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Treatment options for hemifacial spasm

Hemifacial spasm is the involuntary contractions of the muscles of the face, those innervated by the facial nerve (VII). The facial spasms are intermittent and occur on one side of the face only. Hemifacial spasm can involve the upper or lower half of the face and may progress to involve the entire half of the face. The intensity and frequency of these symptoms can increase over time and can persist even during sleep. Hemifacial spasm can be associated with vestibular dysfunction and cochlear dysfunction.
 
Hemifacial spasm is usually more common in women. The most common cause of hemifacial spasm is ...

Per Oral Endoscopic Myotomy (POEM) for achalasia

P.O.E.M. has come to Seattle at Swedish Medical Center.  No, not the kind that rhymes but one that is elegant in its own way.  Per Oral Endoscopic Myotomy or POEM is relatively new procedure used in the treatment of achalasia, which is a disorder of the esophagus due to degeneration of the nerve network within the walls of the esophagus.  The diseases leaves patients with little propulsive power to push food toward and into the stomach as well as causing the “valve” at the top of the stomach to remain closed.  This makes it difficult for patients to eat or drink.   Patients may need to drink a lot of fluid to get food to pass into the stomach whereas others may feel pain or discomfort after eating and still others may have undigested food come up many hours after eating or when lying down.
 
The treatment for achalasia is ...

How to deal with gas and bloating

We all have occasional gas, usually from something we have eaten, but many people feel that they pass too much gas or burp too frequently. Intestinal gas can result in abdominal pain, bloating and embarrassment.
 
The amount of gas produced by the body depends upon your diet and other factors. Most people with symptoms of excessive gas do not produce more gas than the average person, but are more aware of normal amounts of gas.
 
Where does the gas come from?

Human Papillomavirus (HPV) in Head and Neck Cancer

Cancer of the oropharynx (throat) has undergone a drastic and dramatic change over the last decade.  In the past, most throat cancers were linked with prolonged cigarette smoking and alcohol use.  Now, the occurrence of throat cancer is rising and 80-90% is likely caused by an infection with Human Papillomavirus (HPV).  Many high-profile personalities, including actor Michael Douglas, have recently revealed that they have experienced HPV-related throat cancer.

What causes HPV-related Oropharynx cancer?

Infection with the Human Papillomavirus (HPV) is known to cause genital warts and lead to various genital cancers, but now it appears to also cause the majority of throat cancers.  The types of HPV that lead to throat cancer are generally sexually transmitted, though some researchers believe that even kissing may result in HPV transmission.   The time period from HPV exposure to the development of a throat cancer is often decades. Although the cancer may be slow-growing, it is important to have annual check-ups with your physician and dentist who can assess your oral health appropriately. 
 
How is HPV-related Oropharynx cancer treated?


HPV-related throat cancer can ...

Mesothelioma update: shorter course of treatment and improved survival rates?

There have been some very exciting recent developments we (the Thoracic Surgery team at Swedish Cancer Institute) are utilizing in the treatment of malignant pleural mesothelioma (MPM).

Over the past year we have offered some of our patients deemed appropriate for surgery a more streamlined approach to their overall care. Previously we have tried to offer chemotherapy, surgery, and radiation to all patients who were healthy and strong enough to undergo the three treatments, as mesothelioma is an aggressive cancer requiring aggressive treatment to optimize survival. This new approach still offers both surgery and radiation, but chemotherapy is given only to those found to have cancer in lymph nodes in the center of chest during surgery.

The advantages of this new treatment paradigm are ...

Dealing with vaginal dryness

One of the more annoying situations that many of my patients have been in is having painful intercourse due to vaginal dryness. In general the cause of dryness of the vaginal tissue is lack of estrogen. This can occur postpartum, especially in women who are breastfeeding a baby, and it can occur just before and during menopause.

When estrogen is in the body, one of the effects of estrogen is to ...

Reducing visits to the operating room for breast cancer patients

Swedish Cancer Institute has changed the way early stage breast cancer patients are cared for by adopting new surgical margin guidelines.  These guidelines will reduce the need for taking women back to the operating room if cancer cells are found at or near the specimen edge, also known as the margin. Following extensive review of the data, this new guideline was established by breast experts from the Society of Surgical Oncology and the American Society of Radiation Oncology and has been endorsed by the American Society of Breast Surgeons and the American Society of Clinical Oncology.
 
Many women with early stage invasive breast cancer opt for breast conserving surgery, known as lumpectomy or partial mastectomy. For 20-25% of these patients, a second surgery or re-excision was performed because the margin was not considered adequate based on previous practice guidelines. The latest peer reviewed evidence shows disease control is excellent when surgery is combined with whole breast radiation with or without hormonal therapy and/or chemotherapy, regardless of the margin width.
 
The Swedish Cancer Institute’s multidisciplinary breast cancer team reviewed and approved these guidelines for our program. We believe by reducing the need ...

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