There are various treatment options for childhood cancers

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

September is Childhood Cancer Awareness month.

During the last two weeks, we’ve discussed what cancer is and some of the common types of childhood cancers.

This week, we discuss the various treatment options, how they work and some of the side effects.

Doctors have three main treatment strategies to treat cancer: surgery, radiation, and chemotherapy.

Depending on the type of cancer and how much it has spread, the overall treatment may combine several of the different kinds of therapy.

We’ve found it useful to explain cancer treatment with an analogy many people can easily relate to — fighting weeds in your yard.

When you discover a small cluster of weeds in the middle of your yard, you can probably successfully get rid of them by digging around the offending patch and pulling them out by the roots. Continue reading

Childhood cancer is random mistake in DNA instructions

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

The word cancer certainly strikes a scary and emotional note in our hearts, and when attached to the word childhood, it can be especially frightening.

However, as with many things we fear, we can be empowered by understanding. This week, we explain just exactly what cancer really is.

Every part of the body — the brain, liver, heart, bones, fingernails, muscles and so on — is made up of hundreds of millions of microscopic cells that are specialized for that particular organ.

These cells follow a very complex and highly organized instruction set from their DNA to multiply, grow and eventually die and become replaced throughout our entire lifetimes.

Occasionally, however, the instruction set becomes damaged as it is copied into newly formed cells. Usually our bodies can recognize cells with damaged DNA and repairs or destroys them. Continue reading

Thirdhand smoke is dangerous, too

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Science has long proved that smoking is bad for you and those around you, with 90 percent of lung cancer cases caused by smoking.

Even secondhand smoke is dangerous enough to warrant banning smoking in public places. The idea of thirdhand smoke premiered in 2009, and scientific evidence shows that it, too, can harm human health.

Thirdhand smoke is the many toxic compounds from tobacco smoke that settle onto surfaces (particularly fabrics) such as carpet, furniture and the inside of a car. Researchers have identified chemicals in thirdhand cigarette smoke called NNA and NNK that can bind to DNA, a person’s genetic information, and cause damage and mutations that could lead to cancer. Continue reading

Legal for medical research: Marijuana is beneficial for cancer patients

Dr. Victor Sierpina

Dr. Victor Sierpina

Rocky Mountain high. Imagine my surprise when I returned to visit the tiny mountain hamlet in Colorado where I was in solo practice as the country doc for nearly a decade back in the 1980s and ’90s and discovered a new clinic on main street.

The town is in a mountain valley situated at 7,500 feet above sea level. So, the new clinic was appropriately and whimsically called The High Valley Cannabis Center.

Medical marijuana had come to a town long known for its aging hippies and artists who were no strangers to its usage. Many not only inhaled weed in the ’60s, but I suspect a number had never exhaled.

As more states, now numbering around 15, approve marijuana as legal for medical, or even recreational, use, as recently occurred in Colorado, we come inevitably to the question of is this a good idea for sick people or is it a social folly? Continue reading

Cancer Goggles

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Cutting people open and sewing them back up for a living is a pretty stressful occupation to begin with, but some surgeons have tougher jobs than others. Cancer surgeons are charged with removing all tumor cells on the first try. But tumor growth can be irregular, and it can be hard to distinguish cancer cells from normal cells during an operation. Imaging techniques like MRIs and CT scans can give surgeons a road map to the tumor, but they offer only limited help once an incision has been made.

This is because these images are merely snapshots — a single frame and dimension. Even three-dimensional images can only be viewed one frame at a time. In addition, the inside of the body is dynamic and it takes a skilled surgeon to understand the orientation of tissues and the precise margins where tumor tissue ends and regular tissue begins.

Because of this challenge, surgeons often have to remove healthy tissue to be sure all tumor cells are gone. This requires a special step: staining the removed tissue then looking at it under a microscope to identify the cells. The surgeon wants to be sure a margin of healthy tissue is removed so no tumor cells remain. Continue reading

Pancreatic Tumor Marker

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Pancreatic cancer is the most deadly form of cancer. Each year, 45,000 Americans are diagnosed with it and every year 40,000 people (90 percent) die from it. One reason most people don’t survive pancreatic cancer is most of the pain and symptoms don’t appear until the cancer has progressed and treatment comes too late. Even then, pancreatic cancer is resistant to chemotherapy and radiation. Another reason is that there is not an easy, reliable test for pancreatic cancer — until now.

