Health

What should I look for when I examine my skin for melanoma?

DEAR DOCTOR K: My aunt developed the skin cancer called melanoma, and I hear that this cancer can run in families. What should I look for when I examine my skin for melanoma?

DEAR READER: Skin cancers are the most common cancers in the United States, and skin checks are an important way to identify them. You asked about the deadliest type of skin cancer, melanoma. My Harvard Medical School colleague, dermatologist Dr. Kenneth Arndt, says that more than half of melanomas are identified by patients, either alone or with the help of a partner. That's important because more than 90 percent of cases can be cured with early detection and treatment. Skin carries out many functions that help maintain health. It forms a defensive barrier, protecting inner organs from foreign invaders such as bacteria and viruses.

How does my diet and stress level affect my baby’s health?

DEAR DOCTOR K: My husband and I are planning on having our first baby. I've been told that what I eat, and how much stress I have while I'm carrying the baby, could affect the baby's health decades later. That seems hard to believe. Is there any truth to it?

DEAR READER: It makes sense that a child's nutrition and exercise during childhood might affect the child's health as an adult. But it's harder to imagine that your behavior and your health while you are pregnant could affect your child's health for decades to come. But over the past 35 years, many studies have found that a mother's diet and stress levels can shape her child's health in middle age.

How strep throat is diagnosed.

DEAR READERS: In yesterday's column, I responded to a reader's question about acute pharyngitis -- inflammation of the throat caused by infection with bacteria or viruses. I was taught that diagnosing and treating a patient with a sore throat was not complicated: The sore throat was caused either by Group A streptococcus ("strep," a kind of bacteria) or by a virus. If a throat culture showed strep, you treated it with penicillin. Simple. But in my view (some colleagues disagree), it's not that simple. The risk from an untreated infection with Group A strep is much lower today in the United States than it was 70 years ago. That means that the value of treatment is reduced. But the chance of side effects from the treatment -- antibiotics -- is not reduced.

What is acute pharyngitis?

DEAR DOCTOR K: I saw my doctor last week, who said I had acute pharyngitis but didn't say what that was. It sounds serious. What is it?

DEAR READER: Good news: It's rarely serious. I know the word "acute" in front of any medical term makes it sound serious. And I know that Latin-based words like "pharyngitis" sound alien. But acute pharyngitis simply means that your throat has become inflamed by something, usually an infection.

Are there any effective treatments for Peyronie’s disease?

DEAR DOCTOR K: I have Peyronie's disease. Are there any effective treatments for this condition?

DEAR READER: Peyronie's disease is, fortunately, relatively uncommon. About 5 percent of men in the United States may have it. The condition affects the penis. It causes inflammation and then scar tissue to form in the area of inflammation. The scar tissue accumulates and hardens, causing the penis to bend when it becomes erect, and potentially keeping it from becoming fully erect. This can make sexual intercourse difficult and painful. (I've put an illustration, below, showing the effect of Peyronie's disease.)

Can you explain what Sjogren’s sydrome is?

DEAR DOCTOR K: I have Sjogren's syndrome. People tend to dismiss it as a problem with dry eyes, but it's so much more than that. Can you please describe this condition for your readers?

DEAR READER: Sjogren's (pronounced "show grins") syndrome is a lifelong condition. It does tend to be best known for causing dry eyes, but it can cause other problems as well. For example, Sjogren's syndrome can produce dry mouth and affect any of the body's glands, including those that secrete sweat, saliva and oil. About half of people with Sjogren's syndrome also have another connective-tissue disease such as rheumatoid arthritis or lupus. Named after Swedish eye doctor Dr. Henrik Sjogren, this syndrome affects people of all ages and races. However, 90 percent of all cases involve women, most commonly between the ages of 45 and 55.

How does Alzheimer’s wreak so much havoc in the brain?

DEAR DOCTOR K: My grandmother has Alzheimer's disease. Over the past few years I have watched the disease take a toll on her judgment, memory, even her personality. How does Alzheimer's wreak so much havoc in the brain?

DEAR READER: In the past 25 years, medical science has learned a great deal about what causes Alzheimer's disease. Before that, we basically knew just that the brains of people with this disease, viewed with a microscope, had some unusual features. We knew that the disease caused brain cells to die prematurely, but we didn't know why. Today, I think we are closing in on understanding some major causes (if not all of the causes) of brain cell death.

Common medications used to treat heart failure.

DEAR READERS: Yesterday, I answered a question about treatments for heart failure. It's a big topic, and so today I'm talking about the medicines that are typically used to treat heart failure. As we discussed, heart failure is a condition in which the heart cannot pump efficiently enough to meet the body's need for blood. As a result, tissues and organs throughout the body don't get enough oxygen. Also, fluid builds up in the lungs and other body tissues. Taking heart failure medicines as prescribed is perhaps the single most important thing you can do to feel better and live longer. The medicines available today are dramatically more potent than the medicines that were available when I was in medical school.

How can I stop my heart failure from getting worse?

DEAR DOCTOR K: I've been diagnosed with heart failure. Thankfully, it is still in the early stages. What can I do to keep it from getting worse?

DEAR READER: The function of the blood is to carry nutrition to every cell in the body and to carry away waste from the cell. The function of the heart is to keep pumping blood so that the blood reaches every cell in the body. Heart failure is a condition in which the heart cannot pump efficiently enough to meet the body's need for blood. As a result, tissues and organs don't get enough nutrition, and fluid builds up in the lungs and tissues.

What is difference between vitamin D2 and vitamin D3?

DEAR DOCTOR K: My doctor advised me to take a vitamin D supplement. Why do I need vitamin D? Also, my pharmacy sells vitamin D in two forms: D2 and D3. What is the difference, and which one should I take?

DEAR READER: This is an area full of controversy because not enough research has been done. I typically recommend getting vitamins from food, but vitamin D is found naturally in only a few foods. Fatty fish is the main dietary source, and milk, many juices and breakfast cereals are fortified with it. We get most of our vitamin D from the sun: When sunlight strikes the skin, skin cells make vitamin D. But these days, people get a lot less sunlight than they used to.