Tag Archives: Navid Mootabar MD

Preventing Cervical Cancer Screening

Posted on: January 23, 2015

Women – This Regular Screening Can Save Your Life

by Dr. Navid Mootabar

There’s important news for every woman in a recent report from the Centers for Disease Control and Prevention (CDC): Despite evidence that cervical cancer screening saves lives, iStock_27565368_Women_Coffee_HiRezabout eight million women, ages 21 to 65 years, have not been screened for cervical cancer in the past five years. In addition, more than half of new cervical cancer cases occur among women who have never or rarely been screened.  Here, I explain which tests you need, when to get screened, and demystify the protective HPV vaccine. I also offer women a silver lining: You rarely have to worry about advanced cervical cancer if you are regularly screened.

Did you know that cervical cancer was the leading cause of death among women 40 years ago?

The introduction of screening through the Pap smear has caused the disease to drop to the fourth cause of female mortality. But that incidence could be lowered even further if more women had the recommended Pap test. To understand this screening’s exceptional value, you need to know more about the primary cause of cervical cancer: Human Papillomavirus (HPV).

HPV causes approximately 90 percent of all cervical cancer cases.

This sexually transmitted virus is so common, most people will contract it at some point in their lives. There are many strains (types) of HPV. Certain HPV strains are responsible for changes on a woman’s cervix that can result in cervical cancer. Other strains may cause genital or skin warts.  Additional factors that contribute to an increased risk for cervical cancer include smoking, extended use of birth control, and having multiple sexual partners.

Most women who have cervical cancer will have no symptoms. However, infrequent symptoms may include unexplained vaginal bleeding, bleeding after intercourse and abnormal vaginal discharge. What’s more, the strains of HPV that may lead to cervical cancer are also asymptomatic.

Regular screening for cervical cancer has extraordinary life-saving potential.

The screening test — the Pap smear– involves brushing cells off the cervix, which are then examined for abnormalities. Our goal is to identify cervical cancer in a precancerous state, when it is highly curable. The impact of identifying the disease early through a Pap smear is evidenced by the fact that, from 2001 to 2010, the incidence of the disease decreased by almost two percent per year.

So when should you get screened? New guidelines recommend that women start at age 21. A Pap smear is recommended every three years, combined with an examination of the same cervical cells for HPV, until the age of 65, provided you have no risk factors or abnormal Pap smears. At 65, screenings can be discontinued if there have been no abnormal results in the previous 10 years, or no history prior to the past ten years of moderately pre-cancerous growth.

“Seeing your gynecologist annually is a vital
part of a woman’s comprehensive health care.”

The three-year guideline takes into account that for most women, cervical cancer doesn’t progress quickly. Very rarely does it advance from normal to cancer in one year. Therefore, if a woman is screened every three years, there is every likelihood the disease will be caught while still in the highly curable pre-cancerous stage.

Keep in mind that the guideline represents the minimum number of screenings you need to be safe. However, some women require more frequent screenings. At each visit, your gynecologist will determine if it is appropriate to do a Pap smear, by assessing all risk factors.

There are two other forms of prevention for cervical cancer.

One is the condom. The other is the HPV vaccination, which protects women from several of the most common and aggressive strains of HPV that can lead to cervical cancer. However, it does not protect against all strains that can lead to the disease. The vaccine – a series of three injections over six months – is recommended any time from age 9 to 26. Because HPV is transmitted through intercourse, I often recommend to my patients that they wait until they are considering becoming sexually active. Many parents question if their daughter needs the vaccine at such an early age.  The decision as to when to receive the vaccine is very individual, and I believe it should be made in consultation with the patient’s gynecologist or pediatrician.  I want to stress that the vaccine does not replace regular Pap smears.

Treatment for cervical cancer in the pre-cancerous stage can be as simple as an office procedure called a LEEP (loop electrosurgical excision procedure) which involves a local anesthetic and removal of all pre-cancerous cells from the cervix. There is a low incidence of recurrence. If the disease advances to cancer, treatment depends on the stage and the woman’s wish to remain fertile.  It can involve a cone biopsy, in which the outer portion of the cervix is removed; a hysterectomy, involving removal of the uterus and cervix; or radiation therapy.

It is essential to understand that, although the recommendations call for a Pap smear every three years, seeing your gynecologist annually is a vital part of a woman’s comprehensive health care. Pelvic exams, Pap tests and cancer screenings can help prevent illness and detect problems at an early and potentially more treatable stage. All women need to be diligent about visiting their gynecologist each year.

Editor’s Note:
Dr. Navid Mootabar is a member of Westchester Health Associates in Mount Kisco, NY. He is the Chief of Obstetrics and Gynecology and a Director of the Institute for Robotic & Minimally Invasive Surgery at Northern Westchester Hospital. He received his medical degree from the Mount Sinai Medical School, where he also completed his residency in Obstetrics, Gynecology, and Reproductive Medicine. Dr. Mootabar completed his undergraduate courses at Columbia University and was named among “America’s Top Obstetricians and Gynecologists” from the Consumer Research Council of America. Dr. Mootabar has received advanced training in robot-assisted Single Incision Laparoscopic Surgery (SILS) and utilizes this approach for select gynecologic surgery procedures.

 

 

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New York Obstetrician Shares Advice for Surviving the Heat While Pregnant

Posted on: June 28, 2012

Expectant Moms: Summer Survival Guide

An Interview with Dr. Navid Mootabar

www.NWHmaternalchild.orgBy the time summer rolls around, everyone’s so tired of being cold that they can’t wait to get outside and garden, barbecue, head to the beach. But basking in the heat and sun can be hazardous for pregnant women, according to Navid Mootabar, MD, Associate Chief of Obstetrics and Gynecology and Director of Gynecologic Surgery at Northern Westchester Hospital.

“A pregnant woman’s body temperature is already a bit higher than normal,” says Dr. Mootabar, who is also the hospital’s Director of Gynecologic Surgery. But by taking a few precautions, even expecting mothers can embrace the joys of summer.

Keep Cool

Lightweight cotton or linen fabrics are best. They breathe and allow air to circulate.
Try the personal fans and misters that you can find at convenience stores.
Take a dip in the pool or place a damp washcloth or an icepack on your forehead for relief.

Fluids are Crucial

Drink a glass of water for every hour of the day to keep well-hydrated. 
Mix in some juice or sports drinks to help replace the salts and sugars your muscles need, but just be aware of the calorie content. 
Don’t count coffee, soda, or tea among your eight to 10 glasses, and drink them sparingly.

Sun Sensitivity

Due to hormonal changes in the body, “a pregnant woman’s skin will be more sensitive to the sun,” says Dr. Mootabar. Cover  up with clothing as much as possible, and be sure to slather SPF 15 or higher sunscreen on any exposed skin.

Exercise Advice

If you have a regular exercise program, there’s no need to stop. Schedule your workouts for early in the morning or late in the evening (or in the air-conditioned indoors, if possible). Dr. Mootabar generally tells mothers “if they’re used to working out, they should be fine.”

How do you know when you’re overdoing it or getting too dehydrated? The signs of low fluids include lightheadedness, heart palpitations or racing, muscle cramps, and contractions, says Dr. Mootabar. The baby may not be moving as much if amniotic fluid levels fall. If you reach this stage, contact your doctor. But you can easily avoid these problems by listening to your body. “If you’re feeling tired, weak, or thirsty, that’s your body telling you to rest and drink water.”

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