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

Physical and emotional scars can heal with breast reconstructive surgery

Dr. Karen Powers

Dr. Karen Powers

Few things are more frightening for a woman than receiving a breast cancer diagnosis. The nightmare doesn’t end quickly. Often, women must undergo a mastectomy or lumpectomy in addition to chemotherapy or radiation. Although these procedures can be life saving, they’re also potentially devastating to a woman’s self-esteem and sense of femininity. It can be an isolating, depressing experience.

In years past, women who underwent mastectomies had no choice but to wear breast prostheses to look “normal” in clothing. Removing the prostheses while dressing and undressing often triggers anxiety and stress. Today, the emotional and physical results after surgery are much more positive. New insight about breast cancer, new treatments and improved reconstructive surgery options mean that women need not feel disfigured or less attractive after surgery. Continue reading

Treatment options for childhood cancer

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. This would be like removing a cancerous tumor with surgery. For some cancerous tumors discovered very early, surgical removal may be virtually all that is needed. There are inevitably some effects on the remainder of the organ involved, depending on the size of the tumor and extent of the surgery. Continue reading

Thalidomide: a nightmare revisited

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

While thalidomide is now being tapped for its cancer-fighting properties, it has a more notorious history. Starting in 1957, doctors recommended thalidomide as a mild over-the-counter sleeping pill supposedly safe enough for even pregnant women. That it also reduced morning sickness made it even more popular. The company that made thalidomide aggressively marketed the drug in 46 countries even after an employee’s wife who took the drug before its release gave birth to a child with no ears. Within two years, an estimated 1 million people in West Germany were taking the drug daily. However, thousands of babies born with severely malformed limbs revealed that this drug was not safe — but that connection was not made until 1961.

German pharmaceutical company Chemie Grünenthal GmbH originally developed thalidomide to treat convulsions, but users reported feeling sleepy. During testing, the company discovered that it was almost impossible to take enough thalidomide to be fatal. The company did not test the drug’s effects during pregnancy. Though thalidomide was approved for use in Germany and elsewhere in Europe, a U.S. Food and Drug Administration medical officer named Frances Oldham Kelsey denied its license because there was insufficient clinical evidence about its side effects. This decision limited the impact of the drug in America. In 1962, President John F. Kennedy awarded Kelsey the President’s Medal for Distinguished Federal Civilian Service. Continue reading

Leukemia, brain cancer most common type of childhood cancers

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

According to the American Cancer Society, more than 10,000children 15 and younger in the United States are diagnosed with various kinds of cancer each year.

Last week, we discussed what cancer is and how it begins when microscopic cells that make up a normal body part start growing out of control. This week, we discuss some of the different types of childhood cancer.

Leukemias are the most common, accounting for about one-third of all childhood cancers. Leukemia is a type of cancer that originates from white blood cells, which normally help fight infection.

Leukemia generally begins in the bone marrow where blood cells are formed, but eventually the cancerous cells are released out into the bloodstream so there is no distinct tumor. Continue reading

A top 10 list to die for

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

How are you going to die?

The Centers for Disease Control would answer that life expectancy depends greatly on where someone lives. Life expectancy in the United States ranks 40th in the world with 77.97 years. That addresses when someone might die but what about how? Most likely, it will be from one of these top 10 causes, based on how many Americans they kill each year.

10) Suicide – 38,285. Many factors are now known to influence suicide: mental illnesses, genetics, certain pharmaceuticals, traumatic brain injuries, drug and alcohol abuse and chemical or hormonal imbalances. To decrease these rates, education about the signs preceding suicide and accessible treatment is necessary.

9) Kidney Disorders – 45,731. Although dialysis can help people survive a little longer without a kidney, it is no cure. Kidney damage can occur from infection, high blood pressure, or toxic reactions to drugs, leading to chronic kidney disease that affects more than 26 million Americans. Continue reading

Keeping Kids Healthy – Childhood cancer often is a 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. Continue reading