Cancer Care News and Events - Baptist Health System

Cancer Care Update

Tue, 03 Apr 2012 00:00:00 GMT

In This Issue

A Message from the Baptist Cancer Center Director

Meet Baptist Cancer Center Team

Should I Have a Mammogram?

From Fear to Confidence

Try a Healthy Recipe

Quick Links

Cancer Care

Baptist Breast Center

Cancer Support Group

Baptist Social Media Links

New Baptist Breast Center Upholds Our Commitment to Excellence
The Baptist Cancer Center represents Baptist's commitment to providing state of the art care for patients with cancer and those at increased risk for the development of cancer. Learn More...

Meet the Team at the Baptist Breast Center
The primary goal of the Baptist Cancer Center and the Baptist Breast Center is to put patients in the center and to guide them through every phase of their journey. Learn More...

Decision Making Tool: Should I Have a Mammogram?
Learn the benefits and risks of a mammogram so that you can make an informed decision about your options. Learn More...

From Fear to Confidence
Annette Rues had plenty of experience with cancer - or so she thought. "My husband of 57 years is a cancer survivor, and I was going daily with him for chemotherapy. Learn More...

Try a Healthy Recipe
This delicious dish of chicken salad is adapted from the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services Learn More...

Decision Making Tool: Should I Have a Mammogram?

Tue, 03 Apr 2012 00:00:00 GMT

by Pamela Jones, MA

En Espa�ol (Spanish Version)

A mammogram is a screening test for breast cancer . These types of screening tests play an important role in maintaining good health. While some tests can be done quickly during a regular doctor's visit, a mammogram requires an additional appointment at a special facility. The test itself is also rather uncomfortable, not to mention the stress that just the mention of cancer can cause. Do the benefits of mammograms outweigh these downfalls? The following will help you understand the benefits and risks of a mammogram so that you can make an informed decision about your options.

What Are the Potential Benefits of a Mammogram?

Screening tests can help identify illnesses and health problems before symptoms arise. For illnesses like cancer, early detection may allow for more treatment options and can improve the prognosis.

Catch Breast Cancer Early

Mammograms can suggest changes in the breast that may be cancerous up to two years before a lump can be felt. Ductal carcinoma in situ (DCIS), an early stage of a type of breast cancer, can also be found with mammography. An early start to treatment may also stop the cancer before it spreads to the rest of the breast tissue or to other organs.

What Are the Potential Risks and Limitations of a Mammogram?

As a screening test, a mammogram cannot actually diagnose breast cancer. To diagnose breast cancer, other tests or procedures will need to be done to closely examine the suspicious tissue. A mammogram simply suggests that cancer may or may not be present. Limits of the test can lead to false results. The test can suggest that cancer is present when there is none (false positive), or it may suggest that cancer is not present when there is cancer (false negative).

False Positive

Sometimes, a mammogram may suggest that there is a cancerous change in breast tissue when there really is not. Benign (noncancerous) tissue can look suspicious on a mammogram. Follow-up tests to confirm what the tissue is may include additional mammograms, ultrasound exams , breast biopsies , and other medical tests. If the original mammogram was a false positive, the additional medical tests and associated stress are unnecessary.

A review of research found that for every 2,000 women that were told to have mammograms, 200 experienced unnecessary distress because of false positive test results.

False Sense of Security

A normal mammogram does not guarantee that you are cancer free. One possibility is that the test result may be a false negative, meaning the mammogram was not able to show a cancer that was there. A clear test may also encourage a false sense of security, which may lead you to ignore symptoms that should be discussed with a doctor. You may be inclined to rely solely on mammograms instead of manual exams at doctor's appointments or general self-health awareness.

Radiation Risk

Radiation is a known carcinogen, however, only small doses of radiation are given during a mammogram and are considered safe.Some have voiced concerns about long-term exposure with repeated mammograms. Research has not found a link between mammogram testing and cancer development. There appears to be very little risk of harm from this radiation.

Can It Improve Your Health?

Early diagnosis is important to cancer outcomes; but do mammograms really lead to better outcomes? To help find this answer, researchers have looked at whether regular mammograms were able to decrease the rates of death from breast cancer, but the results were mixed.

