Oncology Questions and Answers with Dr. Gast

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Dr Gast 2Questions and Answers with Dr. Gast.

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You can email Dr. Gast your questions about cancer to:kvann@fsro.net

March 30, 2014

Question: Is there a new test for cervical cancer?

Answer: For nearly 60 years, the standard screening for cervical cancer has been the Pap test. However, just this past week an FDA advisory committee recommended that HPV testing become the first line of screening for cervical cancer. This test, performed just like a Pap test, detects DNA of the human papilloma virus, the cause of 99% of cervical cancer cases. Currently, the American Cancer Society recommends for cervical cancer detection that women between ages 21 and 29 undergo the Pap test alone every three years, with women between the ages of 30 and 65 having the HPV and the Pap tests every five years. However, if the FDA follows the advisory committee’s recommendations, this recommended schedule could change.

March 23, 2014

Question: I don’t know the difference between normal breast lumps and cancerous ones. When should I be concerned?

Answer: Because forty percent of diagnosed breast cancers are detected by women who feel a lump, establishing a regular breast self-exam is a helpful health habit. Adult women of all ages are encouraged to perform breast self-exams at least once a month. For women with a menstrual cycle, the preferred time for examination is two weeks after the period. To detect a change, women have to be familiar with their own breasts. Most women do have “lumps” in their breasts. However, watching for a new lump, a change in an existing lump, or an area that has become harder is important. Also, the American Cancer Society recommends yearly mammograms starting at age 40 and continuing for as long as a woman is in good health.

March 16, 2014

Question: What method do you recommend I use to stop smoking?

Answer: Many of my patients struggle with not smoking, even though numerous methods to quit are known. To succeed, most people have to try more than one way. Some of my patients have found success by using the medication Chantix; while others have chosen to use the nicotine patch. Nicotine gum is also a good resource to help decrease a smoking habit. Many patients just go “cold turkey.” Whatever method used, having a good support system of friends and family can greatly help. Visit http://www.cdc.gov for more helpful tips for quitting from former smokers.

February 16, 2014

Question: I have multiple family members with cancer.  Is there some type of test I could take to see if I have cancer?

Answer: Sadly, no magic test can diagnose cancer.  However, a number of different blood tests can help in the diagnosis of cancer based on a patient’s symptoms. Doctors can check tumor markers, substances found in the blood, urine, other bodily fluids, or tissues of some patients with cancer. Tumor markers may be used to help diagnose cancer, but limitations to their use exist. Some noncancerous conditions may cause the levels of certain tumor markers to increase. Another possible consideration is genetic testing for those having a strong family history of breast cancer.  This test could identify a marked increase risk of developing breast cancer.  However, it will not identify any current cancer.  The best advice to decrease the risk of developing cancer is to refrain from use of tobacco products, maintain a healthy weight, exercise, and visit a physician regularly.

February 9, 2014

Question: The World Health Organization just announced that the rate of cancer is going to double by 2024! Why are the numbers going up?

Answer: The incidences of cancer cases are expected to rise for a number of different reasons.  In countries like the United States, the population is not only aging but also living longer.  Moreover, nearly 20% of our population still uses tobacco products, a major cause of cancer.  In developing countries, smoking rates are even higher.  The report also states that developing countries are reflected most in this new data, because of their population growth, longer lifespans, and susceptibility to cancers associated with industrialized lifestyles. Good news from the report is that over half of all cancers are preventable.

February 2, 2014

Question: What are side effects of radiation treatment to the brain?

Answer: Being nerve tissue, the brain takes a long time to show changes and to heal.  Common side effects of radiation to the brain can be hair loss, skin redness, itching and fatigue. Also, some patients will experience short-term memory loss a year or two after treatment.  Another side effect can be somnolence syndrome, a condition causing drowsiness during the day or a need to sleep for longer than normal at night.  This effect usually occurs one to two months after treatment and resolves fairly quickly.

January 26, 2014

Question: Can a biopsy of a cancer cause the cancer cells to spread?

Answer: Cancer is almost always diagnosed by a biopsy, a surgical procedure that removes tissue samples from tumors.  The biopsy specimen is then viewed under a microscope by a pathologist to determine the presence and type of cancer. A good biopsy specimen is absolutely critical to select the proper type of cancer treatment.

The worry that having a biopsy could, in fact, spread the cancer is a common concern for most patients. The short answer is no; a biopsy does not cause cancer to spread. Historically, the common perception is that when a biopsy is performed either by a needle or by surgery, the exposure of air to the tumor site could cause the cancer to spread.  This assumption is not true. A fear of “seed tracking”, spread (or seed) of the cancer along the line of the needle insertion and withdrawal, with needle biopsies is another concern.  However, this risk is theoretical, as it has never been proven in a strong, reliable, scientific cancer study.

January 19, 2014

Question: Why do people not like to go to the doctor?

