Archive for the ‘breast cancer’ Category

Week in Review: (May 22 – 28, 2011) The Eye Opener Health, Law and Medicine Blog

Saturday, May 28th, 2011

From the Editor – Brian Nash

Last week’s posts by our blawgers were packed with information about a variety of topics ranging from the medicine you need to know about concussions, living with cancer, cerebral palsy resources and the potential risks of overdosing your child with medications.

On the legal front, we began a series I’m personally excited about. We call it Legal Boot Camp. It will be a series for those in our practice jurisdictions of Maryland and Washington, D.C. Our teacher’s face is on – lesson plans in place. We hope you learn some things about the laws that can affect your lives in the areas of personal injury – particularly medical malpractice law.  Our first class took place with a piece by Sarah Keogh that examines the law in Maryland on the right to claim loss/diminished earning capacity. If you’re wondering if you can have such a claim even if you weren’t working when you were injured, Sarah has some information for you. Check it out. Turn in your class card and have some fun.

We wrapped up the week with a piece by yours truly on a wonderful community outreach program by our local baseball heroes, the Baltimore Orioles. Aptly named – OriolesREACH, this initiative has a number of wonderful events, charities and missions that are worth knowing about. One in particular, Shannon’s Fund, is a great program to help those in need while dealing with the financial burdens while dealing with cancer. It is run by the University of Maryland Medical Center. Read about our challenge to our brethren before the bar in the Greater Baltimore Area.

Without further ado, here are the blogs we posted this past week …. and a sneak peak of the week ahead.

Concussions: The Message of Brian Roberts’ Injury Should Not Go Unheeded

Posted by Brian Nash

Anyone who follows sports is well aware that finally the old school mentality of “gut it out and get back in there” following blows to the head are coming (not too soon) to an end. Committees have been formed, articles written and the national spotlight of the media have finally focused on this issue. Those recommendations, debates and guidelines are beyond the scope of this post. Nevertheless, those involved in sports…Read more >

Children’s Medications: Coming Changes and Tips to Avoid Overdose

Posted by Sarah Keogh

My children are both young; the youngest is now a little past her second birthday. In the last few years, we have had both infant and children medication in the house, liquid and tablets, and I have been very careful to make sure to double-check myself if I ever have to medicate either child to make sure that I am reading the correct dosing matrix for the correct concentration and for the correct child. More often than not, I have found that children need medication when their parents are tired. As parents know – children frequently…Read more >

 

Living With Cancer: What to Expect After the Diagnosis

Posted by Jon Stefanuca

About a million and a half people will be diagnosed with cancer in the U.S. this year. The devastating truth about cancer is that about one-third of these people will die from cancer at some point. For most, the diagnosis is unexpected and completely overwhelming.The cancer does not just affect how one feels, it undermines all sense of security and stability. It changes lifestyles and redefines relationships. So often the emotional trauma is equally shared among family members and loved ones. Read more >

New Blog Series: Legal Boot Camp

Posted by Brian Nash

I’m really pleased to announce a new series we’re starting today. If you’re a reader of our blog, you know that we post numerous times a week on health, safety, medicine and related law topics. That’s what we do in our firm – we represent people who are injured by the negligence of health care providers and those who suffer catastrophic injuries in non-medical settings as well. So, sharing what we believe is some good information about medical, health and safety issues is our mission. We strongly believe that our social networking should be about giving good information, engaging in dialogue about relevant issues – just plain good, old sharing. Read more >

Legal Boot Camp (First Class): The Story of Pam – Maryland’s Law on Loss of Earning Capacity

Posted by Sarah Keogh

A 41-year-old woman, Pam, who was laid off from her job as a swimming instructor and swim coach in December of 2009, has been struggling to find a new position for the last few years. Even though Pam had been working as a swimming instructor full-time for the past 18 years, she felt that she needed to jump into a new career while waiting to find a new position as a swimming instructor and coach. Starting in October of 2010, her father died leaving her a rundown home that he had recently purchased with the intent of renovating it. Pam felt that she could put her physical fitness and knowledge of home aesthetics to work, not to mention the ideas she picked up watching renovations shows while unemployed, by renovating the home her father left… Read more >

Dealing with Cerebral Palsy: A Resource for Parents and Family

Posted by Jason Penn

Today’s society has become increasingly dependent on aggregators. We use a variety of methods to assemble and sort information so that we can easily consume it.  Mint.com and Quicken help with our finances and Google Reader helps to manage our online content. A quick search of the internet suggests that the parents of children withcerebral palsy do not yet have an objective aggregator of information to turn to.  Let’s consider this our attempt to provide parents in the Baltimore and Washington D.C. areas with a place to turn. Read more >

Charity Begins at Home: OriolesREACH Program Hits a Grand Slam with Us!

