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'cancer' posts

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  ...

Breast Cancer Survival Guide: Physical & Clinical Updates

A diagnosis of breast cancer sets into motion a whirlwind of appointments, tests, surgeries and possibly chemotherapy and radiation treatment. A new study reviewed the timeline between surgery and initiating chemotherapy for different subtypes of breast cancer and found a survival advantage when chemotherapy was initiated within 30 days of surgery. Although treating within the 30-60 post-surgical window did not show a statistically significant survival advantage, there is a trend towards better outcomes. Exceeding 60 days post treatment had a negative impact on survival. The clinical impact of timing is most relevant for patients with stage II and III breast cancer, triple negative breast cancer and HER2-positive tumors.
 
Treatment for breast cancer can be exhausting and take a toll on the physical health of patients as treatment ends and they begin post-treatment life. Cancer survivors are at an increased risk of poor health, depression and physical disability. Approximately one third  ...

5 things to know about cancer screenings

Cancer causes 580,000 deaths a year in the United States. One in eight women will develop breast cancer and one in six men will be diagnosed with prostate cancer during their lifetimes. However, many deaths can be prevented when cancer is detected at an early stage. Cancer screening and risk assessment tests are the tools we use to find cancers early.
 
How do we find early cancers?

Some cancer screenings can be done yourself at home at essentially no cost or risk. This includes regular self-examination of the breasts, testicles and skin. Home fecal occult blood testing can also be done to screen for colorectal cancer. Additional information on cancer screening and self-examinations can be found on websites such as www.cancer.org or www.webmd.com.

 
Other screening requires medical interventions. There is good evidence that well-targeted screening saves lives. However, screening tests such as mammography, colonoscopy and prostate-specific antigen (PSA) are  ...

Why I'm a cancer doctor

I was traveling last week.  After the stewardess pointed out the exits, the broad shouldered gentleman stuffed into the seat next to the seat I was stuffed into, decided to make some small talk. “What kind of work do you do?” 

“I am an oncologist,” I said, and prepared myself for what I knew was coming next.  There are only two responses to “I am an oncologist.”  The first is, “what’s that?”  (The word oncology is code.  In the 60s it was politically incorrect to say “cancer”.  Even today, patients and clinicians stumble around the word, preferring terms like malignancy, neoplasm, tumor, or just lump.  Cancer care was entering the dawn of an era where not everyone was going to die and was soon to become a new specialty, so the word “oncology” was coined to avoid saying the “C word.”  But when someone doesn’t know the code word you have to be direct.  “I am a cancer doctor.”)

If the second question isn’t asked first, it is asked next.  It isn’t really said like a question, it’s more like a statement with a question mark.  Sometimes the statement is one of wonderment, but as often as not it is pity.  “Why did you decide to be a cancer doctor?”

Cancer is a fascinating disease.  It is the closest thing, in this life, that we will get to immortality.  Take cancer cells, put them in a test tube and take care of them right and those cells can be grown forever.  Take our normal cells and care for them the same way and they will be dead in two weeks.  We do research on cells harvested from cancer patients 20 years ago.  Besides being mortal our normal cells respect the space of other cells ...

Resolve to give the gift of comfort and warmth all year long

The holiday season is the perfect time to give back to the ones we love, our community, and those who have yet to enter our lives. For many of us, small, simple acts of kindness are easiest to introduce in our efforts to give back, especially when we are busy getting back to work or school in the new year. Thankfully, giving back doesn’t mean you have to give up a huge amount of your time!

One unique way to make a huge impact in our community is by using your hands, heart, and brain, together—to knit! The Swedish Cancer Institute (SCI) has been lucky enough to have the support of community members near and far who have donated thousands of knitted hats for patients undergoing cancer treatment. These donations come at prime time during the holiday season but act as gifts all year long!

During chemotherapy, many patients experience hair loss. With the loss of hair, many patients experience low self-confidence, heightened sensitivity to fabric and weather conditions, and limited flexible income to purchase headwear.

With the support from our patients, caregivers and community, the SCI has been able to provide free knitted hats to patients undergoing treatment for over nine years. Knitting hats is fast, and provides both literal and figurative warmth directly to patients at a time when they may feel most vulnerable during their treatment. If you’re an experienced knitter, or someone who wishes to learn how to knit, or would love to knit for a cause, join a Knit for Life group at either the SCI First Hill or Issaquah campus.

This network of volunteers uses knitting as a healing experience to enhance the lives of cancer patients, their family members and caregivers during treatment and recovery. The group provides a supportive environment for beginners and experienced knitters. All knitting materials are provided ...

Grieving and the holidays

A cancer doctor is very familiar with the anxious and fearful grief that accompanies a diagnosis of cancer. We are less acquainted with the lonely and empty grief that is experienced by those left behind when our patients die. However, when I wear my hospice medical director hat, I am privy to those struggles, and knowing that the loss of someone close is particularly difficult during the holidays, I have chosen to divert from subjects I am more familiar with and rely on the experts at hospice to help me present a meaningful discourse on grief during the holiday season.

For the bereaved, the joyous holidays trigger emotions of great conflict. Every act of preparing for the holidays, once a time of cheer and anticipation, becomes another stabbing reminder of ones loss. The demands of family and friends, always a bit stressful around Thanksgiving, Hanukkah, Christmas, and New Year, now are overwhelming, both physically and emotionally. Traditions, designed to create love and family unity, now seem empty and may even create divisions among the grieving. Even successful celebration may bring on a deep surge of guilt for enjoying the holiday alone. And those who have no physical or emotional reserves left for thanksgiving or joy making, may feel great pressure to “get on with their life, and join in the fun.”

It has been suggested that the key word in grief is “permission.” The bereaved need permission from themselves, and from family and friends, to grieve as long as necessary and in any way that works, remembering that what works may not always be the same. It means permission to only do what you can. A turkey and all the trimmings may just be too much this year. Eating out may be perfect. Having someone else do dinner may be better yet. 

Permission may also be needed to change some timeworn traditions. It must be recognized that ...

Radiosurgery treatment for brain metastases reduces risk of memory loss and improves survival

When a person has metastatic cancer, the brain is one of the organs that cancer cells can migrate to. If this happens, the condition is called brain metastases. The brain metastases will have the same cancer cell type as the primary cancer, such as lung or breast cancer.

If this occurs, radiation treatment is often used to control these areas of disease. Research is finding that utilizing stereotactic radiosurgery as the initial treatment for people with four or less brain metastases is associated with improved survival and reduced risk of memory loss compared to whole brain radiation. Stereotactic radiosurgery ....

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