Question: Can lab tests tell when a woman has osteoporosis? It was on the female side in my family. Do I need testing?
- Mrs. W.M.Answer: Yes, tests can establish the bone thinning of osteoporosis.
X-rays can show sufficient bone changes in areas of the anatomy where osteoporotic thinning typically occurs. However, more sensitive tests might be required. Photon absorptiometry involves less radiation than X-raying does and affords a much clearer picture of bone mineral status. For some, test results can be a guide to treatment, when needed.
Do you need tests? Most women do not. Usually, the well-known broader risk factors suffice. Age, menopause status and family history of bone problems increase a person's proneness to osteoporosis. Back pain typical of osteoporosis can be another strong clue.
Menopause increases the osteoporosis risk most, for that's when production of bone-protecting estrogen wanes. That might occur earlier if the ovaries have been removed surgically. Smoking and alcohol abuse add to the risk picture, as does race. Caucasian women are at greater risk than others. Heredity can be involved.
Most women, with or without risk factors, can assume the need for prevention, which includes calcium supplementation, exercise emphasizing weight-bearing joints and estrogen replacement when needed.
My osteoporosis report discusses treatment. Readers can order a copy by writing: Dr. Donohue - No. 23, P.O. Box 5539, Riverton, NJ 08077-5539. Enclose $3 and a self-addressed, stamped (52 cents) No. 10 envelope.
Question: Can you explain what keratotic lesions are? A friend has them, and her doctor tells her not to worry about them. She is in her 70s and gets upset about it. Her doctor removed some near her eyes, with cryosurgery.
- D.M.
Answer: Keratotic lesions are skin blebs composed of special cells called "keratinocytes." They normally produce keratin, a protein that gives the skin strength.
There are two kinds of keratotic lesions.
The actinic kind are red, brown or flesh-colored. They arise from a life of heavy sun exposure. Actinic keratotic lesions might eventually become cancerous, so they are removed, often with cryosurgery. That ends the problem. They often occur on the face near the eyes, but do not threaten vision.
The other kind are seborrheic keratotic lesions. They appear as brown lumps on the chest, back, scalp, face or neck. They do not become cancerous, but for cosmetic reasons they can be similarly removed.
Almost everyone has keratotic lesions of one kind or the other.
Question: I fell while skiing, and the ski hit my breast. The bruise is gone, but the skin is thicker there. I hope you don't think I am foolish, but I remember my mother telling me that a friend got breast cancer from a childhood blow. It worries me.
- A.L.
Answer: I cannot find any body of evidence listing injury among factors in breast cancer. Yet, I get reader mail telling me the opposite, often with sworn testimony, citing example after example of breast cancer from a sharp blow, etc. If someone has reliable evidence that says I'm wrong, I will change my tune.