Posted by Brian Nash

I recently wrote a post about our local area charities and civic organizations who do so much for so many in our community. With that in mind, as I was happily reading the sports page in the warm glow of the Orioles’ 12th inning victory yesterday (5 in a row – Go O’s), I came across a piece about a new initiative for our military personnel by the Birds. While looking at the details of this worthy program, I noticed (ashamedly for the first time, I admit) a host of community programs being run by the Orioles. The team uses the name OriolesREACH for the community programs they sponsor, promote or fund. Read more >

Sneak Peak of the Week Ahead

Here’s a sampling of what’s coming next week on The Eye Opener: Views and Opinions from the Nash Community:

  • As families prepare for the upcoming holidays and summer vacation, Theresa Neumann has some important medical advice about what else needs to be included in your travel plans.
  • Legal Boot Camp: Prepare for our second class – get those pencils, pens, iPads and whatever else you need out and ready – there could be a pop quiz on next week’s primary on law.
  • What rights do babies-before-birth (fetal rights) have in our legal system? Do parents who lose a child just before birth have any rights of recovery? You’ll find out next week.
  • Home births are on the rise. Is that a good or a bad thing? Sarah Keogh weighs in on that issue in the coming edition of The Eye Opener

And….maybe even more to come…you can never tell….

Have a wonderful and safe Memorial Day Weekend. Best to All of You and Your Families and Friends from All of Us at Nash & Associates

Living With Cancer: What to Expect After the Diagnosis

Wednesday, May 25th, 2011

Alicia Staley - Cancer Survivor - Visual (Image from her site - awesomecancersurvivor.com

About a million and a half people will be diagnosed with cancer in the U.S. this year. The devastating truth about cancer is that about one-third of these people will die from cancer at some point. For most, the diagnosis is unexpected and completely overwhelming.The cancer does not just affect how one feels, it undermines all sense of security and stability. It changes lifestyles and redefines relationships. So often the emotional trauma is equally shared among family members and loved ones.

Needless to say, the original cancer diagnosis marks the beginning of a difficult, frightening and frustrating experience. For this reason, it is critical not to despair. One must always remain hopeful, adjust, and prepare for the way to recovery. A fundamental step in this process is gaining an understanding and familiarity with the impending medical treatment and associated lifestyle changes. A good deal of stress can be avoided by simply understanding what to expect. While cancer treatment varies depending on the type of cancer and the individual characteristics of the patient, the patient should generally be aware of the following:

Chemotherapy

The vast majority of cancer patients will receive some degree of chemotherapy. This may consist of one or more chemotherapy cycles.  Each cycle can be as long as 3-6 months. Chemotherapy involves the administration of various chemical agents called antineoplastic drugs in order to stop cancerous cells from dividing. Antineoplastic drugs are designed to attack and kill cells that divide in an uncontrolled or rapid matter. Antineoplastic drugs, however, are not able to discriminate between cancerous cells and normal cells. Therefore, cells that divide rapidly as part of their normal life cycle are also attacked. Chemotherapy may cure the cancer entirely or control its growth. Many times, chemotherapy is used in conjunction with other treatments. Some associated complications of chemotherapy include:

  • Anemia
  • Hair Loss
  • Lethargy
  • Nausea and loss of appetite
  • Kidney damage
  • Liver damage
  • Heart damage
  • Deterioration of pre-existing medical conditions such as osteoarthritis, among other things.

Radiation Therapy

In addition to chemotherapy, a patient may also receive radiation therapy. Radiation therapy involves exposing cancerous tissue to ionizing radiation (electromagnetic waves), which tends to destabilize the molecular structure of cancerous cells. In essence, the electromagnetic waves will ionize the atoms of the cancerous cells, by displacing electrons within the inherent structure of the atom. In turn, this process destabilizes the molecules of the cancerous cells, causing them to die.

