Dear Dr. Roach: I am an active 65-year-old woman with no significant health issues. I walk at least two miles a day. My 87-year-old mother was diagnosed with rectal cancer in May and died in September of this year. After her diagnosis, she informed us that her mother had colorectal cancer at age 74. My 67-year-old sibling had polyps removed during a colonoscopy five years ago. His doctor recommended exams every seven years instead of every 10 years.
I informed my doctor of all this during my last annual exam. He wants me to have a routine colonoscopy every five years as opposed to the standard 10 years due to my family history. In one of your recent columns, you seemed to suggest that after 75, the risks of a colonoscopy outweigh the risks of getting colon cancer. Is that still true in my case, or should I continue to have screenings every five years past age 75?
D.M.
Screening recommendations are, at best, suggestions that can help a provider determine the best course for patients. However, they are only guidelines, not rules, and clinical judgment is always called for. In the case of screening colonoscopy, age 75 is not an absolute age cutoff. It is true that age 75 is a reasonable time to stop doing colonoscopies, as the risks and the benefits become nearly equal for many people. However, it is reasonable to continue colonoscopies for older people who are very healthy and are thus likely to benefit more than the average person from screening exams. In addition, continuing screening on people who are at higher risk, such as those with a family history, also makes sense. It sounds like you are both very healthy and have a significant family history. I think your doctor’s recommendation is very reasonable.
Most authorities say that screening colonoscopies after age 85 are inappropriate, but there may be a handful of people in whom it may be reasonable even at that age.
Dear Dr. Roach: I am 93, in very good health, belong to a gym and take only simvastatin, some vitamins (D3, C, calcium) and Prolia. Two years ago, I began growing hair on my arms. They now are very hairy, and my head is mostly bald. I do not think this is a major health issue, but I may be wrong. My internist is not concerned.
B.J.H.
Both you and your internist are probably right. Even after 91 years, your body can surprise you with something new. In general, men’s body hair grows faster, and thus often gets more profuse as we age (the hair on the head is different), so this is likely just normal physiology.
You might have been concerned about a testosterone-producing tumour, but these generally do not cause an increase in body hair growth in men.
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 [email protected]
