Healthwise Maui

Q: What are the best treatments for asthma?

Dr. Michael Shea, critical care medicine, Pacific Permanente Group: Every case of asthma is different, so treatments are different as well. Your doctor will work with you to come up with the treatment plan that’s best for you. There are two main kinds of medicine that can be used to treat asthma: long-term medications that help control your asthma and prevent symptoms, and quick-relief medications you can use to control symptoms and open your airways immediately when you’re having an asthma attack.

When you first start treatment, your doctor will probably have you start a long-term medication to bring your asthma under control. These can be inhaled medications or pills you take every day or an injection you take every few weeks. They can help reduce symptoms by relaxing the muscles in your airways and reducing swelling and also by reducing mucus in your lungs. Over time, you might be able to reduce the amount of medication you take, or control your symptoms with quick-relief medication alone.

Medication isn’t enough to control asthma. It’s also important to learn what your triggers are so you can avoid the things that might cause your asthma symptoms to flare up.

Q: My mother is 86. Should she still be undergoing cancer screening? At what age should someone stop screening and is a person ever too old to undergo surgery or treatment for cancer?

Dr. Derrick Beech, surgical oncologist, Maui Memorial Outpatient Clinic: Generally speaking, cancer screening should continue as long as a person is expected to live an additional 10 years or more with an acceptable quality of life. This is particularly true with breast cancer screening, which is recommended to start at the age of 40 years for most women. Similar to breast cancer, colon cancer screening should continue in the elderly based on their projected life span of an additional 10 years. The American Cancer Society suggests a tailored approach to colon cancer screening beyond the age of 75 years of age, suggesting that people should discuss screening with their health care provider based on their risk and health status after age 75 years. It is generally accepted that cervical cancer screening can stop after age 65 for women who have had regular pap smears with negative results. Of particular importance is that even if a women received the HPV vaccine, she should still follow the recommended cervical cancer screening guidelines for her age. Screening for lung cancer and prostate cancer should be based on individual risk factors and discussed with your health care provider.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem.org/contact.