DEAR DOCTOR K: I'm in treatment for colorectal cancer. My doctor has scheduled a PET scan to see how well my treatment is working. What will happen during this test?
DEAR READER: A positron emission tomography, or PET, scan is an imaging technique. Unlike most imaging techniques, a PET scan primarily shows how different parts of the inside of the body are working, rather than just how they are shaped.
DEAR DOCTOR K: I'm scheduled to have my first colonoscopy. My friends tell me the preparation is worse than the procedure. What am I in for?
DEAR READER: From my long experience as a doctor -- and as a patient -- I think your friends have it right. The large intestine (colon) is a long tube through which digested material passes. In a colonoscopy, a flexible tube with a light and camera at the end is placed inside the colon. What the doctor is looking for are abnormalities in the circular inner wall of the colon, including tumors, bleeding and inflammation.
DEAR DOCTOR K: For years my doctor has been telling me about the benefits of high levels of HDL cholesterol. Now I read that high HDL may not protect against heart disease after all. Is "good" cholesterol still good for you?
DEAR READER: The HDL cholesterol story is a cautionary tale. It demonstrates once again that even the most persuasive theories about what should make us healthy need to be put to the test. It has been solidly established that people who have high levels of LDL (bad) cholesterol have a higher risk of developing heart disease. Moreover, it has been solidly established that treatments that lower LDL cholesterol reduce the risk of developing heart disease.
DEAR DOCTOR K: The last time I had blood work, my doctor didn't check my CRP level. Wouldn't my CRP level have given him a better idea of my risk of heart disease?
DEAR READER: You ask a good -- and controversial -- question. Let me say up front that this test has been developed and studied by a colleague of mine at Harvard Medical School, and revenue from the test comes to my colleague and to the hospital where I practice. Also, I'm talking only about the use of the CRP test to screen for future heart disease in people who are not known to have heart disease. I'm not talking about using the test in people who already have heart disease.
DEAR DOCTOR K: My doctor suspects I have heart disease and wants me to have an angiogram. What will happen during this procedure?
DEAR READER: Coronary angiography is the gold standard for diagnosing coronary artery disease, a narrowing of the coronary arteries that reduces blood flow to the heart.
DEAR DOCTOR K: I have recently developed chest pain when I exercise. My doctor wants me to have a nuclear stress test to check my arteries for blockages. I would like to limit my exposure to radiation. Are there other tests that could be done instead?
DEAR READER: There are many causes of chest pain besides heart disease. Clearly, however, your doctor is concerned that you may have coronary artery disease (atherosclerosis causing blockages in the arteries of your heart), with the accompanying chest pain called angina.
DEAR DOCTOR K: My doctor did a urine test and says I have hematuria. What is this? And what could have caused it?
DEAR READER: Hematuria is the presence of red blood cells in the urine. It means there is bleeding somewhere in your kidneys, your prostate (if you're a man) or your bladder.
DEAR DOCTOR K: I'm a healthy, 60-year-old woman. What screening tests do I need, and how often?
DEAR READER: Too many people wait until something is wrong before visiting their doctor. Keeping up with screening tests can help you identify and nip a problem in the bud. I'll give you the general guidelines for a woman your age as laid out by the U.S. Department of Health and Human Services. As you'll notice, the frequency of some tests is left up to your doctor.
DEAR DOCTOR K: My doctor wants me to have a spinal tap to help confirm a diagnosis. What happens during a spinal tap?
DEAR READER: A spinal tap is also called a lumbar puncture, or "LP" for short. During this procedure, fluid known as cerebrospinal or spinal fluid is removed from the space surrounding your spinal cord. The term "spinal tap" sounds scary, but it is only briefly painful and mostly risk-free.
DEAR DOCTOR K: I had an abnormal Pap smear. Now my doctor wants me to have a colposcopy. What can I expect during this procedure?
DEAR READER: Pap smears help determine if you might have cancer, or a precancerous condition, of your cervix. When a Pap smear raises such suspicions, the next step is a colposcopy. Colposcopy is generally safe and painless. It takes about 15 to 30 minutes and doesn't require anesthesia.
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Dr. Anthony Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of Harvard Health Publications. Learn more »
Harvard Health Publications is the publishing division of Harvard Medical School, providing the general public with authoritative, trustworthy, and accessible health information. Learn more »
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