Answer: In the medical world we call this reluctance to see a physician the “white coat syndrome.” Many people develop great anxiety at the thought of visiting their doctors. Why? One reason may be that they are afraid of what the doctor might find.  On the other hand, some people have the attitude of “If it’s not broken, why fix it?” Another unfortunate reason is that many patients today have financial issues that may prohibit them from routinely visiting their doctors. Whatever the reason, just remember your doctor is there to help you take better care of yourself and live a healthy life.  Since often health issues can be avoided with preventative care, a visit with your physician before a major health problem occurs is definitely beneficial.

January 14, 2014

Question: My father had prostate cancer and later developed bone cancer.  How common is bone cancer?

Answer: Primary bone cancer is, in fact, quite rare.  Without reviewing your father’s medical records, I will assume that he actually had prostate cancer that spread to his bones, called metastasis.  For nearly half of the patients in the United States who die of cancer, their disease had spread to their bones.  Most frequently, the cancers that tend to spread to the bones are breast, lung, and prostate cancer.  Bone metastasis can result in bone pain and even fractures. With today’s technology bone metastasis can be treated with drug therapy, which can help stabilize the bones and hopefully delay the pain or fractures. Radiation therapy is also an excellent tool to use to help eliminate the pain caused by the bone metastasis.

January 07, 2014

Question: Are there any cancer-fighting foods I should be eating?

Answer: Yes, certain foods are associated with a lower risk of getting cancer.  The top ten recommended foods are as follows:

  1. Red wine (in moderation)
  2. Vegetables from the cabbage or mustard family
  3. Green tea
  4. Foods that contain vitamin D, such as fish, eggs, fortified cereals
  5. Foods that contain vitamin B along with folate, such as whole-grained and enriched-grain products
  6. Dark green vegetables
  7. Ginger and turmeric
  8. Beans and lentils
  9. Dark chocolate containing 70% cacao, preferably higher
  10. Berries

The answers to why these foods are considered “cancer-fighting” can be found in the February 5th Cancer Demystified column.

December 1, 2013

Question: I have been recently screened for prostate cancer. My doctor has stated I have level 6 prostate cancer, what does that mean?

Answer:  The level your doctor is referring to is called a Gleason score. A prostate cancer diagnosis is made by looking at prostate tissue under a microscope. Once prostate cancer has been identified, the doctor must determine both the stage and grade of the cancer. One way of grading prostate cancer is called the Gleason system. This scoring system assigns a Gleason score of 2 to 10 to grade prostate cancer, quantifying the aggressiveness of the cancer. A tumor with a low Gleason score is likely to be slow-growing, while one with a high score is more likely to grow aggressively.

November 24, 2013

Question: Are daily radiation treatments painful?

Answer: When patients receive radiation, the treatment is pain free; they will not feel a thing.  However, the patient’s skin in the treatment area can become sore over time.  As the daily treatments pass through normal tissue, such as the skin, changes will occur.  At first, no differences to the skin are noticeable, but over many weeks of radiation treatments, the skin in the treatment area can become red, dry, and itchy, much like a sunburn. To remedy this, I recommend my patients apply a fragrance free, moisturizing lotion made for sensitive skin twice a day.

November 17, 2013

Question: What are the signs and symptoms of thyroid cancer? What tests can detect thyroid cancer? What are the recommended treatments?

Answer: The initial symptom of thyroid cancer is a mass in the neck either at the level of the thyroid or in a lymph node.  As the cancer grows, additional symptoms can include pain and hoarseness.  Anyone having these symptoms should visit with an endocrinologist.  The endocrinologist will order tests, such as an ultrasound of the neck, lab work, and a biopsy if needed to determine if the patient does indeed have thyroid cancer.  The most common treatment of thyroid cancer is surgery followed by radioablation, which is a type of thyroid cancer treatment that utilizes radioactive iodine to destroy thyroid cells. Chemotherapy and external beam radiation therapy are used only if surgery and radioablation fail.

November 10, 2013

Question: Are  e cigarettes safe? Could I use them to stop smoking?

Answer: By 2016, the regulatory agencies of various countries intend for the manufacturing companies of e cigarettes to be licensed. Currently, no standard for quality and safety exists.  Studies here have shown that the amount of nicotine placed in e cigarettes can vary widely even within the same company.  This variable amount of nicotine means that the e cigarette would not be a good way to stop smoking.  Another concern with  e cigarettes is that they could become the “gateway” for nonsmokers to start smoking.  The Centers for Disease Control found that 20% of users of e cigarettes in the United States have never smoked before.  Recommendations to stop smoking at this time are to use licensed medication and behavioral support, and if you don’t smoke, don’t start!

November 3, 2013

Question: What is an e cigarette?

