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Posts Tagged ‘Cancer’

Terry

I am in remission of my multiple myeloma cancer. The three months of chemotherapy last fall and winter did a great job in knocking out most of those cancerous plasma cells which were taking over my body. The stem-cell transplant I was originally to have following chemotherapy has been canceled. I will have my blood tested regularly to monitor my remission. My thanks to Dr. Michael Wu and his wonderful caring staff at the Palo Alto Medical Foundation oncology department who did a superb job treating my disease.

I discovered that one doesn’t necessarily have to leave Santa Cruz for state-of-the-art cancer care that I found right here through my group at PAMF. I sure wasn’t used to being — nor particularly enjoyed — being on the patient side of the doctor/patient relationship. It was a humbling experience and has taught me more about patients and patience along my journey.

Unfortunately, I am suffering from a fairly severe neuropathy of my feet from the chemo drugs, and this is currently adversely affecting my ability to walk normally. I do, however, feel it’s a small price to pay for my successful cancer treatment. I’m told the neuropathy should improve with time. I’ll try to be patient, (not one of my virtues however).

Another little complication I had in the past month, most likely unrelated to my cancer or treatment, is a condition of my heart called constrictive pericarditis. This occurs when the sac of tissue surrounding the heart (the percardium) becomes inflamed and tightens in on the heart, causing the heart to pump less efficiently.

This threw me into mild heart failure with significant shortness of breath, swelling of lower extremities and general fatigue. Dr. Neil Sawheny, one of my cardiologist partners at PAMF, is treating me for this unexpected complication and I seem to be responding well and improving day by day.

In general , my overall well-being is improving significantly. I feel as though my life as I once knew it is being slowly restored. Once my neuropathy shows signs of improvement, I hope to return to work at least half-time.

I’ll give myself a break to work a bit less since I’ve now been practicing medicine for the past 40 years, 27 years in urgent care Scotts Valley. I love my staff, my patients, many of whom I’ve come to know quite well. Most of all, I love the satisfaction I receive in helping make people feel better and in maintaining their good health.

My thanks to all of you who have mailed get-well cards or sent email messages for my recovery. I am a strong believer in the power of prayer and I know your prayers for me have been heard.

My personal lesson from my cancer experience is this: If you have any health symptoms that seem unusual to you or are lasting longer than you think they should, see your doctor for a work up. If everything checks out OK and your symptoms soon improve, then be thankful.

If something serious like cancer is found, the sooner it’s treated the better the outcome. This a proven fact. Also, for those many of you who are healthy, give thanks every morning that you can begin a new day.

My best wishes to you for long healthy lives.

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CancerTreatment

In previous articles (February 28 and March 14) I described cancer in general terms and then discussed specific common cancers. Now I would like to describe various cancer treatments available and methods of cancer prevention.

There are a variety of treatments available today for treating cancer, including:

– Surgery. This can remove the cancer or as much of it as possible.

– Radiation. This uses X-rays to kill cancer cells.

– Chemotherapy. This uses potent drugs to kill the cancer cells.

– Stem cell transplant. This is also commonly called bone marrow transplant. This uses stem cells which are found in the bone marrow and are the precursors to all other blood cells. The cells are collected from the patient, or less commonly from a donor, and then placed back into the patient after receiving a large dose of chemotherapy or radiation. This allows for the creation of a new healthy bone marrow and immune system.

– Hormone therapy. Some cancers such as breast cancer and prostate cancer are worsened due to the effects of certain hormones in our bodies. Blocking these effects is the goal of hormone therapy.

– Targeted drug therapy. This method allows an anti-cancer drug to specifically attack a specified cancer cell.

– Biological therapy. Helps your own immune system to better recognize and fight off cancer cells.

– Alternative medicine. Not scientifically proven, yet found to be quite helpful for many patients. Such therapies include meditation, acupuncture, yoga, massage, and hypnosis.

– Vitamins and food supplements. Also unproven, but widely used with some success.

