Understanding Hormone Therapy For Breast Cancer

In order to better understand hormone therapy, it is important to differentiate it from hormone replacement therapy (HRT); as the two are sometimes confused.

HRT is a form of treatment used to alleviate symptoms that are associated with menopause; while hormone therapy is often recommended as a form of treatment for women with hormone receptor-positive (ER-positive and/or PR-positive) breast cancers.  HRT is used to increase estrogen levels, and hormone therapy is used for the opposite effect—to block or lower estrogen levels in the body.

In women diagnosed with hormone receptor-positive breast cancers or hormone-sensitive breast cancer, elevated levels of the hormone estrogen help cancer to grow. Hormone therapy can be administered by medication or by surgical interventions to either lower estrogen levels or to completely stop estrogen from stimulating and growing breast cancer cells.

Hormone therapy is mostly used after breast cancer surgery to help reduce the risk of cancer returning, decrease the risk of cancer developing in other breast tissue, stop or slow the growth of cancer that has spread.  There are some instances in which treatment may begin before surgery as neoadjuvant therapy.

As with all forms of medical treatments, there are side effects associated with hormone therapy.  Side effects depend on the course of treatment but are known to include hot flashes, vaginal dryness, night sweats, mood swings, and depression and bone loss.

Treatments vary from person to person but there are guidelines set in place to ensure that all patients receive quality healthcare. Guidelines are based on research and agreement among experts. Updated guidelines and overviews can be found in resources provided by the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO) and the National Cancer Institute (NCI).

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Types and Stages Of Lung Cancer

Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) are the two major types of lung cancer. About 80 to 85% of diagnosed cases of the disease are attributed to NSCLC and the remaining 10 to 15% to SCLC.

Once diagnosed, a doctor will try to determine how much cancer has spread; this process is known as staging.  Different stages of the disease describe how much cancer is in the body and can help doctors to decide on suitable treatment options.

The staging system most commonly used for NSCLC is the American Joint Committee on Cancer (AJCC) TNM system.  There are four stages which include:

Stage 1- Cancer is found only in the lungs and has not spread to lymph nodes.

Stage 2 – Cancer is found in the lungs and surrounding lymph nodes.

Stage 3- Cancer is found in the lungs, lymph nodes, and in the middle of the chest.

Stage 4- Cancer is found in the lungs, fluid in the area around the lungs, as well as other parts of the body and other organs.

The stages of SCLC are based on the results of biopsies, physical exams, imaging tests or any additional form of testing used to determine how far this type of cancer has advanced. Doctors typically use a two-stage system to help them to decide which form of treatment is best.  The stages of SCLC are:

Limited Stage- This is when cancer is found in only one side of the chest and in the lymph nodes above the collarbone – on the same side of the chest.

Extensive Stage- This describes when cancer has spread to lungs, the lymph nodes and other parts of the body.

Treatment for each type of lung cancer varies by stage.   Typical approaches for NSCLC may include surgery, radiation, immunotherapy or chemotherapy.  Radiation or chemotherapy are the most common types of treatment used for patients diagnosed with SCLC.

Smoking cigarettes or other tobacco products contribute greatly to the development of lung cancer. Quitting smoking can reduce your risk of developing this deadly disease.

If you are ready to quit smoking, Jamaica Hospital Medical Center provides a free smoking cessation program. To learn about our Freedom From Smoking program please call, 718-206-8494 or visit www.JamaicaHospital.org.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Baby Boomers Encouraged To Get Hep C Testing

Hepatitis C is a virus that affects the liver. It can be a short-lived infection, however more often; it is a chronic silent disease that leads to liver failure and sometimes liver cancer after many years.

Your risk of being infected with hepatitis C is increased if you:

  • Were born from a mother with the virus
  • Received body piercings or tattoos from non-sterile instruments
  • Had unprotected sexual contact with multiple partners
  • Received blood transfusions, blood products or organ donations before 1992
  • Are on long-term hemodialysis treatment
  • Work in health care or public safety and were exposed to blood through a needle stick
  • Were treated for a blood clotting problem before 1987
  • Shared needles, syringes, or other equipment to inject drugs

Baby boomers or people born between the years 1945-1965 are recommended to get tested once, regardless of exposure history or risk. If you were born between these years, please ask your doctor to order this blood test for you.

If you have hepatitis C, a cure can be possible with the appropriate treatments.   Recent research has produced new medications that can essentially cure hepatitis C from the blood and liver. These newer medications have few side effects and are usually taken once daily for 8 or 12 weeks for most uncomplicated hepatitis C infections.

Contact your primary care doctor about how to start the process. Once cured, you are likely to regain improved liver function and reduce the risk of liver failure and liver cancer in the future.