Surgery

In a number of instances, cancer patients will also require surgery to treat their cancer. Often times, the malignant tumor is identifiable and localized (as opposed to metastasized). In such instances, timely surgery is preferred. Chemotherapy of radiation therapy may follow the surgery. The type of surgery  will vary depending on the type of cancer and how advanced it is. For example, a woman with ovarian cancer will likely undergo a total hysterectomy, including the removal of the ovaries. A patient with intestinal cancer may undergo a laparotomy with dissection of the cancerous tissue. Generally speaking, the sooner the cancer is identified, the less extensive the surgery.

Monitoring

After surgery and chemotherapy/radiation therapy, each cancer patient/cancer survivor should establish a systematic and well developed course of monitoring and supportive care with his/her physician. This will often involve a number of other health care providers such as physicians, nurses, and physical therapists. For example, a patient who has undergone treatment for ovarian cancer may require monitoring by an oncologist, a surgical oncologist, an internist (primary care physician), a gynecologist, and even a urologist. One must then factor in the extent to which the cancer treatment resulted in additional complications or the extent to which pre-existing medical conditions deteriorated as a result of the cancer treatment. As such, the patient may require the involvement of additional specialists to address and monitor the side effects of the cancer treatment. It is very important that the patient maintain a healthy nutrition and exercise regimen, if and as prescribed by the physician.

The bottom line is that cancer patients will invariably have a long and difficult road to recovery, which may take months or even years. Drastic lifestyle changes may be necessary, and patience as well as perseverance are essential. A cancer patient must know what to expect and be proactive to create support structures involving health care providers and family members/loved ones.

Helping Others in Need

If you or someone you know is a cancer patient/survivor, I encourage you to share your story with our readers. What helped you most to cope and persevere on your way to recovery?

Related Posts:

Ovarian Cancer: Five Tips to Get the Medical Care You Need

Ovarian Cancer: Early Intervention is Key – What You Must Know…

Breast Cancer: What You Need to Know About Digital vs. Film Mammograms

Warning to Women of Menopausal Age: HRT Linked to Increase in Death From Breast Cancer

What you need to know about digital vs. film mammograms

Tuesday, February 22nd, 2011

In a recent report published in the journal Radiology, the findings of a research group from Barcelona, Spain, provided women and the medical community with some key information about the use and efficacy of digital mammography. As reported in DoctorsLounge, the researchers, headed by Maria Sala, M.D., Ph.D, concluded that digital mammography had a lower false-positive rate than screen-film mammograms; however, there was “no significant difference in the cancer detection rate between the two, according to [the] study.”

If you are unfamiliar with this new technology, here’s a video presented by WellSpan HealthSource. See what they believe some of the benefits are for digital mammography.

httpv://www.youtube.com/watch?v=_TLhjsFeQDg

Here’s the statistical information regarding false-positive and detection rates between these two modalities of mammograms.

The researchers found no significant difference in the cancer detection rate between the two modalities, with the screen-film detection rate at 0.45 percent and digital at 0.43 percent. The false-positive rate for screen-film mammography was 7.6 percent but for digital mammography the rate was 5.7 percent. Digital mammography also had lower recall rates and was less likely to result in a false-positive result leading to an invasive procedure. The lower false-positive risk remained even after results were adjusted for women’s characteristics, screening program characteristics, and time trends.

Who should undergo digital mammography?

Dr. Michael Wu, of the Palo Alto Medical Foundation, has an informative post on the issue of who the best candidates are for digital versus film mammography. He gives a synopsis of the groups, as reported by The New England Journal of Medicine, who are the best candidates to undergo digital mammograms.

Those who benefited:

  • Women < 50
  • Women with dense breast tissue
  • Women who were premenopausal or perimenopausal.
  • Those who did not appear to benefit:

  • Women > 50
  • Women post-menopausal
  • Those without dense breast tissue
  • Dr. Wu’s post also addresses issues such as cost effectiveness and radiation exposure differences between the two methods of digital and film mammograms. What may be of interest to many women is that the actual technique (which I understand can be painful for many women) is the same. Perhaps further development of devices and systems will lower this problem – hopefully – in the future. Needless to say, the discomfort for 20 – 30 seconds is far outweighed by the benefits of early detection of breast cancer.

