Spotlight Health

Moderator
Here is a question from honeybunny: 'Stefanie, is there anything you do in your day-to-day life, in terms of diet or other therapies to help you stay healthy? I'm still a huge Hart to Hart fan and you've always been my ideal as a healthy person.'

Stefanie Powers
Thank you very much. First of all, I'm a vegetarian. I do exercise very regularly when I'm home in Los Angeles. I live in one of the canyons. My two dogs take me on walks. I do Pilates and play polo. I don't smoke, except for the occasional cigar.

Moderator
Here is a question from dragonswing: 'Stefanie, please tell me about the William Holden Wildlife Foundation.'

Stefanie Powers
The William Holden Wildlife Foundation was founded in 1982 after the death of William Holden, who was an avid conservationist. And it was founded in order to fund the continuation of the work that he began in Kenya. He originally came to Kenya in the 1950s as a hunter and became a conservationist before conservation was an issue that anyone discussed. It was his dream to establish an education center on the game ranch we have in Nanyuki, near the base of Mount Kenya. Over the years, we've raised enough money to fulfill that dream, and we now bring families to the education center. We service an average of 10,000 students a year. We teach them about the ecology of their country, the wildlife. We hope they can take back to their communities what they learn and utilize that knowledge in order to preserve their environment. We also have field centers throughout the country which people can go to if they can't come to our location.

Beth Karlan, M.D.
I think one of the reasons women need to stay healthy is so they could potentially go and enjoy those wonderful sights out in the wilderness.

Stefanie Powers
Absolutely.

Beth Karlan, M.D.
That's another reason for everyone to have a healthy lifestyle: eat right, exercise and take care of themselves so they can enjoy the beauties and wonders of the nature around us.

Stefanie Powers
That's so true. And at the game park we have established nucleus breeding herds of 37 different species, some of which are endangered. We work with them on a regular basis to prevent their extinction.

Moderator
Here is a question from Chattycathy: 'My grandmother died from ovarian cancer at 78. Am I at a high risk myself?'

Beth Karlan, M.D.
One needs to look at the many factors of the family history. You may be at a higher risk compared to another woman whose grandmother did not die of ovarian cancer. But you may be at the same risk as any other woman in the United States, which is approximately 1 in 70. To better assess your risk, look beyond your grandmother. Look at the other cancers which may be in your family, such as breast cancer, colon cancer, and even prostate cancer. The one thing that's important in looking at genetic risk and family history risk is that the father's side of the family and the history there is just as important as the cancers on your mother's side. As Thanksgiving, or your next family gathering, approaches, try to find out what your aunt or cousins or other individuals may have died from. It's just like in some families where heart disease, diabetes, or even red hair, may run in that family. Similarly so are for the genetics of cancer-associated risks. So your grandmother having had ovarian cancer at an older age is less likely to be associated with an increased risk through genetic transmission. But let's say it was your father's mother or your father's sister or some other relatives who may have had ovarian cancer also, then you may be at a higher risk. So get a fuller assessment of your family history and then discuss it with your physician.

Moderator
Here is a question from honeybunny: 'Stefanie, what is your exercise regimen?'

Stefanie Powers
Like I said before, I do a lot of walking with my dogs, polo, Pilates.

Beth Karlan, M.D.
If one can have 30 min of aerobic exercise of some sort per day for three to five days a week, it does improve one's life span from many aspects, in terms of heart disease, diabetes, and cancer risks. Whether you choose to do something as rigorous as polo or just taking a stroll, going upstairs, swimming, some type of aerobic exercise, you should try to incorporate that into your lifestyle so it becomes something you do on a regular basis. And try to find a partner to do it with.

Moderator
Here is a question from mare_tyndall: 'Dr. Karlan, what routine tests should I have to screen for all the cancers that you can get? I'm 32 and have 2 kids. Does that affect my chances of getting cancer?'

