SHAREing & CAREing’s 16

Oct 09, 2023

By qgazette | on August 23, 2023

SHAREing & CAREing NYC Cancer Support Services released the following recommendations and 16-point checklist for your annual gynecological exam:

Regular checkups with a doctor are one of the easiest ways to detect serious health conditions like cancer early, in its most treatable stages. A regular exam with an OB/GYN doctor (which stands for obstetrics and gynecology) is when you can address concerns and practice preventative healthcare involving pregnancy, menstrual cycles, sexually transmitted diseases, and vaginal, ovarian, uterine, and breast health. If you have (or ever had) breasts, a uterus, ovaries, or a vagina, we recommend seeing an OB/GYN once per year. Use this handy 16-point checklist to make sure you get all your questions answered, and cover all your reproductive health bases.

Before your appointment, review the latest issues in breast and reproductive health so you’re better armed to ask questions and bring up concerns. Write down your questions so you don’t forget. Check the last time you had an appointment and what the results were. Do a quick health inventory—how are you feeling? Has anything changed? Are you in pain? Are you taking any new medications?

Most patients aim for a checkup annually, but if you are experiencing symptoms or issues always make an appointment as soon as you can. Depending on risk factors, your doctor may even recommend you come less often than once per year. If you have a menstrual cycle, it’s best to avoid making an appointment right before and during menstruation since breasts are tender and results may be harder to read.

If you feel comfortable, when you make an appointment, mention any concerns beyond a typical checkup, such as pain, pregnancy, or birth control. When you make an appointment or when you arrive, you may request or decline a medical chaperone for your exam or bring a friend or family member. You are in charge of your body and you must feel comfortable. If you have had past sexual trauma or are transgender, make sure your doctor is empathetic and understands your unique needs and can make the exam comfortable for you. Support groups are often good sources for doctor referrals in these specialized situations.

Preventative healthcare is extremely dependent on knowing and understanding your risk factors for a variety of conditions and diseases. Not all doctors will ask about these risk factors (or even know to ask). Some may even make assumptions about your risk factors based on your age, race, marital status, or other personal details. Even if your doctor doesn’t ask, proactively communicate which risk factors for breast cancer and ovarian cancer you have, especially if you have a family history of either. Be open about your current and previous sexual history and partners, and possible exposure risk to sexually transmitted diseases. Make sure they are aware of any previous diagnoses, symptoms, surgeries, hospitalizations, and pregnancies. Tell them about your good and bad health habits, like exercise and smoking, your weight, and any medications or supplements you are taking, either prescribed or over-the-counter. Your doctor is your partner in your health and needs to know your full history to give good recommendations and understand your risks better.

If you have a strong family history of cancers like breast cancer, ovarian cancer, or prostate cancer or if anyone in your family has the BRCA gene mutation, male breast cancer, or you have Ashkenazi Jewish heritage, you may have a genetic predisposition to cancer. Now is the time to discuss with your doctor if genetic testing is a good fit for you. Studies have shown that many people feel less stress when they know their genetic risk levels.

Do you know how how to do a breast self-exam? Now is a great time to ask your doctor to show you how. If you do know how, ask your doctor to check your technique. Discuss any breast changes you’ve felt in the last 12 months and any previous benign breast diseases you’ve had. Your doctor will also do their own version of a breast exam, called a clinical breast exam, to feel for lumps and abnormalities.

If you’ve had a mammogram before, ask your doctor if it showed dense breasts. When you received your previous results, if you live in New York state, you may have also gotten a notification that you had dense breasts. Having a high breast density increases breast cancer risk and impacts how effective mammograms are, so it’s important to know if this applies to you.