Answer: An e cigarette is an electronic inhaler device that was created to be a substitute for tobacco smoking.  A heating element in the unit vaporizes a liquid.  Some units release a flavored vapor.  Originally designed to look like cigarettes, newer brands and models are getting away from the cigarette “look.”   Restricted use of the e cigarette is beginning to occur.  For example, the Fort Smith Public Library’s board of trustees voted recently to ban the e-cigarettes, as well as smokeless tobacco, from use in all its libraries.  The library’s previous policy only banned smoking. Because these electronic inhalers are fairly new on the scene, health issues, risks and benefits of use, and legislation are all still pending.

October 20, 2013

Question: Is there a way to prevent lymphedema in breast cancer patients?

Answer: Lymph is a fluid that flows through a low pressure system of attached lymph nodes.  Lymphedema is a swelling in a part of the body having a blockage of this lymph flow.   Breast cancer patients are particularly prone to lymphedema, typically occurring in the arm or the breast itself.  Once lymphedema develops, stabilizing it is extremely difficult. A recent study shows that the use of manual lymphatic drainage performed within days after surgery, by a certified massage therapist, can prevent lymphedema in breast cancer patients.  At Fort Smith Radiation Oncology, we are proud to have a certified massage therapist trained in manual lymphatic drainage on staff. If you are experiencing lymphedema, please call 479-648-1800 to set up an appointment with our therapist.

October 13, 2013

Question: Can having breast implants affect my risk of getting breast cancer? If I get breast cancer, can the implants impact my survival?

Answer: Cosmetic surgery for breast implants has seen a 227% increase since 1997.  Last year in the US alone over 330,000 implant surgeries were performed, with one million performed worldwide. Studies have shown that women who have breast implants are at no greater risk of developing breast cancer.  However, an extensive review of these studies by a Canadian team of researchers has shown that women with implants are more likely to have a later stage of cancer at diagnosis.  Additionally, the researchers found a decrease in survival in women with implants.  With the number of breast implant surgeries increasing every year, additional studies will be on going.

October 6, 2013

Question: Is there treatment for arm swelling after breast cancer treatment?

Answer: If arm swelling, known as lymphedema, develops, certified massage therapists who are specifically trained in lymphedema management may help you.  Using special massage techniques to move the fluid through the body to reduce swelling, these specially trained massage therapists also keep track of the swelling with the use of measurements and wraps.  Additionally, these therapists can use this technique on other parts of the body, such as the legs, back, and neck.

September 29, 2013

Question: How common is breast cancer?

Answer:  Even though breast cancer does appear in men, occurrence is one hundred times more common in women. In fact, worldwide, breast cancer accounts for nearly 23% of all cancers in women.  Survival rates in the Western world are quite high with 8 out of 10 women surviving for at least five years after their diagnosis.  In developing countries survival rates are considerably lower.  Unfortunately, nearly half a million women die every year from breast cancer.

In honor of Breast Cancer Awareness Month, let’s spend October learning all about breast cancer.  Please send your questions to info@fsro.net .

September 15, 2013

Question: What can I do to keep my prostate healthy?

Answer: Actually, many actions will help to keep your prostate healthy, plus improve your overall health.  Consider the following:  adding foods with lycopene to your diet, such as red peppers and tomatoes; eating fish (omega 3 acids) and increasing soy in your diet; taking zinc supplements since a zinc deficiency has been linked to prostate enlargement; limiting your consumption of alcohol and caffeine; exercising on a regular basis at least 150 minutes a week, especially if you are over the age of 50; and having regular checkups. To learn more, please plan to attend the UAFS Lifelong Learning lecture titled Prostate Cancer: Myths and Reality at UAFS on September 18at 1:00 pm at the Echols Conference center.  Visit the website http://uafs.edu/cll/lifelong-learning-lecture-series to register for the lecture or call 479-648-1800 for more information.

September 8, 2013

Question: Does having a vasectomy increase my risk of prostate cancer?

Answer: From all the studies I have read, none have shown a link between having a vasectomy and developing prostate cancer.  This thought is just one of the many myths regarding prostate cancer.  Other myths can include the following: prostate cancer treatment always causes impotence, sexual activity increases the risk of prostate cancer, prostate cancer is contagious, and prostate cancer is an “old man’s” disease.  For more information about prostate cancer, please make plans to attend my UAFS Lifelong Learning lecture titled Prostate Cancer: Myths and Reality at UAFS on September 18at 1:00 pm at the Echols Conference center.  Visit the website http://uafs.edu/cll/lifelong-learning-lecture-series to register for the lecture or call 479-648-1800 for more information.

September 1, 2013

Question: How do you know you have prostate cancer?

Answer: Most men with early stages of prostate cancer are symptom free.  More advanced prostate cancer may cause signs and symptoms such as painful urination or bowel movements, blood in urine or stools, and difficulty urinating or being constipated.  The late symptoms indicating the cancer has spread can include bone pain.  A prostate specific antigen (PSA) blood test can detect prostate cancer long before any symptoms might appear.  The recommendation is that men over the age of 50 or men ages 40 to 50 who have a family history of prostate cancer be screened.  On September 19, 2013, Fort Smith Radiation Oncology is offering a free PSA screening from 8am-11:30am and 1pm-3:00pm. Please call 479-648-1800 to receive additional information and to schedule your free screening.

