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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 ...

New products available for allergy treatment

For those with seasonal allergies, treatment can be as simple as an over-the-counter medication, but often requires more.  The good news is that there are a lot of options now. Some new products have been recently approved by the FDA to help individuals who are dealing with grass and ragweed allergies.

The treatment of nasal and eye symptoms from allergies includes antihistamines, nasal sprays and allergy shots.  Over the counter antihistamines include diphenhydramine (ex. Benadryl), loratadine (ex. Claritin), cetirizine (ex. Zyrtec), or fexofenadine (ex. Allegra).  Over the counter allergy eye drops are also available, such as ketotifen (ex.Zaditor).  Together, these help with itchy, sneezy, watery nose and eyes.  Nasal antihistamines are prescription and also help with these symptoms.  Nasal steroids help decrease congestion and postnasal drip.  

A long-standing solution ...

Facts and myths about antioxidants and cancer

Some of the most popular misconceptions surrounding cancer, cancer prevention and cancer treatment are about the role of antioxidants. Like many of the popular myths about cancer, there are facts, half-facts and outright falsehoods.
 
Fact: Damage to genes, particularly those involved in the regulation of cell division and cell death, is the key event in the development of cancer. 
Fact: Oxidants are substances, most often generated by our own body, that cause damage to chemicals, including the DNA that makes up our genes, by oxidizing them. The oxidation reaction most familiar to us is when metal rusts. 
Fact: Our bodies’ oxidants can contribute to cancer.
 
Half-fact: Antioxidants are chemicals we ingest that then run around neutralizing oxidants, rendering them powerless to promote cancer. The so-called antioxidant vitamins, of which vitamin C, E, and beta-carotene are the most well known are more properly called redox agents. In a particular environment, they prevent or reverse oxidation, called reduction. But they may change the acidity or even just the concentrations of the components of the reaction, and they may facilitate just the opposite. For example ....

Why aren't my bowel habits normal?

Do you have irregular, uncomfortable, or distressing bowel habits? Irritable Bowel Syndrome (IBS) is the most common gastrointestinal condition affecting an estimated 15% of the general population.  It is most common among women aged 30 to 49 years old.

IBS is a chronic condition of the digestive system that is not generally associated with more concerning findings of anemia, weight loss, family history of colorectal cancer, inflammatory bowel disease, or celiac disease. Symptoms of IBS include abdominal discomfort, constipation and diarrhea. Despite extensive research, no common cause of IBS has been identified. Some theories include:

When you should seek treatment for abdominal pain

As a general surgeon, the majority of my practice is spent evaluating patients with abdominal pain and deciding whether the cause of their pain requires surgical treatment. These patients are only a small fraction of the number of people who seek medical attention for abdominal pain. Abdominal pain is fairly common and something almost all of us have experienced. Usually it is not cause for alarm and resolves on its own after a limited course if we wait and treat symptomatically. We have all had a moment however when we wondered whether this time was more serious, and how would we know if it was?

Every organ in the abdomen and pelvis (including the muscles and skin of the abdominal wall) has nerve endings and can cause pain. While nearly everyone has experienced abdominal pain, it is usually self limited and mild. Think antacids for heartburn symptoms, diet modifications for food intolerances, fluids and time for gastroenteritis, stool softners for constipation. While more severe causes of abdominal pain are rare, it is important they are recognized as they may have more severe consequences to health.

Only 15%-20% of people with abdominal pain require surgical treatment (this number increases with age). The most common reasons for surgery are  ...
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