There’s a new head at the helm of Temple University’s Department of Surgery.
Effective July 16, Dr. Selwyn O. Rogers Jr. will begin his new post as Temple University Health System’s surgeon-in-chief, professor and chair of surgery at Temple’s School of Medicine.
Rogers currently serves as associate professor of surgery at Harvard Medical School and chief of the Division of Trauma and Burn and Surgical Critical Care at Harvard-affiliate Brigham and Women’s Hospital in Boston, Mass.
In his new role, Rogers will lead the surgery department’s efforts in enhancing the patient-care experience, expanding surgical programs and ensuring quality outcomes within a patient-centered environment of care.
He’s also charged with recruiting faculty, developing improved business operations and establishing a research program that distinguishes Temple Surgery’s efforts at a national level.
“I have been called here by forces beyond me,” Rogers says of his move to Temple.
“I don’t think a hospital should be defined by the walls of the building and I am hoping with the help of many we can redefine what a hospital is. A hospital is not a place of sickness, but it should be a beacon of wellness. So one of the things a hospital should engage in is looking beyond the patching of bones and the closing of blood vessels, and addressing social determinants of disease, poverty, homelessness and helplessness,” says Rogers, who is a native of the U.S Virgin Islands.
Rogers succeeds Dr. John M. Daly, who is serving as interim chair of Surgery until Rogers starts his new post.
Rogers views Temple as an institution with a wealth of opportunity.
“There is incredible opportunity here. Being in North Philly is not a disadvantage. It’s a unique opportunity to change the dialogue of how can a hospital aggressively partner with the community that we serve, to not only help improve health but to be a model for what the rest of the country can do,” he says.
Hospitals often have campaigns centered on stopping hospital-acquired infections. With Philadelphia’s high rate of homicides, Rogers wonders why there aren’t campaigns based on saving the lives of young men.
“Why don’t we have a campaign that we don’t want another dead kid?” questions Rogers, who views violence as a health problem.
Rogers represents the appointment of Temple’s first Black chair of surgery. According to the National Medical Association, there are eight other African Americans who chair surgical departments at academic medical centers.
Dr. Donald Parks, assistant dean, Minority Affairs, Temple School of Medicine, regards Rogers’ appointment as a big deal for the institution.
“I’m ecstatic because I think it’s a very big deal for Philadelphia medicine. It’s transformative because it’s going put us on the map,” Parks said, noting that Rogers’ appointment has already generated buzz among the city’s medical community.
As a member of the search committee, Parks interviewed about 10 candidates for the position of chair of surgical department.
He noted that Rogers’ appointment is a part of the overall changes being made at the Temple School of Medicine.
Parks said Temple is located in one of five zip codes identified by the U.S. Census as having the highest rates of diabetes and obesity. With that in mind, Parks says it’s important that Temple provides its patients with superior academic physicians.
“I think that the university is committed to making Temple of the key institutions in the city,” Parks added.
As Temple’s chief of surgery, Rogers will lead a department with eight specialty divisions: abdominal organ transplantation, cardiothoracic surgery, colorectal surgery, general surgery, plastic and reconstructive surgery, surgical oncology, trauma/surgical care and vascular surgery.
Becoming a physician was not a part of Rogers’ initial career path. While attending Central High School in St. Croix, Rogers aspired to become a biology teacher.
Rogers started out by majoring in biology at Harvard College with the intention of returning to St. Croix to teach. However he ended up switching gears to study medicine.
This led him to pursue a career that allowed him to blend a fascination for surgery with an interest in research.
After completing his undergraduate education at Harvard, Rogers earned his M.D. from Harvard Medical School in 1991, after which he completed his general surgery residency, surgical critical-care fellowship, and a research fellowship in surgical oncology at Brigham and Women’s Hospital. He subsequently earned a master’s degree in public health from Vanderbilt University, while also serving as assistant professor of surgery at Vanderbilt University Medical School and Meharry Medical College.
In 2001, Rogers joined the faculty of Harvard Medical School, and in 2003 he assumed leadership of the Section of Trauma, Burn and Surgical Critical Care Section at Brigham and Women’s Hospital.
From 2005 to 2008, he developed and directed the Center for Surgery and Public Health, a joint program of Harvard Medical School and School of Public Health. The center seeks to illuminate issues such as the causes of medical errors, the nature of racial/ethnic disparities in healthcare and the role of surgery to strengthen health systems.
Rogers has published research articles relating to health care disparities, the impact of race/ethnicity on surgical outcomes and quality improvement in surgery. In 2004, Rogers wrote an article that showed the disparity of Blacks dying disproportionately from colon cancer could be eliminated if everyone had equal access to medical care.
Throughout his career, Rogers has encountered patients who were shocked when they met him for the first time, because they weren’t expecting an African-American physician.
“I don’t fit what people expect me to be. I have had more than my share of the quizzical look,” says Rogers, who is the father of three sons.
Rogers plans to focus on diversifying Temple’s Department of Surgery.
“One of the things that I am going to work on is diversifying the department, not because it’s a good thing, but because it will lead to excellence,” says Rogers.
Rogers is the recipient of the Matson Award for Excellence in Teaching and the Dennis Thomson Leadership and Compassionate Care Award from Brigham and Women’s Hospital and the Harold Amos Faculty Diversity Award from Harvard Medical School.
