.
Screening can have a very big impact on the ultimate outcome.”
The following are a few diseases that could be managed with early detection:
Blood pressure – An estimated one in four American adults has high blood pressure, also known as hypertension. Labeled “the silent killer” because thousands of Americans are undiagnosed, the disease can exist for years without any symptoms.
Early detection and control of hypertension – especially important now that there are new, lower guidelines – could lead to a reduction in the number of heart attacks and strokes, said Dr. Shawna Nesbitt, assistant professor of internal medicine. The new guidelines consider blood pressure above 120 over 80 as pre-hypertension. To prevent full-blown hypertension (140 over 90), patients with pre-hypertension need to make aggressive dietary and lifestyle changes, including exercising and avoiding salt.
Dr. Nesbitt said the quick-and-easy test should be done at all doctor visits.
“If individuals are able to maintain a healthy lifestyle, they may not need drugs,” she said. “Lifestyle changes should not be a temporary fix like dieting to get in a certain dress size, but changes that are permanent.”
Flu shots – Every fall, thousands of adults rush to get an annual flu shot, but they should be taking their children with them too, said Dr. Jane Siegel, professor of pediatrics at UT Soutwestern.
Dr. Siegel, a Healthcare Infection Control Practice Advisory Committee liaison to the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, said doctors began the push for childhood flu shots last season and hope even more children become protected this year.
Flu shots are especially important for high-risk children and their close contacts. Children most at risk for developing severe disease after catching the flu include those with asthma and other chronic lung disease, those with congenital heart disease, and children undergoing chemotherapy and healthy infants between 6 months and 2 years old. Studies have shown that flu shots can also prevent kids’ ear infections and asthma attacks. And for those with needle phobias, a vaccine in a nasal spray form has been approved for use for the first time this year in healthy people ages 5 to 50.
Glaucoma – More than 5 million Americans are at risk for developing glaucoma, a blinding disease of the optic nerve caused when there is too much pressure on the inside of the eye. Causes include eye trauma and injuries; it also can be hereditary. The disease can be easily detected through routine, comprehensive eye exams, which should be performed annually after age 60 or age 40 if the patient is among those most at risk. Smoking, family history, diabetes, heart disease, high blood pressure, or African-American descent all raise the risk of glaucoma.
Many suffering from the disease don’t know it, said Dr. Jess Whitson, associate professor of ophthalmology.
“It’s progressive and doesn’t cause symptoms until the very end stage, and by then, patients have lost most of their vision,” Dr. Whitson said. “Treatment has been shown to be effective in preventing or delaying vision loss.”
Mammograms – Breast cancer is the most common cancer in women and is the second-leading cause of cancer deaths in women. Incidence of the disease increases markedly with age, with 60 percent of all deaths from the disease occurring in women 65 and over. An annual mammogram is crucial for women older than 40, said Dr. Marilyn Leitch, professor of surgical oncology and medical director of the Southwestern Center for Breast Care.
“If cancer is diagnosed early, the woman is more likely to be able to save her breast and avoid chemotherapy,” Dr. Leitch said, adding that early diagnosis leads to excellent chances for survival.
Mammograms can detect breast cancer in its earliest stages, when the cancer is too small to feel during a regular physical breast exam. Medicare has covered routine mammography for years, but many older women still fail to get screened.
Osteoporosis – The National Osteoporosis Foundation reports that about 10 million people in the United States, mostly women, have osteoporosis – defined as having both low bone mass and structural deterioration of bone tissue. Some 34 million already have low bone mass, a risk factor for the disease.
“In the first seven to 10 years after menopause, bone loss is very excessive,” said Dr. Khashayar Sakhaee, chief of mineral metabolism at UT Southwestern. “After that, the rate slows, but the risk of a fracture has already increased significantly, and it can lead to other health problems.”
A bone mineral density test at the onset of menopause and repeated measurements annually are recommended, said Dr. Sakhaee. A recent Oregon study found that regular resistance exercise can help women avoid losing bone mass. But no amount of exercise will prevent bone loss if a proper diet is not also maintained, Dr. Sakhaee cautioned.
Prostate cancer – One out of every six men will develop prostate cancer in his lifetime. The good news is that prostate cancer usually is treatable with surgery or radiation therapy if it is found in the early stages.
A simple, annual blood test, known as a prostate-specific antigen (PSA), can help a physician make that early diagnosis, said Dr. Claus Roehrborn, chairman of urology.
“A PSA test is imperative for men,” Dr. Roehrborn said. “A man’s PSA value might change from year to year, so it is important to measure it annually.”
Vascular disease – Most people know the risks of heart disease, but vascular disease, which affects all the body’s arteries, not just those leading to the heart, remains little-known and rarely diagnosed, said Dr. Patrick Clagett, chairman of vascular surgery.
“A lot of people are walking around with these conditions, and they don’t know it and their doctors don’t know it,” Dr. Clagett said, adding that there are rarely symptoms in the early stages.
In the later stages, vascular disease can cause muscle cramps in the calf after walking, gangrene in a foot and discoloration or swelling in one of the lower legs. Strokes and aneurysms in the abdomen can also occur without warning.
Risk factors are the same as with heart disease: smoking, hypertension, diabetes, hypercholesterolemia or known cardiovascular disease, and age. The disease is most common among seniors. People who have had previous heart or leg surgeries or have had a stroke should also be screened.
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