Diablo Valley Oncology & Hematology Medical Group

January is Cervical Cancer Awareness Month

2012-01-19T13:54:00.000-08:00

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

2011-12-29T08:24:00.000-08:00

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”

2011-11-11T15:42:00.001-08:00

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

2011-11-08T10:11:00.000-08:00

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

2011-11-02T16:41:00.000-07:00

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

2011-10-10T08:53:00.001-07:00

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!!

2011-10-06T08:35:00.000-07:00

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!

September is Ovarian Cancer Awareness Month

2011-09-12T13:44:00.000-07:00

Dr. Gigi Chen

Ovarian cancer is the fifth most common cancer among women in the United States. About 21,000 women are diagnosed each year of ovarian cancer in the US. About 1 in 70 women develop ovarian cancer and the mean age of diagnosis is 59. Increasing age is one of the strongest risk factor in ovarian cancer. Risk increases from age 20 to 80 then declines. Family history is the next strongest risk factor. Woman who have first degree relative as well as those who carry BRCA mutation are at increased risk for developing ovarian cancer. Other risk factors include diet high in animal fat, early menarch and late menopause. Oral contraception is associated with decreased risk for ovarian cancer.

The screening of ovarian cancer is only recommended for high risk women such as those with strong family history of ovarian cancer and for women with BRCA mutation or HNPCC genetic mutation. Women do need to realize that false positive results in screening may lead to significant emotional distress and more invasive procedures.

Symptoms of ovarian cancer include abdominal discomfort, bloating and abdominal distension. Treatment strategy includes surgery to remove as much tumor as possible, followed by chemotherapy according to the surgical stage and amount of residual disease. For some patients, it may be feasible to receive chemotherapy first before surgery depending on the clinical presentation.

A number of new drugs are being studied for treatment of ovarian cancer. One that has received most attention is Avastin which inhibits new blood vessel formation in tumors. A large trial conducted by gynecological oncology society compared chemotherapy alone to chemotherapy in combination with avastin and found that combination therapy followed by avastin maintenance slowed tumor growth significantly. More studies are underway to confirm the benefit of avastin in upfront ovarian cancer treatment after surgery.

A number of studies are looking at YOGA and exercise in reducing fatigue, sleep disturbance from cancer treatments. Studies show that YOGA can favorably alter circadian rhythm and improves anxiety and mood. Exercise also improves concentration, nausea, sleep and memory in patients undergoing cancer treatments.

Gigi Chen, MD is a Medical Oncologist and Hematologist with Diablo Valley Oncology. She sees patients in Pleasant Hill and Rossmoor. For more information call 925-677-5041 or go to www.DiabloValleyOncology.md where you will find Northern California’s most comprehensive online cancer library.

Pints for Prostates

2011-08-09T16:13:00.000-07:00

Matthew Sirott, MD

Medical Oncologist

“Pints for Prostates” is a grassroots campaign that uses the universal language of beer to reach men with an important health message about their prostate health. Founded by a prostate cancer survivor who was diagnosed at the age of 48, this non-profit campaign raises awareness among men about the need for regular health screenings and PSA testing. In partnership with Pyramid Brewery and Pacific Urology, Diablo Valley Oncology brings the first ever “PINTS FOR PROSTATES” fundraiser event to Walnut Creek on September 7, 2011.

Prostate cancer is the most commonly diagnosed cancer in American males today (220,000 cases in 2010) and is the second leading cause of cancer death (32,000 in 2010) in the United States. 1 in 6 men is at a lifetime risk of developing prostate cancer. Age is the strongest risk factor for prostate cancer. The disease is rare in men younger than 45, but the chance of getting it goes up sharply as a man ages. Also, a man’s risk of prostate cancer doubles if his brother or father had the disease. Prostate cancer is more common in African American men and less common in Asian and Native American men.

Early-stage prostate cancer may not be associated with any obvious signs or symptoms, or may cause symptoms that can be mistaken for those of other disorders.

The signs and symptoms of more advanced prostate cancer may include frequent need for urination, difficult or painful urination, blood in the urine, pelvic pain, painful ejaculation, loss of appetite/weight and bone pain.

If detected early, prostate cancer is treatable and curable. Today, there are more than 2 million prostate cancer survivors in the US. Treatment for prostate cancer can include active surveillance, surgery, image-guided radiation therapy using Calypso GPS technology, hormonal therapy, immune therapy and chemotherapy.

The American Cancer Society’s guidelines recommend that men should get routine PSA screening at age 50. However, if you are under 50 and experience any of the above symptoms or have a close relative who has had prostate cancer, it is reasonable to discuss earlier prostate cancer screening with your primary care physician.

Join us at “Pints for Prostates”, guaranteed to be a fun and informative evening. September 7, 2011, 6-8pm at Pyramid Alehouse, 1410 Locust Street, Walnut Creek. For a $20 donation, you will receive the “Pints Package” which will include a custom beer glass, beer, heavy hors d’oeuvres, and raffle tickets. Space is limited so RSVP at 925-677-5041 extn 260.

Treating skin cancer without surgery

2011-07-06T11:40:00.000-07:00

A technology developed in the Bay Area is now being used as an alternative therapy for treating the most common form of skin cancer. There's now a non-surgical option to consider.

"It was right in my right ear, it was like four little spots," said skin cancer patient L.J. Hauss.

When Hauss was diagnosed with squamous cell carcinoma, the first option was surgery.

"He said you could do an operation with a skin graft and that would take a long time to heal," said Hauss.

Instead, Hauss' doctors turned an alternative for treating common types of carcinoma. It's a form of precisely targeted radiation known as brachytherapy, which normally involves the placement radioactive pellets near the site of the cancer. But Sachin Kamath, M.D., from Diablo Valley Oncology, says this system, called Axxent, works differently.

"Instead of using a radio isotope, that actually constantly emits radiation this is actually a miniaturized X-ray tube that will actually give off X-rays with push of a button," said Kamath.

Kamath says the lower energy radiation can be delivered directly onto the skin, with a minimal chance of spill over into adjacent tissue.

"It's very important that I place this applicator right up against the area where the cancer is, so we can treat it and not nothing else that doesn't need radiation," said Kamath.

The procedure is typically limited to non-melanoma cancers, such as squamous and basal cell carcinoma -- the most common form of skin cancer. And researchers say it's most effective for use on lesions located near the surface of the skin.

For years the gold standard for skin cancer treatment has been a procedure called Mohs surgery. The technique that tests tissue samples as the surgery progresses, ensuring that no cancer cells are left behind.
"Meaning, only two patients in 100 will have a reoccurrence of the cancer," said Sara Arron, M.D., Ph.D.
Arron is chief of the high risk skin cancer program at UCSF and a trained Mohs surgeon. She says Mohs has a cure rate of up to 99 percent and believes it's still the best option for many skin cancers.

