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'cancer' posts

Swedish Cancer Institute and community events in August

Can you believe the month of August has already arrived? Some may see the end of August as an end to summer, but it doesn’t mean the end of community events. Two particular events taking place toward the end of August are the American Cancer Society Relay for Life—Capitol Hill event and the Northwest Hope and Healing Alki Beach Run 5K. We are happy to announce the Swedish Cancer Institute will be supporting both!

On Saturday, August 23rd ...

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 ...

PALB2 Gene Mutation & Breast Cancer: What it Means For You

PALB2 is a gene that was first linked to hereditary breast cancer risk back in 2007. Today’s Seattle Times reports on a recent study about PALB2 that was just published in the New England Journal of Medicine. The study, the largest to date, detailed the breast cancer risks faced by  women – and to a lesser extent, men – who carry a mutation in their PALB2 gene. The breast cancer risks were several times greater than the ~12% risk faced by all women, and varied with the woman’s age and family history. Currently, there is no consistent evidence to suggest  that men or women who carry a single PALB2 gene mutation are at greater risks of developing ovarian or other cancers.
 
PALB2 genetic testing can provide very important information that can help women and their families better understand and reduce their risks of developing breast cancer. However, even among women with a very strong personal or family history of breast cancer, very few will test positive. Studies suggest that only about 1-3% of high risk women  will carry a PALB2 mutation. In my personal experience, I have tested about 300 high risk women for PALB2 mutations, and ...

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 ...
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