Although there is no way as of yet to prevent cancer, there are ways to reduce the risk of having cancer including:

– Stop smoking. Smoking has been associated with many types of cancer, not just lung cancer.

– Eat a healthy diet. Concentrate on fruits and vegetables and select whole grains and non-fatty proteins.

– Avoiding excessive sun exposure. Avoid mid-day sun, use sun screen liberally and avoid tanning booths.

– Get plenty of exercise. At least 30 minutes of exercise daily is a good goal.

– Avoid obesity. Maintain a healthy weight.

– Drink alcohol in moderation if you choose to drink. One dink per day for women, two drinks per day for men.

– Schedule routine screening exams. Talk to your doctor about what exams you may need depending on your risk factors.

The bad news about cancer is that it is still so very prevalent in our society. As I have personally found out, anyone can experience it. The good news is that through early detection and rapidly improving treatments, cancer patients in general have a much improved survival rate. I think that if researchers can somehow find methods to mobilize our immune systems to better recognize cancer and to successfully overwhelm it in its early stages, we may then be close to a cure for many cancers.

From my own personal experience with cancer and from many patients I have treated, my advice is that if something about your health just doesn’t seem right, don’t assume it’s nothing to worry about. Listen to your body as only you can do. Don’t take a chance. Being checked out by your doctor sooner rather than later could save your life.

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cancer2

In this article I would like to summarize information for a variety of common cancers as the second of my three-part series on the disease.

Breast: More than 225,000 new cases of breast cancer are expected this year among women and over 2,000 cases in men. Breast cancer is the most frequently diagnosed cancer in women. Increasing age is the most common risk factor. The survival rate has improved dramatically due to early detection and improving treatments.

Prostate: Close to 250,000 new cases of prostate cancer are expected this year. It is the most common cancer for men. Increasing age is the most common risk factor. Fortunately more than 90 percent of all prostate cancers are discovered before metastasis occurs, for which there is a five year survival rate close to 100 percent.

Lung: Some 250,000 cases of lung cancer are expected this year which accounts for more deaths than any other cancer in both men and women. Cigarette smoking is by far the most common risk factor for lung cancer, and increases depending on the number of cigarettes smoked daily and the number of years of smoking. Death rates are dropping as a greater number of people are quitting smoking.

Colon and Rectum: Over 150,000 cases of colorectal cancer are expected this year. Fortunately, the rate is falling significantly as more people are having colonoscopies which allows for the removal of precancerous polyps. Only 65 percent of eligible adults have been screened as recommended.

Urinary bladder: Some 75,000 cases of bladder cancer are expected this year. It is found four times more frequently in men than in women. The most common symptom is blood in the urine.

Uterine: Almost 50,000 cases are expected this year. Early symptoms include vaginal bleeding or spotting, as well as pelvic pain. Obesity and exposure to the hormone estrogen are risk factors.

Melanoma: Close to 80,000 people will be diagnosed with melanoma, a potentially deadly skin cancer which often metastasizes to other parts of the body. Major risk factors include family history of melanoma, the presence of numerous moles (more than 50), and exposure to ultraviolet rays mostly from sun exposure, but also from tanning booths.

Kidney: Over 65,000 cases of kidney cancer are expected this year. There are usually no symptoms early in the disease. Tobacco use is a strong risk factor.

Lymphoma: Close to 70,000 cases of lymphoma will occur this year. This is a cancer of lymphocytes, a type of blood cell. Symptoms include swollen lymph glands, night sweats, weight loss, fatigue, and fever.

Leukemia: Around 50,000 cases of leukemia are expected this year. Leukemia is a cancer of the bone marrow and blood cells. Leukemia is difficult to diagnose early because symptoms often mimic other less-serious conditions.

Pancreas: Some 45,000 cases of pancreatic cancer are expected this year. Unfortunately, there are very few symptoms early in the disease, and is therefore not detected until it has spread to other organs. By the time it is detected treatment is often unsuccessful.