The pancreas is a small, oblong, flat organ at the back of abdomen between the stomach and the spine. It is responsible for regulating blood sugar levels by producing hormones such as insulin. The pancreas also produces enzymes for the digestive system that neutralize stomach acid and help break down carbohydrates, fats and proteins.

While there aren’t many noticeable symptoms at first, as pancreatic cancer advances it can cause abdominal pain, weight loss, nausea, fatigue and jaundice (when the skin, eyes and mucus turn yellow). Since these symptoms are rather generic, even once someone starts experiencing them it is hard to tell the difference between pancreatic cancer and something benign, like gallstones or bile duct stones. While doctors normally use imaging techniques and endoscopies to distinguish between the two, scientists have identified a new marker that can be used to accurately diagnose a pancreatic tumor.

Continue reading

Keeping Kids Healthy – Parents should urge children to not use e-cigarettes

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

E-cigarettes are easy to buy — but can hook children on nicotine. Parents may try electronic cigarettes to help them quit smoking. Teens may try them because they think they are safer than regular cigarettes.

One electronic cigarette can have as much nicotine as a whole pack of cigarettes. In addition, the Food and Drug Administration has found cancer-causing chemicals in electronic cigarettes. Continue reading

Breast cancer: Making the tough decisions

Drs. Techksell Washington & Karen Powers

Drs. Techksell Washington & Karen Powers

The BRCA1 and 2 gene mutations that predispose women to aggressive breast cancer got a lot of attention this year when actress Angelina Jolie shared her preventive double mastectomy with the world.

In honor of Breast Cancer Awareness Month, and as breast specialists at the University of Texas Medical Branch, we think it’s a good time to take another look at some of the details surrounding genetic testing, treatment options and reconstruction decisions.

Jolie’s public sharing of her personal story surely resonated with many women who think they may be at risk. If you were one of them, we advise speaking with your primary care physician about genetic testing.

UTMB’s Breast Health and Imaging Center has a high-risk clinic with genetic counselors who can guide patients through screening and potential genetic testing for the BRCA1 and 2 mutations. Women with those mutations have a more than 80 percent chance of developing breast cancer and a 40 percent chance of developing ovarian cancer during their lifetimes. Continue reading

More than just mammograms

Dr. Angelica Robinson

Dr. Angelica Robinson

As the director of breast imaging at the University of Texas Medical Branch at Galveston, I am often asked to give public talks during Breast Cancer Awareness Month. Invariably, during the question and answer period, someone in the crowd timidly asks me to explain what exactly I do as a radiologist.

Radiologists are doctors who interpret images from X-rays, ultrasounds, CT scans, PET scans, MRI scans and mammograms. We have many years of specialized training – four years of undergraduate education, four years of medical school, five years of residency training in diagnostic radiology and a final year of subspecialized fellowship training for those of us who choose to focus on a specific aspect of radiology (such as breast imaging).

Radiologists do not “take” the actual images. Radiology technologists are the health professionals who do that. Our job is to review the final images, interpret the findings in the context of the patient’s clinical history and provide a written report that details the findings and provides an impression of those findings. Continue reading

Breast cancer treatment continues to evolve

Dr. Colleen Silva

Dr. Colleen Silva

Breast cancer treatment has changed dramatically in the past 25 years.

When I entered the field of breast surgery in the late 1980s, modified radical mastectomy was still the standard treatment.

We removed the entire breast, all the lymph nodes under the arm, the nipple and much of the breast skin.

Breast reconstruction was rare.

Today, however, we offer breast-conserving surgery to two out of three women with early-stage breast cancer. The partial mastectomy or lumpectomy has replaced the total mastectomy as the treatment of choice whenever possible.

When mastectomy is required, we now perform a skin-sparing version of the procedure, sometimes even saving the nipple.

We also offer immediate breast reconstruction — a procedure that has been fully reimbursable by insurance since the federal government mandated coverage in 1998. Patients can choose saline or silicone implants or they can choose tissue transfers from their own lower abdomen, back or buttocks. Even if a woman had her mastectomy many years before the coverage mandate went into effect, she can still undergo breast reconstruction now and receive full reimbursement. Continue reading