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'cancer' posts

Detecting thyroid cancer using ultrasound

The incidence of thyroid cancer is steadily increasing in the U.S. while the reasons for this increase are still unclear.  No environmental exposure or lifestyle trend has been linked to this recent rise but interestingly, some researchers believe that the increasing use of ultrasound in evaluating the neck and thyroid has raised the number of cancers being detected at earlier stages. Regardless of the cause of this recent uptick in thyroid cancer, there is no doubt that ultrasound has fundamentally changed the way in which thyroid lesions and cancers are evaluated and followed.
 
Ultrasound technology has undergone a dramatic improvement in recent years providing clear and precise images without exposing the patient to any radiation.  Thyroid nodules that are suspicious for malignancy can now be identified before they are large enough to be felt in the neck by the patient or health care provider.

 
When a  ...

The Science and the Art of Exceptional Cancer Care

Not long ago, I read two articles, one by a cancer doctor and another by a journalist. They both left me steaming a bit.  In medicine, we talk about the science (the factual database and knowledge that we use) and the art of medicine (how we use and adapt that database to the benefit of individual and different patients). Both of these articles, the first overtly and the second more indirectly, suggested that the art of medicine is about hiding the science from the patient in order to provide hope, albeit false hope to the cancer victim. Let me state clearly, despite paternalistic instincts, dishonesty has no place in the practice of oncology.

Both of my grandmothers died from cancer. Grandma S. died of stomach cancer when I was in college. As far as I know, she was never told that her cancer had recurred after surgery. Her second husband and family wanted it that way. “Knowing that she has cancer will devastate her, let her have her hope,” we were told. When my cousins and I visited, we were under strict orders to not ask too many questions about her “gall stone” problems. She knew though. You could see it in Grandma’s eyes. But the web that had been woven kept her from being able to grieve and gave no opportunity for good byes. As she slipped away she became withdrawn and depressed.

Grandma B. was diagnosed with an aggressive lymphoma when I was just out of medical school and in my training. She was fully informed by her doctors. She had opportunity to seek second opinions. She conferenced with her children. When she chose to not leave her little ranch valley in Idaho for desperate treatments far from home, and to die in her own home, her family rallied around her in support. For six weeks, she narrated her life history, wrapping up a legacy of lasting value for her family. She was the recipient of an outpouring of love from her community and she died fulfilled, with a smile of satisfaction on her face.

The science and art of medicine are ...

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 ..

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 ...

Join Swedish Cancer Institute at Seattle's Lung Force Walk on June 7

The American Lung Association (ALA) has dedicated 100+ years to promoting lung health through prevention of tuberculosis, cleaner air, smoking prevention, and providing resources to those who wish to quit smoking.

In their fight for healthy lungs, the ALA has taken on a fight with lung cancer.  Lung cancer is the #1 leading cause of cancer deaths in America for men and women.  This initiative against lung cancer is called Lung Force.

Swedish Cancer Institute has a long history of fighting lung cancer through research, early detection via low dose CT screening, staging of lung cancer, surgical and medical therapies, and palliation of lung cancer.

In support of the ALA and their efforts to spread awareness of the risks of lung cancer, raising funds for lung cancer research and providing advocacy for those affected by lung cancer, Swedish will participate in the Lung Force Walk on June 7th, in Seattle.

We welcome you to join Team Swedish for a fun filled morning of music, the 5K walk, and festivities at the finish line.  You can register for the walk for free and/or make a donation in any amount that you wish.  Dogs are invited to walk too!

To join and learn more, click here and  ....

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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