Ovary: Over 22,000 women will be diagnosed with ovarian cancer this year. Symptoms are often nonspecific and include sensations of bloating, pelvic or abdominal pain, and urinary urgency and frequency. Diagnosis is usually confirmed by a pelvic exam and ultrasound test.

Cervical: Around 12,000 cases will occur this year in women. The most common symptom is abnormal vaginal bleeding. The Pap test is the most common screening method. The primary cause of cervical cancer is infection with the human papillomavirus transmitted by sexual intercourse. It can now be prevented by a vaccine, which is highly recommended for females and males from ages nine to 26.

In this article, I have attempted to cover the most common types of cancer. Unfortunately there is a long list of other less common cancers.

My next and final article on cancer will discuss treatment and prevention of cancer. It will publish March 28.

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C

My stem cell transplant has been put off for a while until I see some improvement of severe peripheral neuropathy in my feet and legs caused by the chemotherapy I received. So I am at home biding my time and able to continue writing for the foreseeable future. I’d like to begin today a three-part series on cancer.

Cancer definition and a description

When my oncologist told me that I had multiple myeloma, a type of blood cancer, all I could hear was the dreaded word “cancer.” I felt as if I had just received a death sentence. Even as a seasoned physician I found this difficult to accept. Throughout my career it was always other people who got cancer, not me. When I shared this news with my wife we both had a good cry. It wasn’t until I was told that of all the known cancers—multiple myeloma has one of the most successful treatments for remission—was I then able to get a grip on reality and wanted to get started with treatment.

Since my diagnosis, it seems that everyone I talk to has either had cancer, or has a family member or friend with cancer. It struck me that cancer is a lot more prevalent in our society than I had realized.

What exactly is cancer? Cancer is a group of diseases characterized by uncontrolled growth of abnormal cells that have the ability to spread to and destroy normal body tissue. Cancer cells may stay in one location only or they can spread to all parts of the body by traveling through the blood stream or the lymph system. Once cancer cells arrive at their final destination, they begin to grow and destroy normal tissue. When cancer spreads in this manner it is referred to as metastasis.

Cancer can be caused by internal factors such as genetic mutations, immune system conditions and metabolic disorders, and also by external factors, such as radiation or chemical exposures, tobacco or alcohol use, and even by infectious organisms.

As I have found out, anyone can develop cancer. The risk of cancer increases with age, with the majority of cancers occurring in those above 55 years of age. Sadly, it can also affect the very young. The risk for getting cancer over the course of a lifetime is one in two for men and for women it is one in three. In other words, one-half of all men and one-third of all women can expect to develop some form of cancer during their lifetimes. Only about five percent of all cancers are due to heredity (an internal factor) and the remainder are due to damage to genes occurring during one’s lifetime (the external factors as mentioned above).

About 15 million Americans are living with cancer. It is expected that over a million and a half new cases of cancer will occur this year. Almost 600,000 people will die this year from cancer which works out to more than 1,500 people a day. Cancer is the second leading cause of death in the U.S. exceeded only by heart disease. The cost of cancer is high, with some $100 billion being spent on direct medical care and treatment and about $125 billion of lost productivity due to premature death.

Common symptoms of cancer are:

– A change in weight, especially unintended weight loss.

– Significant fatigue or unexplained increasing pain.

– Changes of skin color, or texture or changes to an existing skin mole, or a sore that doesn’t heal.

– Persistent cough, difficulty swallowing, or hoarseness.

– Changes in bowel or bladder habits.

Risk factors for cancer include:

– Age. Since cancer can take long to develop it most commonly occurs later in life.

– Habits. Smoking, excessive alcohol consumption, exposure to the sun or tanning facilities, and unsafe sex.

– Environmental. Exposure to certain chemicals and second-hand smoke.

– Family history. Cancer development passed on through genes.

– Excess weight and lack of exercise.

There is some good news amongst all this information about cancer and that is that the survival rate for most cancers is improving. This encouraging improvement is due to earlier diagnosis of many cancers, as well as improvement of treatments.