He is a member of various professional organizations including the American College of Surgeons, the Association for Academic Surgery, the Society of Black Academic Surgeons, the National Medical Association, the American Medical Association, the American Association for the Surgery of Trauma and the Society of University Surgeons. He also serves on the Study Section of the Agency for Healthcare Research Quality.
When Tyler Campbell was diagnosed with multiple sclerosis almost five years ago, the news came as a shock.
At the time, he was 24 and preparing for the NFL draft while a running back at San Diego State University.
Multiple sclerosis is a disease of the central nervous system. The autoimmune disease interrupts the flow of information within the brain, and between the brain and body.
“When my episode hit me, it was like nothing I’ve every experienced before. It was quite frightening,” Campbell said, recollecting how it felt not being able to move his arms or legs.
“For you to have something taken away from you without any warning, it’s quite a shock and a scare. I was terrified at first. It was a very humbling experience.”
When he first diagnosed in November 2007, Campbell wanted to continue playing football and finish his education. At the time, Campbell started feeling better due to his medications and thought that he still had a shot as a professional athlete.
He had a positive outlook on living with the MS because it wasn’t holding him back from doing the things that he liked to do.
But then he was hit with a curve ball. Due to his condition, his doctor told him he’d have to forgo a NFL career.
“I didn’t see it as a big deal then, but I see it as a big deal now because it’s just a testament to this disease because it does not mean that your dreams or everyday life can be taken away from you. It does not mean that your world is over,” says Campbell, who hails from Texas.
“I’ve spent a lot of time in prayer. I’d be lying if I said that if I didn’t know the Lord for myself, this would be much more of a struggle. My thing is, I’ve learned that when adversity comes your way, you can’t quit.”
With that in mind, he turned his attention to pursing his education and joining his family’s business, Earl Campbell Meat Products. He currently works as a sales account manager for the Texas-based business. Last September, he married his college sweetheart.
“I now have the opportunity to share my experience to help others living with this disease and make an impact on the MS community.”
Due to lesions on his brain caused by the MS, the right side of Campbell’s body is affected. For instance, when he’s tired, he walks with a noticeable limp on his right side and his right arm will become stiff.
Since he was diagnosed in November 2007, Campbell has been on three different medications to treat the MS.
“I understand the frustration of trial and error that so many go through with this disease because not everybody responses the same way to medication,” Campbell said, noting that he’s been on three different medications for MS since he was diagnosed that were not effective.
He’s finally found a medication that works for him.
“I think that just as much as the medication is important, I think its just as important to have family and friends to lean on from time to time because its hard thing to battle all by yourself.”
His father, Pro Football Hall of Famer Earl Campbell, has partnered with the National Multiple Sclerosis Society to honor his son’s struggle with the disease through a specially commissioned piece of art. The limited edition autographed “The Unstoppable Earl Campbell” features Campbell from his days as a University of Texas Longhorn alongside famous Warner Bros. Looney Tunes characters. Proceeds from the art sales are being donated to the National MS Society.
According to the National Multiple Sclerosis Society, MS typically affects African Americans differently.
Dr. Thomas Leist, director of the MS Center at Thomas Jefferson University Hospital says approximately 35 percent of his patients are African American.
Some of the disease’s gradual symptoms include loss of coordination, numbness, tingling, difficulty walking, blindness and paralysis.
“The problem is sometimes in African Americans, the initial symptoms are less than clear attacks. The initial event may be less than crystal clear. The other issue that is often in African-American individuals, is that the disease can have a more severe course,” Leist said.
Leist says this could be due to the disease being diagnosed later or the disease has progressed more rapidly.
He noted that many of the trials for the medications that are being used to treat MS, enrolled predominately white populations.
“One of the things is that while we know these medications are effective, sometimes we don’t have a clear view how effective they are in the African-American population because people of African-American descent were only a small minority in these studies,” says Leist.
While there is no cure for MS, Leist says the condition can be managed if patients adhere to their medical regimen.
Because sometimes in patients of African-American descent the diagnosis may be made later or the disease may be more aggressive, it become even more important that a patient is adhering to treatment, Leist says.
The disease is more frequent in women. Approximately 75 percent of those who are newly diagnosed are women in their 20s and 30s.
A higher incidence of secondary breast cancer is seen among Black women regardless of age, research has found.
The findings were highlighted during a press call from the fourth American Association for Cancer Research conference on The Science of Cancer Health Disparities held September 18–21 in Washington, D.C.
The teleconference was hosted by Chanita Hughes-Halbert, director of the Center for Community-Based Research and Health Disparities at the University of Pennsylvania.
When cancer is diagnosed in women younger than 45 years old, the incidence of primary breast cancer is higher among Blacks than among whites — and the cancer tends to be more aggressive.
“While the incidence of breast cancer is generally higher among whites for first-time diagnosis, we found the incidence of the second contralateral diagnosis was higher among Blacks,” said lead researcher Nsouli Maktabi Hala, Ph.D, graduate of George Washington University.
“Our findings were unexpected, since Blacks have a higher mortality rate than whites from the first cancer, so you would expect Blacks to have lower rates of second cancers.”
The research also found that when cancer is diagnosed at an older age, the incidence is higher among white women. Since most breast cancers are diagnosed in older women, the overall incidence is higher in whites, said Maktabi.
Maktabi said about four percent of all breast cancer patients will present with a second primary cancer.