"When a patient is deciding what type of treatment they want to pursue, they should talk with their doctor about the specific cancer type that they have, because the potential of that cancer reoccurring could be more significant in a high-risk squamous cell carcinoma than with a very small, superficial, basal cell carcinoma," said Arron.

Still, manufacturers of the Axxent system say it produces similar results for lesions no deeper than five millimeters and it also offers cosmetic advantages.

"The way I present this is that this is good option or a good alternative," said Kamath.
The procedure itself takes about five minutes, with patients like Hauss returning for sessions at least twice a week for two to three weeks.

"They said there was no pain involved and it wouldn't take long and so all those sounded good," said Hauss.

The Axxent system is manufactured by Sunnyvale based Xoft. The treatments are covered by Medicare and most insurance plans.
Written and produced by Tim Didion

(Copyright ©2011 KGO-TV/DT. All Rights Reserved.)

2 Birds with 2 Stones

2011-06-09T09:30:00.000-07:00

By Matthew Sirott, MD

Medical professionals and lay persons have long known that heart disease, the number one cause of death in America, can be modified by exercise and aspirin. Less well publicized, but probably of equal importance, is the newly emerging data of their benefits in cancer prevention.

Clinical trials have clearly documented the benefits of moderate exercise daily (40 minutes of rapid walking). Exercise has been shown to prevent both the initial occurrence, as well as a recurrence of some cancers in patients at risk for relapse. Almost 100 studies performed worldwide have documented the benefits in breast cancer; the magnitude of benefit may be as high as 50%. The implication is that, if 10 young women were destined to relapse (and likely die) from recurrent breast cancer, then “only” five will relapse if they all exercise adequately. Similar findings are documented in colon and prostate cancer. The mechanisms explaining these results have not yet been clearly elucidated, but have been postulated to include reductions in systemic inflammatory mediating compounds.

Aspirin use has also been shown to reduce cancer development and recurrence; much of the data was initially developed in colon cancer. However, a clinical trial published in 2011 in the prestigious medical journal The Lancet combined multiple randomized published trials evaluating the use of aspirin to prevent vascular events into one single analysis (called a meta-analysis), which looked retrospectively at cancer prevention. The results are astounding: a 34% reduction in risk for all cancers and a remarkable 54% reduction in gastrointestinal cancers. The risk of death from all cancer was reduced by 20%, with an incredible 60% reduction in death from gastrointestinal cancer with greater than 7.5 years of aspirin consumption. The types of patients included those with esophageal, pancreas, brain, lung, stomach, and colorectal malignancy.

The use of any new medication, including aspirin, is not without some potential risks, and daily use should absolutely be discussed with your personal physician. Similarly, an exercise plan should not be initiated until reviewed by your physician, to be certain that you are physically fit. Those caveats aside, I am hard pressed not to recommend throwing these simple, but powerful “stones” at the two “birds” that cause more deaths in America than all other causes combined.

My Relay Experience

2011-05-27T12:11:00.000-07:00

Celebrate. Remember. Fight Back.

By: Leanne Marie Francisco

Last weekend was Pleasant Hill’s Second Annual Relay for Life event that was held at Pleasant Hill Middle School. Relay for Life is a 24-hour event, where teams of people of all ages raise money for the American Cancer Society, as well as raise cancer awareness.

At the beginning of the event, we Celebrated cancer survivors with a “Survivor Lap.” A survivor is anyone who has ever heard the words “You have cancer.” Survivors are the guests of honor at the Relay and it was very heartwarming to see some of DVO’s patients there supporting our team. Throughout the day, there were many events for kids and fun music & entertainment. After sunset, the Luminaria Ceremony began, where we Remembered those who have lost their battle with cancer or those who are still fighting this disease. This was my favorite part of the Relay and it is always simply magical. The Brownie Troop from Glorietta Elementary in Orinda played a very special part in this year’s ceremony. Dr. Tiffany Svahn, breast cancer specialist of Diablo Valley Oncology, introduced the girls and they serenaded us with a few songs to open up the ceremony. It was a very sweet and cute touch that lightened our hearts. The track was lined with luminaria bags that were decorated in memory of, in honor of, or in support of their loved one; some of which were decorated by the Brownie Troop, they even used some of their money raised from Girl Scout cookie sales to buy art supplies to do so… very thoughtful! The luminaria bags were lit up by glow sticks (also with the help of the Brownie Troop) and they illuminated the field as we walked a silent lap in remembrance. On Sunday morning, after hours and miles of walking, there was a Fight Back Ceremony, where we found out how much we have raised to date and how we can all fight back as a community against cancer.

This year, our team was privileged to help set up the Luminaria Ceremony. This was my 5th Relay since 2009 and 2nd Relay as team captain…each event is always an indescribable experience. There is something unique about being in a place where you are surrounded by people who are all there for the same reasons -- we were all there because we have been touched by cancer and we want to see an end to cancer in our lifetime. You can feel the strength and hope in the air. I was blown away by all the participants that never stopped and walked for miles and miles… a few kids beat their own goal of walking a marathon (26 miles), one of the boys walked 116 laps! AMAZING! They were an inspiration.

At first, attending the Relay was just something to do for work, but now, it has become personal. It has become more personal, not because I have a family member that had cancer; it is personal because our patients look at us like friends and family. Every day, I meet such wonderful, strong people, who are unfortunately fighting this dreadful disease, so I relay for them.

I relay in honor and in support of all cancer patients and their families and friends… and I relay in memory of all those who lost their battle but will never be forgotten.

After a long and eventful weekend, I was exhausted and sore… but at the same time I felt refreshed and happy. I’m excited to say we’ve raised over $3,000 so far… and we still have three months left to keep fundraising. This all couldn’t have been done without the help of everyone who participated and who came out to support our team, thank you!

I was very fortunate to have worked with people like Kelli Nahas, and Ken & Eileen Housfeld, who dedicate their lives to the American Cancer Society’s Relay for Life. I’m looking forward to working with them for next year’s Relay.

Life is a Cabernet!

2011-05-19T09:15:00.000-07:00

By Jewel Johl, MD
Medical Oncologist

Resveratrol is a substance that is produced by plants in response to stress. It is a phytoalexin, a major constituent of red wine, and abundant in the grape skin. The cardioprotective and chemopreventive activities have brought resveratrol to public and scientific attention.

Several animal studies performed in the lab have shown that resveratrol prevents development of cancers of the skin, breast, esophagus, intestine, colon and prostate.

