Ask specialist for precise diagnosis

Dear Dr. Gott: I am an 80-year-old woman in good health. Last year I passed blood in my urine, and extensive testing revealed a small tumor on my right kidney. My choices are: an operation to remove my kidney, or wait six to 12 months and be re-scanned. I’d appreciate your opinion.

Dear Reader: I hope that your “extensive testing” included a biopsy of the tumor. Without a tissue diagnosis, it is virtually impossible to know what is causing the growth. If, for example, it is a highly malignant cancer, your best option – despite your age and the obvious risks – is surgery.

On the other hand, if the lesion is a pre-malignant but relatively innocuous collection of cells, re-scanning in six to 12 months is certainly appropriate because the risks of unnecessary major surgery are significant in a person your age.

In my view, you need a detailed sit-down session with a urologist or oncologist (cancer specialist). Any decision will depend, as I stated above, on the precise diagnosis of your kidney lesion. Let me know what you and your doctors decide.

To give you related information, I am sending you a copy of my Health Reports “Kidney Disorders” and “An Informed Approach to Surgery.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Dear Dr. Gott: I am a smoker, age 60, with chronic obstructive pulmonary disease. Because my cigarettes have already damaged my lungs, is there any benefit to me stopping smoking?

Dear Reader: You have been given a death sentence if you continue to smoke. Air pollution, including tobacco smoke, will not only cause COPD but will worsen the condition fairly rapidly.

As you pointed out, some permanent damage is done, so even if you give up cigarettes, the COPD will not go away. However, in my experience, people with chronic lung disease often notice as much as a 30 percent improvement in breathing capability after giving up tobacco. More important, you need to arrest the progressive lung damage before your pulmonary disorder results in a permanent handicap and the need for oxygen supplements. “Chronic lungers” (as they are sometimes called) who refuse to alter their cigarette habits often end up slowly and progressively suffocating to death. – not a favorable prognosis.

To give you related information, I am sending you a copy of my Health Report “Pulmonary Disease.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.