Re: Question about pap test frequency
From: Andrew Folley (agfolley@hotmail.com)
Fri Jan 26 17:01:16 2007
Skip the yearly pap and pelvics and get total body CAT scans yearly along
with a BP by the tech and we have it all covered.
>From: Barbara Nicol <blnicol@ix.netcom.com>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: Question about pap test frequency
>Date: Fri, 26 Jan 2007 15:41:50 -0600
>
>Dr. Provatopoulous -
>
>I totally think it's worth it. What I'm saying is: show me a study that
>says diagnosis on physical exam versus at presentation with symptoms
>prolongs life to that extent. I think that it is the TREATMENT for the
>cancer which prolongs life 2-4 years, not the detection on physical exam.
>And I think that it does so for Stage 3 cancers, which is where we pick
>them up in the office and also where we find them symptomatically. I've
>picked up my share on exam, but I'm not convinced that I was ahead of the
>symptoms by more than a few weeks. Only when we find it serendipitously
>at laparascopy or oophorectomy in early stages do we change the outcome
>perceptibly. Stage 3 is stage 3.
>
>But I'd be very interested - and change my opinion significantly - if you
>could show me a study documenting that we have improved outcomes with
>ovarian cancer diagnosed on screening pelvic exam - as opposed to with
>symptoms. It costs money to see us, as well as time and discomfort - we
>should be able to justify it. (I've never liked cost-effectiveness as a
>main argument, though - I'd rather stick to patient experience and risks as
>opposed to benefits.)
>
>respectfully,
>
>Barb Nicol, M.D.
>
>-----Original Message-----
> >From: "Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C."
><johnprov@sympatico.ca>
> >>>
> >>Does that benefit really justify putting women through an exam which
>ranks right down there with dental visits on the No Fun scale?
> >>
> >>- Barb Nicol, M.D.
> >
> >Maybe you don't think extending someones life by 2-4 years of good
> >quality is worth it but many patients and oncologists would disagree.
> >Actually many palpable cancers are asymptomatic. If the pt. refuses
> >its fine but I document that it was offered.
> >
> >--
> > Take care, John
>
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