Not only does red wine has properties that help prevent cancer, in moderation it has long been thought of as heart healthy. The alcohol and antioxidants in red wine may help prevent heart disease by increasing levels of "good" cholesterol and protecting against artery damage.

Research has shown that resveratrol might also help protect against obesity and diabetes, both of which are strong risk factors for heart disease. However, those findings were reported only in mice, not in people. In addition, to get the same dose of resveratrol used in the mice studies, a person would have to drink over 60 liters of red wine every day, not recommended.

Resveratrol Content in Different Beverages and Foods
Food and Beverage Serving Size Total Resveratrol (mg)
Muscadine wine 5 ounce glass 2.12-6

Red wine
-Global 5 ounce glass      0.30-1.07
-Spanish    5 ounce glass     0.29-1.89
Red grape juice    5 ounce glass      0.17-1.30
Rose wine            5 ounce glass      0.06-0.53
Pinot noir            5 ounce glass      0.06-0.30
White wine          5 ounce glass      0.01-0.27

Peanuts
-Raw    146 g              0.01-0.26
-Boiled 180 g              0.32-1.28
Peanut butter 258 g             0.04-0.13
Red grapes          160 g              0.24-1.25

While the news about red wine might sound great if you enjoy a glass of red wine with your evening meal, doctors are wary of encouraging anyone to start drinking alcohol. That's because too much alcohol can have many harmful effects on your body.

Resveratrol supplements are currently widely available at health food stores, pharmacies and online, however, the tablet doses are not standardized, side effects are unknown and these supplements are not regulated by the FDA. For this reason, the supplements are not generally recommended. It is not known whether high intakes of resveratrol can help prevent cancer in humans. Clinical trials are currently underway to address this question and to also determine whether resveratrol might be beneficial in cancer treatment. Until more data is available, moderate red wine consumption is reasonable in terms of its health benefits.

WCPD holds ST. Baldricks Foundation Fundraiser

2011-05-15T14:14:00.000-07:00

community noun ( pl. -ties) a feeling of fellowship with others, as a result of sharing common attitudes, interests, and goals

It was an honor to be able to attend a St. Baldrick’s Foundation fundraiser hosted by the Walnut Creek Police Department yesterday at The Shadelands Art Center. There aren’t many things more extraordinary than people making sacrifices to support those who are in need.

The Shavee’s all had their own motivations for participating in this event. Adam Lechner was participating in honor of 5 people in his life that are friends and family who are battling cancer. As I stood among the crowd watching these peoples hair being shaved I tried to imagine what this event must mean to their friends and family; the ones who are daily battling cancer, who can’t ignore the side effects of treatment, the survivors, the fighters. For these shavee’s, and others to be saying, “You are not alone, I will stand with you.”

Latasha Bouzek and Dides Mariel had their long, beautiful hair shaved. This gorgeous act raised $4,214 dollars of the $40,865 total. When all their hair was gone there beauty shone through from the inside out and they radiated a love that was breath taking.

When every person was shorn there was a catharsis in each of his or her eyes. Observers clapped and cheered, in a small way a victory was won with each moment. There are no words to express the gratitude to those who are willing to participate to this event.

We become more than the sum of our individual hopes, fears, joy and pain when we are united with individuals after the same goal. At Diablo Valley Oncology we are looking forward to Relay for Life in Pleasant Hill May 21, 2011 and Making Strides on June 18, 2011. These events are more than fundraisers; they awareness in the fight against all cancer.

We want to thank the Walnut Creek Police Department, St. Baldricks, the volunteers, to all who made donations for the raffle, and to the event and the ‘cheerleaders’ who came to encourage and support. We are proud to be a part of this wonderful community.

For more coverage on this event please visit: Contra Costa Times

(Written by Shayna Jung)

May is Skin Cancer Month

2011-05-04T16:26:00.000-07:00

By Gigi Chen, M.D.

Melanoma ranks as the seventh leading type of cancer in the United States. The lifetime risk for a diagnosis of melanoma in the United States is 1.94% for males and 1.30% for females; the lifetime risk for death from melanoma is 0.35% for males and 0.20% for females.
PREVENTION: There are many risk factors for developing melanoma, both environmental and genetic. The factor you can best control to reduce your risk of melanoma is exposure to ultraviolet (UV) radiation from the sun. Some experts believe that 65% or more of melanoma is caused by exposure to the sun, especially during childhood. Following is a list of prevention tips.
• Protect your skin. Stay out of the sun during the midday hours (10 a.m. to 4 p.m.).
• Wear protective clothing. This includes a hat with a brim to shade your ears and neck, a shirt with sleeves to cover your shoulders, and pants.
• Use daily a sunscreen with an SPF of at least 15. Look for a sunscreen that protects against both types of ultraviolet radiation in the sun's rays-UVA and UVB.
• Use a higher SPF when you are at higher elevations.
• Set a good example for your children by always using sunscreen and wearing protective clothing.
• Avoid sunbathing and tanning salons.
• Examine your skin regularly, and have your doctor check your skin during all other health exams, or at least once a year.
DETECTION: Detection of melanoma at early stages is essential and lifesaving. The ABCDE of melanoma recognition are: asymmetry, border irregularities, color variation, diameter greater than 6mm and evolving or changing lesions. If you have a suspicious lesion, you should talk to your primary care physician or dermatologist about biopsying the lesion.
TREATMENT: Proper surgical management is essential in obtain the diagnosis and the stage of the melanoma. Lymph node biopsy is done in patients at high risk for lymph node metastasis. Radiation can be used for patients with significant risk of local recurrence. Interferon is used in patients with high risk resected melanoma. In patients with metastatic melanoma, biologic therapy such as high dose interleukin-2, oral temodar, biochemotherapy and combination and single agent chemotherapy all have been used. A therapy for metastatic melanoma treatment, ipilimumab (Ippy) recently received FDA approval. It is one of the first antibody-based therapies that uses the body’s immune defenses to destroy cancer cells. Ippy was shown to offer a survival benefit for metastatic melanoma, which is often a fatal disease.

Four DVO Physicians Receive Patients’ Choice Award

2011-04-20T11:51:00.001-07:00

By Sandy Goldberg

Diablo Valley Oncology physicians Matthew Sirott, Robert Robles, Tiffany Svahn, and Sachin Kamath of Contra Costa County are recipients of the latest 2010 “Patients’ Choice Award” from the popular rate-your-doctor website Vitals.com.

“The honor is bestowed to physicians who have received near-perfect scores as voted by patients,” the website says.

The annual award is based on more than 1 million patient reviews nationwide and goes only to doctors who earn four-star ratings on the site. Out of the nation’s 720,000 active physicians, less than six percent receive this honor. Dr. Svahn has received the award three years in a row.

