January is Cervical Cancer Awareness Month

By Gigi Chen, MD

It is estimated that last year about 12,710 new cases of invasive cervical cancer were diagnosed. Cervical cancer is typically diagnosed in the mid life of women, between 20-50 years of age. It is important that women older than 50 continue to get their annual checkups as 20% of women diagnosed are over 65 years of age.


There are many risk factors that attribute to cervical cancer including:

• Early onset of sexual activity, multiple sexual partners, or history of sexually transmitted disease increase the risk of cervical cancer.

• Family history – Population studies show that if a women’s mother or sisters have been diagnosed with cervical cancer than she is 2 to 3 times more likely to develop cervical cancer.

• HPV - The human papilloma virus infection is one of the most important risk factors for this type of cancer. HPV is a grouping of viruses that occur on the surface of skin, on genitals, anus, or mouth causing papilloma’s, otherwise known as warts. Certain HPV infections have a stronger link to cancers than others. Receiving the HPV vaccine is highly recommended along with abstinence of sexual contact with someone you know has HPV.

• Oral Contraceptives - Recent studies have shown that women who are taking oral contraceptives for longer than 5 years doubled their risk of having cervical cancer. Consequently, a women’s risk lowers after she stops the oral contraceptives.



It is important to remember that your daily actions affect your body long term; it is your responsibility to take care of it. To help lower your risk of cervical cancer as well as other cancers make sure to have annual exams and pap smears, be aware of others with HPV, eat right, exercise and no smoking!

Managing Cancer Related Fatigue

By Sarah Buenviaje, NP

Cancer Related Fatigue can be a symptom of your cancer, or a side effect from cancer treatment. Normal day-to-day activities can be draining, and sleep may only provide a short reserve of energy. Fatigue affects every part of us, our physical, mental and emotional being. Cancer patients experience fatigue most during and/or post treatment. This lack of energy causes a change in our daily activities, hobbies, work and our relationships.



Talk to your doctor about your fatigue. They can help to determine what is causing your fatigue and may be able to help manage this symptom. There are other things that you can do to help manage your symptoms.



• Remember, fatigue is a physical, mental, and emotional draining of energy. Talk to your health care provider about managing symptoms like anemia, and pain.

• Take rest breaks in your day, but avoid long naps in the late day so that you are able to sleep well at night.

• Human connection is very important in battling depression, which is closely linked to fatigue. Enjoy the company of a friend when possible.

• Meeting with a dietitian to help establish your nutritional needs is recommended to help fight fatigue. Eating the right foods can give added energy. Make sure you are getting plenty of fluids throughout the day.

• Delegate your needs. Adjusting to a lifestyle with cancer related fatigue can be difficult. Please ask friends and family members for help. Minimizing the amount of tasks you need to complete in a day can provide time to do things you enjoy.

• Everyone has their own way of relaxing. Enjoy activities that do not require physical energy. Reading, needlework, listening to music or creating small art projects are some suggestions.

• Consult your physician on the appropriate exercises you are able to do such as walking, yoga, or swimming. Exercising regularly helps to improve appetite, muscle strength, and sleep.



Each person’s fatigue is unique and it is important to talk to your doctor about what may work best for you. Keep a ‘Fatigue Diary’ that shows a scale 0 -10, and the activities you are able to perform. By keeping track of your treatment appointments, diet, and exercise you may be able to learn what works best for you in improving your energy.

“Breast Radiation in One Day With IORT”

Traditionally, early-stage breast cancer treatment has been treated with surgery (usually lumpectomy) and six weeks of whole breast external beam radiation therapy, either with or without chemotherapy or hormonal therapy.  Not all patients who choose lumpectomy comply with the recommended follow-up radiation treatment because of factors relating to time, money, distance and access to a radiation center.  Neglecting follow-up radiation therapy after lumpectomy can increase the risk of cancer recurrence.   Fortunately, today there is another newer method of delivering radiation to the breast after lumpectomy—intraoperative radiation therapy (IORT)--that allows for a more expedited, convenient treatment schedule.

IORT has been performed successfully over the past several years with good results, but very few centers around the country could afford to have the specially shielded operating rooms that were necessary.  With the advent of electronic  brachytherapy  technology,  like the Xoft eBx  system,  IORT can now be more easily performed  since  a shielded vault is not required.  With breast IORT, the radiation is delivered in a single treatment right to the target tissue (lumpectomy cavity) in the operating room at the time of surgery.  The rationale for IORT is to deliver a high dose of radiation precisely to the target area with minimal exposure to surrounding tissues, which can be displaced or shielded during the IORT procedure.  With conventional radiation techniques after lumpectomy there are some drawbacks. First, the tumor bed, where the highest radiation dose should be applied, can be missed due to the complex localization of the wound cavity even when modern radiotherapy planning is used. Second, the usual delay between surgical removal of the tumor and radiation treatment may allow for repopulation of tumor cells.  These potentially harmful issues can be avoided by delivering IORT directly to the target tissues with IORT, leading to immediate sterilization of any residual tumor cells.  With the Xoft eBx system, a typical IORT treatment for breast cancer can be completed in as little as eight minutes.

