What’s going on in
women’s health care these days?

In honor of Mother’s Day and women everywhere, for our May Perspective we spoke with Dr. Deborah Sommer at Magee Womancare Center-North to learn more about women’s health care. Dr. Sommer specializes in obstetrics and gynecology, and expressed a strong opinion that every woman should have an annual physical examination, even if there are no obvious signs of any problems.

By Jack Etzel

North Hills Monthly Magazine: If there are no symptoms, why should every woman undergo a physical every year?

Dr. Sommer: The thing about Pap smear tests is that they really have cut down on the risk of cervical cancers. Even though there is a false-negative rate with Pap smears, by taking a Pap smear annually, it’s very unusual to have things progress to an invasive cancer without catching it. I can’t quote statistics because, thankfully, we don’t see invasive cervical cancer as often as we used to. Now, it’s really unusual. But the pre-cancerous conditions or cervical dysplasias are very, very common.

NHMM: I can just imagine that more than one woman reading this interview has not had a Pap smear and cervical exam, or a mammogram, in years.

Dr. Sommer: Yes, that’s probably true, unfortunately. I have to say that an annual examination is very important, because while it may not prevent people from getting cancer, it really helps increase the early detection rate. And, by having an early detection, it helps the outcome to be much, much better. When we see patients annually, we can have them sent for their mammograms, when that’s appropriate. We also do a physical breast exam as well because 10 to 15 percent of breast cancers do not show up on mammography. Statistics show that between one in seven to nine women will develop breast cancer at some time in their life.

NHMM: These women, who are not getting annual physicals, may not have insurance, or they have insurance that doesn’t cover preventive medicine.

Dr. Sommer: I really don’t see that as much of an issue anymore. That used to be, but not now. This is a big change, a great change. One that still doesn’t pay for some of these procedures is, unfortunately, Medicare. Medicare will pay only every two years instead of annually.

NHMM: What other procedure is vitally important for a woman?

Dr. Sommer: Every woman 50 or older should have a colonoscopy. This is not routinely done every year, but it should be part of a woman’s physical when they’re 50 years old or younger if there are symptoms. Colon cancer was once thought of as a man’s disease, but that’s not true. Colon cancer often presents no symptoms in the beginning, and a colonoscopy can detect pre-cancerous polyps, which can be removed during the colonoscopy.

NHMM: Dr. Sommer, at what age should girls be taught about, well, everything, such as proper nutrition, about their own bodies, and how to stay healthy in order to become a healthy woman?

Dr. Sommer: While that would vary, I would say certainly by the time they are beginning their periods. They have to learn what’s normal about their bodies, what’s not normal. And, yes, that would include encouraging proper nutrition and also starting to talk about sex.

NHMM: I understand that we now have a three-part vaccine to prevent sexually transmitted diseases that range from warts to cervical cancer.

Dr. Sommer: That’s right. That’s the Human Papilloma Virus or HPV. We’re starting to immunize young women as young as 12 to help prevent problems for when they do become sexually active. I find it a shame that it’s controversial. I don’t know why it should be. It’s actually a public health issue. We all want to protect our children against infections and diseases. Surely, we should protect them against sexually transmitted diseases including cervical cancer. We protect them against getting hepatitis and that’s good. But in reality, the probability of getting HPV is much higher than the chance of getting hepatitis, and the long-term effects are much worse.

NHMM: Obviously, you see this HPV vaccine as a major step in medicine.

Dr. Sommer: It is revolutionary. HPV vaccine is one of the biggest and most important things in medicine, and probably the only vaccine we have to actually help prevent cancer. Girls from 12 years old up to 26 years old can all benefit from it. And, now we have a test that we can use right off the Pap smear that can be enhanced to help us pick up the higher risk HPV virus strains.

Certain strains of the HPV have a higher propensity to develop into cervical cancer than others. We have a test we can use right off the Pap smear to identify these higher risk strains of the virus. It doesn’t require any further testing or sampling. It just involves checking off a box.

Earlier you mentioned insurance coverage on certain preventive procedures. Unfortunately, when it comes to HPV immunizations, there are variations as to which insurance companies will pay and which ones will not.

Nevertheless, every woman should have the Pap smear, pelvic exam, breast exam, as well as having her blood pressure taken, thyroid checked, and simply a top-to-toe exam once a year.