DEAR DR. DONOHUE: I am a 75-year-old woman whose life has come to a halt. I have no energy. I did see a doctor, who gave me a very thorough exam and sent out blood to the lab. My doctor thinks I have something called myelodysplasia, a word totally foreign to me. Is it a form of cancer? Is it treatable? — G.K.

ANSWER: Myelodysplasia (MY-uh-low-dis-PLAY-see-uh) isn’t cancer. It’s an illness in which the bone marrow’s blood-making cells have gone AWOL. “Myelo” refers to bone marrow; “dys” indicates abnormal function; and “plasia” is a word meaning “production of.”Myelodysplasia is a group of bone marrow diseases that produce poorly formed, poorly functioning and too few blood cells. It strikes at older ages. A deficit of red blood cells is anemia, the reason why you have no energy. Too few white blood cells makes a person more susceptible to infection. And too few platelets, the clotting cells, brings on bruises and bleeding.

A word more about red blood cells is required. They bring oxygen to all parts of the body. Without a normal supply, you’re not getting enough oxygen to body cells and organs. Oxygen is their energy. Fatigue is guaranteed in such a situation.

The doctor might ask for a bone marrow examination. It’s most helpful in identifying which of the myelodysplasias you have and what is the most appropriate treatment.

Sometimes myelodysplasia progresses very slowly. For others, it’s a more aggressive illness. One treatment is medicine that increases red blood cell production. Blood transfusions might be required. Two medicines, Vidaza and Dacogen, restore genes affected by this process to a more normal function.

The ultimate treatment — when it is feasible and when the patient is up to it — involves a bone marrow transplant.

DEAR DR. DONOHUE: Will you kindly tell me what is the appropriate time interval for a repeat colonoscopy? I have different information from doctors. I had my first colonoscopy when I was 51. The doctor who performed it said I didn’t need another until I was 61. A different doctor says I need a repeat at 56. Which is it? — E.P.

ANSWER: If no polyps were found on your first exam and if you have no close relatives who have had colon cancer, then the usual time for the next exam is 10 years. Otherwise, it is five years.

The booklet on colon cancer explains its detection and treatment. Readers can order a copy by writing: Dr. Donohue — No. 505, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: When my mother was 63, she developed type 2 diabetes. Four years later, she died of a heart attack. She wasn’t a smoker.

Am I likely to meet the same fate as my mother? I am 47 and do not have diabetes.

ANSWER: For readers not familiar with diabetes terms, type 2 diabetes is what used to be called “adult-onset diabetes.” It is usually treated with oral medicines and diet. Type 1 diabetes used to be called “juvenile diabetes” and requires insulin treatment.

Just because your mother had diabetes at age 63 does not mean that you are destined to have it too. Type 2 diabetes is more affected by genetic influences than type 1, but you received only half of your genes from your mother.

Furthermore, you can somewhat blunt the genetic influences for diabetes if you stay on the lean side, exercise daily and adhere to a healthy diet, one low in sugars and fats and high in grains, fruits and vegetables.

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. Readers may also order health newsletters from www.rbmamall.com.

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