    3-D Mammogram recently approved by FDA

    It was also recently reported by PRNewswire that the FDA recently approved the first 3-D digital mammogram (tomosynthesis scans) system. Hologic, Inc., a leader in the development, manufacturing and distribution of medical devices, including medical imaging systems and the company whose system won this approval, ran a series of clinical trials using this new 3-D mammography system.

    Undoubtedly beaming with joy over having his company’s product be the first to be approved, Rob Cascella, President and CEO of Hologic, has this to say about this new medical weapon in the fight against breast cancer:

    Our Dimensions 3-D takes advantage of all of the benefits of digital mammography and quite simply makes it better with the combination of fast, high quality 3-D breast imaging. We believe tomosynthesis has the potential to change how screening and diagnostic mammography is performed, and over time will prove invaluable to the earliest possible detection of breast cancer and in the reduction of unnecessary diagnostic interventions.

    it will be very interesting to see if the recent study in Spain by Dr. Sala and his colleagues is taken further by his group or other researches to examine whether this newer 3-D technology will further change the landscape in lowering false-positive rates or – even more important – increasing the early detection rate for breast cancer.

    Some basic, highly disturbing facts about breast cancer:

    The PRNewswire release also provides the following information about breast cancer:

    One in eight American women will develop breast cancer sometime in her lifetime. In 2009, an estimated 192,370 new cases of invasive breast cancer were diagnosed among American women, as well as an estimated 62,280 additional cases of in situ breast cancer. Over 40,000 American women died from breast cancer in 2009. Only lung cancer accounts for more cancer deaths in American women. The stage at which breast cancer is detected influences a woman’s chance of survival. If detected early, the five-year survival rate is 98 percent. At this time, there is no sure way to prevent breast cancer, which is why regular mammograms starting for most women at age 40 are so important.

    This video by one of the country’s premier institutions for cancer treatment, MD Anderson Cancer Center, provides some very useful information and some excellent suggestions for undergoing a mammogram.

    httpv://www.youtube.com/watch?v=Y-GmNmPeqHQ

    Readers’ Information

    There is no doubt that many physicians, researchers and women have exceedingly superior knowledge of these techniques, systems, risks and benefits, and the like. Have any of you been involved in this research? Have you  had or do you know someone who has undergone digital mammography? What information can you share with our readers about this new technology? We invite you to share this information and spread the word by sharing this post with you friends. As we always say, being an informed patient is essential to improving your health and survival.

    Mammography the “Australian Way” – Why aren’t we doing this in the US?

    Wednesday, November 17th, 2010

    I came across an online article today by Marianne Betts of heraldsun.com.au that there was a problem regarding mammogram reports that had gone out to over 5,000 women who recently had this test performed. There was apparently a breakdown in their review process, which required massive notifications to the women involved.

    While this is no doubt very serious business for all concerned, I decided to post this blog for an entirely different reason. I simply was not aware that in Australia, two radiologists read mammograms independent of each other as a normal practice.

    A senior radiologist, Professor Jenny Crawson, is quoted as saying that this standard practice of two separate, independent radiology reads (i.e. interpretations) is standard practice in Australia was a “proven success.”

    The article goes on to report that with this practice, if both radiologists agree the images are “clear” (no evidence of detectable suspicious lesions/cancer), then the patient is given the “all clear” notification. However, if they disagree, the opinion of a third radiologist is sought.

    Dr. Cawson is then quoted to say:

    There’s a lot of  scientific evidence that if you have two radiologists reading mammograms you have a higher detection rate of breast cancer than if you have one radiologist.

    So it’s a quality assurance mechanism to maximise cancer detection.

    Have any of you heard of this practice being followed anywhere else? Anywhere in the United States? Is anyone aware if this program or practice has been studied in the United States or elsewhere in terms of effective higher detection of breast cancers? If we are not doing this (which I’ve never heard of) here in the US, why not? Cost?

    I would really like to hear what you know about such a practice.