If you have concerns about your risk for hepatitis C or have questions about testing and treatment, please call 718-206-6942 to schedule an appointment with a Family Medicine doctor at Jamaica Hospital Medical Center.

Radeeb Akhtar, MD MPH, Family Medicine

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Cervical Cancer

Cervical cancer is a cancer that involves the lower part of the uterus (womb), which is known as the cervix. This can involve a microscopic lesion, that cannot be seen with the naked eye; or it can involve a larger area that is visible while performing a pelvic exam or during colposcopy.Signs and symptoms can include bleeding after sexual intercourse, irregular vaginal bleeding, bleeding after menopause, abnormal vaginal discharge, and/or pain.

Risk factors for cervical cancer include: infection with certain types of human papilloma virus, and having diseases that lead to lower immunity (such as HIV). Smoking is also a risk factor.

A vaccine is available that can prevent infection with some of the high risk and low risk types of HPV. The Centers for Disease Control and Prevention recommends routine vaccination for boys and girls ages 11 or 12. Vaccination is also recommended for women 13 years through 26, and men ages 13 through 21. Routine screening with a pap smear or going for an annual gynecologic exam can help with the detection of early signs and symptoms of the disease, or the detection of pre-cancerous changes of the cervix. Practicing safe sex and smoking cessation are also some methods to reduce your risk.

Cervical cancer is diagnosed with a biopsy of the cervix.  Prior to having a biopsy, there are abnormal results that can be encountered on a pap smear, that would require further testing or exams (such as colposcopy). There are also two types of procedures that can be performed if there is an abnormality detected with colposcopy and with biopsies, called a Loop Electrosurgical Excision Procedure (LEEP) or a Cone biopsy of the cervix. These procedures can be diagnostic as well as therapeutic.
Treatment options for cervical cancer include surgery, radiation, chemotherapy or a combination of these methods. If you would like to schedule an appointment with a physician in the Women’s Health Center, please call 718-291-3276.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Prostate Cancer – Screening and Treatment

The prostate gland is a part of the male reproductive system that produces a fluid that mixes with sperm and other fluids during ejaculation.  It sits just below the bladder and is normally about the side of a walnut.

Prostate cancer is an abnormal growth of cells within the prostate gland.  Prostate cancer is one of the most common types of cancer in men and the second leading cause of cancer deaths among American men.  The majority of men who reach the age of 80 are found to have prostate cancer however most of types of prostate cancer grow slowly and may not contribute to any serious harm.  Some types of prostate cancers are more aggressive and can spread to other parts of the body.

Prostate cancer, especially in its early stages, may not have any symptoms.  When symptoms are present they may include difficulty starting urination, less force to the stream of urine, dribbling at the end of urination, needing to urinate frequently, urinating frequently at night, pain while urinating, blood in the urine or semen, difficulty starting or maintaining an erection, pain with ejaculation, pain or stiffness in the lower back, hips, pelvis and upper thighs, or unintended weight loss.

Although it is not known exactly what causes prostate cancer some risk factors for developing prostate cancer are older age (more than 65% of prostate cancers are diagnosed in men older than 65), race (African-American men are 60% more likely to develop prostate cancer than Caucasian men), family history (having a father or brother with prostate cancer) and obesity.

There is an ongoing debate among physicians and medical groups about screening for prostate cancer.  Currently many organizations including the U.S. Preventive Services Task Force (USPSTF) and the American Academy of Family Physicians (AAFP) recommend against routine screening for prostate cancer.  Having a discussion with your doctor about prostate cancer screening can help you decide if you should consider undergoing prostate cancer screening based on your unique health history and preferences.

When screening is done there are two tests that are available.  The available tests are a digital rectal exam (DRE) and prostate-specific antigen (PSA) test.  To perform a digital rectal exam your doctor uses a gloved finger, inserted a few inches into your rectum, to check your prostate gland.  A prostate-specific antigen test is a blood test that measures the level of PSA in your blood.  Many men who have prostate cancer have elevated levels of PSA however PSA can also be elevated for less serious causes such as prostate enlargement or infection.  Further testing is needed to diagnose cancer.  Additional tests that your doctor may recommend to diagnose cancer include an ultrasound of the prostate and a biopsy of the prostate.  A biopsy is when a small piece of the prostate is removed to look for abnormal cells.

Treatment of prostate cancer depends on many factors including your age, your overall health and the growth and spread of the cancer when it is diagnosed.  Some men who have slow growing tumors may not need treatment right away and some may never need treatment.  Other types of prostate cancer are aggressive and can quickly spread to other parts of the body making treatment difficult.  Common treatment options include watchful waiting or expectant management (regular testing and checkups to assess for new signs or symptoms), radiation therapy (high-energy x-rays used to kill cancer cells), chemotherapy, surgery (having the prostate gland removed) and hormone therapy. Flushing Hospital also offers robotic surgery and physicians specially trained in its use, as an option for the treatment of prostate cancer.