“Collectively our findings should urge physicians to watch patients carefully for the second breast cancer in the contralateral breast, especially in the first six to 10 years following the diagnosis of the first time,” Maktabi said.
The researchers used the Surveillance Epidemiology and End Results Registry 9 data to determine breast cancer incidence among 415,664 white women and 39,887 Black women diagnosed with primary breast cancer at age 19 or older and possible development of a second cancer in the opposite breast.
Results showed that 22,290 (40 percent) developed a second breast cancer, of which 18,142 (four percent) occurred in the opposite breast. Incidence of second primary cancers of the opposite breast was higher among Black women and 15,101 (83.2 percent of second cancers developed in those who were diagnosed with first breast cancer at age 45 or older.
Maktabi joined three other researchers in highlighting their studies during the teleconference.
According to study results, an association has been found between stress and breast cancer aggressiveness.
“We found that after diagnosis, Black and Hispanic breast cancer patients reported higher levels of stress than whites and that stress associated with tumor aggressiveness, said Garth H. Rauscher, Ph.D., associate professor of epidemiology in the division of epidemiology and biostatistics at the School of Public Health, University of Illinois at Chicago.
Rauscher and colleagues studied patient perceptions of fear, anxiety and isolation, together referred to as psychological stress and associations with breast cancer aggressiveness.
The study included 989 breast cancer patients who were recently diagnosed. Of those, 411 were non-Hispanic Black, 937 were non-Hispanic white, and 181 were Hispanic. Results showed that psychosocial stress scores were higher for both Black and Hispanic patients compared to white patients.
“Those who reported higher levels of stress tended to have more aggressive tumors. However, what we don’t know is if we had asked them the same question a year or five years before diagnosis, would we have seen the same association between stress and breast cancer aggressiveness?” Rauscher said in a release.
Depression affected preventive health screenings among Latina breast cancer survivors according to data presented during the conference.
“Depression can make people more inattentive to potential risks to their health and more likely to ignore recommendations to reduce their risk,” said lead researcher Amelie G. Ramirez, professor and director of the Institute for Health Promotion Research at the Cancer Therapy and Research Center at the University of Texas Health Science Center at San Antonio.
Ramirez and colleagues examined the extent of depression among a group of 117 Latina breast cancer survivors to assess the barriers to preventive health screenings for colorectal and ovarian cancer.
“The most important thing we found was that Hispanic breast cancer survivors were more depressed than Hispanics in the general population and that they were not following recommendations to continue other cancer screening behaviors.”
Research also indicated that U.S. immigrants are still less likely to have undergone breast cancer screenings than native U.S. women.
Researchers at Pennsylvania State University believe that lack of access to health insurance and a regular source of health care are important factors related to the lower percentage of mammography screening among U.S. immigrants.
“There is progress, overall, in use of mammography among foreign-born women in the United States, but there is still a lot of work to do to improve their use of recommended breast cancer screening,” said lead researcher Nengliang Yao, a doctoral student in health policy and administration.
My cholesterol number is below 200. Is this number low enough?
Jane, Camden, N.J.
It’s not enough to know your total cholesterol number is below 200. You also need to know the ratio of good cholesterol to your total cholesterol level. You can find this number by dividing your total cholesterol number by the HDL. If the number is greater than 4.5, you’re on the fast track for a heart attack, stroke or any number of other heart and lung diseases.
To lower your cholesterol level, limit your saturated fat intake to 14 grams daily, don’t smoke, lose excess body fat and get involved in a regular exercise program. If you lower your cholesterol level by 2 percent, you lower your risk of a heart attack by 30 percent.
Muscle Sprains and Strains
What should you do if you sprain or strain a muscle?
If you suffer a sprain or strain, your immediate aim is to minimize internal bleeding and reduce swelling. “RICED” is the acronym you should remember when you’ve suffered a sprain or strain. Rest, Ice, Compression, Elevation and Doctor.
Here’s what they mean:
Rest – Don’t use the injured joint. Using an injured body part will only aggravate the injury.
Ice – Apply ice to the injured area as soon as possible. The cold constricts blood vessels, helps limit internal bleeding and prevents some swelling.
Compression – Wrapping or gently compressing the area with massage will help to reduce swelling and discoloration.
Elevation – Elevating an injured area also helps to reduce swelling, reduce pain and discoloration.
Doctor – See a doctor to insure that you only have a sprain or strain.
“My thighs have gotten out of hand. They are the biggest parts of my body. People have even nicknamed me thunder thighs. What can I do to reduce my thunder thighs?”
Jersey City, N.J.
Your thighs probably have some excess fat you could stand to lose. Weight training shapes the body while aerobic exercise burns fat. You’ll need to do both to resculpt your body. When you build muscle it stimulates your body to burn more calories and fat. For your thigh workout start with leg extensions for the front of the thighs and leg curls to shape the back of the thighs. You can also do lunges with dumbbells in each hand. Work up to 8 sets of leg curls and 4 sets each of leg extensions and lunges. The weight should be heavy enough to allow only do 8 to 12 repetitions comfortably. You’ll also need to do some aerobic exercises for at least 30 to 45 minutes 3 to 5 times a week. This will help you burn fat and calories. Walking, jogging, biking, jumping rope and rowing are good aerobic exercises. Your thighs may take a while to reduce, but they will taper down if you work at it.