August 25, 2013

Question: Do natural remedies for cancer work?

Answer: The standard treatments for cancer, recommended by doctors today, have been tested multiple times over many, many years.  Treatments options go through three phases of testing before being approved for treatment. The Phase I trial tests to see if the proposed new treatment option works for any type of cancer and also tests how well patients tolerate the treatment.  Phase II trials are used to determine if it is successful against just one type of cancer.  If the treatment option passes Phase II, a Phase III trial is performed where the new treatment option is compared with the normal standard treatment.  If the new treatment option is found to be better than the standard, it becomes the new standard treatment.  This entire process can take up to 10 to 15 years or more to complete and test subjects have to be followed for years to check for long term side effects.

Natural remedies do not go through this process. Typically a company or individual may think “This will work, let’s sell it.” Therefore, there is really no way of knowing if natural remedies do indeed work.

August 18, 2013

Question: Is radiation always necessary for breast cancer treatment?

Answer: At the time of a patient’s diagnosis with breast cancer, the majority of women will have a choice between a mastectomy and breast conserving treatment.  A mastectomy is a surgery to remove part of or the entire breast.  Patients that choose mastectomy generally do not need radiation as an additional treatment, unless they are diagnosed with a later stage cancer. Breast conserving treatment involves a lumpectomy, which is an operation where a small volume of breast tissue containing the tumor and some surrounding healthy tissue is removed to conserve the breast. This type of treatment is then followed by a course of radiation treatments to the whole breast.  Both options have the same chance of recurrence thus the preference lies with the patient.  The best advice is to talk to your physician about your choices.

August 11, 2013

Question: My mother just finished radiation to her head.  Her scalp is now very red and itchy.  We weren’t told how to care for this.  What do you recommend?

Answer: At my office, we recommend patients use a mild soap or shampoo, such as Dove soap or Johnson’s baby shampoo during their treatment.  Also, we provide our patients with a special order moisturizing body cream that contains Vitamins A and D for them to use starting their first day of treatment.  The use of this cream has dramatically reduced skin reactions with my patients. If a patient has more itching with treatment, I recommend 1% hydrocortisone cream to be applied to the area twice a day. After treatment is finished, use of a lotion that has no fragrance or alcohol will minimize any reactions or dryness.

August 4, 2013

Question: I have a yearly physical exam every year.  Should I still worry about developing cancer?

Answer:  Unfortunately, the answer is yes.  A yearly physical exam is designed to check your vitals, lungs, and heart and to order routine lab work.  The physical exam is fairly basic, and the blood tests usually ordered would not be looking for cancer.  The typical blood work simply checks your cholesterol, kidney function, electrolytes, and iron levels.

However, your yearly physical is the perfect time to discuss with your doctor any symptoms or findings you have noticed.  Since you and your doctor are a team, sharing information can help your doctor take better care of you.

July 28, 2013

Question: I have had normal pelvic exams in the past, but I have low back pain and have frequent urination.  Could this be ovarian cancer?

Answer: Ovarian cancer is known as the silent cancer with subtle symptoms easily confused with other illnesses.  Ovarian cancer symptoms can be bloating, weight loss, urinary frequency, and problems eating.  If these symptoms have been present for 6-12 months, they could very well be related to ovarian cancer.  However, the most common cause of the combination of low back pain and urinary frequency is a bladder infection.  I suggest you see your doctor for a urinalysis and to discuss your symptoms.

July 21, 2013

Question:  Can you give me information about brain tumors?

Answer: A primary brain tumor actually arises from the brain or spinal cord.  This is not to be confused with a metastatic brain tumor, which is a tumor that has spread from some other part of the body, such as a lung cancer that has spread to the brain.  Brain tumors are classified by cell origin and cell behavior from the least aggressive (benign) to the most aggressive (malignant). Additionally, some tumor types are assigned a grade, ranging from Grade I (least malignant) to Grade IV (most malignant), which signifies the rate of growth.   Accounting for less than 1% of all cancers and 2.4% of all cancer deaths, more than 120 types of brain and central nervous system (CNS) tumors can occur with about 45,000 cases reported yearly.  However, in pediatric cancers (those found in children) the occurrence rate is 20-25%.

July 14, 2013

Question: I am a 22 year old male and have stomach pain between meals with lots of belching.  After starting to take nexium, the pain is less, but I still belch. I’m afraid I have stomach cancer.

Answer: Incidence of stomach or gastric cancer is actually on the decline in the United States.  Symptoms are bloating, feeling full quickly, persistent heartburn, pain, weight loss, and fatigue.  Risk factors for developing gastric cancer are eating a diet high in salty and smoked foods and low in fruits and vegetables, having a family history of gastric cancer, presenting a history of H. pylori infection( a type of bacteria which infects the stomach, usually during childhood), and smoking.  Gastric cancer is more common in middle age to elderly white males.

