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'prevention' posts

Bilateral Mastectomies: a patient’s personal decision

Last week the Seattle Times reported that women diagnosed with early stage breast cancer in one breast are choosing to have bilateral mastectomies to reduce their chances of getting cancer again, but recent research shows that that there is no survival benefit, even in younger women. Researchers at Stanford and the Cancer Prevention Institute of California evaluated the outcomes of over 190,000 women from the California Cancer registry who were diagnosed with breast cancer in one breast between 1998 and 2011. The rate of bilateral mastectomies rose from 2% to 12.3% over the study period, yet there was no survival benefit to bilateral mastectomies versus lumpectomy and radiation.

To those of us who work in the field, this data comes as no surprise; the trend of bilateral mastectomies is a known phenomenon. More than 10 years ago, I remember the chatter among surgeons at national meetings asking if others noticed that more and more, younger women were coming in asking for bilateral mastectomies. Back in 2007, Dr. Todd Tuttle authored a study in the Journal of Clinical Oncology that found that the rate of contralateral prophylactic mastectomy was on the rise, from just under 2% in 1998 to 5% in 2003. This week’s study only validates that this upward trend shows no sign of leveling off.

Why do patients choose bilateral mastectomies?

Many women ....

Preparing your teen for college and taking care of their health

College is a huge and exciting step in an adolescent’s development. Being prepared can help your teen stay healthy and know where to go when they’re not. Whether your child is staying close to home, or going across the country for school, here are a few tips to add to your college checklist:

Schedule a visit with your primary care physician. (See a list of local Swedish physicians who can see your teen here.)

  • Physicians can make sure your teen is up to date on immunizations that many colleges require. Teens commonly need influenza, Tdap, HPV, and meningococcal vaccines.

  • Ensure that your child has prescriptions (with refills) for all medications they routinely use. Even “as needed” medicines may become needed in college. These medicines should be kept in a locked box in your teen’s room, as many medications can be stolen or used illicitly.

  • Your teen should ...

Summer, sun, and skin cancer - what you should know

It is easy to get carried away enjoying the string of lovely sunny summer days we have had in Seattle. Our sun is strong, and our unprotected skin vulnerable to UV damage that can lead to sun damage and perhaps skin cancers. Skin cancers fall into the broad categories of squamous cell cancer, basal cell cancer and melanoma. Each of these cancers are usually surgically excised or destroyed by either a dermatologist or general surgeon.

How to tell if a skin lesion is concerning

Warning signs include moles larger than a pencil eraser head, change in size, change in color, itching, bleeding or scab forming over the mole. Areas of particular concern include face, neck, back and extremities. However, skin cancers can also develop in areas where the sun does not shine.

What to do if I have a skin cancer?

If you have a mole or skin lesion that is concerning, bring it up with your family physician who may biopsy it or refer you ..

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 ....

When stress takes a toll on your heart

When you face danger, your body’s built-in alarm system triggers the production of adrenalin and cortisol. Adrenalin makes your heart beat faster and cortisol produces sugar to help you physically and mentally react. Your body returns to normal when the danger is over.

Unlike cavemen, barbarians and knights, we don’t face extreme danger very often. Unfortunately, every-day stress also triggers your alarm system.

Work. Commute. Kids. Relatives. Friends. Death of a loved one. Money. Everything in life can cause stress.

Stress takes a toll on your body — including your heart. Because stress can linger, your body continues to produce extra adrenalin and cortisol.

When your body’s alarm system doesn’t turn off, you may eat more, exercise less, lose sleep, argue more, forget things, get depressed, or smoke or drink more than usual. These things put an added burden on your heart and increase your risk of heart disease. Recent studies have shown that laughter and positive thinking promote heart health, while anger and job stress can increase the risk of heart attacks.

Here are some tips to protect your heart from stress:

Parent's guide to newborn testing, screening, and prevention measures

When picturing the first days of an infant’s life, what we look forward to the most is love. We express our love in so many ways: skin-to-skin, breastfeeding, swaddling and snuggling. 
 
Love also means keeping them safe. 
 
Advances in maternal-infant health are one of the greatest success stories of the 20th century, with a drop in the death rate of 99%. But some of those dangers only stay in the past through constant vigilance. Behind every screening test and preventive measure is a careful, research-driven rationale. Here are seven newborn tests, screenings, and prevention measures you should know about:
 
Vitamin K injection 
Vitamin K is vital for blood to clot properly. Newborns cannot make Vitamin K and it is poorly transferred in breast milk. Without this injection, babies are at risk for spontaneous bleeding from the umbilical cord, mucus membranes, even in the brain. Giving Vitamin K has greatly reduced this "hemorrhagic disease of the newborn," but rates are increasing as more parents refuse it. Oral Vitamin K has not been shown to prevent this potentially devastating disease. 
 
Hepatitis B vaccine
This is an anti-cancer vaccine. Before this vaccine existed, approximately 10,000 kids under age 10 contracted hepatitis B each year. Most had no known exposure to it. Kids are more likely than adults to get very sick and to have complications. Vaccination at birth has greatly reduced rates of pediatric liver cancer due to hepatitis B. 
 
Antibiotic eye ointment
This prevents bacterial eye infections. Some of these infections are associated with sexually transmitted bacteria, but not all of them are. Negative testing or a monogamous relationship does not ...

When a mole is more than a mole

As a general surgeon, I am often asked to evaluate a patient with an abnormal mole (pigmented nevus) or one that has been biopsied, revealing a premalignant or malignant growth.  It is not uncommon for the patient to tell me they either were totally unaware of the lesion or dismissed changes in the lesion over time. 

All skin cancers are not alike, and melanoma, a malignant cancer of pigmented skin cells (melanocytes), is by far the most dangerous of the group, accounting for over 75% of skin cancer deaths in the United States.  This amounts to about 48,000 melanoma related deaths world wide per year. 

Found early, when the lesion is superficial and small, cure rates are high, but as the cancer progresses, it invades deeper into the skin, and becomes far more likely to spread far from where it started.  It is for this reason that  ...
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