DEAR DR. DONOHUE: I got a letter from my doctor along with a copy of my Pap smear report. The report has “ASCUS” on it, and the doctor made a notation for me to call for a follow-up visit. I am embarrassed by my ignorance of all this. Could you please tell me what is going on? – W.R.

ANSWER:
Thanks to Pap smears, the incidence of cervical cancer has greatly decreased. Many women are in the dark about the location of the cervix.

The cervix is the neck of the uterus that projects into the vagina. Imagine the uterus as a balloon filled with air and the cervix as the rubber tip through which the air gets into the balloon. It is the most likely place for cancers of the female genital tract to arise.

“ASCUS” on the report stands for “atypical squamous cells of undetermined significance.” “Atypical” signifies that the cells on the smear are not cancerous but look a bit different from perfectly normal cells. “Squamous” is the name of the cells that line the surface of the cervix. Your report is the kind that leaves everyone up in the air. It isn’t indicative of cancer, but it doesn’t look completely normal.

In these circumstances, there are a number of ways to deal with such a report. One is to repeat the Pap smear in four to six months. Another approach is to immediately perform a colposcopy exam. A colposcope is a viewing device that has a source of light along with a magnifying lens. The doctor can clearly spot any cervical abnormalities that might need to be biopsied. A third alternative is to test for the human papillomavirus – HPV. The HPV virus is found in almost all cervical cancers. Not finding it provides assurance that the chance of cancer is infinitesimal.

Answers to questions about cervical cancer and Pap smears is presented in the newly printed pamphlet on that topic. Readers can obtain a copy by writing: Dr. Donohue – 1102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My doctor thinks I might have bronchiectasis. I’ve never heard of it. What is it, and how do you get rid of it? I have had a cough for the past year. – R.D.

ANSWER:
Bronchiectasis (BRAWN-key-EK-tuh-suss) is a permanent bulging of airways – the bronchi. Its usual cause is a previous infection like pneumonia. The infection destroys the support structures in the airways’ walls so they bulge like an old-fashioned inner tube through a hole in a tire. In the days before antibiotics, bronchiectasis was rampant. Since the onset of the antibiotic era, it is seen with much less frequency.

The airway bulges are perfect spots for bacteria to proliferate. People with bronchiectasis, therefore, have one respiratory infection after another. Coughing can be constant, and almost always a cough brings up thick, yellow sputum.

Chest X-rays can often identify bronchiectasis, but CT scan pictures provide excellent images of bronchiectatic lungs. Are you waiting to have a scan done?

At the first sign of a respiratory infection, antibiotics are prescribed to stop further airway destruction. Therapists can teach patients how to go about postural drainage – a series of moves that empties the lungs of its thick secretions. If bronchiectasis is limited to a restricted portion of the lung, surgeons can remove that part of the lung, and the results are quite gratifying.

DEAR DR. DONOHUE: I was brought up to believe pork was unhealthy. I did not have a pork chop until I was 32. Now I read ads saying it is a healthy food. Is it? – M.K.

ANSWER:
Many people were brought up thinking the same about pork. I don’t know how it got such a reputation.

There is nothing wrong with pork. Amounts of pork compare quite well to the same amounts of poultry. Pork has less cholesterol and fat than the light or dark meat of chicken.


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