Every month, tens of thousands of patients across the United States provide online feedback on Vitals.com about doctors’ quality of care, post-appointment follow-up, bedside manner, and office staff courtesy. While physicians generally receive positive feedback from their patients, only a select few consistently receive rave reviews.

Doctors Sirott, Robles, and Svahn specialize in medical oncology and hematology. Dr. Kamath is a radiation oncologist. In April, Diablo Valley Oncology and Hematology Medical Group celebrated their 10 year anniversary. They also recently became one of the first oncology practices in the nation to receive the Quality Oncology Practice Certificate from the American Society of Clinical Oncology.

Diablo Valley Oncology founded the California Cancer and Research Institute. Located in Pleasant Hill, the cancer center is the largest freestanding, non-hospital based facility in Contra Costa County. The center brings together medical oncology, hematology, radiation, chemotherapy, diagnostic imaging, laboratory, pharmacy, clinical trials, and supportive care services – all in one convenient location. The facility provides the latest in technology and therapies – to better serve patients in this community. www.DiabloValleyOncology.md

Pleasant Hill's Relay for Life 2011

2011-04-13T16:23:00.000-07:00

As employees, friends, family and community members our team, Diablo Valley Oncology- Change for a Cure, is happy to participate once again in our local Relay for Life. Joining together with our neighbors for a cause close to our heart has been a wonderful experience in the past, and we are excited to see everyone coming together again this year!

This is a fundraising event that raises money for American Cancer Society, and awareness in our community. With the theme “Cancer Never Sleeps” we intend, as a team, to do the same. We will walk around the track for twenty four hours. Sharing education and awareness about cancer prevention and treatment is extremely important to us, and we know it is not a fight to be made on our own.

Survivors are our honored guest at the relay, and thanks in part to the event there are more than 11 million survivors today. During the event is a survivors lap to recognize, celebrate, motivate and bring to life the “Cancer Never Sleeps” theme! Sign up as a survivor and share your story.

We want to welcome you to join our team, make a donation, or buy a Luminary to honor a loved one. The Luminaria Ceremony is an important event at Relay for Life, and is a time to honor those we love who are battling, are survivors, or have lost their fight to cancer. At the evening of the walk bags decorated by individuals line the track and glow sticks are placed in each one to light the path all night long. If you can not participate in this relay but wish to have your loved one represented feel free to visit Relay for Life's Website to make a donation. On the day of the walk your bags will be decorated placed on the path.

Glow sticks aren’t enough to weigh the path down therefore we are joining up with Contra Costa Food Bank for a can goods drive! The can goods collected will be used to hold down the Luminaria bags during the event and then given to the food bank as a donation. For more information on location and drop off times visit our Facebook events page.

To find our more visit Relay in the news to see all about Pleasant Hills impact on the community.

Like Sweets? Visit our events page to get the scoop on our bake sale that will be held on April 25th. Anyone is welcome! If you would like to make a donation to our team it is simple and secure to donate online on Relay for Life's website, every penny counts. Thank you for your participation and support, we hope to see you there!

Shayna Sullivan & Leanne Francisco
Diablo Valley Oncology & Hematology

Fighting Cancer with a Cup of Tea

2011-04-06T10:07:00.000-07:00

By Jewel Johl, MD
Medical Oncologist/Hematologist

Cancer is one of the leading causes of death in the United States. Despite the estimated 565,650 deaths in 2008 of Americans as a result of cancer, it is mostly a preventable disease. Simply by modification of diet, maintenance of optimum body weight, and regular physical activity, 30% to 40% of all instances of cancer could be prevented. Modification of diet alone by increasing vegetable and fruit intake could prevent 20% or more of all cases of cancer and may potentially prevent approximately 200,000 cancer-related deaths annually. Because of their safety, low toxicity, antioxidant properties, and general acceptance as dietary supplements, fruits, vegetables, and other dietary elements (phytochemicals and minerals) are being investigated for the prevention of cancer. Extensive research over the past several decades has identified numerous dietary and botanical natural compounds that have chemopreventive potential.
Tea is one of the most widely consumed beverages and is rich in substances with antioxidant properties. Different processing techniques yield different types of tea. Epigallocatechin-3-gallate (EGCG) is the most abundant polyphenol in green tea and has gained the most attention with respect to anticarcinogenic activity. Although both black tea and green tea both have potential in prevention of cancer, green tea shows higher promise and greater efficacy against multiple types of cancer.
Various studies performed in the lab and in the clinics have shown that EGCG found in green tea can potentially help patients suffering from various cancers such as cancers of the breast, colon, ovary, lung, prostate and blood such as chronic lymphocytic leukemia. It can potentially make cancer therapies more effective by making resistant cancer cells more sensitive to the effects of EGCG.
Because of these promising results, several clinical trials are currently ongoing involving green tea alone or in combination with other drugs that are used to fight cancer.
At Diablo Valley Oncology, we take an integrative approach to treat patients with cancer by educating patients about the therapeutic benefits of natural compounds that have very little or no side effects.

National Doctor's Day - March 30th

2011-03-30T11:20:00.000-07:00

by Sandy Goldberg, Community Outreach Manager
National Doctor's Day was created to show appreciation to your doctors. Doctors perform vital diagnosis, treatment and care for yourself and your family. When you are well, your doctor keeps you well. When you are sick, there is no other person more important to you than your doctor.
Hallmark suggests you send your doctors a card of appreciation. (it's no surprise to hear this from Hallmark). Card companies have cards for this event....no surprise here, either!
We suggest you simply tell your doctor(s) that you appreciate all that they do for you and your health. If you don't see your doctor today, make a note to thank him (or her) at your next appointment. You can also send them an E-card or go to an online physician rating site to give them a positive rating.
________________________________________
Origin of "National Doctor's Day":
Doctors' Day observances date back to March 30, 1933. It was started by Eudora Brown Almond of Winder, Ga. The day marks the anniversary of the first use of general anesthesia in surgery. The first National Doctor's Day was celebrated in 1991.
On March 30, 1958, the United States House of Representatives adopted a resolution commemorating Doctors' Day. In 1990, the congress and the senate approved legislation establishing National Doctors Day. The resolution designating March 30 as National Doctors' Day was signed by President George Bush.