    Image from norwalkradiology.com

    Warning to Women of Menopausal Age: HRT Linked to Increase in Death from Breast Cancer

    Friday, October 22nd, 2010

    One day after Pfizer wins the latest lawsuit regarding HRT in Arkansas, a new study published in the October 20, 2010 issue of the Journal of the American Medical Association found a link between prolonged use of HRT and the risk of not only developing breast cancer but of dying from the disease.

    This new study began with data from the Women’s Health Initiative, a randomized-controlled study of post-menopausal women that abruptly ended in 2002, when a definitive increase in the incidence of breast cancer was discovered in women taking the combined HRT of estrogen-plus-progestin.  Since the end of that study, researchers continued to follow the participants and found that women taking the combined HRT were more likely to have an invasive breast cancer, more likely to have breast cancer that spread to the lymph nodes, and more likely to die from breast cancer than participants in the placebo group.

    Estrogen-plus-progestin pills like Prempro increase breast density making tumors difficult to identify on mammograms which delays the diagnosis and inevitably the treatment for the disease. The researchers conclude that women taking HRT should use the lowest dose for the shortest amount of time to reduce their risk of developing breast cancer.

    The Today Show’s Dr. Nancy Snyderman discusses the study’s conclusions on the Today website with a warning to women of menopausal age to consider the risks of HRT and to discuss with their physicians the possibility of taking the lowest dose for the shortest amount of time.

    It is important to note that the study findings only apply to hormone replacement therapy with estrogen-plus-progestin pills or combined hormone therapy, not to estrogen-only therapy.

    Contributing Author: Rachel A. Leyko

    Woman undergoes mastectomy only to learn a week later, she never had cancer. Now another patient of same doctor claims the same fate.

    Friday, June 4th, 2010

    The Vancouver Sun reported that in 2001, Dr. Barbara Heartwell of the Hotel Deiu Grace Hospital in Windsor, ON performed an unneccessary mastectomy. Janice Laporte was the victim of Dr. Heartwell’s disfiguring mistake.

    Ms. Laporte underwent a mastectomy in September of 2001 , and was told just one week post-operative that she never had breast cancer. Ms. Laporte’s case details are protected by a confidentiality clause; her case was settled soon after filing suit in 2002. Ms. Laporte told the Canadian Press, after a second patient came forward:

    “It’s bad enough to have to be told you have cancer or to have a mastectomy,” she said.

    “That is devastating enough, but then to hear that it was done for no good reason just compounds everything.”

    “At least things are being looked in to now,” she said. “It’s unfortunate that this has to happen for them to look into this kind of stuff.”

    The second woman who allegedly fell victim to Dr. Heartwell’s “mistaken diagnosis” is Laurie Johnston, a middle-aged single mother of a teen daughter. Ms. Johnston claims she underwent an unneccessary mastectomy in November of 2009.

    Ms. Johnston has filed suit with similar accusations to those of Ms. Laporte. “Heartwell performed ‘dramatic, disfiguring and invasive surgery’…” Since filing suit, Ms. Johnston has also taken her case public.

    Hotel Deiu Grace Hospital claims it became aware of the lawsuit when a reporter inquired about details of the case. The hospital has since launched an investigation into Dr. Heartwell’s cases. Dr. Kevin Tracey stated during a news conference with the Canadian Press that:

    “During the course of our investigation she indicated that in our review of her past cases we would find additional cases of concern”

    Apparently, these “additional cases of concern” caused the hospital to widen it’s investigation to include over 10,000 pathology reports  which were completed by Dr. Olive Williams.

    Dr. Williams’ privileges were suspended in January; Dr. Heartwell voluntarily stopped operating in the early weeks of March. Both physicians have been reported to the College of Physicians and Surgeons of Ontario.

    To prevent further such tragic events as happened to Ms. Laporte and ostensibly Ms. Johnston as well, a pre-surgery safety checklist was implemented into hospital practice in April. Deb Mathews, Ontario’s Health Minister, claims that of the items on the checklist, review of biopsy results are required prior to administering anesthesia.

    A Windsor lawyer, Harvey Strosberg, predicts that Ms. Johnston’s case will never see the inside of a courtroom. Her case is strong and he predicts that she will likely reach a settlement agreement.

    Simply put – it SHOULD never see ‘the inside of a courtroom. How tragic!