Riding Up Hill
“I have trouble getting up hills when I ride my bike. How do you get use to riding up hills?”
Here are some tips that will get you up and over that hill. First, as you start going up the hill, sit up on your bike and put your hands on the top position of your handlebars. This position will help you breathe more easily. Try to keep your upper body relaxed. If it’s a long hill, alternate standing and sitting. Toe clips are another good aid that will help you get up that hill. The best way to build up your endurance for hills is to make them a part of your regular ride.
“Is a vegtarian diet safe?”
Many people are turning to a vegetarian diet. This type of diet will have you eating more vegetables but it does have some pitfalls. A vegetarian diet can reduce the risk of obesity, coronary diseases, hypertension, type 2 diabetes and colon cancer. But, this diet can create other problems.
Vitamin D deficiency is one of the problems for vegetarians who don’t drink milk. A vitamin deficiency can cause poor bone and tooth formation, a softening of the bones and teeth and an inadequate absorption of calcium. Two cups of fortified milk will satisfy the daily requirements for an adult. But, it takes 4 cups to satisfy the requirements for children, nursing women and expectant mothers.
Vitamin B-12 is another vitamin that is hard to get in if you’re a vegetarian. The only foods that provide vitamin B-12 are animal products. An adult needs 3 mcgs of vitamin B-12 daily. If you don’t get enough vitamin B-12 it can cause brain damage, anemia and nervousness. Vitamin B-12 is essential for normal formation of blood cells, the metabolism of food and maintaining a healthy nervous system. Six ounces of animal flesh will provide you with all the Vitamin B-12.
The easiest form of usable iron comes from lean beef, chicken and fish. If you don’t get enough iron you can suffer from general weakness, pale skin, constipation and anemia. Men need 10 mgs of iron and women need 18 mgs daily. Iron is also needed for blood formation and protein metabolism. Active people may need more. The need for iron increases during menstruation, periods of rapid growth, pregnancy or whenever there is a heavy loss of blood.
If you are going to be a vegetarian you have to plan your meals carefully. For breakfast have some fruit juice and a fresh fruit salad. Later in the morning have a seven-grain bun with soy margarine. At lunch, have a bowl of black bean soup garnished with celery and scallions. Include a salad on the side with this meal. For a between meal pick-up have unsalted popcorn or a bran muffin. For dinner have a veggie burger on a seven-grain bun with alfalfa sprouts and salsa with a dish of steamed broccoli. For a late snack have a salad with a baked potato. If you want the recipe for the black bean soup just write us.
“How do I get in more vitamin C?”
Vegetables and fruits provide us with the vitamin C we need, but we lose much of it when we handle our food. Vitamin C, which is also known as ascorbic acid, is a water-soluble vitamin that is found in fruits and vegetables. Vitamin C plays a major role in healing wounds, burns, red blood production, formation of connective tissue, fighting infections and preventing hemorrhaging. This vitamin is destroyed easily when foods containing the vitamin are stored or cooked. Vitamin C sensitive to light, heat and air. Smoking, excessive drinking, antibiotics, cortisone aspirin pain killers, excessive amounts of water, cooking in cooper utensils and sulfa drugs can reduce the body’s ability to absorb vitamin C. You should store vitamin C as little as possible. When you do store foods containing vitamin C you should keep them refrigerated. When cooking foods containing vitamin C you should cook them as little as possible. Steaming and microwaving them in a small amount of water for short cooking time help to ensure you will get the most of the vitamin C found in the food.
“My doctor told me to add more fiber to my diet. How do I get in more fiber?”
Are you getting all the fiber you need daily?
The average American diet includes about 10 grams of fiber daily, which is, less than half the amount recommended by the National Cancer Institute. The National Cancer Institute recommends 25 to 30 grams of fiber daily.
If you start your day with a banana and later have a bran muffin you’ll get in most of the fiber you need for the rest of the day. By eating these two items you’ll get both soluble and insoluble fiber.
Soluble fiber is found in dried beans, apples, citrus foods and oat products. It absorbs fluid while moving through your digestive tract. This keeps moisture in your digestive tract. Soluble fiber will help in the prevention of heart disease.
Insoluble fiber is found in vegetables and whole grain products. It aids in the elimination of waste and toxic materials. Insoluble fiber will help in the prevention of hemorrhoids and colon cancer.
Fiber is not digestible, so it’s not a nutrient; but it is essential in preventing and treating illnesses, such as cancer of the colon and rectum, varicose veins, phlebitis, diverticulosis, heart disease and abdominal pain.
A serving of brown rice contain 2.5 grams of fiber; a baked potato contains 3.8 grams and kidney beans contain 5.8 grams. Spinach contains 2.0 and bananas contain 2 grams of fiber.
Each day you should have at least 2 slices of whole grain bread, 3 pieces of fruit and 3 servings of vegetables.