Dr. Tiffany Svahn, a breast cancer specialist, receives Patient's Choice Award for third year

2011-03-25T16:17:00.000-07:00

Contra Costa Times correspondent Lou Fancher wrote an amazing story on our doctor, Dr. Tiffany Svahn:

Dr. Tiffany Svahn, a breast cancer specialist, receives Patient's Choice Award for third year
By Lou Fancher
Correspondent
Posted: 03/22/2011 12:18:56 PM PDT

When an East Bay doctor specializing in treating breast cancer wins a Patient's Choice Award three years in a row, there's a reason.
After all, less than 6 percent of the country's 720,000 active physicians earn a place on the national honor roll of favorite doctors who are rated by patients and selected by Patient's Choice for receiving across-the-board positive reviews.
One minute with Dr. Tiffany Svahn, Diablo Valley Oncology/Hematology Medical Group's breast cancer specialist, easily explains her achievement: She's vibrant, intelligent and exudes health with every gesture and word.
"I wanted to be a doctor because I liked science," Svahn recalled. "I remember having a kit and mixing things to make bubbles or steam when I was 8."
Those early experiences, encouraged by her father, who was also a scientist, led to volunteer work with cancer patients. While in high school, she started a Make a Wish Foundation in Westchester, N.Y., and discovered another love: patients.
"I liked the relationships. Female cancer patients talk. These patients become a part of you," she said.
The Pleasant Hill cancer center she joined in 2006 is also a research institute.
Successful treatment of young breast cancer patients inspires the most passion in Svahn.
"It's an emotional thing for me. They're dealing with the same things I am: raising kids, working "... and their cancers are aggressive. These are intense cases, but you go home at the end of the day and say, 'This is why I do this.'"
Svahn said the combination of new drugs with chemotherapy has led to significant changes in patient care over the past few years.
"Ninety percent of breast cancers are sporadic, which means they weren't inherited, they're not genetic," she said. "So what I love to talk about is diet and exercise. It's very much a preventive element."
Svahn also said researchers are learning about how alcohol is involved. A 2009 Kaiser study quantified how much a woman can safely drink after having cancer.
"Half a drink a day was the cutoff for increasing your risk of breast cancer," Svahn said. "I could finally say to my patients three-to-four drinks a week was the limit."
Not content with treating the disease in the office, Svahn has found a number of ways to step into larger forums.
Last year, she organized and led the inaugural Many Faces of Breast Cancer, a free, all-day event held at Walnut Creek's Lesher Center.
"We had 130 cancer survivors in the audience. Survivors have unique conditions we have to pay attention to," she said.
Relay for Life, an American Cancer Society fundraiser that, like cancer, "never sleeps," gave Svahn another idea for fighting the disease. She enlisted her daughter, 8-year-old Sarah, and Sarah's Brownie troop, in a service activity.
"The girls are raising money with Girl Scout cookie sales and will use the profits to buy art supplies to decorate luminaria, the weighted paper bags holding candles that line the relay paths. And when they light them at the event, the girls will be there."
Svahn is grateful to her patients for teaching her to appreciate life.
"I lost one patient, a mother, in her 40s. There are some -- they get to you. But I learn how strong people are from my patients," she said.
"You meet them in the beginning and they are devastated. They're on the floor, crying, and you're crying with them. In the end, they are so empowered with what they have just done "..." Svahn said, leaving the statement hanging, but not the picture of the highs and lows of her profession.
In a world where online medical jargon, conflicting scientific reports and rapidly changing drug company claims can confuse patients, Svahn said finding a good doctor is straightforward.
"Being able to listen is most important, because female patients have a lot to say about what they are going through. Not all doctors are willing to listen compassionately.
"And being smart. Find someone who's able to adapt to new information and has gone through a good training program."

March is Colorectal Cancer Awareness Month

2011-03-07T15:21:00.000-08:00

By Jewel Johl, M.D., a Medical Oncologist with a special interest in colorectal cancer. He is very interested in promoting education and awareness of colorectal cancer screening and prevention.

Approximately 150,000 new cases of large bowel cancer are diagnosed each year in the United States, of which 108,000 are colon cancers and the remainder rectal cancers. Annually, approximately 50,000 Americans die of colorectal cancer. It is the second leading cause of cancer death, and accounts for approximately 9 percent of cancer deaths overall.
While the majority of colorectal cancers are sporadic rather than familial, inherited susceptibility results in increased risk of developing colorectal cancer. Hereditary non-polyposis colorectal cancer (HNPCC), an autosomal dominant syndrome which is more common than Familial adenomatous polyposis (FAP), accounts for approximately 1 to 5 percent of all colonic cancers. Therefore, you should tell your doctor if you have a family history of colorectal cancer so that appropriate screening tests and colonoscopy can be performed to detect cancer at an early stage.
Screening for colorectal cancer can identify premalignant lesions and detect early stage cancer. There are several tests that are available for colorectal cancer screening. While stool occult blood test can detect cancer at an early stage, colonoscopy has the potential to prevent cancer by detecting polyps that can be removed prior to malignant transformation.
We recommend that average risk patients aged 50 and older be screened for colorectal cancer by colonoscopy. Screening needs to start even earlier for patients with HNPCC or when a strong genetic predisposition is suspected.
For more info please visit: www.DiabloValleyOncology.md

February is Cancer Prevention Month

2011-02-18T12:23:00.000-08:00

Gigi Chen, M.D.
Medical Oncologist/Hematologist
Diablo Valley Oncology/Hematology Medical Group

Sponsored by the American Institute for Cancer Research, February is Cancer Prevention Month. Cancer prevention focuses on modifying environmental and lifestyle risk factors that promote cancer. It is estimated that 50% of cancer can be prevented.
Risk factors for cancer include smoking, alcohol use, diet low in fruits and vegetables, excess weight, inactivity, unsafe sex and pollutions. Studies show that people who never smoked, with body mass index less than 30, physical activity more than 3.5 hours per week and have healthy diet have a one-third of chance of developing cancer compare to people with all four risk factors. Cancer prevention also includes screening for asymptomatic cancers such as colon cancer and breast cancer.
Smoking is responsible for 30 percent of all cancer deaths in the US. Therefore, it is important in both prevent starting and promote cessation of tobacco use. Smoking is also responsible for heart disease and lung disorders. Light and low tar cigarettes are not safer because smokers tend to inhale more frequently or deeply. Those who stop smoking almost immediately stop increasing their risk of cancer.
The rates of breast, colon, uterine and prostate cancer are higher in the West than Far East. This suggests that dietary modification that includes a diet low in red meat and high in vegetables and fruits, legumes, nuts and grains can significantly reduce cancer risk. Recent clinical trials of women with early stage breast cancer on low fat diets had improved survival rates.
Viruses such as hepatitis, human papilloma virus can also induce cancer. Therefore, vaccinations against hepatitis B and HPV in high risk population can prevent the development of liver and cervical cancer.
Since obesity can affect a number of cancers such as breast, prostate and endometrial cancer, weight loss and increasing physical activity should also be an important part of cancer prevention.