With the indicators you described, it would be highly unlikely you have gastric cancer, but you should still visit with your doctor to discuss your symptoms.

July 7, 2013

Question: I have crampy abdominal pain and hard pellet stools. I’m 22 and scared since my grandmother had colon cancer.

Answer: The signs and symptoms of colon cancer can be a change in bowel habits, blood in the stool, abdominal bloating, abdominal pain, pelvis pressure, and weight loss. Occasionally, I have treated multiple members of a family for colon cancer.  These family members tended to be diagnosed with cancer at an early age.  In your situation, if the symptoms you describe are “normal” for you, I would suggest you drink more water, exercise, eat less processed foods, and maybe try taking a probiotic, found in some yogurt. However, if this is a new onset problem, please see your doctor for a thorough checkup.

June 30, 2013

Question: What is cancer of the urinary system?

Answer: The urinary system includes the kidneys, ureters and bladder. The two kidneys, one on each side of the backbone, lie above the waist.  Shaped like a kidney bean, adult kidneys are about 5 inches long and 3 inches wide. The function of kidneys is to clean the blood and make urine to rid the body of waste. Urine then drains through the ureter into the bladder.  Cancer can start in any of these areas.  The most common occurrence is in the bladder, followed by the kidneys; most rare is cancer of the ureter.  It’s not clear what causes kidney carcinoma, but smoking has been shown to be a cause of bladder and ureter cancer.  Symptoms of these types of cancers can include blood in the urine, back and /or pelvic pain, weight loss, and frequent and painful urination.

June 23, 2013

Question: Is it true that drinking wine is good for you?

Answer: Because wine is a naturally rich source of antioxidants, moderate consumption is thought to be beneficial.   Drinking a 4 to 8 ounce glass of dry red wine up to three times a week can actually improve health.  Studies have shown that drinking wine can naturally lower cholesterol, protect the heart nearly as well as taking a baby aspirin, help control blood sugar in diabetics, decrease risk of Alzheimer’s disease and memory disorders, fight off the common cold, decrease the risk of some cancers, and help keep weight down. But, be advised that excessive consumption of wine or any alcoholic beverage will reverse these benefits.

June 16, 2013

Question: What does a skin cancer look like and how common are they?

Answer: Skin cancer is the most common cancer we have–we don’t even keep official track of them as we do other cancers, which are registered with patients tracked through SEER (Surveillance, Epidemiology and End Results Program). The most common skin cancers are basal cell carcinoma and squamous cell carcinoma. At least 500,000 basal cell skin cancers and 150,000 squamous cell skin cancers occur every year. This number, however, is thought to be under reported and on the rise. Basal cell skin cancer can look like a pink bump on the skin, and as it grows bigger, it can develop a scab that won’t heal. In the past, this cancer was called the “rat” cancer because left unattended it would grow to the point where it looked as if a rat had eaten a hole in the person! Squamous cell skin cancer is often a dry, rough, darker area that can be itchy. These can also scab and not heal over time. Although basal cell skin cancers tend to stay right where they are, squamous cell skin cancers can spread to distant sites. The rarer but scarier melanoma is the skin cancer that is tracked and reported into the SEER data. It looks generally like a mole that has changed. If you have any skin changes, make an appointment with your local dermatologist. Those with a previous history of a skin cancer should also have yearly skin exams.

June 9, 2013

Question: My 16 year old daughter just completed treatment for thyroid cancer.  What is her long-term prognosis? Do I need to worry about it coming back?

Answer: Thyroid cancer comes in a number of different varieties, but all have very high survival statistics for stages 1-3.  Thyroid cancer is usually treated with surgery followed by radioactive iodine treatments.  Patients then will have periodic follow-ups to evaluate for recurrence or spread of the disease.  Regarding pediatric patients, follow-ups are critical since the patients are still growing and changing while receiving treatment for the cancer.  All patients and families worry about recurrence of a cancer no matter what the type.  But, the good news is that thyroid cancer has a very low risk of recurrence when compared with other cancers. The best advice is for patients to continue their yearly exams throughout their lives.

June 2, 2013

Question: Why did Angelina Jolie remove both breasts when she didn’t even have cancer? What is BRCA?

Answer: BRCA is a mutation that increases a person’s chance of breast and ovarian cancer.  The mutation is present in only 0.24% of the population and accounts for fewer than 10% of all breast cancer cases.  Not everyone should be tested for this gene since it is present in only 24 out of 10,000 people.  Women who do possess the gene are at 5 times the normal risk of breast cancer and 10-30 times the normal risk of ovarian cancer.

Testing positive for this gene, as in the case of Angelina Jolie, results in what is often a very emotional and personal decision regarding options. These options can include a double mastectomy and removal of ovaries or follow-up mammograms and MRI scans for the earliest detection.

May 26, 2013

Question: Can using antiperspirants or deodorants cause breast cancer?