Beth Karlan, M.D.
I'll go through the most common cancers that affect women and then the ones we have the best screenings for. The most common cancer killer of women is lung cancer. So one of the most important things you can do is not to smoke cigarettes. There is no screening test for lung cancer at this time. Things like annual chest x-rays are not effective at finding the curable lesions. So, again, trying to avoid tobacco and second-hand smoke would be important. The best cancer-screening test we have is the Pap test for cervical cancer. The current recommendation is that, for all sexually active women, women over the age of 18, should have annual Pap smears. So that's the general recommendation which might be changed based on your history, whether you've had pre-cancerous cells on your cervix in the past, or have had a number of various infections which may increase your risk of cervical cancer. So one thing you can do to reduce your risk of dying from cancer is to get your Pap smear. The other cancer-screening test which you're probably not of age to undergo at a regular basis yet is mammography to find early breast cancer and to reduce your risk of dying from breast cancer. The current recommendation for that would be for women over 40 to have an annual mammography. Again, family history is very important in many of these cancers, so that if you have a strong family history of breast cancer, mammography screenings may be recommended at a younger age. And, again, it's something you should individualize and discuss with your physician. Colon cancer is an important killer of women. It's the third most common cancer. Recommendations for screening usually begin at age 50 with tests like colonoscopy and tests for blood in the stool. Again, for each of these things, there are certain dietary changes which are helpful. With colon cancer, clearly having fiber in your diet is important. For breast cancer, reducing alcohol and not having excess alcohol are important. Smoking we've already spoken of with lung cancer. But not smoking also reduces your risk of cervical cancer, esophageal cancer, stomach cancer, bladder cancer, and others, so there are many things there. In terms of ovarian cancer, family history is the most important risk factor for that disease, as we've previously discussed. However, there is currently no widely available screening test to find ovarian cancer at a very early curable stage. For certain high-risk populations, such as those with very strong family histories of ovarian cancer, there are tests which are recommended. But there's a lot of research looking at new blood tests which would be able to detect ovarian cancer at an early stage. And those may be available in the next two to five years. So that's some good news on the way.

Stefanie Powers
Is this being developed for everyone to have as they do their Pap smear, or is this only recommended for high-risk groups?

Beth Karlan, M.D.
Thanks for bringing that up, Stefanie. Ovarian cancer is the most common reproductive tract cancer among women and, as you know, has a high mortality rate.

Stefanie Powers
And it's not easy to detect.

Beth Karlan, M.D.
That's the big problem because, when it's detected early, it's very curable. It's being looked at for all women. That would be the goal. The PSA test for prostate cancer is the same type of blood test we're looking at for ovarian cancer. We're still looking at ultrasound screening and other combinations of tests, but with some of the new molecular technology that has arrived in the last five to ten years, we're able to find these markers much more quickly, and there's one or two right now that are really promising and that I think will be ready for "prime time" very soon after the millennium.

Stefanie Powers
That's great news.

Beth Karlan, M.D.
It sure is. It's very exciting to be in medicine right now.

Stefanie Powers
My personal experience with ovarian cancer is with a good friend of one of my closest friendsÑa childhood friend of hers--, who was recently diagnosed with ovarian cancer. Her husband's a doctor. He felt very guilty for not recognizing what few symptoms she had. And when she was diagnosed, it was already third stage ovarian cancer.

Beth Karlan, M.D.
Over two thirds of women at the time of their initial diagnosis are at the third stage. And the symptoms are there, but they're quite vague. That's part of the problem. But to allay her and her husband's guilt, let me just say that, while the symptoms are there, the symptoms themselves don't reflect stage one cases. They often reflect early stage three cases.

Stefanie Powers
So at stage one you are asymptomatic?

Beth Karlan, M.D.
That's correct. Our ovaries are tucked inside, and every month you ovulate. Your ovary doubles in size, and that just explodes. Sometimes we notice that sharp pain in our lower abdomen, but we get used to that discomfort. So with the discomfort associated with ovarian cancer, the ovary may slowly enlarge, but we don't find symptoms until the cells have spread beyond there. And that's the problem. So if one has symptoms which persist and get slightly worse, even over just two weeks or three weeks, one should consult with their physician and specifically ask whether or not this is consistent with early ovarian cancer. I think, as women, we should take control of our health and get as much information as possible. These symptoms are: pain or pressure in the pelvis, more frequent urination, including waking up at night, worsening constipation, abdominal bloating, feeling that your clothes are getting too tight, but not from weight gain. I think everyone can see the vague nature of this.