DVO Achieves National Recognition

2011-02-14T14:35:00.000-08:00

Diablo Valley Oncology and Hematology Medical Group has become one of the first oncology practices in the nation to be recognized by the Quality Oncology Practice Initiative (QOPI®) Certification Program, an affiliate of the American Society of Clinical Oncology (ASCO). The QOPI® Certification Program is a new initiative to certify oncology practices that meet rigorous standards for high-quality cancer care. Diablo Valley Oncology is one of five in California and the only cancer center in the East Bay to achieve this certification.

The QOPI certification allows oncologists in the community to be at the forefront of cancer care, and to be recognized for their quality. The Certification Program helps practices determine whether they are providing the best treatment and care possible to their patients, and demonstrates a commitment to excellence and ongoing quality improvement in the hematology-oncology outpatient practice. “Increasingly, educated patients and families demand accountability and the highest standards from cancer care providers,” said Douglas W. Blayney, MD, immediate past president of ASCO.

“Our mission has always been to provide excellent oncology and blood disorder care to every patient - every day. To be recognized by these national organizations (ASCO and QOPI) is extremely gratifying.” said Matthew Sirott, MD, the managing partner of Diablo Valley Oncology. “In addition to the certification, we are pleased that many of our procedures exceeded the QOPI requirements and may be incorporated in future ASCO guidelines.”

In the news..patient loves us! thanks Linda

2011-02-03T17:35:00.000-08:00

What you love and hate
Contra Costa Times

Posted: 02/03/2011 01:02:00 AM PST

I love ...

... the Diablo Valley Oncology Group in Pleasant Hill. My doctor J.J., all of the doctors, nurses and the entire staff are remarkable -- especially "my" Megan! I think they must be angels in disguise. How else to explain the level of care, compassion and humor they give on a daily basis? No one looks forward to chemo. but I look at my "visits" as a blessing. I am so grateful to have these wonderful people in my life.

-- Linda Spring, Brentwood

Volunteers Needed

2011-01-13T12:17:00.000-08:00

Volunteer at California Cancer & Research Institute Information Service Desk. Greet and assist patients at 400 Taylor Blvd, Pleasant Hill, CA. Two hour shifts available. Orientation meeting Tuesday January 18th 4pm. Must be 15years old to volunteer. Contact Sam Sirott, Volunteer Coordinator at: ca.cancer.institute.volunteer@gmail.com

"GPS for the Body"

2010-11-30T12:15:00.000-08:00

Diablo Valley Oncology at the California Cancer and Research Institute of Pleasant Hill is the first and only cancer treatment center in the East Bay offering cancer patients the breakthrough benefits of real-time tumor tracking during external beam radiation with the Calypso System. This highly advanced technology—also referred to as “GPS for the Body”—may lead to reduced side-effects by enabling physicians to more accurately deliver radiation to the tumor while minimizing exposure to the healthy tissue and organs surrounding the prostate.
The Calypso System, with its GPS for the Body technology, utilizes miniature implanted transponders (grain of rice size) to provide precise, continuous information on the location of the tumor during external beam radiation therapy. Any movement by the patient, including internal movement of the tumor, may cause the therapeutic radiation treatment to miss its intended target and hit adjacent healthy tissue. In contrast to ionizing tumor targeting methods which cannot track a target in real-time, the Calypso System provides real-time tumor position information, thereby allowing physicians to deliver radiation directly to the tumor while sparing surrounding healthy organs from radiation exposure. Currently the Calypso System is cleared by the U.S. Food & Drug Administration (FDA) for use in radiation therapy for the prostate and prostatic bed; however, the technology is designed for body-wide applications and studies are underway using it in other locations in the body.
“We are committed to providing our patients with state-of-the-art treatments that maintain or improve quality of life,” said Sachin Kamath, M.D., radiation oncologist and medical director at Diablo Valley Oncology Radiation Center. “Like many of the organs in our body, the prostate gland is constantly moving. With the precision targeting provided by the Calypso System, extremely accurate radiation can be delivered directly to the tumor while minimizing the risk of any harmful effects on normal tissues. By doing so, we are likely to reduce side-effects.”
In May, a clinical study published in Urology demonstrated that prostate cancer patients who were treated with radiation and monitored with the Calypso System reported significantly reduced side effects like diarrhea, urinary irritation, and erectile dysfunction than those whose radiation was not complemented by Calypso.
“Radiation therapy has been getting better and better throughout my career, but this really represents an additional improvement for patients getting radiation therapy today, even when compared to just a couple years ago,” says Dr. Kamath

Our NEW MRI is Open!

2010-09-22T11:58:00.001-07:00

MRI Up and Running
September 2010 we added magnetic resonance to our imaging department. The MRI system has a state-of-the art computer assisted detection system to diagnose breast cancers for high risk patients with family history of breast cancer. Adding MRI to the imaging capabilities of the California Care Imaging Center makes them leaders in providing full service ceancer imaging and detection services in Northern California.

Diablo Valley Oncology First Cancer Center in Contra Costa County to Offer NEW Radiation Device

2010-03-23T16:46:00.000-07:00

Advances in the world of radiation therapy have led to the development of a new procedure for the treatment of early stage breast cancer, non-melanoma skin cancers, and some gynecologic cancers.

Diablo Valley Oncology/Hematology Medical Group at the California Cancer and Research Institute is pleased to announce that they recently received state approval to be the only facility in Northern California to offer a new breakthrough radiation therapy for cancer patients.