If your diet doesn’t include whole grains and fresh fruits and vegetables, you should add them to your diet gradually. You should also include about 6 to 8 glasses of water daily. Get your fiber from variety of high fiber foods because balance is important. Too much insoluble fiber prevents the absorption of calcium, iron, zinc and other important minerals. It can also cause bloating and constipation. Try to get in 5 to 7 serving of high fiber fruits, vegetables and whole grains daily. One serving of legumes has 8 grams of fiber, a banana has 3 grams of fiber, a serving of green peas has 3 grams of fiber and a slice of corn bread has 3 grams of fiber. Other high-fiber foods include barley, bran, wheat, rye, oatmeal, prunes, berries, pears, almonds, sunflower seeds, beans, squash, carrots, brown rice, bananas, grapes and oranges. When choosing foods high in fiber keep in mind that the more a food is processed the less fiber you’ll find in the food. There’s no fiber in meats or dairy products. Keep in mind also that the more a food is processed, the less fiber you’ll find in the food. Choose real food to get the fiber you need.
Before starting your fitness program, consult your physician.
For help with drug, alcohol and mental health problems call Sobriety Through Outpatient the area’s most unique drug, alcohol and mental health treatment center at 215-227-STOP (7867) or 800-660-STOP (7867). Watch or listen to our recovery media stations every day at www.stop-recoveryradio.com.
Listen to “Tips to be Fit” with Vince daily at www.stop-recoveryradio.com.
October is National Breast Cancer Awareness Month. One in eight women will develop breast cancer in her lifetime. About 182,000 American women developed breast cancer last year alone. It kills nearly 46,000 American women each year. According to the American Cancer Society, breast cancer is the most common form of cancer among American women. Every woman is at risk for it.
Breast cancer is thought of as a woman’s disease, but men can also develop a form it. Each year, over 400 men die from breast cancer.
The incidence of breast cancer has continued to increase at about 2 percent a year, but the death rate has declined. This decrease is believed to be the result of earlier detection and improved treatment. But 2 percent of the autopsies performed in 2003 showed undiagnosed breast cancer. That means a lot more women have breast cancer and don’t know it.
Breast cancer occurs when a group of cells grows out of control and divide more than they should, forming masses called tumors. Some tumors do not spread to other parts of the body, but may interfere with body functions and require removal. These are known as benign tumors. Malignant (or cancerous) tumors invade and destroy normal tissue, then break from the original tumor and migrate to other parts of the body and may form other malignant tumors. Breast cancer can spread through the lymph nodes to the lungs, liver, bone and brain.
Dr. Elizabeth Patterson, a radiologist at the Hospital of the University of Pennsylvania, said cancer is an attempt of abnormal cells to overtake the normal cells and spread. The incidence of breast cancer in African-American women is less than in the general population, she said, but the death rate is higher. According to a National Cancer Institute study, African-American women are 2.2 times more likely to die from breast cancer than their white counterparts. Black women generally have more aggressive breast cancer and have shorter survival times than white women. It’s been estimated that when comparing white and Black women with breast cancer, Black women had between a 70–90 percent increased risk of dying from it than white women, independent of the stage in which the cancer was diagnosed.
Some studies have argued that the difference in breast cancer mortality between Black and white women reflects different standards of care of women who have different incomes. This could be true, but it does not answer the question of why Black women have more aggressive breast cancer than white women, nor does it explain why breast cancer mortality rates have risen faster in young Black women than in young white women.
Breast cancer is the second leading cause of cancer death among African-American women. The incidence for women under 40 was higher among Black women than among whites, but it is increasing in both the young Black and white populations. However, young Black women are getting more breast cancer and dying from it more often than young white women.
Patterson suggested, “There are several reasons (for the disparity). African-American women tend to seek treatment during latter stages of the disease process. Denial is a big problem which allows time for the disease to spread to other parts of the body.”
Many myths keep women from seeking treatment. These include, “Cancer is a death sentence;” “Once surgery takes place and the cancer is exposed to air, it will spread like wildfire,” and many women don’t believe there is a cure. Patterson believes that these myths exist partly because there aren’t any highly visible African-American role models to show that cancer can be cured and that one can resume a normal lifestyle. Studies show that African-American women don’t think of cancer as one of their diseases. Many older women believe the myth there is something wrong with touching their own bodies. There’s also a lack of awareness about the importance of mammograms and a lack of access to the health-care system, said Patterson. The survival rate is very good when breast cancer is detected and treated early, she said. On an encouraging note, she did say that young African-American women are more aware and do perform self-examinations more frequently.
It is not known what causes breast cancer or how to prevent it. It’s known that the risk for developing it is greater in some women whose mother, sister or other close relative has had it. White women are slightly more likely to get breast cancer than are African-American women. But African Americans are more likely to die of this cancer. Although Asian, Hispanic and American Indian women have a lower risk of getting breast cancer, studies show that there has been a big increase in the numbers of these women developing breast cancer.
Women are at risk for breast cancer if they:
· are over age 40 and especially over 50.
· have already had cancer in one breast.
· have close relatives who had breast cancer before age 50 or menopause.
· take menopausal hormone therapy (either estrogen alone or estrogen plus progestin) for five or more years after menopause.
· had their first menstrual period before age 12.
· went through menopause after age 55 or never had children.
· show mostly dense tissue on a mammogram.
· are obese after menopause.
· are physically inactive throughout life.
· have had no children, or who had their first child after age 30.
· have 2 to 5 drinks daily.
Women with one or more of these risk factors should examine their breasts monthly. They should also have a health-care professional examine them regularly.
The most common sign of breast cancer is a lump or thickening that does not go away or change how it feels. Keep in mind that four out of 5 lumps are benign and not cancerous. Other signs to look for are swelling, puckering or dimpling, redness, and soreness of the skin or nipple discharge. The nipple may become drawn into the chest, change shape, bleed or become crusty. Usually, early breast cancers are painless but if you experience pain and tenderness throughout your menstrual cycle, you should tell your physician.
