DEAR DR. DONOHUE: My husband, 57, died of pancreatic cancer. He didn’t know he was sick until the last two months of his life, when he began having stomach pain and losing weight. It took the doctor weeks to make a diagnosis. Would my husband have lived if the cancer had been discovered earlier? – C.V.

ANSWER:
The pancreas is the next-door neighbor of the duodenum, the first portion of the small intestine. It’s about 6 inches (15 centimeters) long. It performs two important functions: It makes enzymes for food digestion, and it produces insulin for blood sugar control.

Pancreatic cancer is treacherous. It rarely produces symptoms until it is quite large and more difficult to treat. This cancer causes more than 30,000 deaths a year in North America. It’s a cancer that generally strikes older people, with 71 being the average age to have it.

When symptoms appear, weight loss and appetite loss are common. In addition to not wanting to eat, patients cannot digest what they eat because the digestive enzymes from the pancreas are lacking. In time, people begin to complain of upper abdominal pain that sometimes spreads to the back. In a few people, back pain is the only symptom.

The pancreas and gallbladder share a common duct. Through the duct, the digestive enzymes flow from the pancreas into the duodenum, and bile flows from the gallbladder into the duodenum. Many pancreatic cancers wrap themselves around that duct and block flow through it. Bile backs up. Bile pigment levels in the blood rise and turn the skin yellow (jaundice).

Your husband’s doctor wasn’t remiss in not making the diagnosis sooner. It’s a tough diagnosis to make, and it can require many tests. One of the best tests is a CT scan of the abdomen. It takes excellent pictures of the pancreas and outlines any cancer that might be in it.

DEAR DR. DONOHUE: I play basketball twice a week with other men in their 30s and 40s. Last week, during the game, I had a horrible pain in my left testicle. One of the players is an EMS tech. He insisted I be taken to our hospital’s emergency department. He said that I might have testicular torsion. I was taken to the hospital, but I didn’t have testicular torsion. I wonder what that is. Would you please tell me? – G.H.

ANSWER:
The spermatic cord is a ropelike structure that suspends the testicle in the scrotum. The cord contains many structures, including the artery that nourishes the testicle.

If a testicle twists, blood vessels in the cord are strangled. No blood gets to the testicle. If the twist is not relieved promptly, the testicle dies.

I am glad you didn’t have testicular torsion. You have us all on pins and needles. What did you have?

DEAR DR. DONOHUE: What does “CPK” indicate? I have a copy of my blood test results, and one item on it is CPK. Mine is a bit higher than normal. Is this important? I would ask my doctor, but it is too much of a hassle, so I am asking you. – H.J.

ANSWER:
CPK is creatine phosphokinase. It’s an enzyme found in muscle cells, including heart muscle. Enzymes speed up the chemical reactions that take place in cells. This enzyme is involved with the production of cell energy.

When muscles are injured or die, they release their CPK enzymes and other enzymes. A rise in CPK, therefore, points to muscle injury. CPK was one of the tests used to detect heart attacks. It still is, but there are many other tests that are more specific for heart muscle damage.

Exercise can cause a slight, transient rise in CPK from the stress it puts on muscles. Getting a shot into a muscle is another cause for a CPK rise.

No matter how great the hassle might be, you have to rely on your doctor to tell you if this rise is significant. My bet is that it is not. Slight rises of CPK are routinely found.

DEAR DR. DONOHUE: My brother is convinced that eye doctors give you stronger prescriptions in order to have you come back for new glasses every other year. What makes a nearsighted or farsighted person get worse even when that person wears corrective lenses? – S.B.

ANSWER:
Your brother is dead-wrong. Eye doctors prescribe lenses that permit a person to see clearly. Too strong a lens distorts vision.

The shape of the eye determines if a person is near- or farsighted. An elongated eye makes a person nearsighted – unable to see distant things. An eye with a diameter shorter than normal causes farsightedness – the inability to see things up close. As the eye changes shape, stronger lenses are required. Usually a plateau is reached where there is no more change in vision or eye shape.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


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