Stefanie Powers
I can see that. These sound like symptoms for a dozen other things.

Beth Karlan, M.D.
That's right. That's part of the diagnostic dilemma. There are also common complaints as we get older -- our metabolism slows -- that all of us have had from time to time. That's why I say see if they're there day in and day out, over a number of weeks, and that it's really different from what you've had before. Stefanie, I think you bring up a good point with how these can be associated with other ailments, that sometimes even good doctors need to be reminded of all the possible things. And non-gynecologists may not even quickly think of ovarian cancer. So when you go in, I think it's appropriate for the woman to say: "I've had these symptoms. It could be a number of things. Do you think it could be ovarian cancer?" And I think that may also help with some of the earlier diagnoses.

Stefanie Powers
At that point, would the currently available blood test be given?

Beth Karlan, M.D.
At that point, a pelvic ultrasound and/or a CA 125 would often be appropriate.

Moderator
Here is a question from honeybunny: 'Do you notice that celebrities are more willing to discuss publicly their health problems now?'

Beth Karlan, M.D.
I think both Stefanie and I could answer that. Again, I have a biased view perhaps, in that I'm seeing the patients, the women, as they come in with an ailment. I think we need to individualize, "we" meaning everyone in general, whether they're celebrities or lay folks like the rest of us. There's a greater willingness to talk about health issues, whether it's cancer or mental disease or psychological disorders or other types of ailments. Stefanie, correct me if I'm wrong, but I think there used to be a feeling in Hollywood that certain ailments would stigmatize an actor/actress and limit their access to certain roles.

Stefanie Powers
Absolutely. And also, there were issues like insurance. If you were diagnosed with some sort of illness, it might impact your ability to complete a role you'd been hired to play. Personally, I feel, as a celebrity, it's my duty to use my celebrity to create awareness for certain issues, such as health issues and other issues I feel strongly about, like conservation. It calls greater attention to the issue and sometimes, when people hear things like that from someone they admire, they are more likely to incorporate that information into their own lives.

Beth Karlan, M.D.
Stefanie, I think your innate gift of power of communication often helps get across a very important message. So I would applaud you and other colleagues of yours who have been so helpful in educating men and women about these very important issues. So I think, to answer the posed question: yes, I do think that there is a greater willingness to speak about various medical problems, including cancer, but I still think it's an individual choice in terms of how one copes with their disease.

Stefanie Powers
I think you're right. I want to call attention to these issues and encourage people to find out more about certain illnesses and how they might impact their own lives and how they can obtain as much information as is currently available on specific diseases.

Beth Karlan, M.D.
And that's great. That's why you're here today.

Stefanie Powers
Absolutely. And with the advent of the Internet, people have much more access to this information. It's much more readily available to them than when they had to go to a library and pull out some medical journal that may have not made much sense to the layman. There's a lot more information available to people now on the Net, and it's easier to understand.

Beth Karlan, M.D.
I have more and more patients coming to my office with Internet printouts. It's great! I love it! They bring in printouts on whatever disorder they think they may have or that they do have. I have patients bring in recent articles on experimental therapy. They come in with much better questions that I think are more helpful to them. Rather than asking "What is cancer?", they can get down to some real specific points because they've "done their homework." There's a number of websites. Spotlight Health is one. There's another one called the Women's Cancer Network which provides information regarding breast, ovarian, uterine, and cervical cancer and helps assess your own risk for these cancers and gives you information about them. The National Cancer Institute and the American Cancer Society both have websites. And I think it's great that patients can get on their computers at any hour to get information which may help them focus on what's really bothering them or even help allay their fears, rather than just sit there because they're paralyzed with fear.

Stefanie Powers
It gives you the opportunity to be very proactive and ask your doctors about, for example, a certain experimental treatment or a certain drug you understand people have had success with. You can be so much better armed with information than you were years ago.

Beth Karlan, M.D.
And just as we were speaking about some changes amongst the celebrity community to speak about cancer, I think patients shouldn't feel like they would insult their physicians by bringing in information and asking questions. Many patients do feel that it's offensive, but I welcome it, and I know that many of my colleagues welcome it. I think that the medical profession has evolved so that the interaction with patients isn't something which should or shouldn't be done, but contractual arrangements decide what's best for that individual.

