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To Your Good Health: Always Get a Colonoscopy Even if Cancer Free

Dear Dr. Roach: I am 75-plus-year-old female in excellent health. My doctor’s comment on my most recent annual physical test results was: “Great results on all tests. Excellent report.” My question: Is it necessary to have another colonoscopy at my age and with my good health. My mother died of colon/rectal cancer at age 85 in 2002, and all family members were advised to have this procedure. My initial results were two or three polyps removed that were not the type that would recur and were not cancerous. The recommended follow-up was five years. The results of that exam showed no polyps, slight indication of diverticulosis and no recommendation for future follow-up.

My previous doctor has retired, and I just received a letter from his replacement that I am due for another procedure. I am not inclined to do this at my age, and considering the “all clear” reports of the previous exams and my general good health. I would appreciate your thoughts and recommendation. — B.J.M.

Answer: The odds are low that the colonoscopy would find something there, but there is still a small chance, especially with your mother having had colon cancer. Not having it is reasonable. But since you seem to be otherwise healthy and can expect a longer life than average, I would still say to get it. In fact, I would encourage you to have it.

Dear Dr. Roach: I am 92 and have spinal stenosis in my lower back and neck. The neck stenosis is causing a balance problem. Who would treat and/or operate on this — orthopedist or neurologist? — J.W.

Answer: I would be very slow to recommend surgery on the neck at age 92. I would try other treatments, including medication, physical therapy and possibly injection, before considering surgery.

Balance problems may benefit from problem-specific exercises. A neurologist may be very helpful in evaluating whether the symptoms are indeed coming from the spinal stenosis, because balance problems can have many different causes.

If symptoms were intolerable despite everything that could be done short of surgery, I would find the most experienced surgeon around, which could be either a neurosurgeon or an orthopedic surgeon.

Dear Dr. Roach: I read your response to T.M. about his PSA level. Rather than a biopsy, would a PCA3 urine test be as good? — S.R.

Answer: The prostate cancer antigen 3 gene (PCA3) has been proposed both as a screening test by itself, and as a confirmatory test after an abnormal PSA test. It was a bit better than PSA as a screening test, and shows promise as a test to reduce unnecessary biopsies for men with abnormal PSA levels. However, the most recent study from Brown University in 2013 concluded that there isn’t yet enough evidence to start using this test on a routine basis.

Dr. Roach Writes: Quite a few people have written in to recommend nasal saline gel for people with dry nose and recurrent nosebleeds. It is worth a try, especially for those who don’t like petrolatum or for whom it isn’t working.

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 ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.