Patterson said treatment of cancer may use a combination of therapies, Patterson said, including radiation, a lumpectomy, a partial, modified or full mastectomy, chemotherapy and hormonal therapy.
Patterson said families should talk about it more and be open about the disease. Every woman should have a baseline mammogram between the ages of 35 and 39 to help detect changes in later years. Between ages 40 and 50, a woman should have one every one to two years. Those over 50 should have a mammogram every year.
Breast cancer is not a death sentence and neither are the treatments, stressed Patterson.
Before starting your fitness program, consult your physician.
For help with drug, alcohol and mental health problems call Sobriety Through Outpatient drug, alcohol and mental health treatment center at (215) 227-7867. Watch or listen to our recovery media stations every day at www.stop-recoveryradio.com.
Listen to “Tips to be Fit” with Vince daily at www.stop-recoveryradio.com.
Physicians at the Jefferson Hospital for Neuroscience (JHN) are tackling a particularly aggressive brain cancer with a promising new immunotherapy.
The immunotherapy is designed to attack a patient’s tumor with their own cancer cells.
Starting in January, the first of 12 patients diagnosed with a malignant astrocytoma from a clinical trial led by David W. Andrews, M.D., co-director of the Brain Tumor Center of the Kimmel Cancer Center at JHN, will receive a “cancer Trojan horse” that could significantly shrink their tumor and possibly extend their life.
During immunotherapy, the patient’s cancer cells are removed during surgery and then treated with a type of therapy that turns off a growth factor receptor, which plays a critical role in cell survival. Without it, cancer cells die.
Those same cells are then placed in a diffusion chamber (to keep the cells from spreading back into the body), re-implanted back into the patient within a day and then retrieved up to two days later — this is what makes it stand out from other immunotherapies. During their time in the body, those reinserted, extracted tumor cells communicate a message to the other tumor cells to die — and tell the body’s immune system to help do it.
The clinical trial comes off the heels of successful animal research and a pilot study at Jefferson that uncovered its benefits 10 years ago. In that study, eight of 10 patients treated with the immunotherapy had significant tumor shrinkage, with regression on a MRI. One man survived for eight years with no further treatment.
“The preclinical work and our own pilot study tell us that this novel treatment could have a significant impact on these cancer patients who don't have many options,” Andrews said.
Jefferson’s approach differs from other immunotherapy strategies, with many advantages, Andrews said. In this design, the antigen (the treated cancer cells) is released slowly over a 24-hour period enabling many waves of immune cells known as dendritic cells to take up antigen and migrate to nearby lymph nodes, leaving no antigens for replacement dendritic cells. The most popular current approach involves injecting the patient’s own dendritic cells as a single episode of inoculation.
“We feel that our approach will yield a very successful immunotherapy for these patients and perhaps other cancer patients as we open this trial,” he said.
“The previous data and our new Phase I clinical trial will hopefully guide us towards new standards of care.”
Andrews will lead the new Phase I clinical trial, which will investigate the safety and feasibility of the immunotherapy, as well as progress in the 12 patients.
Jefferson, which has an annual tumor volume that exceeds 1,000 cases, is known for its leading clinical trials. That includes participation in a national tumor bank devoted to the genetic analysis of brain tumors (the TCGA project) and a slew of trials testing new combinations of chemotherapy and radiation therapy for the treatment of a variety of brain cancers.
Taking research to bedside is also part of Jefferson’s overall mission for better patient care. Last year, in an article published in the Journal of Clinical Oncology, physicians discussed a treatment technique and results that extended the survival of patients with glioblastoma beyond any previously published results. That treatment, which is now available at Jefferson, delivers stereotactic boost radiotherapy to patients with malignant gliomas and has nearly doubled median survival time from 14 to 24 months.
“It’s vital to this institution to constantly pursue new treatments for these very serious tumors where current treatments often have minimal impact with modest survival benefit,” Andrews said.
“It’s just one example of how the multidisciplinary team at Jefferson, which includes neurosurgeons, neuropathologists, neuro-oncologists, radiation oncologists, and neuro-immunologists, tackles brain tumor research. We strive to apply new knowledge to take better care of the hundreds and hundreds of patients that come through our doors.”
Melvin McKeiver has benefited from a half-match bone transplant procedure at Thomas Jefferson University Hospital.
Bone marrow or stem cell transplants are performed in order to replace a patient’s diseased immune system with that of a healthy donor. A fully-matched donor has been associated with the best results in bone marrow transplant, however many patients lack a fully-matched or unrelated donor.
After a waiting 10 years for a bone marrow transplant, McKeiver underwent the half-match procedure to battle both leukemia and lymphoma in April 2010.
“I’ve been waiting for 10 years and if I hadn’t gotten it, I wouldn’t be here now,” says the 42-year old resident Northeast Philadelphia.
Prior to the undergoing the procedure, McKeiver had been receiving chemotherapy treatment at another cancer institution for nine years.
“I was in so much pain because it got to the point to where the chemo stopped working,” said McKeiver, who was placed on numerous opiates due to the pain.
“I had no idea that I had an option for a half-match. The only option I was led to believe was that I had to get a full-match. If I had known that I had an option for a half-match, I would have gotten that done years ago.”
