Ask the Doctor: Credentials: MD vs. DO; When to Stop Pap Test; Antibiotics & Colon Cancer

Q: My doctor uses “DO” after his name, but my sister’s doctor uses “MD.” What is the difference?

A: “DO” means doctor of osteopathy, while “MD” means medical doctor. Both types of doctors receive the standard medical training necessary to be a fully qualified physician. However, a DO is also trained in osteopathic medicine, which involves a “whole person” approach to healing. A DO receives additional training that focuses on the musculoskeletal system (in particular, the spine) that includes training in hands-on manipulation techniques. An MD, on the other hand, is trained primarily in allopathic medicine, which is also commonly re-ferred to as conventional, mainstream, or Western medicine.

Q: A friend of mine still has Pap tests even though she had a hysterectomy several years ago. Does she really need to have the test? I stopped having them after I went through the menopause.

A: If your friend is still having Pap tests after a hysterectomy, it is likely that she had a partial hysterectomy that removed the upper part of her uterus but left her cervix in place; the medical term for this procedure is “supracervical hysterectomy.” Pap tests can reveal the presence of cervical cancer, so it is recommend-ed for women who have undergone a supracervical partial hysterectomy.

Regarding your own situation, have a discussion with your doctor about having Pap tests. You didn’t men-tion your age, but the risk of cervical cancer does not decrease as a result of being postmenopausal. In fact, postmen-opausal women who engage in unprotected sex with new partners may be at higher risk, because they are more likely to contact human papilloma virus (HPV), which can cause cervical cancer.

Current cervical screening guidelines advise that routine Pap smears can stop once a woman is 65 if she has had normal findings on three previous consecutive Pap tests in the last 10 years and is not otherwise at high risk for cervical cancer. However, there is ongoing debate over whether these guidelines need to be revised, given that, in the U.S., more than 15 percent of cervical cancer cases occur in women age 65 or older.

Q: I recently read that taking antibiotics for more than two weeks can lead to colorectal cancer in women. Is this true?

A: You may have seen a newspaper headline about a study that linked antibiotics to colorectal cancer, but the study was not well reported in some media. In fact, the researchers did not find increased colorectal cancer rates among the women taking antibiotics—rather, it found an increased risk for colon polyps. Polyps are small growths that are typically benign, but, over time, some can become cancerous. In the study, women who reported they had taken an extended course of antibiotics for two months or longer were more likely to have polyps than women who had not taken antibiotics for
long periods.

The researchers theorized that antibiotics make the colon more vulnerable to cancerous growths because they can cause an imbalance in gut bacteria. However, antibiotics are used to treat bacterial infections that cause inflammation in the intestines, and inflammation is a risk factor for colon cancer. Also, the women in the study, who were age 60 and older, self-reported their use of antibiotics between the ages of 20 and 60, and it is possible their recollection of the number of times they took the drugs was not entirely accurate. In addition, many other factors, including age, weight, genetics, diet and exercise habits, tobacco and alcohol use, and exposure to chemicals and toxins, can affect a person’s cancer risk.

The bottom line is that the study you read about does not prove that antibiotics cause colorectal cancer.

—Editor-in-Chief Orli R. Etingin, MD

The post Ask the Doctor: Credentials: MD vs. DO; When to Stop Pap Test; Antibiotics & Colon Cancer appeared first on University Health News.

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