Answer: If you search the internet, you can find many sites and articles that warn women that antiperspirants and deodorants can cause breast cancer.  However, researchers at the National Cancer Institute (NCI) have reviewed all the scientific data and researched all the studies that have been performed.  The NCI has reported that they found no link between antiperspirants and deodorants and breast cancer. Therefore, another urban myth can be laid to rest, and we can all stay clean and smell good!

May 19, 2013

Question: What are the signs and symptoms of thyroid cancer? Is there a screening to detect this cancer?

Answer: Thyroid cancer usually doesn’t cause any signs or symptoms until it has grown for quite a while.  At this time, noticeable signs can be a lump in your neck, a change in your voice, difficulty with swallowing, throat or neck pain, swollen glands in your neck, or a cough not related to a cold. No screening is available for thyroid cancer, but if you do develop any of these symptoms, consult your physician.  If a lump is found, your doctor will most likely order an ultrasound of your neck and possibly a blood test to measure the level of thyroid-stimulating hormone in your body.

May 11, 2013

Question: How exactly does radiation work to kill cancer?

Answer: Highly precise planning is used when radiation is prescribed for cancer treatment. A machine called a linear accelerator is used to deliver radiation to the area that requires treatment. As radiation passes through the cancer and normal cells alike, the energy of the radiation causes changes in the cells.  These changes result in damage to the cell’s genetic material, the DNA.  The damage to the DNA causes the cancer cells to die.  Even though small amounts of normal tissue around the cancer cells also receive radiation, these normal cells are able to repair any resulting damage.  Often, the affected tissue will be replaced by scar tissue, formed in response to inflammation from tissue injury.  This response is the body’s way of healing injury.

April 28, 2013

Question: Is thyroid cancer 100% treatable, and what do you do to treat it?

Answer: Thyroid cancer is a very rare cancer, which fortunately is often diagnosed early.  Therefore, typically, most patients do well. The standard treatment for thyroid cancer is surgery, often followed by radioactive ablation.  Radioactive ablation is the use of radioactive iodine, given in a pill or liquid form, which is then taken in by the thyroid gland.  Because the thyroid absorbs iodine, the radioactive iodine collects in any thyroid tissue remaining in the body and kills the cancer cells.  Other treatments such as external beam radiation therapy and chemotherapy are rarely used except in later stages of the disease.  Thus, yes, thyroid cancer, like all cancers, is certainly treatable.

April 21, 2013

Question: My son has pleomorphic sarcoma.  What kind of cancer is this?

Answer: Pleomorphic sarcomas are cancers that come from the supporting tissue of the body, such as bone, muscle, cartilage, tendons, and ligaments.  This cancer is different from carcinomas, which arise from the lining of organs, and cancer of the blood and bone marrow, which are called leukemia or multiple myeloma.

A pleomorphic sarcoma can also be called a malignant fibrous histocytoma, a name given to a sarcoma when no more accurate identification is possible.  Affecting males more than females, pleomorphic sarcomas occur mostly in extremities.  When this type of cancer is detected in its early stages, a combination of surgery and radiation treatments is usually effective at eradicating the cancer from the body.

April 14, 2013

Question: Can you catch cancer from someone else?

Answer: Cancer is unique to each person.  It is the individual’s cells that have become cancerous cells.  Cancer cells from one person are generally unable to live in the body of another healthy person. A healthy person’s immune system recognizes foreign cells and destroys them, including cancer cells from another person. A few cancers are caused by certain viruses. The human papilloma virus (HPV) and the Epstein-Barr virus (EBV) are two examples of viruses that are linked to certain types of cancer. You can “catch” the virus from another person but the viral infection alone usually does not lead to cancer. A weakened immune system, other infections, risk factors (such as smoking), and other health problems allow cancer to develop more readily. But, the bottom line is—cancer is not contagious.

April 7, 2013

Question: Is colon cancer passed on in families? If my mom had colon cancer, am I more likely to develop this cancer?

Answer: Colon cancer covers the entire large bowel from the end of the small bowel to the rectum.  When combined with rectal cancer, it is often referred to as colorectal cancer.  Yes, risk for colon cancer may increase based on family history of colon cancer by a first degree relative, such as mom, dad, brother, sisters.  Additionally, if several family members are affected, or if they were diagnosed with colon cancer at an early age, risk increases.  If at risk because of family occurrence, what actions should be taken? Most colon cancers develop from polyps slowly over several years. In fact, it can take over ten years for a polyp to turn into a cancer.  Colonoscopy is one screening tool that does decreases the risk of getting colon cancer by 90% since during this procedure polyps are removed, thus, eliminating the possibility of their developing into cancer. Also, some studies have shown that aspirin or ibuprofen use can decrease risk as well.  The best action to take is to talk to your medical doctor about when you should start the screening process based on your family history.

March 24, 2013

Question: I read in a national health news article that radiation treatment for women with breast cancer can actually hurt them and cause heart problems later. Is this true?