Since he received the procedure, McKeiver says his cancer has been cured. Follow up testing has not detected any sign of the cancer.
“There are so many people walking around who don’t know this is an option. People don’t need to be walking around pumped full of drugs and pacified, they need a cure,” he added.
McKeiver’s procedure was done under the direction of Dr. Neal Flomenberg, Chair, Department of Medical Oncology, Thomas Jefferson University Hospital.
McKeiver’s success with the half-match bone transplant comes at a time when a clinical trial at Jefferson has shown that the procedure yields promising results for blood cancer patients.
The study by Flomenberg and nurse practitioner Dolores Grosso, co-principle investigator was reported in the journal Blood.
In the clinical trial, 27 patients were treated in the phase I/II trial with diagnoses that included leukemia, lymphoma and myelodysplasia.
The patients received their transplant in two steps. First, after receiving radiation therapy to treat their disease, the patients were given a specified dose of T cells — an immune cell that fights infection — from their half-matched family donor. The donors were parents, siblings or children of the patient.
Then the patients received the drug cyclophosphamide to help the newly infused donor T cells become more tolerant to the patient’s body. The second step of the transplant occurred when the patients received a dose of their donors’ stem cells to help their blood cells counts return to normal and further strengthen their new immune system.
The clinical trial conducted at Jefferson showed that the probability for overall survival was 45 percent in all patients after three years and 75 percent in patients who were in remission at the time of the transplant.
“Our half-match bone marrow transplant results open up many doors for different types of patient who can’t find an exact match,” said Flomenberg.
“It also justifies recommending that patients at high risk for relapse should consider having a half-match transplant early in the treatment of their disease.”
Fromberg and his team found that after a follow up of 28–56 months, overall survival for patients after one year was 54 percent and 48 percent after three years. Patients in remission at the time of remission fared better with an overall survival of 75 percent. Seventeen of the 27 patients — with a median age of 52 years old — were alive six months after their transplant, which alive six months after their transplant, which was the official end point of the trial.
“We figured out a way of doing a half-match transplant, where if your disease was under control we could probably save you,” said Grosso.
“Up until we developed this new transplant program, survival rates after a half-match program was dismal because the half-matched cells had to be overly treated so that there wasn’t rejection of the cells,” she said.
“Once you treat the donor cells they become less effective in fighting infection and fighting relapse, so when they half match graft went in, patients would either reject the graft of they would die of infection.”
The half-match procedure holds special implications for minority patients who are suffering from blood cancers and need a transplant at a time when the bone marrow registry does not have a diverse pool of donors.
“The problem is that the registry has a lot of people of European ancestry and the registry does not contain a lot of minority patients so its very difficult for African Americans or Hispanics or anyone of mixed race — which a lot of our patients are — to find a complete match,” says Grosso.
According to Grosso, approximately 100 patients have been treated with the procedure at Jefferson.
WHITE PLAINS, N.Y. — Enough with the fun and games. Watson is going to work.
IBM's supercomputer system, best known for trouncing the world's best "Jeopardy!" players on TV, is being tapped by one of the nation's largest health insurers to help diagnose medical problems and authorize treatments.
WellPoint Inc., which has 34.2 million members, will integrate Watson's lightning speed and deep health care database into its existing patient information, helping it choose among treatment options and medicines.
"This very much fits into the sweet spot of what we envisioned for the applications of Watson," said Manoj Saxena, general manager of an IBM division looking at how the computer can be marketed.
Lori Beer, an executive vice president at Indianapolis-based WellPoint, agreed.
"It's really a game-changer in health care," she said.
The WellPoint application will combine data from three sources: a patient's chart and electronic records that a doctor or hospital has, the insurance company's history of medicines and treatments, and Watson's huge library of textbooks and medical journals.
IBM says the computer can then sift through it all and answer a question in moments, providing several possible diagnoses or treatments, ranked in order of the computer's confidence, along with the basis for its answer.
"Imagine having the ability within three seconds to look through all of that information, to have it be up to date, scientifically presented to you, and based on that patients' medical needs at the moment you're caring for that patient," said WellPoint's chief medical officer, Dr. Sam Nussbaum.
Saxena said the WellPoint application would likely be accessed from an ordinary computer or handheld device.
Beer said patients needn't worry that Watson will be used to help insurers deny benefits. If a doctor veers from Watson's diagnosis or treatment recommendations, the insurer would have a clinician review the case like it currently does. It won't base a claim decision solely on Watson.
"Ultimately the goal here is not denying treatment but getting people to the right care," Beer said, adding that Watson was not designed to replace humans.
Beer said WellPoint is trying to offer care providers a tool that helps lead to better treatment outcomes, which is what the insurer wants to base reimbursement on in the future.
Nussbaum said a pilot program will be rolled out early next year at several cancer centers, academic medical centers and oncology practices.
WellPoint is the nation's largest publicly traded health insurer based on enrollment. It operates Blue Cross Blue Shield plans in 14 states, including New York and California.
Neither party would say how much Armonk, N.Y.-based IBM is being paid. Saxena said it's the first money Watson has earned for the company; the $1 million it won on "Jeopardy!" earlier this year was given to charity.