    Univ of Michigan's Cancer Center Study Tests Freezing Technique for Breast Cancer Tumor | Testing It Up – Test Country Blog

    Saturday, March 6th, 2010

    Is there a new treatment for breast cancer on the horizon? Read this blog report –  Study Tests Freezing Technique for Breast Cancer Tumor | Testing It Up.

    Cryoablation – freezing – has been successfully used in mice to stop the spread of breast cancer.  The research was conducted by a team at the University of Michigan Comprehensive Cancer Center, which is affiliated with the university’s medical school.

    Dr. Michael Sabel, who led the team of researchers,  explained the following in a news release:

    “Cryoablation has strong potential as a treatment for breast cancer… Not only does it appear effective in treating the primary tumor with little cosmetic concerns, but it also may stimulate an immune response capable of eradicating any cells that have traveled throughout the body, reducing both local and distant recurrence, similar to giving a breast cancer vaccine.”

    The original report on this important research was done by BusinessWeek – for further information read the posting by that publication.

    If you go to the Center’s site,  you will also find fascinating and important stem cell research being conducted by that institution and an informative video done by the Center’s director, Dr. Max Wicha, regarding their stem cell research efforts.

    It was at this Center that breast cancer stem cells were first discovered in 2003.

    While there has been a steady decline in the death rate related to breast cancer since 1990, the bad news is that approximately 41,000 women are still dying each year in the United States alone from this horrible disease.

    Aspirin Found to Decrease Mortality in Breast Cancer Patients

    Wednesday, February 17th, 2010

    A recent study reported in Medical News Today and published in the Journal of Clinical Oncology suggests that women who take aspirin at the conclusion of chemotherapy are less likely to die from breast cancer.

    The study involved 4,164 female registered nurses who were diagnoses with breast cancer between 1976 and 2002. Because aspirin is contraindicated during chemotherapy, those patients who took aspirin generally began taking the drug a year after their breast cancer diagnosis.

    The result of the study suggests a positive correlation between taking aspiring and decreased mortality rates. Women who took aspirin at least two days a week reduced their mortality risk by 64% to 71%.

    Questioning The Change In Mammography Guidelines

    Sunday, January 31st, 2010

    Recently, I posted a blog on the new guidelines for mammograms  issued in November 2009 by the US Preventive Services Task Force.

    A new posting on Medical News Today provides ‘the other side of the argument.’  Specialist in diagnostic imaging have questioned these new guidelines.  A recent article - Questioning The Change In Mammography Guidelines – takes the position that -

    The methodology and evidence behind a widely publicized change in national mammography guidelines is questionable, according to a review in the Journal of Diagnostic Medical Sonography (JDMS), published by SAGE

    For those who have been following the history of these ‘guidelines,’ you know that they have changed a number of times.  One wonders if they shouldn’t be required reading on Twitter for physicians so that they can keep up with the ‘standard of care’ when treating their patients.  Where will it all end?  Who knows.  I stand by the advice given in our prior post:

    Perhaps the best advice – Women be knowledgeable about the recommendations and discuss them and their application to you and your risk factors for breast cancer with your gynecologist.  If you are a young woman or are unfamiliar with what a mammogram is all about, you may want to consider watching a video of what this test is all about and how it is performed.

    Medical News: Sorting Out the Mammography Mess – in Hematology/Oncology, Breast Cancer from MedPage Today

    Saturday, January 30th, 2010

    Confused about when you should start undergoing screening mammography?  A recent article in medpage today -Medical News: Sorting Out the Mammography Mess – in Hematology/Oncology, Breast Cancer from MedPage Today – attempts to educate women about this seemingly ever-changing set of guidelines.

    The article contains an audio interview with Dr. Len Lichtenfeld, Deputy Chief Medical Officer of the American Cancer Society, which is worth a ‘listen.’

    This whole new discussion as to when women should get screening mammograms arose when the US Preventive Services Task Force issues its recent recommendations.

    Perhaps the best advice – Women be knowledgeable about the recommendations and discuss them and their application to you and your risk factors for breast cancer with your gynecologist.  If you are a young woman or are unfamiliar with what a mammogram is all about, you may want to consider watching a video of what this test is all about and how it is performed.