Answer: It is well known that the treatments used to kill cancer cells can also cause lasting and sometimes permanent side effects. Chemotherapy drugs can damage organs such as the liver, brain, lungs, and bone marrow. Radiation treatments can cause scar tissue in any area of the body that the radiation passes through. Both chemotherapy and radiation can cause a secondary cancer to occur decades later. The study you are referring to in the national press reported that women treated with radiation for breast cancer are more likely to develop heart problems later. But, the study only showed that normally 4 to 5 of every 100 women will develop a major cardiac problem by age 80, and radiation treatment would add just one more case. When a person is diagnosed with cancer, a candid discussion should be held with their doctor to review the side effects of their treatment options. The person will then need to decide if they would like to proceed based on the risk of treatment (side effects) versus the benefit (cure) of the treatment.

March 17, 2013

Question: What stage is a prostate cancer when during a prostatectomy (surgery to remove the prostate) it is found that the cancer has spread to the surrounding lymph nodes? How is this treated and what is the prognosis?

Answer: When staging prostate cancer, the doctor has to look at the extent of the disease in the prostate and at whether it has spread to lymph nodes or other parts of the body. When a prostate cancer has spread to the nearby lymph nodes, it is labeled a Stage IV cancer. In the case where the prostate has been removed, the patient should then be referred to a radiation oncologist to discuss radiation therapy to the pelvis area where the lymph nodes are located. Even though the positive lymph nodes make this cancer a Stage IV, the survival rate is nearly 100% five years from diagnosis. The survival rate drops to 70-80% 10 years after diagnosis. In conclusion, most men with spread of the prostate cancer to nearby lymph nodes can live a very long time with the proper care and treatment.

March 10, 2013

I have heard that the budget cuts will greatly affect research for finding a cure for cancer.  Is this true and if it is, where will doctors find the money to continue their research?


According to the latest news coming out of Washington, this is very true.  The National Cancer Institute is expected to lose a significant amount in funding.  Unfortunately, the budget for cancer research has always been low in the United States when compared to other countries where scientists have found that grants are more readily available.  However, other than government funding, the second largest supplier of funding for cancer research is the American Cancer Society and its Relay For Life fundraisers.  The American Cancer Society has funded 46 Nobel Peace Prize winners and countless scientists over the last 100 years.  They have also spent more than $3.5 billion on cancer research since 1948 and have played a role in nearly every cancer breakthrough in recent history.  My advice is to find your nearest Relay For Life walk and participate! It will take all of us helping the American Cancer Society by raising funds for their research to continue the goal of finding a cure for cancer.

March 3, 2013

My mom was just diagnosed with stage IV breast cancer. She has bone cancer and a brain tumor. Does she have three different cancers, and what does stage IV cancer really mean?
The majority of cancers are staged based on the extent of the original (primary) tumor and on whether or not cancer has spread in the body. To help determine if the patient’s cancer has indeed spread either regionally or distantly to other organs, oncologists use x-rays, CAT scans, MRI scans, and PET scans. Most cancer stages are assigned a number from I-IV, with I being an isolated cancer and IV being a cancer which has spread, or in cancer terms, metastasized. A patient with a stage IV cancer does not have a new or different cancer throughout the body since metastatic cancer has the same name and same type of cancer cells as the original cancer.

February 24, 2013
How can someone who has never smoked get lung cancer?

When discussing lung cancer, doctors tend to lump smokers and non-smokers together, but lung cancer in non-smokers is really a different disease with, obviously, different causes.  The incidences of lung cancer in non-smokers are significant, making up 10-15% of lung cancers, with two-thirds of these found in women.
Besides smoking, what else can cause lung cancer? Many of the other causes are environmental.  In fact, the number one suspected cause of lung cancer, other than smoking, is radon gas in the homes.  Other environmental causes include second-hand smoke, which accounts for 3000 lung cancer cases a year; fumes from wok cooking, thought to be a cause of lung cancer in Asian countries; and asbestos exposure, which can cause a special type of lung cancer called mesothelioma.  Other than environmental causes, genetics often play a role.  Having a first-degree family member (parent, sibling, or child) with lung cancer roughly doubles the risk.  Having a second-degree relative (aunt, uncle, niece, or nephew) with lung cancer raises the risk by around 30 percent.
Currently, whether smokers or non-smokers, lung cancer patients are treated the same.   In the future, treatments could become more specialized based on the fact that these cancers are different on a genetic level. Until then, the most important things to do to lower the risk of lung cancer as a non-smoker are to check homes for radon and avoid secondhand smoke.

