LeDonne, Anthony T.

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The Linacre QuarterlyVolume 35 | Number 3 Article 27August 1968A Cancer Detection Project in NunsAnthony T. LeDonneFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationLeDonne, Anthony T. (1968) "A Cancer Detection Project in Nuns," The Linacre Quarterly: Vol. 35 : No. 3 , Article 27.Available at: http://epublications.marquette.edu/lnq/vol35/iss3/27A . Canc~r Detection Project 1n N t ~, ns Anthony T. LeDonne, M.D. In July of 1967 Saint Joseph's Hospital ; Philadelphia, was awarded a Cancer Detection Grant from the Department of Health, Education and Welfare. The objective was to screen as many women in the area as possible for pelvic carcinoma. It was soon learned that most of the Sisters, who for one reason or another came in contact with the hospital, had never been examined. Upon further research we found th~t most of the Religious Orders in the Philadelphia area had no medical program for routine examination of their members. Knowing that cervical cancer would be almost non-existant, we were reluctant to approach this segment of the population for routine Pap Smears. But after the first few Sisters were examined and cancer of other sites and other pathologic lesions became apparent, we felt that this neglected group should be contacted. The following is a summary of the _rewarding results obtained. 210 Flyers were sent to :he nearby convents and a program .. ,- preventive medicine explained to · he Mother Superior by our nurst. Once the Mother Superior was coir·: 1ced ofthe need of having her membc' s examined, it was surprisingly easy to arrange appointments. The best n· ;ponse came from the young teachint groups who showed not only a des!r;: to have 3 systematic medical progr.l m, but who probably, through their :~· ounger ideas (Anthony Le Donne, M.D, is Clinic Director of Obstetrics and Gynecolo_gy and Director of the Cancer Scree~mg Program under a Health, Educatzo~; and Welfare Grant at St. Josep~ Hosr:ital, Philadelphia, . _Pennsylv~~ He zs a graduate of Jefferson Me rcn College 1958· interned at Je[[erso_, ' ' 0 Ill 1959 He attended his reszdencY . mas Obstetrics and Gynecology at_ Tho er J. Fitzgerald-Mercy Hospital m UpP Darby, Pennsylvania.) :'Of:ientat:iOJ1S, were most interested modern technology and abilities. The older nuns, , still were ~ reluctant group, of whom mysteriously vanished waiting their turn. were very much breast lesions and desired a breast lbnlimtticm. As this was one of the prevalent sites for cancer in the population, and since the desire breast examination was .-nuested, we then included in our addition to the "Pap a complete · breast would be expected, most of the findings were in the age group to 60 years. However, the group of 20 to 40 years had a pathology rate, ranging from lesions that required biopsy and to uterine fibroids and polyps. Althou~ no malignancies were discovered in this group of 118, two important facts must be considered. First, there were pathological lesions that had to be corrected; and second, these groups were being oriented and conditioned to the idea of periodic check-ups so that many of the lesions that would develop in these Sisters in lat_er years would not become neglected as is evident in the present groups of older nuns. In the age group 40 to 50 years, there were 46 Sisters examined. The yield here was 1 7 .4%. Typical lesions found were bartholian cyst, cervical polyps, · severe vaginitis, large obstructive fibroids and three breast lesions. Over age 50, there were 98 patients and 12 lesions, the most . important of which were an advanced carcinoma of the breast and -two carcinomas of the endometrium. Naturally our yield was so high simply because this was, for almost all of these sisters, their first systematic physicaJ examination since they entered their respective order. PATHOLOGICAL FINDINGs· 20-40 40-50 over 50 118 46 98 Breast 3 Breast 3 Breast 3 Cancer 1 Severe Vulvar Leukoplakia Lichen Sclerosis Vaginitis 1 Bartholian Gland Et Atrophices 1 Symptomatic Cyst 1 Vaginitis 3 Uterine Cervical Polyp 2 Cervical Polyp 1 Fibroids 2 Large Uterine Cystocele Cervical Fibroid 1 Symptomatic 1 Polyps 1 Uretlual Caruncl~ 1 Cancer Uterus 2 5.8% 17.4% . 