Are Pap tests necessary after hysterectomy?

Dear Dr. Gott: I had ovarian cancer and had a complete hysterectomy two years ago. My cancer was in the first stage, and, thankfully, I did not need chemo or radiation.
My surgeon continues to schedule me for Pap smears/internal exams yearly and says I will need to have this done for the rest of my life, but I don’t understand why. When I ask him, he gets short with me and says to “look it up on the Internet.” This does not make sense to me. Even my family doctor was surprised that I must continue to have Pap smears after having a complete hysterectomy.
Can you shed some light on this? Thank you.
Dear Reader: First things first. Find another surgeon/gynecologist. A huffy attitude and saying “Look it up on the Internet” is never an appropriate response to a concerned patient’s question, especially one who has a diagnosis of cancer. All patients deserve respect and simple politeness. Physicians dealing with cancer patients should realize this above all others because of the justified high emotions often associated with the diagnosis.
Now, onto your question. There are two types of hysterectomy: total and partial (also known as supracervical). A partial hysterectomy removes the uterus and leaves the cervix intact. A total hysterectomy removes both the uterus and the cervix. In each procedure, the ovaries and fallopian tubes may be removed as well, depending on the reason for the hysterectomy.
I assume your “complete” hysterectomy is a total one. Also, because of your ovarian cancer, it is a given that your ovaries and fallopian tubes would have been removed as well, since they were the source of the cancer and the reason for undergoing the procedure.
Treatment for ovarian cancer often begins with surgery to remove the ovaries, fallopian tubes, uterus, nearby lymph nodes and a fold of fatty abdominal tissue. Tissue and abdominal fluid samples are also taken to determine the stage of cancer and if additional treatments may be required. Depending on the results, chemotherapy and/or radiation are typically ordered. This is especially true for more advanced cases.
Unless you had a partial hysterectomy, a Pap smear, which tests for cervical cancer, doesn’t make any sense because you don’t have a cervix. However, because I am neither a gynecologist nor a surgeon, I must defer a final answer to the specialists.
Find a gynecologist with whom you feel comfortable. You can even make a “get acquainted” visit to determine whether he or she is someone you truly wish to see. Once you have found the specialist of your choice, provide him or her with your medical records. Then sit down to discuss what type of hysterectomy you had, the type of testing you should undergo to monitor your ovarian cancer until you enter remission, and whether Pap smears are necessary in your case.
Also, remember to eat well, exercise, get plenty of rest, and keep stress to a minimum to increase and/or maintain your quality of life. This may also help with any symptoms of menopause, such as hot flashes, mood swings, weight gain, and more, that you may be experiencing following your hysterectomy.
To provide related information, I am sending you copies of my Health Reports “Menopause” and “An Informed Approach to Surgery.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order for each copy to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title(s) or print an order form off my website at www.AskDrGottMD.com.

Dear Dr. Gott: My sister suffered from headaches for several years. When my brother visited her, he checked around her home and found mold underneath the house. She moved, and the cluster headaches have disappeared. I just thought you would like to let your readers know about this as it may help others who suffer from these awful headaches.

Dear Reader: Mold growth in homes can cause a plethora of symptoms, depending on the type of mold. Most often it is associated with cold-like or allergy-like respiratory symptoms, but headaches are definitely possible.
I don’t know that your sister should have moved. There are several ways that mold can be removed from a home. If she was renting, the landlord also has a responsibility to clean up the mold. If she owned her home, she would have had to disclose this information to the purchaser because of the potential health risks.
Thank you for writing to remind me and my readers of this common problem.
To provide related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Dear Dr. Gott: I am writing to find out what you think we should do, because all the specialists are baffled about my husband’s illness. Six months ago, he began to have seizures for no known reason. He was in ICU for three weeks with a diabetic specialist, an endocrinologist and a neurologist on his case. They ran every test possible to rule out this or that for the cause of the seizures. All tests came back negative. His glucose is under control. He continues to have “spells,” with symptoms of lead feet, sweating legs, headache and the smell and taste of burnt beef in his mouth.
He takes synthroid, 175 mcg, once a day. I am wondering and have asked if there is a possibility of him having a reaction to this medication. It falls on deaf ears.
Last night, I called the ambulance, as he was having one of those spells again and could not walk. His speech and thought processes were slow. When the EMTs arrived, he seemed normal. Four hours of observation confirmed that everything was normal. This is not normal for him and never has been. I was questioned why I was wasting precious time calling an ambulance for something like this. I responded I am not a doctor and cannot diagnose what is happening. We have done everything the doctors have required and still want answers as to the cause. I feel they are treating the effects without checking into the possibility of it being a reaction to medication.

Dar Reader: Seizures are commonly brought on by sudden, abnormal electrical activity of the brain. Causes include head injury, drug overdose, brain tumor, accidental poisoning, low blood sugar or sudden lack of oxygen to the brain. They are divided primarily into two categories — focal or partial. Focal seizures occur on both sides of the brain, partial seizures on one side. They may present with muscle spasms, unusual sensations (such as your husband’s taste of burnt beef), loss of consciousness and more. In some cases, the cause is never identified, but the activity doesn’t necessarily represent epilepsy.
I would like to address your husband’s daily use of synthroid. When was he diagnosed as being hypothyroid? Is there a correlation between the time he went on the medication and the time the seizure activity began? The dosage is a rather strong one. Was he begun on a lower amount and increased over time? Has he been tested on a timely basis? The inert ingredients in synthroid include confectioners’ sugar, acacia, lactose monohydrate, magnesium stearate, povidone and talc. The dose also includes FD&C blue No. 1 Aluminum Lake and D&C red Nos. 27 and 30 Aluminum Lake dyes. Perhaps he is responding to the coloring. Were he on a lesser dose, the dyes would vary in intensity.
If he had a CT scan to rule out a brain tumor, didn’t sustain a head injury within the past month or so, hasn’t been accidentally poisoned, and can’t attribute the activity to a recent occurrence, perhaps the medication is the cause of the seizure activity.
I recommend he ask his physician for a little indulgence. If the medication isn’t vital, perhaps they can compromise on a trial without it. He might consider diet modification — include cabbage, Brussels sprouts, lima beans, broccoli, cauliflower, potatoes, bananas, and supplemental vitamins B and C. Fats, sugars, red meats and eggs should be consumed in moderation. And he should exercise 15 to 20 minutes every day unless his doctor says otherwise.
If no improvement is found, request a referral to a new neurologist for a second opinion.
To provide related information, I am sending you a copy of my Health Report “Thyroid Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Dr. Peter H. Gott is a retired physician and the author of several books, including “Live Longer, Live Better,” “Dr. Gott’s No Flour, No Sugar Diet” and “Dr. Gott’s No Flour, No Sugar Cookbook,” which are available at most bookstores or online. His website is www.AskDrGottMD.com.

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