Stefanie Powers
In fact, I would go so far as to say that if your doctor didn't welcome your questions and your search for more information about the disease you've been diagnosed with, then you're probably with the wrong doctor. There really has to be a give-and-take relationship.

Beth Karlan, M.D.
I wholeheartedly agree with you, Stefanie.

Moderator
Here is a question from kerry: 'Stefanie, don't you think most women are afraid to be tested because they are afraid to find out the answers? "What I don't know won't hurt me" kind of thinking?'

Stefanie Powers
I don't know about most women. I can only speak for myself. One only goes so far to be tested when they feel there is something wrong, that they have certain symptoms which are indicative that something is amiss. And certainly we don't want to hear that catastrophic diagnosis. But I don't think you can say that most women say 'what they don't know can't hurt them.' Obviously, what they don't know CAN hurt them.

Beth Karlan, M.D.
Ten years ago, when we started our Gilda Radner Ovarian Cancer Program, our byline underneath was: "Don't be afraid. Look into it." So I think that there is this element of fear, but we need to look around us as women at all the people we support, whether they're partners, children, parents, or whoever. Part of showing your love for them is to take care of yourself. For those women who delay diagnostic tests because of the fear, you'll either sleep better because the fear is alleviated if you look into it, or you'll be able to address the problem directly if there is something there to be worried about.

Moderator
Here is a question from Chattycathy: 'I was diagnosed with ovarian cancer 18 months ago. I had the surgery - they took everything out - and then I had chemotherapy. I have just been told the cancer is back. What can I do?'

Beth Karlan, M.D.
It's hard to give specific recommendations without all of the information. I can tell that, in most cases, there are many additional treatments that may be effective in getting your cancer back into remission. There are new chemo drugs that often work when the original ones have failed. At times, additional surgery is appropriate and can help. Even radiation treatment can be effectively used to treat ovarian cancer. So while I understand your fear and disappointment at this time with the cancer having returned, don't lose hope. Get on the Internet and find out more information. It may be appropriate to get a second opinion if necessary. And discuss with your physician the treatment options which may be available to you right now.

Moderator
Here is a question from mare_tyndall: 'I am so scared about all this cancer talk. I am eighteen, my aunt had breast cancer, but she didn't get it until she was 80 something. What are my risks really and what can I do about it??'

Beth Karlan, M.D.
Your risk at 18 is very small. However, as you get older, everyone's cancer risk increases. What you can do about it proactively is listen to many of the things we've discussed here: exercise regularly, eat well, avoid things in excess like alcohol, and do see your physician on a regular basis. Get Pap smears. Find out what kinds of diseases run in your family. If only your grandmother has had cancer and she did not get it until her eighties, then you're probably not at any increased risk for cancer. But remember that 185,000 women are diagnosed with breast cancer every year in the United States. If you're lucky enough to live into your eighties, your chances of getting breast cancer may be about 1 in 8 or 1 in 9. So at age 18, your actual risk of cancer in the next two decades is really quite small. But to allow yourself to outlive your grandmother, eat well and live well now.

Moderator
Here is a question from farmersdaughter: 'Stefanie, what is your philosophy for taking charge of your life and health?'

Stefanie Powers
I try to live each day to the fullest, but I do take very good care of myself. As Dr. Karlan has said, I try not to do anything in excess. Including exercising too much! I try to keep a very positive mental attitude.

Beth Karlan, M.D.
And get as much information about these things as you can.

Stefanie Powers
Absolutely!

Beth Karlan, M.D.
Information is empowering. Don't be afraid of it.

Stefanie Powers
That's another great quote! You're going to have to write a book!

Beth Karlan, M.D.
With you, Stefanie. We'll do it together. Through Spotlight Health.com.

Moderator
Here is a question from winsomewantsome: 'Dr. Karlan, does sexual activity (or a lack thereof) have any bearing on the risk factor for cervical or uterine cancer?'

