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Support social work services and Swedish Cancer Institute in Issaquah

Come and join us for a handbag auction that supports social work services at Swedish Issaquah and bid on new or gently used designer handbags, sunglasses, and jewelry. The auction will take place on Saturday, October 11, 2014 from 11:30 a.m. - 3:00 p.m., at the Newcastle Country Club in Bellevue.
 
Every dollar raised will go towards funding the Cancer Social Work Services program at Swedish Issaquah. Social workers play a critical role in supporting cancer patients by providing a safe place for patients to talk about their emotions. In addition to ...

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 ....

Red Doors at Swedish Cancer Institute

During the next couple of weeks, you will find various doors and walls at the Swedish Cancer Institute decorated in a beautiful red wrapping paper. This is a symbol of Swedish’ support for Gilda’s Club and their Red Door campaign.
 

The Red Door campaign was established to ...

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 ...

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