Ebola Overview

In Blog, Infections, Obstetrical Care, Women's Health Topics by Dr. Gary Goldman

Ebola – a truly deadly and terrifying disease. The current outbreak in Africa has already claimed over 1,150 lives, and some believe this number is vastly underestimated. A patient in New York was recently admitted to Mt Sinai hospital for suspected Ebola after a recent trip to Africa – fortunately he did not have it. This outbreak has prompted quite a few inquiries in my office, so here are some facts: Ebola was first identified in 1976, in Africa. It is a virus spread through direct contact with bodily fluids, including blood, saliva, semen and even tears. It is not …

Cologuard as a Screening Test for Colon Cancer

In Blog, Cancer, Gynecology, Women's Health Topics by Dr. Gary Goldman

“You are due for a routine colonoscopy.” Not everyone’s favorite message from his or her doctor. But colorectal cancer is the second leading cause of death from cancer, and colonoscopy to detect pre-cancerous lesions or early colon cancers has been demonstrated to significantly decrease this death rate. While most of my patients understand this advice as sound, the process of undergoing a bowel prep and having a colonoscopy remains a point of contention. Two days ago, the FDA approved a new non-invasive test that also screens for both early colon cancers and pre-cancerous lesions, just by providing a stool sample …

Breast Cancer, Ovarian Cancer, and the PALB2 Gene

In Blog, Breast Cancer, Cancer, Gynecology, Ovarian Cancer by Dr. Gary Goldman

A publication in today’s New England Journal of Medicine describes another important gene responsible for some hereditary breast and ovarian cancers. Dr. Antoniou and colleagues at Cambridge University found that mutations in the PALB2 gene were associated with a 9.5 times higher rate of breast cancer, and a 2.3 times higher rate of ovarian cancer in women. They also found an 8 times higher risk of male breast cancer. A family history of breast cancer was also important in calculating risk. If there was no family history, the lifetime risk of breast cancer was 33%. With a family history, the …

Should You Take a Daily Vitamin?

In Blog, Functional Medicine, Holistic Medicine, Integrative Medicine, Nutrition by Dr. Gary Goldman

Should you take a vitamin? This is a very common question in my office. If you are planning on becoming pregnant, then the answer is a resounding “Yes! You should take folic acid supplements to reduce the risks of fetal open neural tube defects, and possibly autism.” If you have been diagnosed with a vitamin deficiency, such as Scurvy, then you need to replenish your body’s stores – in that case, with Vitamin C, to reverse a potentially serious disease. But what about the average person with a fairly good diet? What does the U.S. Preventive Services Task Force say …

Do Birth Control Pills Increase the Risk of Breast Cancer?

In Blog, Breast Cancer, Cancer, Gynecology by Dr. Gary Goldman

Do birth control pills increase the risk of developing breast cancer? This question has been debated for years, with various studies concluding yes, no, and maybe. Yesterday a new study was published in Cancer Research by Elisabeth Beaber which you will surely hear quoted in the news. Her findings were as follows: recent users of the pill, longer-term users, users of higher dose formulations, users of triphasic style pills (pills that change their dose three times in one cycle), and users of certain brands containing particular types of progesterone had a greater risk of developing breast cancer. The good news …

How Should We Screen for Ovarian Cancer?

In Blog, Cancer, Gynecology, Ovarian Cancer by Dr. Gary Goldman

I am frequently asked about screening tests for ovarian cancer. This is a dreaded disease which strikes without warning, and can frequently be deadly. Wouldn’t it be great if we could detect it early and prevent its terrible consequences? You may receive the same emails that I do, presumably from Gene Wilder, encouraging women to have a CA-125 blood test; Gene’s wife, Gilda Radner, died from ovarian cancer. Unfortunately, it’s not a very good test. And what’s worse, it’s about the best test we have. We have studied a variety of blood tests, sonograms, and even screening by symptoms, as …

Listeria Contamination of Our Food

In Blog, Infections, Women's Health Topics by Dr. Gary Goldman

Listeria contamination of fruit prompted a recent recall from Trader Joe’s and Costco, among other stores. While no illnesses have yet been reported from this outbreak, the news alarmed many of my patients who have called for advice. According to the New York State Department of Health, “routine screening or treatment of asymptomatic persons possibly exposed to recalled products is not recommended.” Symptoms can include: high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, particularly those patients with an exposure history of Wawona Packing Co.’s fresh whole peaches, plums, nectarines, and plots. If you should experience these symptoms you …

Morcellators in Laparoscopic Surgery

In Blog, Cancer, Gynecology, Surgical Procedures by Dr. Gary Goldman

Morcellators cut tissue into smaller pieces which can be removed through the tiny incisions made during laparoscopic surgery. The advantage of using this tool is obvious: smaller incisions equates with faster hospital stays, better cosmetics, less pain, fewer wound complications and quicker return to work. But like all surgery, there are risks, one of which is spread of an occult malignancy of the uterus called a sarcoma. Sarcoma’s account for 1/350 – 1/1,000 fibroids, which are the much more common benign growths found in the uterus. Unfortunately, sarcomas and fibroids cannot be differentiated pre-operatively. The FDA “discouraged” use of morcellators …

Routine Mammogram Recommendations

In Blog, Breast Cancer, Cancer, Gynecology by Dr. Gary Goldman

Mammograms – a hot topic for discussion. Today let’s begin with timing: when should a woman get her first mammogram? The US Preventive Services Task Force suggested last year that the baseline study should be done at age 50, conflicting with the recommendations of the American Cancer Society and most other groups, which all recommend starting at age 40. One recent study concurs with the 40 year old baseline, pointing out that about half the breast cancer deaths occur in women below the age of 50, and 71% of them had never had a mammogram. Read more here: https://www.doximity.com/doc_news/feeds/4243#entries/756881