Beth Karlan, M.D.
Good question and yes it does. Not so much with uterine cancer as with cervical cancer. Early age of first intercourse or multiple sexual partners, usually defined as more than three, does slightly increase your risk of cervical cancer. Now let's define why that is. Cervical cancer, in many cases, is associated with the sexual transmission of certain viruses, such as the HPV virus. The HPV virus is what specifically causes warts. There are about 60 different types of the HPV virus, such as the type that causes warts on your hands, or the type that causes warts on the feet, and there's about 20 types that cause a venereal type of warts. You may not see these warts on the outside, on the vulva, but you can have evidence of infection by this virus in the cells of the cervix. That infection is thought to be related to the onset of cervical cancer. Having said that, I think there is a number of caveats. Firstly, you would know by a Pap smear, so you don't all need to run and start looking at your vulva. But if you've had a Pap smear, you can ask your physician if there's any evidence of HPV infection. If you have multiple sexual contacts and unprotected intercourse, then you have an increased risk of HIV infection, and HIV is another risk factor for cervical cancer. So the thought is that with an increased exposure to multiple partners, you have an increased risk of "catching" one of these viruses. Now just because you have evidence of one of these viruses, specifically HPV, it doesn't mean you're going to get cervical cancer. It is an infection that may come and go during life. But just because you find out you do have some evidence of an HPV infection, you may be at a slightly increased risk of cervical cancer, but by no means does it definitively mean you will get cervical cancer.

Moderator
Here is a question from susannabanana: 'Stefanie, did you launch a new perfume? What is it called?'

Stefanie Powers
The new perfume is called Rare Orchid. We launched it last fall on QVC. It was on the air a couple of times before the end of the year. We're currently reorganizing, and hopefully we'll have it back on the air later this year.

Beth Karlan, M.D.
You can only get it through QVC?

Stefanie Powers
Yes, only through QVC. It is a fragrance that is very much in keeping with my own environmental concerns. It's the first fragrance of its kind that replicates the scent of orchids without destroying the plant in the process of creating it. The process, which is called ScentTrek, was developed by the fragrance house of Givuadan Roure. They go into the wild and cover the plant, in this case it was an orchid called the Brassavola Glauca which grows in the wild in Nicaragua, they put a glass bell over the plant and wait for it to emit its fragrance, which it only does once a night since it's a nocturnal plant. The bell analyzes molecules that comprise the fragrance, and then the molecules are replicated in the lab so the plant remains unharmed. Last fall we launched the fragrance and a body spray, and we plan to relaunch it along with a number of other body products before the end of the year.

Moderator
Here is a question from mare_tyndall: 'Dr. Karlan, I had a hysterectomy two years ago - I had terrible fibroids - should I still be having Pap smears?'

Beth Karlan, M.D.
Most likely yes. One can still get a cancer at the top of the vagina where the cervix was. You should find out from your physician if you had a total hysterectomy or a super-cervical hysterectomy. Hysterectomy only refers to the removing of the uterus and, in some cases, physicians do leave the cervix behind. So that would be one thing to clarify. If your cervix has been removed, your risk of cancer to the vagina is less than it is to the cervix, but it does occur. If you've had a hysterectomy and you've previously had abnormal Pap smears, you clearly need to have regular vaginal smears. But you could discuss with your physician how frequently they should be performed. The other question to pose to physicians, if you've had a hysterectomy and are no longer having periods, is whether or not they have also removed your ovaries. There was recently a story in the news that led to some fear amongst women that you can still get ovarian cancer even though you've had a hysterectomy. In some of those cases, it was that only the uterus was removed and the ovaries were left behind. So it's just good to know what was done to you. In other cases, there were women with strong family histories of ovarian cancer and indeed didn't get ovarian cancer but got a rare form of cancer called Primary Peritoneal Cancer. So if you've had a hysterectomy, in general you do need Pap smears but find out from your physician exactly what procedure was done so that you'll know for the future.

Moderator
Here is a question from winsomewantsome: 'Stefanie, could you tell me more about the Romance Classics Wine Express that you are involved with?'

