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May 28, 2021

What women need to know about cancer prevention

Women's Health Cancer

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Cancer — a word no one wants to hear in the same sentence as their own name or the name of a loved one. As a physician, it's my job to not only treat cancer, but also  prevent it.

Earlier this month, Dr. Eva Chalis joined me for a discussion on “Your Radio Doctor,” a medical talk show that airs every Sunday morning at 10 a.m. on Talk Radio 1210 WPHT. Dr. Chalis is a Professor of Obstetrics and Gynecology at NYU Long Island School of Medicine and the immediate past President of the American College of Obstetricians and Gynecologists. She had just returned from the national meeting of the college and shared that the main areas of focus in women’s health were obesity and the importance of family history.


Aside from increasing the risk of hypertension, diabetes, heart disease and stroke, obesity also increases the risk of multiple cancers, including breast, uterine, colorectal, esophageal, kidney, ovarian, gall bladder, and pancreas. Fat tissue converts male hormones to estrogen which is food for breast and uterine cancer.

BMI (body mass index) is the measure of body fat based on height and weight. According to the National Institute of Health, BMI categories include:

Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater

If your BMI falls between 25 and 29, your risk for uterine cancer doubles. Risk is three times greater once your BMI passes 30. “Cycling” weight or “yo-yo” dieting can increase body fat percentage at the expense of muscle mass, especially after menopause.

During our radio show program in April with Dr. Maureen Kelly, we learned excess weight in the female or the male partner can also decrease fertility and increase the rate of miscarriage. Aside from an increased risk for diabetes and hypertension during and after pregnancy, it can also increase the risk of obesity throughout the life of the child.

Family history

Family history also plays a pivotal role in cancer risk. It is very important to learn whether your relatives have had breast, ovarian, uterine, or colorectal cancer. This also includes cases of breast and colorectal cancer in male family members who may have the BRCA (BReast CAncer) gene or Lynch Syndrome.

Most of us are familiar with the BRCA gene mutation causing an increased risk of breast and ovarian cancer. But did you know that it can also increase the risk of pancreas and prostate cancer?

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Marianne Ritchie, MD

The Lynch Syndrome is a disorder that results from a mutation in one of several genes. It carries a lifetime risk for colorectal cancer up to 90% and significantly increases the risk for other cancers – most often uterine but can include stomach, small intestine, pancreas. Growing evidence now includes increased risk of prostate cancer, as well. If a patient has a positive test for the Lynch Syndrome, first degree relatives have a 50% chance of also being affected.

It’s also important to note that even if your genetic testing does not show a specific gene mutation, your family may carry a genetic abnormality that has not yet been identified.

A positive family history may signal the need to begin screening tests at a younger age and to have testing more often.

The American College of Obstetricians and Gynecologists no longer recommends a yearly Pap test. The time interval between Pap tests depends on age, sexual history and results of previous tests. And for women without symptoms, the annual pelvic examination is no longer recommended either. This has led to some confusion for patients regarding their routine care.

Dr. Chalas emphasized that it is still essential for women to have an annual visit with a gynecologist or primary care doctor to discuss their gynecologic health and recommend age-related examinations at proper time intervals. Other topics should include reporting any new symptoms, reviewing their history of abnormal PAP tests/HPV testing, and discussing treatment to regulate menstrual periods, birth control, prevention of miscarriage or menopause issues. It may also provide the opportunity for a woman to discuss issues that she might not find comfortable discussing with her primary care doctor, such as abuse.

Listen to the entire show on to hear more about prevention of cervical, ovarian and uterine cancers.

Pink Plus

Several years ago, I began a program called Pink PLUS that provides women with the opportunity to have three cancer screenings performed in just one visit. Patients can come to Jefferson and have a routine gynecology examination, then a mammogram, followed by a brief visit to review screening options for colorectal cancer.

While the “Pink” campaigns have had a very positive effect on driving women to having mammograms, there are still too many women who think “mammogram and done.” It’s important to know that more people die from colorectal cancer than from breast cancer when we combine men and women, so all of these screenings are important.

Call 215-503-1631 today to make a Pink Plus appointment today.

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