 Last year, a landmark breast IORT study (TARGIT trial) published in the journal Lancet offers tremendous hope that a single radiation treatment at the time of lumpectomy might be able to replace the more cumbersome and time-consuming radiation treatment options commonly used today to treat patients with early stage breast cancer.  If the excellent results with breast IORT hold up long-term, as hoped and expected, then this approach to early stage breast cancer treatment has the potential to significantly increase the speed and efficiency of patient care while at the same time decreasing the overall cost of care.

Unfortunately, not all patients with early stage breast cancer are candidates for IORT because of technical and/or anatomical difficulties.  However, if we continue our efforts to catch more cases of breast cancer in the earlier stages, then breast IORT using the Xoft eBx system has the potential to improve the quality of the lives of millions of patients over time by freeing them up  to move on with their lives more quickly after receiving the breast cancer diagnosis. 

Two bay area institutions, Stanford and UCSF, participated in the TARGIT study.  Diablo Valley Oncology, a UCSF research affiliate, has been using the Xoft electronic brachytherapy technology for two years and is partnering with local breast surgeons to offer the breast IORT procedure beginning in December 2011 at the Aspen Surgery Center.  Diablo Valley Oncology will be the first practice in the East Bay to offer this procedure to breast cancer patients.

Google+ Releases 'Pages' Stay Better Connected

Google+ is a social networking rival of Facebook. In only 16 days Google+ reached 10 million users. Today, G+ has 40 million users.




Google+ has just become more beneficial. For the past several months G+ has focused on connecting people with other people who share their interests. They asked brands, companies and celebrities to hold off on making profiles until they rolled out this 'new' version of profiles for them. So what is so great about G+ pages? Watch this video:
 

We will be utilizing our page to connect with you better. To have conversations with you on the health topics that matter most. DVO will be sharing information that is important for you as a cancer survivor, family member, friend, caretaker, and healthcare provider. We are all in this fight against cancer together and technology is making it easier to connect world wide with people who want to make a difference.

November is Pancreatic Cancer awareness month

By Gigi Chen, MD

This year, more than 44,000 Americans will be diagnosed with pancreatic cancer and nearly 38,000 will die of the disease. It is estimated that more than 200,000 patients worldwide die of pancreatic cancer each year. 95% of pancreatic cancers are exocrine tumors because they begin in the cells that produce enzymes for digestion. Less than 5% are endocrine tumors. This disease has claimed the lives of many public figures including actor Patrick Swayze, opera tenor Luciano Pavarotti, and recently, co-founder, chairman and CEO of Apple, Inc., Steve Jobs.

Pancreatic cancer can be difficult to diagnose. Many patients tend to have vague abdominal pain or back pain for a few months before the diagnosis is made. Other symptoms include weight loss, Jaundice (yellowness of skin), and blood clots. Risk factors can include smoking, physical inactivity, chronic pancreatitis and family history. Selected mutations involving breast cancer such as BRCA mutation and hereditary pancreatitis have been associated with familial pancreatic cancer.

For exocrine pancreatic cancer, once it is diagnosed, about 20-25% of cases can be removed with surgery. Surgery is the only potentially curative treatment. Chemotherapy or chemotherapy plus radiation are considered after surgery. For pancreatic cancer that is localized but not able to be removed, chemotherapy or a combination of chemotherapy and radiation can be used. Radiation is helpful in controlling pain from tumor invasion. In metastatic disease, chemotherapy is the mainstay of treatment. Supportive care, nutrition, and pain control are all important in treating pancreatic cancer.

Pancreatic neuroendocrine tumor is a rare form of pancreatic cancer. Surgery to remove the cancer is a common treatment. At this time, there is not a standard treatment for advanced neuroendocrine tumor. Two targeted drugs, Affinitor and Sutent were recently approved by FDA to treat advanced pancreatic neuroendocrine tumor. We would encourage clinical trial participation to help us find better treatment options for this rare tumor.

Lifestyle modifications that can decrease pancreatic cancer risk include intake of diets rich in fruits and vegetables, keeping blood sugar under control, and maintaining a healthy body weight as well as being physically active.

Cancer Prevention

By Dr. Matthew Sirott

A staggering statistic may catch you off guard; research has shown that environmental oand lifestyle components may be associated with 90-95% of cancers. Approximately 10 million people worldwide will be diagnosed with cancer. Here are some options to modify your habits and avoid joining the crowd.