Stefanie Powers
Certainly. Wine Express is a series of half hour programs about wine. They take viewers to various wine-producing regions throughout the U.S. and Europe and Australia. They talk about the various types of wines that come from those regions. I'm the host of the series, and you'd have to check your local listings as to when it airs in your area on Romance Classics, which is a cable network, of the American Movie Classics Network.

Moderator
Here is a question from elizajody: 'I am a chemistry student planning to work in an environmental laboratory. Could both Stefanie and Beth comment on the impacts to our health that are associated with the pollution of our environment? Thank you.'

Stefanie Powers
I'm not sure there's anything I could say about that.

Beth Karlan, M.D.
The pollution of the environment affects our health in a number of ways. One could start in superficial areas such as having coughs and asthma as we're seeing amongst children and adults. Increased eye soreness, increased acne, associated with increased pollutants in the air. There is pollution relating to various chemicals that we may be more exposed to that may be associated with some of the increased cancer risks. As a chemistry student, one could inquire at the laboratory whether the environmental safety officer has made a visit and are there any specific precautions. Universities and medical centers are required to have radiation safety and environmental safety protocols, procedures, and officers to protect individuals working in those laboratories. Clearly with the increased pollution and changes in the atmosphere, the increasing UV light has increased our risk to various skin cancers such as melanoma. So there are a number of direct health impacts from the environment on how we live, and that's part of why much of the work that Stefanie and others are doing to protect our environment is so vitally important.

Moderator
Here is a question from farmersdaughter: 'Stefanie, what was your favorite role, and why?'

Stefanie Powers
I guess I would have to say my favorite role was Jennifer Hart in the Hart to Hart series, which ran for several years as a weekly series and then became a series of two-hour movies with Robert Wagner. I think the writing was really wonderful, the characters were so finely etched that I just loved to play her.

Beth Karlan, M.D.
Are you as adventurous as Jennifer Hart was?

Stefanie Powers
Some people think I am Jennifer Hart. However, the character was created before I was involved with the series. But yes, there are some parallels. I do a lot of traveling and have done a lot of interesting things that perhaps Jennifer Hart would try.

Beth Karlan, M.D.
That's probably why you did it so well.

Stefanie Powers
Thank you.

Moderator
Here is a question from winsomewantsome: 'Stefanie, could you give us some keys for success?'

Stefanie Powers
Believe in yourself and follow your dreams. And to some extent, don't take "No" for an answer.

Beth Karlan, M.D.
And don't waste a lot of energy on worrying. Go out and do it.

Stefanie Powers
Absolutely.

Moderator
Here is a question from tlh4hart: 'Dr Karlan, I have just started taking birth control pills, and was told that this can increase your chances of cervical cancer. What should I be watching for to prevent this from happening?'

Beth Karlan, M.D.
Birth control pills have a number of medical benefits and risks not associated with their contraceptive role. The increased risk in cervical cancer is very small. And it's a specific kind of cervical cancer, a rarer kind called adeno carcinoma. Get your Pap smears every year but recognize that this increased risk is of a very, very small magnitude. I would like to add, though, that birth control pills will significantly reduce your risk of ovarian and uterine cancer. Every year you take birth control pills between the time of your first period and your last period, you add up your protective factors for things like ovarian cancer. In fact, when we see women at an increased risk of ovarian cancer, one of the few things we can do at this time to reduce their risk is to recommend using birth control pills. Other benefits of birth control pills are less anemia, periods are less severe, less premenstrual symptoms. So there are other benefits in addition to the contraceptive benefits. But you need to weigh how well you tolerate the birth control pills on your own. The impact of birth control pills on cervical cancer risk is very small and in fact has been questioned by many studies.

Stefanie Powers
That's very interesting information.

Moderator
Here is a question from dragonswing: 'Stefanie, what sort of charities or organizations are you involved with?'

Stefanie Powers
The William Holden Wildlife Foundation takes up a good deal of my time. I am the president and chief fund-raiser. So, while I will support other organizations and attend functions supporting various charities, the William Holden Wildlife Foundation is my primary charitable work.

Moderator
Here is a question from Maja: 'Dr. Karlan, I also think that the information available helps the friends and family of someone diagnosed with an illness. I heard about a new clinic in the US that offers many preventive examinations under one roof - is this were the trend is going?'

