bob maginnis - 1/24/02

January 25, 2002

January 24, 2002

A simple test that could save your life

by Bob Maginnis

About six months ago I received a letter from a woman who said her daughter was due to undergo breast cancer surgery in just two days. The daughter, a waitress, had no medical insurance, she said, and her mom asked if the paper would print an appeal for donations.

Let me see what we can do, I told her. I called Y-Me, the local non-profit founded to help breast cancer victims. They directed me to the Washington County Health Department's Diagnostic and Treatment Program, a federally funded initiative that provides free screening and care to women who meet the income guidelines.

I passed along the information to the woman and promised Angie Mulligan, coordinator of Breast and Cervical Cander Program, that I would write about her department's services for women in January, which is Cervical Health Month.


This week Mulligan told me that Maryland Gov. Parris Glendening made the proclamation to "raise women's awareness of the need for regular pap tests."

During a pap test, Mulligan explained, a doctor uses an instrument called a speculum to widen the vaginal canal, then swabs the cervix. The cells that are obtained are then put under a microscope to look for cancerous or pre-cancerous material, she said.

"It's not painful and it only takes a few minutes," Mulligan said.

It's important to have this test done on a regular basis, she said, because cervical cancer is a slow-growing variety and with early detection, it's curable.

In terms of scheduling tests, what does "regular" mean?

Women over 18 and those under 18 who are sexually active should have the test done regularly, as determined by your physician, Mulligan said.

It doesn't detect all sexually transmitted diseases, Mulligan said, but can pick up HPV, which can be associated with a higher risk of cervical cancer.

The important thing, Mulligan said, is to have the test.

"Cervical cancer is most often found in those who haven't had their regular pap tests, or had them done too infrequently," Mulligan said.

How often do serious cases of cervical cancer occur?

In Maryland in 2002, an estimated 300 women will develop invasive cervical cancer. Seventy-five won't survive, she said.

That's not a lot of people, but if you're one of those 75, you'd probably believe it's too many.

Another service provided through Mulligan's department is breast and cervical cancer screening for women 40 and over who don't have health insurance that covers such services, or who have low incomes.

Once you're in the program, you stay as long as you're income-eligible, she said, adding that staffers call participants annually to remind them it's time for their tests.

The services include a mammogram, a pap test and a clinical breast exam, Mulligan said.

If those tests detect an abnormality, Mulligan said that women can apply for help to the Diagnosis and Treatment Program, a federally funded initiative to help with the costs of treatment, prescriptions and diagnostic services.

Again, there are income guidelines, Mulligan said, and unlike the other program, this requires a separate application that asks for more detailed information. For example, to get these services for a patient, a family of four can make no more than $37,000 a year.

"Everything's covered - all diagnostic tests, chemo, radiation, mastectomy, prostheses and medications," she said.

Even if a woman has health insurance that will pay for part of the treatment, Mulligan said the program may be able to pick up what the primary insurance doesn't pay.

How many patients get this sort of help each month?

"Maybe between five and 10 abnormal results have to be followed up on. Most often it is resolved quickly," Mulligan said.

Mulligan emphasized that those figures are only from people in her screening program who need further diagnosis.

How often should women be screened for breast abnormalities?

Between the ages of 20 and 39, Mulligan said, women should do a breast self-exam every month and have a clinical exam every three years. After 40, continue the monthly self-exams and get a mammogram and a clinical exam every year, she said.

How can women learn to do self-exams?

"Ideally, we want to hook them up with their own private gynecologist. That's where they can get training on self-exams. Also, Y-Me, the breast-cancer support group, will teach breast self-exam to anyone who calls," Mulligan said.

For anyone who still has questions, please call Mulligan's program at 240-313-3235. The woman I wrote about at the beginning of this column delayed getting a test, her mother said, because she was afraid of what doctors might find. From what Mulligan told me, the real thing to fear is not finding out that you've got a problem until it's too late.

Bob Maginnis is editorial page editor of The Herald-Mail newspapers.

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