February 17, 2013
My father has lung cancer.  After diagnosing it as a Stage 4 small cell, his doctor told him treatment wouldn’t be worth it and recommended hospice.  Is there treatment available?
Small cell lung cancer accounts for 15% of all lung cancers and usually is caused by smoking. Without any treatment, small cell lung cancer grows rapidly and spreads quickly, usually taking the person’s life in two to four months.  However, small cell lung cancer is the most responsive type of lung cancer, which means it’s very sensitive to chemo and radiation.  When patients are given chemotherapy, life expectancy can jump up to one year. Unfortunately, in more than half of the people with small cell lung cancer, the cancer also spreads to the brain. Because of this possibility, for people whose lung cancer has responded to chemotherapy, doctors may additionally prescribe radiation therapy to the brain to help prevent this spread. This procedure is known as prophylactic cranial irradiation, which may add another six months to the patient’s life expectancy.  Therefore, yes, treatment for small cell lung cancer does exist and can give the patient considerably more time with friends and family.

February 10, 2013
I have been diagnosed with cancer and have been told I will need radiation therapy.  What can I expect?
When you are referred for radiation therapy, you will meet your radiation oncologist and her nurse.  After they review your records, reports, and x-rays, your doctor will perform an exam. Your radiation oncologist should offer to review your x-rays and scans with you.  During this visit the doctor must decide whether or not you require radiation treatment and discuss with you all the risks, side-effects, and benefits of the treatment.  You, the patient, will then decide to proceed or not with radiation treatment.
Once treatment is decided, the next step is simulation.  Simulation is typically a CT scan used to obtain data for designing your radiation plan. All patients have a unique radiation plan that has been customized just for them, their bodies, and their cancers.  Your plan will be unique to you.  After completion of the simulation, you will leave with positioning marks on your skin (made with a sharpie marker or a paint pen) and an appointment to return for treatment.  When you arrive at your next visit, your plan will have been completed. Radiation therapists will be ready to deliver your treatment.  Usually lasting 5-10 minutes administered once a day for 2-7 weeks, radiation therapy is painless: you will not feel anything.

February 4, 2013
Ar there any clinical studies that prove that prostate cancer treatments, such as surgery, prolong life?
Second only to lung cancer-causing deaths, prostate cancer is the most common cancer in men. One in six men will have prostate cancer during their lifetime. The treatments for prostate cancer range from surgery, radiation therapy, anti-androgen therapy, observation or watchful waiting.
To answer your question, it would be impossible to conduct a study or trial where some patients received no treatment while others underwent surgery or radiation.  Patients in trials are randomized, which means they do not have a choice on which treatment they receive.
But, good news came out just this month from the UK, which has found an 18% lower death rate from prostate cancer than reported 20 years ago.  This reduction is most likely from improved treatments and early detection.  Therefore, yes, finding prostate cancer early can save lives.  As our population ages and lives longer, we should also expect additional improvements in survival rates.

January 27, 2013
My dad died from stage four esophageal cancer a little over a year ago.  He had been diagnosed with Barrett’s esophagus.  My question is Barrett’s esophagus hereditary? Could having Barrett’s esophagus have caused his cancer?
Barrett’s esophagus is an abnormal change in the lining of the distal end of the esophagus (food tube). Because it appears at the end of the esophagus closest to the stomach, reflux is thought to be the cause.  However, Barrett’s is found in patients who may or may not have reflux symptoms. Unfortunately, no reliable way to determine which patients with Barrett’s esophagus will go on to develop cancer is available. Also, no data shows it could be hereditary.
The risk of developing esophageal cancer is highest in the United States in white males over the age of 50 with more than 5 years of symptoms which can include trouble swallowing, weight loss, and pain. Treatment for esophageal cancer can range from surgery, to radiation, to chemotherapy, to possibly all three.

My grandfather was just told he has bladder cancer.  Can you tell me more about this?
Bladder cancer grows on the lining of the bladder.  Symptoms include frequent, urgent, painful, or bloody urination. The treatment for bladder cancer depends upon the type.  Some types are superficial and grow like mushrooms inside the bladder.  Usually slow growing, this type of bladder cancer requires removal by use of a scope.   At times, this type may also need chemotherapy drugs placed in the bladder after removal to help prevent the cancer from recurring.  Other types of bladder cancers can be invasive and require much more extensive treatment, such as surgery, radiation, and chemotherapy.  Some patients even need to have their bladder surgically removed. Because invasive bladder cancer has a high risk of spreading to distant organs, a full workup is needed at the time of diagnosis.
Bladder cancer is once again another cancer linked to smoking. Also, people exposed to arsenic, as well as chemicals used in the manufacture of rubber, dyes, textiles, plastics, paints and leather run a higher risk of developing bladder cancer.

September 1, 2012
At what point after receiving a cancer diagnosis should an oncologist be brought on the case?  How long have you been an oncologist in Arkansas and did you go to school here also?
Your oncology team should really be assembled fairly quickly, as in a 2-3 week period of your diagnosis.  The team would of course include all the doctors who would at some point participate in your care…surgical, medical and radiation oncologist.  I personally have practiced oncology for over 22 years, 15 of which have been here in Arkansas.  My training was in Kansas at the University of Kansas Medical School.

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