Beth Karlan, M.D.
There are more multi-disciplinary clinics available that are interested in preventative medicine as well as in straight therapeutic complaints and disorders. There seems to be a more holistic approach to health care and almost a mandate to medical schools to assure that their curriculum looks more at the whole person versus only a disease sight. I don't know whether this is a current trend that is increasing around the country. Clearly, in certain metropolitan areas, there is a consumer push to allow these centers to provide total care. Some of it is driven by medicine itself, but some of it is driven by necessity of our busy lifestyles. One-stop shopping: get your eyes examined, skin examined, mammograms, Pap smears, general physical, cholesterol level checked all in one day. So you only take one day off from work versus having multiple stops along the way. These centers do exist, but one must decide if that best suits their needs in terms of the health care providers available to you in that format. But I think, in general, there is an increased encouragement among physicians to look at the whole person instead of just one organ or disease site.

Moderator
Here is a question from Chattycathy: 'Dr. Karlan, I am 48 and have no children - I had a couple of miscarriages. I have been on the oral contraceptive for about 20 years. Am I at higher risk of any kinds of cancer?'

Beth Karlan, M.D.
On the basis of those few information points about yourself, you have some reduced risks and increased risks. Not having a full pregnancy at age 48 slightly increases your risk of breast cancer, but there are many other lifestyle factors. I hope you haven't been smoking if you've been taking birth control pills for twenty years. Such things would have to be factored in as well. Many of your cancer risks will have to do with family history risks and lifestyle changes and patterns. So I think if you see a doctor regularly, have had mammography, Pap smear screenings, your cholesterol checked, and have other general good health care, you will be doing as much as possible now. It's important to recognize, though, that as we all live older, we are exposed to increasing things in the environment, our diet, and the sunshine itself, so that we do have an increased risk of cancer as we all age. So take good care of yourself. As we said earlier, don't just sit there and worry. Go out and have annual check-ups, and if you see something you're concerned about, see your doctor as soon as possible.

Moderator
We only have time for one more question...

Moderator
Here is a question from Autumn: 'Dr. Karlan, aren't a lot of people likely to try to self-diagnose or come up with problems that they find online?'

Beth Karlan, M.D.
I think that, as people get more information, they may read into it. One used to call it The Medical Student Syndrome: As a medical student learned about each disease, they went home at night and were sure they were dying of that disease. I think you need to look on the Internet and get information and look at it with some sobriety. Try to realistically put your own symptoms and concerns in real perspective, but also have a healthy partnership with your health care provider to review your concerns with them. I wouldn't discourage the interested individual from finding out more information and going on the Internet, or to libraries and bookstores, and getting as much information as possible. But be careful. Remember that most physicians have gone through at least four years of medical school, at least another four years of residency, and then additional time in their practice and their practical care. So yes, it's your body and yes, you're intelligent in what you can discover through the information available today, but do go over it with a trained professional so that the appropriate intervention can be made if necessary.

Stefanie Powers
That sounds like very solid advice!

Moderator
We at Spotlight Health want to thank you, Stefanie Powers. so very much for being our host. To all of you people out there, please check out our other chats, videos, etc.

Moderator
And also special thanks to Dr. Beth Karlan for her helpful information!

Beth Karlan, M.D.
Stefanie, your willingness to get the information out there is very important for people to live longer and better.

Stefanie Powers
Thank you.

Beth Karlan, M.D.
You're quite welcome.

Moderator
Thanks to all of you, along with Stefanie and Dr. Karlan, for participating in the chat.

If anyone's interested, and I hope you are, I'll make you a custom 3D screen saver for a $5.00 (or more) donation to the William Holden Wildlife Foundation.

All you need to do is e-mail me your six favorite pix, and I'll make you a 3D screen saver featuring those pix on cool, rotating picture cubes. I'll deliver your screen saver and instructions on how to install it on any machine running Windows 98 or above via e-mail.

You can be assured that every cent that comes to me will go straight to the William Holden Wildlife Foundation.

Please contact me @ . I accept cashier's checks, personal checks, or money orders made out to the William Holden Wildlife Foundation, or PayPal. PayPal is not preferred because of fees charged.

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