12.2% 211 Examinations were performed without too· much difficulty even in the older groups of Sisters. With gentle . technique, virginal speculum and adequate lubricant, most of the cirvices were visualized. In the few in whom it was impossible to insert any type of speculum, a cotton-tipped applicator and rectal examination . yielded as much information as needed for a screenit:lg procedure. Embarrassment was negligible and these sisters were the most cooperative . and grateful patients in our program. All of us ' who are practicing physicians realize the e~se with which a small lesion can be treated ~nd in most instances, cured. Not only is it most frustrating to care for an advanced lesion , but we must realize the financial and personnel hardships . to these religious communities. Our statistics indicate that advanced lesions were found in the older patients. But it is this group from which the administrators, the Mother Superiors, the experienced teachers and the backbone -of the communities come. It is indeed unfortunate that so much 212 time and so much effort be e: Jended in formation and then wa: ed by neglected lesions, for a great 1eal of time and money has gone 1to the education and formation 1 Sisters. Yet, unfortunate!: lesions are most prevalent at when they are at their most p; stage and ready to l• administrative responsibilitie: communities. RECOMMENDATIONS: Our program has proved th this era of modern techniqw. the easy availability of pro.grams, there exists a medically neglected female little education and en co · agement these Religious will submit 1 periodic health examinations. h early diagnosis and adequate treai .ent most of the Sisters will be able t continue in their productive cape :ties . and religious works. The loss of ;1ch Sister is an immeasurable los~ to ~ach community, therefore , !~ ·r health should be safeguarded by e . ~ ry means possible. Linacre QuarterlY The Family Doctor and Mental Health Kevin Hargadon, F.S.C. public today is being gly exposed to advertisements the importance of a regular check-up. In no uncertain it is being told that early of disease can forestall and eliminate the severely ••"··--••·~·~-·~ and deadly effects of that has been allowed to go on . ·We are all aware of such red campaigns now being out in the areas of cancer s and arthritis. Except for a~ nal voice raised in protest 1967), there is general of this increasing role of medicine in America. Would like to suggest that this n t i ve, rather than merely approach should also be to the psychological field. In I would suggest that our medical doctors could do in this area. For many reasons it be advantageous if a regular as well as physical were ' recommended by to t~eir patients as a routine Kevin Hargadon is a clinical r:no'IOi'ist residing . at De La Salle Washington, D.C. He is completing his dissertation Ph.D., while also engaged in young Christian Brothers studying at Catholic . Articles written by him Cbe~n published in the University hicago School Review, the Catholic Guidance Journal La Sallian Digest.) matter. In this way any unhealthy aspects of a person's physical or emotional well-being would have the advantages of early detection and possible prompt attention. It would seem at first thought that a recommendation for a regular psychological check-up should be the task of the psychiatric or psychological professions rather than that of the regular medical practitioner. Perhaps it should. Both professions undoubtedly would support the early detection of emotional disturbance. However, this does not negate the fact that the regular family doctor is in a very advantageous position for making this recommendation. He usually has the faith and confidence of his patients. Realistically it must be admitted that _there is still much fear and suspicion surrounding the psychiatric and psychological professions. There is a great deal of stigma and misunderstanding associated with ·a visit to a "headshrinker." A recommendation from a trusted doctor would help to counteract this ,' especially if this recommendation were a matter of routine procedure. Such a routine recommendation would not unduly raise the fears of the patient, although some anxiety will surely be called into play. Not only is the regular family doctor in a good position to make this recommendation , but he is also in a good position to appreciate the role that emotional problems play in either 213 . . ~ 

A Cancer Detection Project in Nuns

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A Cancer Detection Project in Nuns

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