DEAR DR. ROACH: I’m 82 years old, and I just found out that I have chronic lymphocytic leukemia. I have had it for almost four years, but I didn’t find out until I changed doctors. Should I have done something about it by now? They tell me there is nothing they can do. — E.A.

ANSWER: I am surprised to hear that there are still some physicians out there who don’t tell their patients their diagnoses and their options for treatment. I have always felt that it is our obligation to share our knowledge so that the person can make the best decision for him- or herself, which may include no treatment.

The treatment for CLL recently and dramatically has improved, with the arrival of a powerful new treatment, ibrutinib. Nonetheless, not every person with CLL needs treatment or would even benefit from it. Age is a factor for choosing treatment, but not the only one. Because CLL is a condition with a wide range of severity, it is absolutely imperative that you speak with a hematologist who treats CLL to hear what your options are.

DEAR DR. ROACH: I had my annual mammogram yesterday. While my left breast was being compressed (front view), my left jawbone up to my temple suddenly started to tighten. I mentioned it to the technician, who immediately stopped the compression. After a few seconds, the pain stopped, and she was able to continue. The same thing happened to the left breast when doing the side view. What would have caused this tightening of the jawbone, and should I be concerned? — M.L.

ANSWER: Seventy-two percent of women report pain during their mammogram, usually rated at less than 4/10 on a standard pain scale. However, the pain usually is described as being in the breast, rib or breastbone, or with movement. I’ve never heard the complaint of jaw and face pain during a mammogram. It could be “referred pain,” where pain in one part of the body is misinterpreted by the brain as coming from an entirely different part. In any event, I don’t think it should be a cause for worry. I specifically don’t think it’s heart pain, which sometimes feels like it is coming from the face or jaw.

If any readers have had this sensation during a mammogram, please let me know.

DEAR DR. ROACH: I just read your column about Barrett’s esophagus and taking proton pump inhibitors such as omeprazole.

I have Barrett’s, but I have never had symptoms of acid reflux. I didn’t have symptoms of acid reflux before taking it, and didn’t experience any when I was off of it this past winter. I had my esophagus stretched five weeks ago, and the doctor prescribed omeprazole again — to be taken forever.

Omeprazole causes me intestinal problems — gas, abdominal discomfort at times and going to the bathroom at least three times a day, sometimes four. It’s my understanding that omeprazole is for acid reflux. I’d like to know if you think I should continue it since I have Barrett’s even though I don’t have symptoms of acid reflux. — G.G.

ANSWER: Barrett’s esophagus, a change in the lining of the esophagus, which predisposes one to cancer, is caused by acid reflux. Not everybody with reflux has symptoms of heartburn. If I had Barrett’s I would CERTAINLY take a proton pump inhibitor forever, even if I had no symptoms, since I think the evidence, though not definitive, is strong enough that the benefit of cancer reduction outweighs the risks. However, as the omeprazole is causing you side effects, you definitely should try a different one, such as pantoprazole or lansoprazole.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from

(c) 2014 North America Syndicate Inc.

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