In my next article I will discuss some of the most common types of cancers.

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multiple, myeloma, cancer

I would like to begin this week’s article with a deeply sincere appreciation for the outpouring of emails, cards, well wishes and words of encouragement from my readers, patients, friends, family and even strangers. This support will go a long way in getting me through my recent diagnosis of multiple myeloma. I’ve survived my first two weeks of chemotherapy and feel fine, except for the persistent back pain.

Although described as being somewhat uncommon, I’m aware of a number of people who have had multiple myeloma and many more who are acquainted with or related to someone with the disease. The good news is that most of them are doing well. I like to hear that.

So what is multiple myeloma?  It is a cancer that causes an over production of plasma cells — a type of white blood cell found in the bone marrow. Plasma cells function to produce antibodies which are necessary for our immune system to fight infections. In multiple myeloma, the growth of the cancerous cells causes them to produce an over-accumulation of a certain protein called immunoglobulin that travels throughout the body and can cause damage to various organs.

The other problem, as in my case, is that the plasma cells can enter normal healthy bone causing osteoporosis as well as causing local areas of bone weakness leading to bone fractures, such as I have in my spine. I also have the typical anemia because the plasma cells crowd out the red blood cells in the marrow.

The cause of multiple myeloma remains a mystery, however there are some associated risk factors such as:

– Being over age 65.

– Being a male.

– Being African-American.

– Having a family member with multiple myeloma.

Early stages of multiple myeloma may cause no symptoms. However, as the disease progresses, plasma cells accumulate in the bones and other tissues causing these symptoms:

– Unexplainable persistent pain in any location of the body especially the back.

– Extreme weakness and fatigue.

– Unintended weight loss.

– Recurring infections.

After seeing your doctor for any of these symptoms, you will have some blood tests done and if there is some indication that you may have multiple myeloma you will be referred to a doctor specializing in blood and cancer diseases. Further testing can prove or disprove whether or not one has multiple myeloma.

Therapeutic options include the one I just began, which is undergoing up to four months of chemotherapy followed by a stem cell transplant which I will explain in more detail as I get further along with my treatment.

What I have learned from my experience is that it is important to recognize early symptoms and see your doctor about your concerns. As with any cancer, the sooner it is detected and treated the better the chance of survival. If you or a loved one have any of the above-mentioned risk factors and unexplainable symptoms, see your doctor.

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I was very pleased to see the article “Consider quitting smoking for health” published by the Press-Banner last week (Page 18, Nov. 6). Allow me to add my own opinion on this subject — from a doctor’s point of view.

From my experience and based on information from the Centers for Disease Control and Prevention, I offer the following information:

Tobacco use causes a great increased risk of death. More deaths are caused by tobacco use — mostly in the form of cigarette smoking — than by HIV infection, illegal drug use, alcohol use, motor vehicle injuries, suicide and murders combined.

Cigarette smoking causes 1-in-5 deaths in the U.S. each year, with about 400,000 deaths attributable to direct smoking and about 50,000 deaths to indirect smoking, or secondhand smoke. On average, adults who smoke die 14 years sooner than nonsmokers. Between the years 1960 and 1990, deaths from lung cancer in women increased more than 500 percent.

Smoking damages nearly every organ in the human body. Here are some of the more common health problems caused by tobacco products:

• Cancer of the lung (at a rate 23 times higher than among nonsmokers)

• Cancers of the bladder, mouth, throat, vocal cords, esophagus, cervix, kidneys, pancreas and stomach and certain forms of leukemia

• Coronary heart disease, which usually leads to heart attacks

• Doubles the risk of a stroke

• Blockage of blood flow to legs and feet, sometimes requiring amputation

• A 10-times higher likelihood of dying from emphysema, a condition in which lung tissue is slowly destroyed by smoke

• Reproductive problems, such as infertility, early birth, stillbirth and impotency

• Decreased bone density in old age, leading to increased chance of fractures

Who smokes the estimated 371 billion cigarettes consumed yearly in the U.S.? Millions of people smoke cigarettes — 20 percent of all adults and 20 percent of all teenagers. Every single day, about 1,000 teenagers become smokers.