Some studies suggest that mammograms can decrease the rate of cancer death, while other studies have questioned these findings. What is agreed on is that the effectiveness of the mammogram may change based on the individual and the type of cancer, for example:

Aggressive (fast growing) tumors-Younger women tend to have more aggressive cancerous breast tumors. By the time a mammogram finds an aggressive tumor, some cancer cells may have spread to another organ. Therefore, detection may be too late.
Indolent (slow growing) tumors-These are more common in older women and make up half of all breast tumors. According to the National Cancer Institute (NCI) panel, these tumors could be detected by breast exams without regular mammograms. With this type of tumor, women who perform breast self-exams and undergo breast exams by doctors would have as high a survival rate as the women who do have mammograms.
Inflammatory breast cancer -This can be very hard to detect by manual exam. A mammogram may be able to detect this type of cancer before visual symptoms appear.
High risk groups-Women with a family history of breast cancer may undergo more aggressive screening, although changes in genetic testing may change recommendations in the future.
Dense breast tissue-This makes it harder for mammograms to locate tumors. Young women and menopausal women on hormone therapy tend to have denser breast tissue. This can make a mammogram less effective for women in their 40's and younger.

According to research, women who were told to have mammography screening over a 10-year period had a 15% decrease in breast cancer mortality. This means that for every 2,000 women who are told to be screened through a 10-year period, one woman will not die from breast cancer because of the screening.

Expert Advice

There are many professional, medical, and cancer groups that have their own set of mammography guidelines. The majority of guidelines agree that:

Beginning at age 40, women with an average risk of breast cancers should have a mammogram every 1-2 years.
Women who are at higher than average risk of breast cancer should seek expert medical advice about:
- Whether they should begin screening before age 40
- How frequently they should be screened

Most guidelines do not have a recommended age to stop mammogram screening. The American Geriatric Society recommends mammography frequency changes to every 2-3 years after 75 years of age and the termination of screening if life expectancy is less than four years.

Putting the Pieces Together

Discuss these benefits and harms, as well as any risk factors you may have, with your doctor. This may help you make a decision on whether to have a mammography exam.

The Baptist Breast Center provides genetic counseling and breast cancer risk assessment to better help you understand your risk of developing breast cancer.

Awareness of your own health and periodic check-ins with your doctor will help identify signs of illness that need further testing, as well as ensure regular screenings. Contact your doctor if you notice a change in the look or feel of your breast.

Innovative Breast Care in a Healing Environment

Mon, 11 Apr 2011 00:00:00 GMT

A change in breast care is coming to San Antonio. When it opens this summer, the Baptist Breast Center will offer comprehensive breast care - from screening mammograms and genetic counseling, to biopsy, diagnosis, and should cancer be found - treatment and rehabilitation.

"We will provide services for the entire spectrum of breast care," says Morton Kahlenberg, Medical Director of the Baptist Breast Center. "Women will be able to count on the Baptist Breast Center for any needs regarding her breast care."

The Baptist Breast Center philosophy puts patients in the center, whether their need is a yearly mammogram or the multidisciplinary team approach a diagnosis of cancer requires. A team of breast specialists walks with patients during and after each woman's journey. Breast care Guides meet with patients at the time of recommendation for breast biopsy and provide education, support and guidance every step of the way. Breast Center physicians are board certified and continue to obtain specific breast related education to offer the most up-to-date treatment and care. Some of the benefits of care with the Baptist Breast Center are:

State-of-the-art imaging and diagnostic technology
Genetic counseling for women who have a family history of breast cancer
Information on cancer prevention
Physicians and center personnel have specialized training and expertise in the diagnosis and treatment of breast cancer
Single point of contact from diagnosis and throughout your care plan
The only cancer care center in San Antonio with Personal Guides who walk with patients throughout the care plan
A comfortable and healing environment
A commitment to provide a comprehensive care plan including surgery, chemotherapy, radiation therapy, rehabilitation and post- treatment follow up
Educational materials and support groups
Access to information on Clinical Trials

The Baptist Breast Center is committed to providing today's most innovative treatments, the highest quality and most comprehensive level of breast care in San Antonio and South Texas.

