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Doctor Q&A for Dr. Myron Arlen

A 34-year-old member asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
Non specific test: Ca 125, a protein frequently found in ovarian cancer can also be found in other diseases. We have seen high levels when there is end stage alcoholic cirrhosis producing ascites which might suggest ovarian Ca but ovaries are normal. Protein produced by liver. Ca 125 should only be used for monitoring direction of treatment when dx of ovarian tumor known. It is not a diagnostic test.
A 31-year-old male asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
Internal hemmorhoids: asymptomatic bleeding usually attributed to internal hemmorhoids. Proctoscopy should be performed to define site of problem and resolve it so that no further bleeding should be noted.
A 39-year-old male asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
You are in trouble: The presence of any benign nevi cells left to the chance for growth usually over a prolonged period of time will continue to transform and occasionally metastasize without regrowth of the primary lesion. If you leave it alone, it will grow on you.
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A 22-year-old female asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
Usually not: appendicitis begins in the mucosal lining of the appendix and as such exhibits referred pain unually around the periumbilical area with associated nausea. As inflammation progresses to serosal surface the pain becomes localized to the RLQ, In the female a small follicular cyst of the ovary can occasionally bleed and the presence of pelvic blood can cause RLQ pain also.
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A 30-year-old female asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
R.O. lymphoma: When bilateral nodes do not resolve, they may be totally benign, but occasionally low grade lymphoma can present in this manner. I have had cases lasting 6 yrs. without nodal change and when finally biopsied, low grade lymphoma found. Treatment is to watch because many remain unchanged. If enlargement or more nodes then bx required.
A 19-year-old male asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
Depends where: While a lymph node can be tender and probably represents an associated inflammatory process, the origin of the problem depends on where in the rt. neck the node is. In region of the digastric, it can arise in the hypopharynx or larynx. In the mid neck it can come from piriform sinus or thyroid. In supraclavicular area the problem may be pulmonary in origin. Biopsy for path is essential.
A 35-year-old member asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
Ulceration: Vulvar cancer is a squamous cell malignancy that initially ulcerates. It is usually induced by the UPV virus and behaves as most squamous cell lesions do; that is metastasis to regional nodes in the inguinal area. Such lesions require vulvectomy combined with radical groin dissection.
A 25-year-old member asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
Radiation: One form of radiation emission from radium is via radon gas. While few ever get exposure, many home sites are built on areas where radon gas can be detected such as in the basements. This exposure can lead to the appearance of malignancies. Many homes have been tested for such emission. Kits are available for such testing
A 35-year-old member asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
A premalignant state: Carcinoma of the cervix, a common malignancies of uterus begins in the premalignant state. The Pap test reveals cells that already show signs of transformation or dysplasia. Detecting transforming cells by cytology, , is about 60%. This improves by sampling for HPV to about 80%. We have developed a new mAb (squamous) that gives better than 90% accuracy by IHC
A female asked:
Dr. Myron Arlen
Surgical Oncology 64 years experience
Possibly: Cancerous cells in the cervix and possibly surrounding region usually represent Ca in situ. Otherwise you would be complaining of an ulcerating lesion that was bleeding. For in insitu disease cryousurgery is usually sufficient followed by repeat Pap. Sometimes of cone resection of the cervix is indicated but disease in-situ , it is usually very curable.
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