Now that your doctor knows your risk factors and is aware of your breast density, it’s time to formulate a screening plan together. Mammograms are the most common type of breast cancer screening tool and studies have shown that getting regular mammograms reduces death from breast cancer. Depending on your risk factors, you may want to consider getting your first mammogram as early as 35 years old. And if you have dense breasts, you might want to consider an MRI instead of a mammogram or doing a breast ultrasound in addition to the mammogram. Mammograms aren’t usually ordered if you’re pregnant or could be pregnant. A ‘fast’ MRI might be an option for you, too. Don’t be shy about asking what screening method or frequency is right for your health situation. Because of New York state health legislation, basic breast cancer screenings are very affordable, but this is not true for all tests and all situations. If you need access to free or low-cost mammography ask your doctor or contact SHAREing & CAREing.

Are you planning on getting pregnant? Could you be pregnant now? An OB/GYN can do a pregnancy test and discuss pre-conception and pregnancy concerns. If you are trying to avoid pregnancy, your doctor can discuss birth control options with you. Remember to ask about risks of each type. Hormonal birth control, for instance, increases risk for developing breast cancer later in life.

Menstrual irregularities can be a symptom of serious diseases and conditions such as fibroids, endometriosis, pelvic inflammatory disease, or endometrial, uterine or ovarian cancer. But they can also be the sign of stress or weight loss. That’s why it’s important your doctor know your full history. Are you repeatedly early or late in your menstrual cycle? Is your cycle irregular? Have you missed a period? Do you spot or bleed heavily? Do you have excessive pain or mood swings? Are you nearing the age of menopause? If you keep records of your menstrual cycle, now’s the time to discuss this with your doctor. Based on your discussion, you and your doctor might decide to do a pelvic exam to further investigate issues.

Ask your doctor if you need a pelvic exam. Since 2014, The American College of Physicians has strongly recommended no annual pelvic exams for adult non-pregnant women with no symptoms and who are at average risk. Pelvic exams are recommended only on an “as needed” basis. If you do need one and you have anxiety about this type of exam, now is the time to be open with your doctor. You can brainstorm together how to feel more comfortable, for example by having the doctor narrate out loud as they move through each step, guiding their hands, or using a mirror to understand what’s happening.

Even if you skip the pelvic exam, you’ll want to get a pap smear, which screens for cervical cancer. This test detects HPV (the human papillomavirus) which can cause cancer in the cervix as well as any abnormal cells that might turn into cancer.

Depending on your risk factors and symptoms, your doctor may suggest getting screened for sexually transmitted diseases (STDs) or sexually transmitted infections (STIs). Common tests done during an OB/GYN visit include tests for chlamydia, gonorrhea, HIV, syphilis, trichomonas, herpes simplex virus, and hepatitis, a major cause of liver cancer.

While there is no vaccine that prevents all types of cancer, there is one that prevents nearly all forms of cervical cancer—an HPV immunization. If you are younger than 26 or believe you have a high exposure risk, ask your doctor about getting an HPV vaccine.

Hepatitis-C (HCV) is the most common blood-borne infection in the U.S., is a factor in 50% of all liver cancer cases, and also increases the risk for developing neck and head cancers and non-Hodgkin lymphoma. If you haven’t been vaccinated against it already, ask your doctor if a hepatitis vaccine makes sense for your health situation.

Lastly, before your appointment is over, verbally summarize everything with your doctor to make sure you understand what they found and are recommending. Clarify next steps. When should your next appointment be based on your risk factors? What are the follow up tests? When will you hear the results? Make sure you have referral paperwork for imaging and prescriptions have been sent to your pharmacy. If you had a procedure done, like a vaccine or IUD-placement, make sure you know what kind of side effects to expect in the next few days.

Remember, your doctor is your partner and advocate, but you are in charge of your healthcare. It’s up to you to make the appointment, get the tests, and act on screening, surgical and medication recommendations.

If you are having trouble understanding your payment or treatment options, consider our free patient navigation services. As a New York City-based non-profit, SHAREing & CAREing can also help connect you and your family members to free or reduced-cost cancer screenings, transportation services, cancer treatments, and help with out-of-pocket costs. Need a friendly face? Contact us for individual support, attend a monthly support group meeting or join our online Facebook group.

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