Beating Pancreatic Cancer

Fri, 29 Oct 2010 00:00:00 GMT

Morton Kahlenberg, M.D. is in the business of making miracles happen. He is a fellowship-trained surgical oncologist and medical director of Surgical Oncology Associates . Cancer is a scary diagnosis and hearing that you have pancreatic cancer can be especially devastating. But with the right medical team, anything is possible.

Case in point - a patient treated by Dr. Kahlenberg who had�pancreatic cancer similar to that suffered by actor Patrick Swayze.� "The patient had locally advanced cancer of the pancreas and had been told he was not a candidate for surgery. Working with his medical oncologist and radiation oncologist, we decided to try and shrink the tumor with chemotherapy and radiation first to bring it to an operable size. The tumor responded to the treatment, I was able to remove it surgically, and today he is doing well. This type of approach results in better outcomes, even in the case of these bad cancers," says Kahlenberg.

Watch�the video version of this remarkable story.

Specialized Care for a Rare Cancer

Fri, 29 Oct 2010 00:00:00 GMT

Bone cancer is a rare disease, but if you're the one who has it, you want to know that the expertise to treat it is available. Spencer Frink, M.D. is one of only two orthopedic oncologists in South Texas. He is part of the triple threat of surgical oncologists at Surgical Oncology Associates. For cancers of the bone, Dr. Frink is the physician you want on your team. Research has shown that outcomes are better when an orthopedic oncologist is involved in the treatment of bone cancers.

The additional training orthopedic oncologists possess can really make a difference in limb preservation, pain management, mobility and survivability, as it did recently for one of Frink's patients. She had not walked for six months and was in constant pain. After treatment she is walking again and her pain is manageable. In another case, in a 16-hour surgery, Frink and two other surgeons from Surgical Oncology Associates removed a tumor the size of a basketball and a major portion of the patient's pelvis, then reconstructed it. They were able to get the entire tumor, and the patient is doing well and up and walking again.
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Stories like these are possible due to the specialized training and education Frink has undertaken which includes a fellowship in orthopedic oncology at M.D. Anderson Cancer Center. "Being able to cure or at least improve the quality of life for patients is very rewarding," says Frink. "Helping them beat the disease, get rid of their pain, return to mobility and back to enjoying life - I feel good about that." With current chemotherapy and surgical intervention Frink says 60 to 70 percent of the people with cancers that have not metastasized beat their disease.

To find out more about Surgical Oncology Associates, visit www.surgoncsouthtexas.com or call (210) 946-1400

Attention Cancer Patients, Need A Ride?

Thu, 18 Feb 2010 00:00:00 GMT

If you are a cancer patient and need transportation to your cancer related appointments in Bexar County, the American Cancer Society can provide transportation.

Please call 1-877-227-1618.

Recent Recommendations on Mammographies

Mon, 30 Nov 2009 00:00:00 GMT

Hello everyone,

This is a special time of the year where families join together and share and recognize the importance of having each other and valuing life's true gift of health and wellness. I thought I would take this time to focus on recent reports about early detection of breast cancer which challenges our current patterns of screening. Clearly, as an oncologist, I am a strong proponent of early detection.

Recent recommendations from the US Preventative Services Task Force have suggested that mammography should no longer be routine or mandated for all women ages 40-49 and even amongst higher risk age groups, mammography should be done every 2 years or perhaps in the aged-women > 74 years of age, mammography should not be done at all.

These recommendations are sobering to us who are directly involved in patient care. The facts are that mammography can detect breast cancer in about 80% of all breast cancer cases (current annual statistics suggest over 184,000 new cases will occur by years end). It is one of the least expensive tools in cancer detection when compared with CAT scans, MRI scans and PET scans and yet if done routinely, mammograms can be useful in discovering cancers in their early development before being discovered by examination.