Electronic Brachytherapy vs. Traditional Radiation
Diablo Valley Oncology’s new advanced Electronic Brachytherapy system is very different from conventional brachytherapy because instead of a radioactive source, the eBx system uses a miniaturized X-ray tube that is inserted directly into the tumor site. “This means that the source is not continually radioactive; it can be turned on and off as appropriate to deliver precisely localized, targeted radiation treatments which protect healthy tissues,” says Sachin Kamath, MD, Director of Radiation Oncology at the cancer center. “The fact it can be used to deliver radiation in minimally shielded therapeutic settings gives us a different way to administer therapy. Treatment can be performed without the need for a shielded room, allowing the radiation oncologist and other medical personnel to be present during treatment delivery and minimizing patient anxiety.”
“Electronic Brachytherapy allows us to focus the radiation ‘more tightly’ around the tumor target, compared to external beam radiotherapy or radioactive isotope-based brachytherapy systems,” says Dr. Kamath. Xoft eliminates the use of radioactive isotopes, resulting in less exposure to radiation, fewer side effects, and excellent outcomes for patients.
Shorter treatment, less radiation
One of the biggest benefits to Electronic Brachytherapy is that it requires fewer sessions than traditional radiation:
v Most women with early stage breast cancer who need radiation treatment undergo whole breast irradiation, which usually requires 6 to 7 weeks (30 to 35 treatment sessions). Some of these women are candidates for partial breast irradiation with Electronic Brachytherapy, which can be completed in 5 days.
v Non-melanoma skin cancers are often treated with 6 to 7 weeks of conventional external beam radiotherapy. With Electronic Brachytherapy, skin cancers can be treated in as little as 5 sessions.
v Some women with gynecologic cancers require radiation treatment after surgery. The treatment may involve a combination of external beam radiotherapy and/or brachytherapy. With Electronic Brachytherapy the treatment can generally be completed in less than 5 sessions.
"We are dedicated to bringing the best, most comprehensive and innovative cancer care to patients in the San Francisco Bay Area. We are so excited to introduce the Xoft Electronic Brachytherapy System as a possible treatment for early stage breast cancer, skin cancers, and some gynecologic cancers," said Dr. Kamath.
Diablo Valley Oncology encourages newly diagnosed patients with early stage breast cancer, skin cancers, and some gynecologic cancers to call to learn if this newer and safer form of radiation treatment is right for them. 925-677-5041 extn 260 or visit http://www.blogger.com/www.DiabloValleyOncology.md

Diagnosis and Treatment of Epithelial Ovarian Cancer

2009-11-27T14:42:00.000-08:00

Ovarian cancer represents about 25% of all female genital tract malignancies. However, there are more deaths from ovarian cancer each year in the United States than from endometrial cancer and cervical cancer combined. The lifetime risk of developing spontaneous ovarian cancer is about 1.7%. Epithelial ovarian cancer was expected cause 15,520 deaths in 2008. Mean age at diagnosis is 60. There has been a significant improvement in the five year survival rate for patients with ovarian cancer. This is likely a combination of better tumor debulking surgeries and better chemotherapeutic options.

Most patients with epithelial ovarian cancer do not have signs or symptoms until disease spreads to the upper abdomen. 70% of patients present with advanced disease. Symptoms for early stage ovarian cancer can include nonspecific pelvic discomfort, urinary frequency and constipation which are caused by an enlarging pelvic mass. With advanced disease, patients experience abdominal pain, bloating, anorexia, nausea and constipation.

The best tumor marker for ovarian cancer is CA 125. Minor elevations in CA 125 can also be seen in endometriosis, benign tumors, fibroids and in pregnant and postpartum women. In addition, moderate elevation of CA 125 can be seen in other adnocarcinoma such as breast and endometrial cancer. The sensitivity of CA 125 is 70% to 80% and the specificity is 98.6% to 99.4%. However, in the average risk population with low prevalence of ovarian cancer, the false positive can be unacceptably high.

The National Cancer Institute recommends screening for ovarian cancer in women with known genetic syndromes associated with this disease and for women with strong family history. Routine screening of women without family history of ovarian cancer is not recommended. The known genetic syndromes include hereditary breast and ovarian cancer syndrome associated with BRCA 1, BRCA 2 and Hereditary Nonpolyposis Colorectal Cancer Syndrome (HNPCC). The absolute risk of ovarian cancer in the presence of either BRCA 1 or BRCA 2 mutation ranges from 16% to 60%. For patients with HNPCC syndrome, the lifetime risk of ovarian cancer is 9% to 12%.

Epithelial ovarian cancer accounts for about 90% of ovarian cancers. Common histologies include serous, mucinous, endometroid, transitiona and clear cell types. Germ cell tumors include dysgerminoma, endodermal sinus tumor, malignant teratoma embryonal carcinoma or primary choriocarcinoma. Stromal tumors include granulose tumor or Sertoli-Leydig tumor.

Upon initial presentation, surgery is used for confirmation and staging of ovarian cancer. Stage I disease is confined to one or both ovaries. Stage II involves one or both ovaries with extension to the pelvic viscera. Stage III is associated with implants on the abdominopelvic wall or the serosal surface of the liver or involves small bowel or omentum. Stage IV disease involves distant metastasis. The 5 year survival for stage IA disease and grade 1 or 2 histology is greater than 90%. For high risk stage I disease and stage II disease, 5 year survival is 80%. For patients with stage III disease after optimal debulking, 5 year survival is 20% to 30%. This reduces to be less than 10% for stage III patients with suboptimal debulking and stage IV disease.

Stage I ovarian cancer with favorable prognostic features can be treated with surgery alone. For women with high risk, early stage cancer (Stage I grade 3 or stage II disease), adjuvant chemotherapy with platinum based agents show an 11% improvement in progression free survival and 8% improvement in overall survival. For stage III and IV disease, the current standard of care include maximal attempt at surgical cytoreduction followed by chemotherapy with platinum based agents.

Optimal debulking is an important part in the treatment of ovarian cancer. Retrospective data have shown that survival is better for women who receive chemotherapy in the presence of low volume disease. In the setting where optimal surgical cytoreduction cannot be achieved, an alternative approach is for the patient to receive chemotherapy up front. For patients who have a partial response to neoadjuvant chemotherapy, it may be appropriate to attempt surgical removal of macroscopic disease at that time.

As for the standard of care in chemotherapy for advanced ovarian cancer, studies have shown that paclitaxel/cisplatin combination is superior to cyclophosphamide/cisplatin combination. Later studies showed that carboplatin/paclitaxel is at least as effective as cisplatin/paclitaxel.

Intraperitoneal chemotherapy is an appealing approach for treating a disease that is largely confined in the peritoneal space. GOG 172 which was a phase III clinical trials demonstrated that this regional approach resulted in superior progression free survival and overall survival when compared with the intravenous approach alone. The disadvantage of this approach includes local toxicity, and requirement for intraperitoneal catheter placement.

Because of the high recurrence rate in patients with advanced ovarian cancer, the issue of whether consolidation chemotherapy may improve time to progression and overall survival was examined in a phase III trial comparing 3 and 12 cycles of taxol. Progression free survival favored the 12 cycle arm. However, overall survival was not different between the two arms. Therefore, the oncologist needs to discuss with the patient and allow them to decide whether the improved progression free survival justifies toxicities including peripheral neuropathy and alopecia.

For many patients with advanced ovarian cancer who have an initial treatment response, disease relapses at a later time. The treatment of patients with recurrent disease or resistant disease needs to be individualized. For people with long treatment free interval, similar drugs many be reused. There are also a number of single agent drugs with activity in ovarian cancer. These include altretamine, bevacizumab, docetaxel, etoposide, gemcitabine, liposomal doxorubicin, paclitaxel, tamoxifen, topotecan and vinorelbine.