Tobacco use accounts for nearly 25-30% of cancer-related deaths. Smoking cessation dramatically reduces the risk of developing lung, kidney, bladder, mouth, throat, esophageal, or pancreatic cancer. Ten years after quitting, the risk of receiving a cancer diagnosis is halved; After twenty years, one is back to near the baseline of a never-smoker. Many resources are available to help you to quit smoking, including newer prescription drugs like Chantix, which have higher success rates than previous methods.

Exercising daily is of great benefit toward reducing an individual’s risk for breast, colon, endometrial and prostate cancer. Just 30-45 minutes of daily moderate physical activity, such as walking rapidly, can reduce your risk by over a third.

Simple changes to your diet, such as consuming five servings of fruits and vegetables daily, can reduce your risk of cancer. Grapefruits and oranges have high concentrations of Vitamin C, while milk and cereals are great sources of Vitamin D; both may significantly reduce the risk of cancer. Choose more fish and poultry over red meats when making meal choices. Cut excess added fats from your diet completely (such as butter, lard, and full fat dairy products) and use olive oil for cooking. Limiting the consumption of alcoholic beverages to no more than 1 drink per day will reduce the risk for head and neck, esophageal, stomach, pancreatic, and liver cancers. This Mediterranean diet may reduce overall risk for cancer by as much as 30-35%.

Skin cancer accounts for approximately half of all cancer in the United States. The primary cause for skin cancer is unprotected or excessive exposure to ultraviolet radiation. The greatest way to lower one’s risk for skin cancer is to take precautions when in the sun; wear protective clothing and apply sun screen with SPF 15 or higher to exposed areas, even on overcast days. Also remember to reapply after sweating, or swimming. Always avoid other sources of UV light such as tanning beds. Daily application of sun lotion has even been recently shown to markedly reduce the most dreaded skin cancer of all – malignant melanoma.

Early detection through regular check-ups and screening is important. Simple yearly physical exams of lymph nodes, gynecological exams, and rectal exams can screen for cancer. Other helpful diagnostic tools are mammograms for women older than 40, colonoscopies for individuals 50 and over, and even CAT scans for heavy smokers.

For people with higher risk rates of cancer because of genetic factors, history of smoking or obesity, pharmacological interventions have shown some promise in reducing that risk. The daily use of aspirin results in as much as a 20% decrease in the overall cancer death rates; it has long been used for reducing heart and stroke risk too. Several prescription drugs can specifically reduce the chances of developing breast, cervical or prostate cancer. Discuss these risks and benefits with your physician.

Start making these simply changes to your daily routine and increase your chances of living a long, healthy, happy, cancer free life.

Breast Cancer Awareness Month is Here Again!!

About 1 in 8 women in the United States (12%) will develop invasive breast cancer in their lifetime. Breast cancer is a very important health issue for women – it is the most common cancer, and the second most common cause of cancer death. In 2010, there were more than 200,000 new diagnoses and more than 39,000 deaths in the United States.  The good news is that death rates have been decreasing since 1990 as a result of treatment advances, earlier detection through screening, and increased awareness.

 

‘Frankly Speaking About Breast Cancer’ is on October 4^th from 6-8pm  at the Cancer Support Community.  It is a discussion I will be leading about the latest treatments for advanced breast cancer and side effect management. Social and emotional challenges will also be addressed. 

Join me on October 7^th at 3pm for the opening ceremony at St. Mary’s College’s first Relay for Life for the American Cancer Society.  All cancer survivors are invited to participate in the survivor lap at the beginning of the event.

On October 15th, “The Many Faces of Breast Cancer” will take place at the Lesher Center for the Arts in Walnut Creek, from 10am – 12pm.  This educational community event focuses on the unique needs and issues of survivors, providing the latest information on breast cancer.  Heather Quarterman from KKDV 92.1 FM will be the moderator and medical experts will speak on issues effecting survivors and offer insight into treatment options and lifestyle changes that can help with rehabilitation. There is no charge for the event, however reservations are required as seating is limited.  RSVP at 925-677-5041, x231.

This year, Diablo Valley Oncology, Sunvalley Shopping Center and Arthur J. Gallagher Insurance are partnering together to host a special Breast Cancer Awareness event entitled “Pink Up The Mall”. Throughout the month of October, Sun Valley merchants will feature “Pink” themed merchandise and special discount offers.  The highlight of the event will take place on October 16^th at 1pm in the Grand Court.  Breast Cancer survivors will be recognized by their oncologists and surgeons where they will be featured in the Surviving in Style Fashion Show. 

Join John Muir Health for a fun night out to help support and raise awareness for breast health in Contra Costa County on October 20^th from 6-9pm at the Women’s Health Center in Walnut Creek.  The evening includes education, special offers and goodies from participating downtown restaurants and businesses, and raffle prizes.  Proceeds benefit the Every Woman Counts Program. 

These are a just a few of the Breast Cancer Awareness events in our area.  Raising awareness about the importance of early detection is one of the most important things we can all do to make a difference in the fight against breast cancer!