Current statistics world-wide show that breast cancer mortality rates continue to decline by 2% per year which translates, according to the American Cancer Society, in a reduction of breast cancer deaths of 15,000 per year. Clearly, regular mammography screening can and does save lives.�The crux of the controversy is that certain women have mammograms that may miss early cancers (remember that there is an accepted false negative rate of about 10-20%) and some mammograms will detect changes that lead to unnecessary biopsy.��

Current American Cancer Society data show that about 8-10% of all mammograms show serious enough changes to warrant a breast biopsy. Eighty percent of these biopsies show no breast cancer.�There is a concern that this false positive rate leads to more anxiety, expenses and further unnecessary tests for months and years to come. It is important to understand that there is no perfect test -however, it is important to balance the expenses with the importance of cancer death reduction. Several studies have been done since the 1960's showing the reduction of breast cancer mortality which has met statistical significance.��

Again, many cancers detected by mammogram are small and current ACS data shows that breast cancer discovered early can lead to 5-year breast cancer survival rates of >90-95%. Early detection does save lives-mammograms often can detect cancers <2 cm-most cancers found on physical exam (recent reports have questioned the usefulness of breast examinations also) are much larger. Cancers that are larger not only lead to poorer outcomes in breast cancer survival but also typically require more treatments including chemotherapy which is costly-current estimates suggest for a 3-6 month course of therapy, treatment expenses exceed $20-40,000. In addition to this are the costs related to loss of work and the management of short and long-term effects of this therapy. The balance of all aspects favors mammography and one important recommendation is to emphasize improved methods of detection to reduce cancers being missed and allowance for improvements in breast cancer discovery: for now, regular mammography clearly has a role and must be considered for regular screening to allow for early detection of cancer that can meaningfully save lives.

My recommendation is to talk to your doctor about your personal risks of breast cancer, remain aware of your breast health and help with improvements in awareness about the facts about early detection of breast cancer.

There always will be controversies about detection because not all tests work for everyone but one thing that you can continue to do is eat well, exercise and enjoy life!

Take care,�
Sharon Wilks, MD FACP
Chair of the Cancer Committee for BHS

Attention Breast Cancer Patients: Do You Need A Ride?

Wed, 11 Nov 2009 00:00:00 GMT

If you are a breast cancer patient and need transportation to your cancer related appointments in Bexar County, the American Cancer Society can provide unlimited transportation. Please call 1-877-227-1618.

This free service is made possible through a generous grant from the Susan G. Komen Breast Cancer Foundation.

What is a Lymph Node Biopsy?

Tue, 30 Dec 2008 00:00:00 GMT

by Patricia Griffin Kellicker, BSN

Definition
A lymph node biopsy is the removal and examination of all, or part, of a lymph node. Lymph nodes are found throughout the body, and are part of the body's immune system. These nodes help fight infection by producing special white blood cells called lymphocytes. They also work by trapping bacteria, viruses, and cancer cells.

Normally, lymph nodes cannot be felt unless they become swollen. Infection, usually by a virus, is the most common cause of lymph node swelling. Other causes include inflammatory disease, abscess, and cancer.

Parts of the Body Involved
Lymph nodes may be biopsied wherever they are enlarged and can be felt. Common areas for biopsy include:

Groin
Armpit
Neck
Under the jaw and chin
Behind the ears
On the back of the head

Reasons for Procedure
Lymph node biopsies are performed to find out why a node is swollen. This procedure is also used to see if there are cancer cells in the lymph node(s).

Risk Factors for Complications During the Procedure
Complications from a biopsy are rare. There is a small risk of bleeding or infection. If you have a bleeding problem, or take medication that causes increased bleeding, you may be at greater risk for complications. Pregnant women may also be at increased risk for complications.

What to Expect

Prior to Procedure
Depending on the type of lymph node biopsy, the procedure may be done in an operating room, an outpatient surgical facility, or a doctor's office.

In the days leading up to your procedure you will need to:

Tell your doctor if you have any allergies
Sign a consent form
Inform your doctor of all medications you are taking, including any herbs, vitamins, or other supplements
Discuss your medical history with your doctor
Have nothing to eat or drink after midnight the day before your procedure, unless your doctor specifies otherwise
Arrange for a ride home
Wear comfortable clothes, especially near the biopsy site

Stop taking aspirin or other anti-inflammatory drugs for one week before surgery, unless told otherwise by your doctor. You may also need to stop taking blood-thinning medications. Examples include clopidogrel (Plavix), warfarin (Coumadin), or ticlopidine (Ticlid). Talk to your doctor.

