DEAR DR. DONOHUE: Please advise me about fibroid tumors. I have five. Several years ago, I had a pelvic ultrasound that showed them. I have had no problems with them. Now, however, because of a little spotting of blood, my primary doctor did a pelvic exam, and it showed that they had enlarged. Does something have to be done? I had hip surgery two years ago and wonder if this has anything to do with them. I don’t want to have any unnecessary surgery. I am 84. — C.C.

ANSWER: Fibroids are noncancerous growths of the uterine muscle that project into the hollow interior of the uterus. By age 30, 20 percent of women have one or more of them. By age 50, 40 percent do. With the decline of estrogen production at menopause, fibroids usually shrink.

Uterine cancer mostly arises from sites other than fibroids. If they are not kicking up a fuss — bleeding, causing pain or pressing on adjacent organs — they can be left alone.

Unhappily, you have two signs that cannot be ignored: Your fibroids have grown larger. (Was the growth documented by a second ultrasound? It should be. A physical exam can give only a rough estimate of growth.) Bleeding is another unsettling sign.

I’m sorry to tell you this, but there is a necessity for establishing why fibroids grew at your age and to determine the source of bleeding. Perhaps these goals can be met in ways other than surgery — an ultrasound and possible scope examination of the uterus. All of this is unusual at 84.

DEAR DR. DONOHUE: What is the difference between dementia and Alzheimer’s disease? Are they the same? — M.J.

ANSWER: “Dementia” is an encompassing word that includes many different conditions. Those conditions have some similar features that indicate an impairment or loss of important mental functions. The inability to retain new information, getting lost in familiar surroundings, difficulty choosing the proper words to express oneself, trouble doing simple arithmetic like adding and subtracting, the failure to recognize close relatives and friends, and showing poor judgment like dressing for winter in the middle of summer are signs of dementia.

Alzheimer’s disease, Pick’s disease, vascular dementia (dementia due to many small strokes), dementia with Lewy bodies and frontotemporal dementia are but a few of the dementia illnesses. Each of these illnesses has special features that set it apart from the other dementing conditions.

Alzheimer’s disease is the most common kind of dementia. People often use “dementia” when they mean “Alzheimer’s disease.” It’s best to give the exact name for the illness that is causing mental deterioration.

The booklet on Alzheimer’s disease provides the signs and symptoms of this illness. Readers who would like a copy can obtain one by writing: Dr. Donohue — No. 903, 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: Would you please comment on tongue piercing? My granddaughter (late teens) had this recently done. I told her I thought it was dangerous to her health. It gives bacteria a direct route into her body. She didn’t believe me. What’s the medical stand on this? — T.E.

ANSWER: I can’t give you the official medical stand, but I can give you my stand. I find it strange, unappealing and lacking in good sense, and I can’t imagine why anyone wants it done.

The initial piercing site could develop an infection. Once it has healed, however, it’s unlikely to do so. The metal can cause tooth damage if it contacts a tooth or teeth.

I’m happy to present the opinions of any dentists who want to contribute their view.

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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