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Re: Paps / preventive medicine From: Charlie Chambers (cchamber@gorge.net) Wed Jan 7 20:33:36 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joanne Bulley, MD: "Re: Priority in Post partum retained products?" Previous message: Joanne Bulley, MD: "Re: Hairless pudenda" In reply to: Joanne Bulley, MD: "Paps / preventive medicine" Next in thread: Joanne Bulley, MD: "Re: Paps / preventive medicine" Reply: Joanne Bulley, MD: "Re: Paps / preventive medicine" Joanne, nice pickup on the carcinoid. I've always told my patients that of all the things we do in the "yearly", the pap works. I'd rather listen to their hearts a little less frequently or palpate their ovaries not as often. It's going to take a large body of evidence to PROVE we should do something less frequently that has been so effective. To this day, there isn't another paradigm of cancer screening that compares in terms of evidence (i.e. mammography, colonoscopy, PSA etc.) BTW, Joanne, in case you haven't noticed, I think Oregon got your N.H. weather. You can have it back anytime now. ************************************************************************ **** Charlie Chambers Hood River, OR USA cchamber@alumni.rice.edu "...not because I regard fishing as being so terribly important but because I suspect that so many of the other concerns of men are equally unimportant-and not nearly so much fun." John Voelker ************************************************************************ ***** On Jan 7, 2004, at 7:25 PM, Joanne Bulley, MD wrote: > Bravo! You said it well. > > The "better go yearly" gets the reluctant person to come in - perhaps > every 2-4 years. With the "every three years" - there will be many - > who don't realize they are higher risk (how many partners has the > patient or her partner had?) - and they come in every 5 years now. > > I also have a patient who I managed to figure out that she had to be > worked up - for what turned out to be carcinoid. She had had three ER > visits for fairly classic symptoms and was told nothing could be found. > > Anyhow - she is now on Octreopeptide shots 1-2 times per month - at a > cost of about $5200 each. > > She is on Activella - and her insurance won't cover the $28 per month > for that. > > Go figure. > > Joanne > > At Tue, 6 Jan 2004, Charles Chambers wrote: >> >> Joanne >> >> I would agree with you. We've come up with a system that actually >> works to prevent cancer. I get worried about how easily one can go >> from every 3 years to showing up in the office every 5 years. Given >> that compared to the cost of so many other things, a Pap once a year >> is so cheap, why are we looking to do less? >> >>>> ---- Original Message ---- >> From: islesannie@yahoo.com (Joanne Bulley >>> >>> I just got a Pap back opn someone today - 29yo - normal liquid prep >>> paps >>> past 3 years - and HGSIL now! >>> >>> I have a REAL hard time with the new recommendations of the ACS and >>> ACOG >>> - to do paps q3 years after three normal paps. >>> >>> Joanne > > -- > Joanne Bulley, MD > Keene, NH, USA > > ----- > Work to create peace everywhere you go and with everything you do. > ----- > Let us accept truth, even when it surprises us and alters our views. > -George Sand > Next message: Joanne Bulley, MD: "Re: Priority in Post partum retained products?" Previous message: Joanne Bulley, MD: "Re: Hairless pudenda" In reply to: Joanne Bulley, MD: "Paps / preventive medicine" Next in thread: Joanne Bulley, MD: "Re: Paps / preventive medicine" Reply: Joanne Bulley, MD: "Re: Paps / preventive medicine"

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