Anesthesia
Most biopsies are performed using a local anesthetic. Your doctor will inject a small needle with anesthetic into your skin to numb the area. You may feel some mild stinging. A sedative is sometimes given before the procedure.

General anesthesia is sometimes used for open biopsies. In this case, you may feel sleepy until the anesthesia wears off.

Description of the Procedure
Lymph nodes samples can be obtained by a needle biopsy or an open biopsy. There is also a procedure called a sentinel lymph node biopsy.

Needle Biopsy
There are two types of needle biopsies, fine needle biopsy, and core needle biopsy. A fine needle biopsy uses a thin, hollow needle to obtain fluid and tissue samples. A core needle biopsy uses a larger needle to cut a piece of tissue from the sample. Sometimes an ultrasound or computed tomography (CT) scan is used to help locate the biopsy site.

Lymph Node Biopsy
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�© 2008 Nucleus Medical Art, Inc.
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Open Biopsy
An open biopsy means removing the lymph node(s) through an incision, or surgery. For this type of biopsy, a surgeon will cut into the skin and remove either the whole lymph node or part. More than one lymph node may be sampled. After removal, the incision is closed with stitches and bandaged. Either local or general anesthesia may be used, depending upon where the sample is taken.

Sentinel Lymph Node Biopsy
This type of biopsy is used to detect cancer. A sentinel lymph node is the first node or nodes, that cancer is expected to spread to from the primary tumor. For this biopsy, a special dye and a radioisotope tracer are placed near the tumor. The doctor then traces where the dye and isotopes go, and removes the lymph nodes the dye reaches first. These nodes are then checked for cancer. The benefit to this type of testing is that fewer lymph nodes may need to be removed.

After Procedure
After the procedure the tissue samples from the lymph node(s) are tested for the presence of infection or cancer. In some cases, the sample is sent to the lab during surgery for a quick test for cancer. This helps the surgeon determine if more samples need to be taken. A pathologist will prepare the sample and view it under a microscope for any abnormalities.

How Long Will It Take?
Depending upon the type of biopsy, the procedure can take from 30 minutes for a needle biopsy to an hour or longer for an open biopsy. If a CT scan or ultrasound is used, the procedure may take longer.

Will It Hurt?
You will be given anesthesia to numb the area, and prevent pain during the procedure. You may feel some pressure or pinching during local anesthesia. If you feel any pain, tell your doctor at once. Some tenderness at the biopsy site is expected after the procedure.

Possible Complications
There are generally few complications after a lymph node biopsy. There is a small risk of bleeding or infection. Nerve damage including numbness at the biopsy site may occur.

If you received dye during a sentinel biopsy, you may experience discolored skin or urine. There is also a rare risk of allergic reaction to the dye.

Average Hospital Stay
Most lymph node biopsies are performed on an outpatient basis. A short stay in the hospital may be necessary in some cases.

Postoperative Care
Your doctor will give you specific instructions based upon where the biopsy was performed. General instructions include keeping the biopsy site clean and dry.

Outcome
Your biopsy will be sent to a pathologist to examine. Results are generally ready in a few days. Your doctor will give you the results from the test, and let you know if any further treatment is necessary.

Call Your Doctor If Any of the Following Occurs
It is important for you to monitor your recovery once you leave the hospital. If you notice any of the following, call your doctor:

Bleeding
Pain
Fever
Redness or swelling at biopsy site
Worsening symptoms
New symptoms that persist

RESOURCES:

American Cancer Society
http://www.cancer.org/

National Cancer Institute
http://www.cancer.gov/

CANADIAN RESOURCES:
Canadian Cancer Society
http://www.cancer.ca

Cancer Care Ontario
http://www.cancercare.on.ca/

References:
Lymph node biopsy. Medline Plus, US National Library of Medicine and the National Institutes of Health website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003933.htm . Accessed August 29, 2005.

Testing biopsy and cytology specimens for cancer. American Cancer Society website. Available at: http://www.cancer.... . Accessed August 29, 2005.