Watson's next jobs will probably also be in health care, but financial services and public safety applications are on the horizon, Saxena said. -- (AP)
Thanksgiving pies, holiday turkey, macaroni and cheese, creamed corn, chocolate cake, and even more deliciously bad-for-you holiday treats. We’re all sure to indulge in a little overeating during this holiday season.
The holiday season means many things, but one of the most universal holiday experiences is: Lots of food! It can also mean some terrible experiences with the gallbladder and gallstones.
Especially with the holiday season upon us, we have to be especially vigilant about not eating large, fatty meals. One of the biggest digestive problems that can quickly turn a festive and joyous time, into a period of misery is gallstones or gallbladder disease.
The gallbladder is considered by some as an "unimportant" organ, when in reality it is an essential part of the digestive system. Why we have a gall bladder at all is something of a mystery. Many animals such as horses, pigeons and rats manage quite wellwithout one.
Gallstones are clusters of solid material that form in the gallbladder. They are made mostly of cholesterol. Gallstones may occur as one large stone or as many small ones. They vary in size and may be as large as a golf ball or as small as a grain of sand.
Experts estimate that 16 to 22 million people in the United States have gallstones—as many as one in every 12 Americans. Most people with gallstones do not know that they have them and experience no symptoms
Gallstones may form in one of three ways:
1) When bile contains more cholesterol than it can dissolve,
2) When there is too much of certain proteins or other substance in the bile that causes cholesterol to form hard crystals,
3) Or when the gallbladder does not contract and empty its bile regularly.
What are the symptoms when the gallbladder is sick? We experience signs such as:
• An aversion to eating greasy foods
• Anorexia or bulimia
• Chest pain
• Enlarged abdomen
• Gas and indigestion
• Loose bowels
• Nausea even at the thought of eating high fat foods
• Pain on the right side of the lower rib cage
• Pain under right shoulder blade
• Skipping heart beat
• Intestinal pain
So you can see why the gallbladder is known as the "great masquerader" — when something is wrong with it, there is such a wide variety of symptoms.
A gallbladder attack occurs when a gallstone becomes lodged in the duct of the gallbladder. A gallstone is formed when a substance called bile, which is normally released by the gallbladder to aid in digestion, forms a hard stone that can be as small as a grain of sand or as large as a golf ball. A major cause of gallstones is the presence of too much cholesterol in the bile. This excess of cholesterol is primarily the result of eating a low-fiber, high-cholesterol and high-fat diet, sometimes referred to as the "Western Diet." You know, the kind of stuff that’s going to be everywhere you go during the holidays.
A diet rich in fruits (except citrus) and vegetables (except the cabbage family), vegetable juices, fish, flax or other Omega 3 oils, and certain spices, such as garlic and tumeric, has been shown to promote gallbladder health and prevent the formation of the gallstones that cause gallbladder attacks. Juices or teas made from cucumber, beets and flax seem to be particularly helpful in relieving the symptoms of a gallbladder attack.
Foods to be avoided, especially if you are suffering from a gallbladder attack, include citrus fruit, nuts, beans, onions, pork, chicken, turkey, corn, dairy products, eggs, alcohol, coffee or other caffeinated drinks, and breads.
Before you start your season celebrations and get carried away, consider the following facts about “binge eating”:
1. The most common symptoms of binge eating include excessive intestinal gas, indigestion, bloating and acid reflux. Depending on what you ate, and how much of it that you ate, it’s also very possible that you will suffer from constipation, as a result of not being able to digest all of the food in a timely manner.
2. When you binge eat, you’re making your body work harder to digest all that food. This puts a strain on your body and may increase the risk of health complications.
3. Did you know that binge eating affects approximately twenty five million Americans each year? It’s the most common eating disorder in the United States.
4. When you binge eat, your stomach’s capacity can grow up to 25%… and it can stay that way for up to two weeks, meaning that you’ll need to eat more and more food to become full. Eating more high fiber foods can help you feel fuller, without actually eating as much overall.
5. Binge eating causes your gallbladder to work harder to keep up with fat digestion. In fact, eating large, fatty meals are a common cause of gallstone attacks.
6. Eating a large meal can cause drowsiness, which can be dangerous if you’ll be driving home after your meal.
7. According to the Mayo Clinic College of Medicine, binge eating a number of fatty foods can lead to blood clotting more easily, which leads to the increased risk of heart attack. There is a fourfold increase in the risk of a heart attack within the two hours following a binge eating session.
These are just seven facts about holiday binge eating that you may not have known about previously. Before you jump into your next big holiday meal, take a minute to remember these facts and slow down-you’ll savor what you’re eating even more, and you won’t feel so terrible afterward.
Although a healthy diet will go a long way toward minimizing the risk of a gallbladder attack, other factors, such as age, gender, race and weight, also play a role. Women have gallbladder disease more often than men. These attacks occur more often after the age of 60. Being obese, having diabetes, and taking estrogen replacement hormones or cholesterol-lowering medications can also increase your chances of developing gallstones or gallbladder disease.
Remember, I’m not a doctor. I just sound like one. Take good care of yourself, and live the best life possible!
The information on healthfinder.gov is not meant to take the place of health care or services you may need. Please see your primary health care provider about any personal health concerns.
Glenn Ellis, is a Health Advocacy Communications Specialist. He is the author of Which Doctor?, and is a health columnist and radio commentator who lectures, and is an active media contributor nationally and internationally on health related topics. His next book, “Information is the Best Medicine”, is due out December 2011.