In 2005, cigarette manufacturers spent more than $13 billion on advertising to lure people into smoking.

But what is the cost to our financially precarious health care system? It is estimated that cigarette smoking costs us $96 billion yearly in health care expenditures and nearly $100 billion more in lost productivity.

I personally find all of this data shocking. We must take a firmer stand against the use of all tobacco products. We need do a better job to prevent our youth from beginning to smoke and to get those, young and old, who are already addicted to tobacco to quit.

I cannot sit in judgment of those who smoke, as I smoked for a number of years during my youth. I know how seemingly impossible it is to quit — I tried many times — but as I became more knowledgeable about the effects of smoking during my medical school training, I knew I had to quit.

One night, while working in the emergency room during my internship, I saw a patient who had developed cancer of his throat from years of smoking. He previously had a tracheotomy — a metal tube surgically inserted into his neck through which he could breathe.

When I saw him light up a cigarette in the waiting room and hold it up to his breathing tube so he could smoke, I quit right then and there and never smoked again. That was almost 40 years ago.

Yes, quitting was still a very difficult thing to do, but it’s the best thing I ever did for myself — and for my family and friends who love and care about me.

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Interesting facts from medical literature

Beginning today, I will occasionally share with you some interesting facts from articles I have read during my review of current medical literature.

Did you know:

  • Skin cancer on the head or neck is more deadly than on other parts of the body.
  • 30 minutes of aerobic exercise five days a week can reduce blood pressure between 5 and 8 points
  • Extensive use of flip-flop shoes can cause pain in the heel, ankle, lower leg and toes.
  • Pessimistic heart patients are almost twice as likely to die within six to 10 years as heart patients with an optimistic outlook.
  • Trans fats, found in many processed foods, not only increase the risk of heart disease but also increase the risk of breast cancer.
  • If you think you’re having a heart attack, call 9-1-1, then chew and swallow one 325 mg. aspirin
  • Exercising in water burns more calories than doing the same exercise on land.
  • People, who engage in vigorous cardiovascular activities regardless of their size, are healthier and live longer than their sedentary counterparts.
  • Fish oil may help to ease depression.
  • To halt a lower leg calf cramp, flex your foot by pointing it up toward your shin. You can grab and pull the toes and ball of your foot to help flex it.
  • Sixteen percent of people between the ages of 20 to 69 suffer significant hearing loss.
  • Memory loss is linked to low levels of “good” (HDL) cholesterol
  • The spread of flu is linked to airline travel. The fewer people who travel by airline over the Thanksgiving holiday, in particular, the slower the flu moves across the country.
  • Vitamin C may fight wrinkles.
  • Excessive drinking of alcohol leads to increased risk of pre-diabetes.
  • Eating or drinking food high in cocoa improves blood flow to the brain and may help prevent stroke and dementia.
  • People with type 2 adult onset diabetes are two to four times more likely to develop heart disease, mostly because of increasing cholesterol and blood pressure.
  • Those who receive the pneumococcal pneumonia vaccine may be at a lesser risk of heart attacks.
  • Adult muscle mass decreases by 1 percent a year after the age of 30.
  • Drinking up to three cups a day of black or green tea reduced stroke risk by 21 percent.
  • Symptoms of depression can be improved by eating less processed sugary foods and increasing foods such as grains and vegetables.
  • For acute low back pain, a day or two of bed rest may be helpful. For more rapid healing, it is best to get out of bed and move around as soon as possible.
  • Newer cooking recipes have larger portion sizes. Stay conscious of portion size when eating.
  • Drowsy driving is linked to 100,000 motor vehicle accidents causing 1,000 deaths and 40,000 injuries.
  • Accidents with dogs and cats cause 80,000 emergency room visits annually for their owners in the United States.

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