Sentinel lymph node biopsy: questions and answers. National Cancer Institute website. Available at: http://cis.nci.gov/fact/7_44.htm . Accessed August 29, 2005.

Swollen glands. Medline Plus, US National Library of Medicine and the National Institutes of Health website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003097.htm . Accessed August 30, 2005.

Zaret BL, Jatlow PI, and Katz LD. The Yale University School of Medicine Patient's Guide to Medical Tests . New York: Houghton Mifflin Company; 1997.

Last reviewed November 2008 by Mohei Abouzied, MD

Last Updated: 11/17/08

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To send comments or feedback to our Editorial Team regarding the content please email us at HLEditorialTeam@ebscohost.com .

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BRAC Testing: What Does it Mean for Me?

Tue, 30 Dec 2008 00:00:00 GMT

Did you know that there are gene tests for breast and ovarian cancer? Testing negative does not always mean you are in the clear.�

What are the BRCA genes?

The BRCA1 & BRCA2 genes normally function as an essential part of the normal process of double-strand DNA repair of DNA strand breaks. When these areas mutate, the individual who has inherited such a mutation is significantly more at risk for development of breast and ovarian cancer. It is uncertain why these kinds of mutations lead to these types of cancers and much research is needed to continue to understand this. It is realized that individuals with tumors are more susceptible to alkylator therapy like Cisplatin which can cause DNA cross linking breaks which can make tumor growth cease.

What is the risk?�

It has been reported that amongst individuals who inherit these types of genes there is a life-time risk as high as 85% for development of breast cancer by age 70. Ovarian cancer risk is common as well, and reports suggest carriers may have as much as 40-50% life-time risk for development of ovarian cancer.�

How does one get tested?

The test is performed on blood samples.�

What do the results mean?

A positive test means that the individual has acquired a harmful mutation that has been associated with a high chance of developing breast or ovarian cancer or both.

A negative test means that the person does not have a gene mutation and as a result has a lower lifetime risk for development of ovarian and/or breast cancer.� However, depending on one's family history and own personal risk factors, a negative test does not mean the person will not get cancer.

Who should be tested?

Current recommendations for individuals at high risk include:

Onset of breast cancer before age 50
History of breast cancer in 2 or more relatives
History of breast cancer in a male relative
History of breast cancer in both breasts or breast cancer occurring more than once in the same breast
Individuals of Ashkenazi Jewish descent
History of ovarian cancer at any age

What to do if you have been tested and have BRCA gene mutation?

You should review options of intervention with your doctor. Due to the high risk or development of breast and ovarian cancer, some women consider undergoing removal of breast (mastectomy) and ovarian tissues (oophorectomy). Although this approach reduces breast cancer and ovarian cancer substantially, it is not fool proof but the best-proven method for protection against development of these cancers. Recent studies suggest a role for tamoxifen for reduction of breast cancer. Some recommend close vigilance including ultrasounds and use of screening test with CA-125 levels for ovarian cancer while use of semi-annual to annual screening with MRI of the breast for breast cancer surveillance.� These interventions can be life changing and expensive - it is important to talk with a physician who you trust and who has experience in counseling women about risk reduction to guide you with the best decision of care.

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Cancer Care News and Events - Baptist Health System

Cancer Care Update

Decision Making Tool: Should I Have a Mammogram?

Innovative Breast Care in a Healing Environment

Beating Pancreatic Cancer

Specialized Care for a Rare Cancer

Attention Cancer Patients, Need A Ride?

Recent Recommendations on Mammographies

Attention Breast Cancer Patients: Do You Need A Ride?

What is a Lymph Node Biopsy?

Groin Armpit Neck Under the jaw and chin Behind the ears On the back of the head

Lymph Node Biopsy � �© 2008 Nucleus Medical Art, Inc. � �

Click Here To Go Back To The E-Newsletter

BRAC Testing: What Does it Mean for Me?

Click Here To Go Back To The E-Newsletter

Groin
Armpit
Neck
Under the jaw and chin
Behind the ears
On the back of the head

Lymph Node Biopsy
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�© 2008 Nucleus Medical Art, Inc.
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