How does colorectal cancer start?

It is generally agreed that nearly all colon and rectal cancer begins in benign polyps. These pre-malignant growths occur on the bowel wall and may eventually increase in size and become cancer. Removal of benign polyps is one aspect of preventive medicine that really works! Hemorrhoids may produce symptoms similar to colon polyps or cancer. Should you experience these symptoms, you should have them examined and evaluated by your physician.

Stuart R. Grant, M.D. Diplomate,
American Board of Colon & Rectal Surgery
Member, South Bay Independent Physicians Medical Group, Inc.

Do I need to have cataract surgery?

Ophthalmologists recommend cataract surgery when the vision with glasses is too blurry to do the activities the patient enjoys, or needs to do. For example, if a patient wants or needs to drive and cannot pass the driver's visual acuity test (20/40 vision), cataract surgery is recommended. Likewise if a patient has trouble reading, cataract surgery could clear the vision to enable the patient to read clearly again.

Matthew L. Hecht, M.D.
Diplomate, American Board of Ophthalmology
Member, South Bay Independent Physicians Medical Group, Inc.

What should I do about my chronic lower back pain?

Although the causes of lower back pain are variable, a sedentary lifestyle contributes to most cases in otherwise healthy adults. Many medical studies strongly suggest that exercise is more effective in treating chronic lower back pain than traditional medications. Exercises that stretch the legs and hips are important for both recovery and to prevent back pain from recurring. Strengthening exercises that target the abdominal and back muscles are also vital. Even regular aerobic exercise such as walking should be done. Of course, if your chronic back pain is the result of a serious injury, talk to a qualified health care provider first.

Mark C. Howard, M.D.
Diplomate, American Board of Family Practice
Member, South Bay Independent Physicians Medical Group, Inc.

What is available beside a facelift to minimize wrinkles?

Several non-surgical cosmetic procedures reduce visible signs of aging in 30 minutes or less. Botox softens the appearance of wrinkles, such as frown lines and crow's feet, by "relaxing" the underlying muscles that cause them. Inject able fillers such as Collagen, "fill in" frown and smile lines as well as enlarge lips. Improvement of targeted areas, although temporary (on average three months), is immediate.

To achieve longer-lasting results, UltraSoft, an implantable material, provides a permanent solution for the reduction of wrinkles and lip enhancement. The NLITE laser, a quick, non-invasive, and pain-free "anti-wrinkle" tool, produces longer-lasting results than injectable fillers because it simulates production of your own collagen to fill depressions beneath a wrinkle. A regimen of monthly "medical quality" glycolic acid facial treatments combined with daily use of home care products also help to repair and revitalize the skin.

Harold J. Kaplan, M.D., F.A.C.S.
Diplomate, American Board of Facial Plastic and Reconstructive Surgery
Member, South Bay Independent Physicians Medical Group, Inc.

What are those bright zigzag lines in my vision?

Eye migraines are often described as bright shimmering lights in shapes of pinwheels, zigzag or lines. They may start in one half of the field of vision and spread across the entire field. There may be an area of reduced vision outlined by flickering lights. Other people may have double vision.
Eye migraines may have these symptoms but without the headache. Older persons are especially likely to have this type and may have had a previous history of migraines.
The lights are thought to be caused by tightening of blood vessels in the brain and the headaches of classic migraines are believed to be caused by relaxation of the blood vessels.
Sometimes it is difficult to tell the difference between an eye migraine and symptoms of retinal detachment or stroke; so it is important to speak to your ophthalmologist.

Jean P. Katow, M.D.
Diplomate, American Board of Ophthalmology
Member, South Bay Independent Physicians Medical Group, Inc.

What causes a Eustachian tube in the ear to stay "open", all the time and what treatment will be required to return it to normal?

A eustachian tube that is always open is referred to as a hyperpatent eustachian tube. It may be congenital or acquired. Acquired may be from rare neuromuscular disease that keeps the mouth of the tube open. The tube normally opens when one swallows and does so approximately every two minutes when awake and every three minutes when asleep.

A hyperpatent tube rarely has an adverse effect on hearing but is annoying as your respirations may be heard through the tube and some patients can feel the ear drum move in and out due to suction on the tube (venturi effect). Correcting this problem, as with salicitate powder installations in the tube to scar the tube down may be performed, but is hazardous as the tube may over close and this is a much more difficult problem. Fortunately a hyperpatent tube is rare.

David C. Owen, M.D.
Diplomate, American Board of Otolaryngology
Member, South Bay Independent Physicians Medical Group, Inc.

I was found to have hepatitis C antibody when I went to the Red Cross. What does this mean?

Recently the Red Cross and other blood donating sites have had a new test available, the Measurement of the Hepatitis C Antibody. Combined with liver tests and hepatitis B blood tests they can now ensure a safe donation of blood.

This test indicates a previous exposure to the hepatitis C virus during a person's life. People who have had blood transfusions, needle sticks, tattoos or unsafe sex are at risk for this disease. When the antibody is found, you should see your doctor to see if the virus is still in your system and if it has caused any serious damage. Further blood tests, x-rays and biopsies can supply this information. Thirty percent of patients with the antibody will have cured themselves requiring no treatment while seventy percent will require further tests and treatment. Fortunately new medication, including PEG-Intron plus ribavirin, can now cure the majority of patients. See your doctor now.

Edward Piken, M.D.
Diplomate, American Board of Gastroenterology
Member, South Bay Independent Physicians Medical Group, Inc.