If you would like to schedule an appointment with a physician at Jamaica Hospital Medical Center to discuss prostate cancer screenings and treatment options, please call 718-206-7001

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Now That You’ve Quit Smoking –How Do You Resist Temptation?

Congratulations, you have quit smoking.  You have accomplished a major milestone in your journey to achieving good health.  A challenge you may face after your Quit Day is remaining tobacco-free by resisting the temptation to smoke again. Coping with tobacco cravings can be difficult; however, by applying the following tips you can decrease the urge to smoke:

  • Remove yourself from situations that may trigger the urge to smoke
  • Spend free time in environments where smoking is not allowed
  • Reduce alcohol consumption
  • Create or join a support group
  • Think about how harmful tobacco is to your health
  • Think about the health benefits you will gain by remaining smoke-free
  • Try nicotine replacements such as gum, patches or prescription medications
  • Do not have just one cigarette to satisfy a craving- one cigarette will make you want more
  • If you miss the feeling of having a cigarette in your mouth try a toothpick, a stick of gum, celery -anything besides a cigarette
  • Exercise
  • Practice relaxation techniques
  • Give yourself credit for each day you are tobacco free
  • Envision being tobacco-free long-term

Quitting smoking and remaining smoke-free can be difficult and requires a life-long commitment but the benefits to your health are immeasurable.

Jamaica  Hospital Medical Center offers a Freedom from Smoking Tobacco Cessation Program to help you overcome your addiction to tobacco and enjoy the benefits of better health in a fun and interactive environment. Receive personalized attention as well as the support from group members who are experiencing this journey with you. For more information, please call 718-206-8494.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

HEPATITIS C

Hepatitis C (HCV) is a disease that infects and causes damage to the liver. It is caused by the hepatitis C virus and is spread from person to person through contact with blood. Over time, this disease can lead to cirrhosis, liver cancer and ultimately, liver failure.

Although hepatitis C is the most common reason for liver transplants in the United States, many people do not know they have the disease until they are donating blood or are diagnosed with liver damage.  The symptoms of HCV can take years to present and may include:

  • Joint pain
  • Sore muscles
  • Dark urine
  • Stomach pain
  • Yellowing of the eyes (jaundice) and skin
  • Fatigue
  • Loss of appetite
  • Fever
  • Clay-colored bowel movements

Learning the risk factors of hepatitis C and receiving treatment promptly can reduce the severity of symptoms. Talk to your doctor about getting tested if the following pertains to you:

  • You were born between 1945 and 1965
  • You are infected with HIV
  • You received a blood transfusion or organ transplant before July, 1992
  • You are having or have had unprotected sex with multiple partners
  • You are a current or former drug injection user and have shared needles
  • You work in an environment where you are exposed to blood through a needle stick
  • You have liver disease or have received abnormal liver test results
  • You were treated for a blood clotting problem before 1987
  • Your mother had hepatitis C when she gave birth to you

If diagnosed with hepatitis C, consider seeing a specialist who is trained and experienced in treating patients with your condition. There are several therapies and medications that your doctor may recommend.  A complete list of approved medications and treatments for HCV can be found on the U.S. Food and Drug Administration’s website.

In addition to treatment, your doctor will also advise that you live a healthy life by maintaining a balanced diet, exercising regularly, reducing or eliminating alcohol consumption, quitting recreational drug use, practicing safe sex and getting regular checkups.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

What are the Symptoms and Risk Factors of Prostate Cancer?

Prostate cancer is one of the most common cancers that affect men living in the United States. The American Cancer Society estimates that in 2017 alone there will be about 161,360 new cases of prostate cancer and 26,730 deaths caused by the disease.

It is important for men to know if they are risk for developing prostate cancer. Risk factors for the disease include:

Age – The chance of developing prostate cancer increases after the age of 50
Race/ethnicity- Prostate cancer occurs more in men of African American and African Caribbean ancestry
Family History- Men with a family history of the disease are more likely to develop prostate cancer
While prostate cancer usually does not present symptoms until its later stages, it is also important for men to know the symptoms. Symptoms include:

Difficulty urinating
Frequent urination
Pain or burning during urination
Painful ejaculation
Blood in urine or semen
Difficulty emptying the bladder completely
Pain in the hip, pelvis or back that does not go away
If you are at risk of developing prostate cancer or are experiencing symptoms, it is recommended that you speak with your doctor as soon as possible. He or she may suggest that you receive testing to find out if you have the disease or to assess the severity of your condition. If you are diagnosed with prostate cancer, there are several treatment options available. Your doctor will discuss which treatment is best based on the advancement of the disease.