Radiation can also play a role in the palliation of some patients with recurrent ovarian cancer. Symptoms such as pain from growing pelvic mass or bone metastasis can be palliated. Very rarely cerebral metastasis can develop which can also be treated with radiation.

The best treatment of ovarian cancer needs a team approach between the primary care physician, gynecological oncology surgeon, medical oncologists and radiation oncologists. As more chemotherapeutic agents become available and as we further understand the biology of epithelial ovarian cancer, we hope to further improve the overall survival and quality of life of our patients.

Gigi Q. Chen, MD, received her medical oncology and hematology training at University of California at Davis. She now practices at Diablo Valley Oncology and Hematology at the California Cancer Research and Treatment Center at Pleasant Hill, California. Her facility specializes in comprehensive, cutting-edge treatment of all forms of cancer through clinical trials, chemotherapy, biological treatments, diagnostic imaging, and radiation. She is on the medical staff of John Muir Medical Center in both Walnut Creek and Concord and the San Ramon Regional Medical Center.

Visit the Diablo Valley Oncology website to learn more about the California Cancer and Research Institute.

Diablo Valley Oncology Breast Cancer Specialist Recognized

2009-11-27T14:41:00.000-08:00

Diablo Valley Oncology and Hematology Medical Group’s breast cancer specialist, Tiffany Svahn, M.D. was given the honor of accepting a Proclamation declaring October Breast Cancer Awareness Month and October 16th National Mammography Day in the City of Orinda. Dr. Svahn received this recognition because of her dedication, hard work, leadership and perseverance in the fight against breast cancer.

Seeing approximately 800 breast cancer patients a year, Dr. Svahn’s approach involves treating the whole person, not just their disease. “I find it important to address not only my patient’s medical needs, but their emotional and psychological ones as well. In addition to focusing on treatment of the disease, I urge my patients to lead a healthy life style with exercise and good nutrition and I help them learn about the different aspects of wellness,” says Dr. Svahn.

As a recognized leader and expert in her field, Dr. Svahn was recently asked to organize and lead a national event for East Bay breast cancer survivors. Held in major metropolitan areas across the country, the event is called “the Many Faces of Breast Cancer”. Dr. Svahn and Diablo Valley Oncology and Hematology Medical Group partnered with the American Cancer Society, the Wellness Community, and AstraZeneca to bring this program to the community. It was held at the Lesher Center for the Arts in Walnut Creek on Saturday October 24th with a full house of breast cancer survivors!

Dr. Svahn has been in private practice since 2006 at Diablo Valley Oncology/Hematology Medical Group located at the California Cancer and Research Institute in Pleasant Hill. She is board certified in Internal Medicine and Medical Oncology and has full privileges at John Muir Medical Center’s Walnut Creek and Concord Campuses and San Ramon Regional Medical Center. Her group’s facility is the largest freestanding community focused cancer center in central Contra Costa County and provides comprehensive cancer and blood disorder care all at one convenient location. There are six medical oncologists and one radiation oncologist in the group and they each focus on one or more specific tumor types and blood disorders. This specialization gives patients an extra level of comfort and confidence knowing they are being cared for by the very best, most knowledgeable practitioners in the field.

The California Cancer and Research Institute is a three story building located in a peaceful, park-like setting at 400 Taylor Blvd in Pleasant Hill. The facility opened in 2008 and is a contemporary and serene space where patients come for medical oncology & hematology appointments, radiation, chemotherapy and biological treatments, diagnostic imaging, clinical trials and supportive services. The comment physicians hear most from their patients is, “You’ve made this so much easier for me. I can see all my doctors and get state-of-the-art treatment all in one location plus I know you are talking to each other about my medical care and condition. It’s like coming to a mini-Stanford or UCSF.” That is the benefit of a community setting facility - patients don’t have to travel far to receive academic level medicine with cutting-edge services where they can navigate through the system faster and easier.

Visit the Diablo Valley Oncology website to learn more about the California Cancer and Research Institute.

East Bay Cancer Center Celebrates 1-Year Anniversary

2009-11-16T10:00:00.001-08:00

Diablo Valley Oncology/Hematology Medical Group celebrates first year anniversary of the opening of the California Cancer and Research Institute in Pleasant Hill. It is the largest nonhospital, freestanding community based cancer treatment facility in Contra Costa County and provides what every cancer patient wants and deserves…the very best in leading-edge cancer treatment with services all in one convenient location.

“We made it our priority to establish the first and finest comprehensive cancer center in the East Bay,” says Dr. Matthew Sirott, President and CEO of Diablo Valley Oncology/Hematology Medical Group. There are six medical oncologists and one radiation oncologist in the group and they each focus on one or more specific tumor types and blood disorders. This specialization gives patients an extra level of comfort and confidence knowing they are being cared for by the very best, most knowledgeable practitioners in the field.

California Cancer and Research Institute is a three story building located in a peaceful, park-like setting at 400 Taylor Blvd in Pleasant Hill. The facility opened in 2008 and is a contemporary and serene space where patients come for medical oncology appointments, radiation, chemotherapy treatments, diagnostic imaging, clinical trials and supportive services.

Gathering state-of-the-art equipment, electronic medical records, and multiple specialties under one roof provides for better coordination of patient care. “It allows an ease and convenience for patients that couldn’t be done before,” Dr. Sirott says. “If I see a patient, order a PET-CT, and decide this person needs to see a radiation oncologist, they can do so on the very same day. The radiation oncologist can evaluate the patient and if necessary, he can treat the patient that day. Because we have these services and physicians working together at the same location, communication and coordination of patient treatment is more efficient and much better. Even the academic centers, which do have all of these pieces, are harder to utilize. That’s the benefit of a community setting - you don’t have to travel far to receive academic level medicine with cutting-edge services where you can navigate through the system faster and easier.”

“Many patients today get radiation therapy and chemotherapy at the same time, so it’s great for them to come to our center for both services and not have to do so much running around,” says Dr. Kamath. “The thing I hear often from patients is, ‘You’ve made this so much easier for me. I can see all my doctors and get my treatment in one location, and I know you are talking to each other about my medical care. It’s like coming to a mini medical center.’”

“When someone is first told that they have cancer, they are shocked, they’re scared, and of course they want to get the best treatment they possibly can,” says Dr. Kamath. “I think this facility is very unique in that we don’t just treat cancer, we treat people with cancer. We use the most advanced, proven technologies to deliver the same level of care as a Stanford or a UCSF, and we do it in a very personalized way,” he adds. “We take care of each of our patients as if they were a close family member; they become part of our DVO family.”

Visit the Diablo Valley Oncology website to learn more about the California Cancer and Research Institute.