To schedule an appointment with a doctor a Jamaica Hospital Medical Center, please call 718-206-7001.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Treating Prostate Cancer

Prostate cancer is one of the most common diseases that affect men’s health.  It is estimated that one in every seven men will receive a prostate cancer diagnosis during his lifetime.

If you or a loved one has been diagnosed with prostate cancer, you most likely have questions about available treatment options.

Before recommending a course of treatment, your doctor will need to determine the stage or severity of the disease.  This can be concluded by using imaging technology to assess how aggressive the cancer might be.  Some of the testing methods utilized by physicians include:

  • multiparametric MRI
  • enhanced MRI
  • positron-emission tomography (PET)

Once the stage of the prostate cancer has been determined, your doctor will recommend the best treatment option. Treatment is unique to each individual and may include a combination of therapies and medication management.

Depending on the severity of your case, treatment may include:

  • Active Surveillance- This is where your doctor will monitor your cancer closely. Surveillance typically includes conducting blood tests and digital rectal exams every six months, observing changes in symptoms and possibly administering prostate biopsies each year.
  • Surgery- One of the most common options used to treat prostate cancer is surgery. Surgery is usually considered when cancer has not spread outside the prostate gland. A radical prostatectomy is the operation that your doctor may perform. It involves removing the entire prostate gland as well as surrounding tissue.
  • Radiation Therapy- Is often used to treat cancers that have grown outside the prostate gland and have spread to nearby tissues. High levels of radiation are used to kill cancer cells or to keep them from growing.
  • Hormone Therapy- Also known as androgen deprivation therapy (ADT) or androgen suppression therapy,  is an option a physician may explore when cancer has spread too far to be treated with surgery or radiation therapy.  The goal of hormone therapy is to reduce the amount of male hormones (androgens) that are produced.   This helps delay the progression of prostate cancer.
  • Chemotherapy- If hormone therapy is not working; your doctor may consider chemotherapy as a form of treatment. During chemotherapy, a combination of cancer–fighting drugs is administered by mouth or intravenously.  This form of treatment is best used to shrink or eliminate cancer cells that have spread outside the prostate gland into other parts of the body.

Making treatment decisions can be challenging.  Your first step in making a decision is to learn about your options. As an informed patient, you will be able to help your doctor to make a care plan that is best for you.

To schedule an appointment with a urologist at Jamaica Hospital Medical Center, please call 718-206-7110.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Colorectal Cancer Risk factors and Prevention

colonoscopyColorectal cancer is a disease that causes abnormal cells or tumors to develop in the colon or rectum.  It is the third most commonly diagnosed type of cancer found in men and women in the United States.

Although colorectal cancer causes the deaths of approximately 50,000 people each year; the rate of survival is improving due to education, early detection and treatment.

Learning the risk factors of colorectal cancer is essential as there are risk factors you can control and some you cannot. The risk factors you can control include:

  • Smoking
  • Being overweight or obese
  • Lack of physical activity
  • Poor diet – a diet rich in red meats and processed meats can increase your risk
  • Heavy alcohol consumption

These factors can be addressed by quitting smoking, exercising, eating a healthy and balanced diet and moderating your consumption of alcoholic beverages.

The factors that you cannot control that may contribute to colorectal cancer are:

  • Age- people over the  age of 50  have a higher risk in developing the disease
  • A family history of colorectal cancer or adenomatous polyps
  • A personal history of colorectal polyps, colorectal cancer or inflammatory bowel disease
  • Having an inherited gene defect  that can cause family cancer syndromes such as familial adenomatous polyposis (FAP), Gardner syndrome, Turcot syndrome or Lynch syndrome
  • Race or ethnicity
  • Having type 2 diabetes

Knowing your risk factors and taking appropriate actions can help you to reduce the probability of developing the disease.

Although it is not completely clear what causes colorectal cancer; it can be prevented by receiving regular screenings. With regular screenings, polyps or colon cancer can be found and treated early before advancing.

There are several testing methods your doctor may use to screen for colorectal cancer. Screening tests may include a colonoscopy or other testing methods such as fecal occult blood test,   flexible sigmoidoscopy, CT colonography or double-contrast barium enema. The American Cancer Society   recommends that men and women should receive screenings beginning at the age of 50.

For a complete guide to the American Cancer Society’s recommendations for colorectal cancer early detection, please visit https://www.cancer.org/cancer/colon-rectal-cancer/early-detection/acs-recommendations.html

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.