Healthy Mama: Breast Cancer News

Breast cancer is something moms must always stay up-to-speed on, so we did a question and answer session with Dr. James Irwin of Mercy Health. Dr. Irwin is a board certified surgeon who did his Master’s thesis on cancer research. He is also the son of a breast cancer survivor who underwent bilateral mastectomies during her fight against the disease.

Recent reports have confused me about how often I should get a mammogram. What’s the current recommendation on how frequently I should have this test?

Certainly the reports are confusing and differ depending on where you look. I follow the recommendations from the American Cancer Society, which are yearly mammograms starting at the age of 40 and continual as long as the woman is in good overall health. These are also the recommendations that are supported by the American College of Surgeons.

What is dense breast tissue and how does it affect screenings for breast cancer?

Dense breast tissue is normal breast tissue that can contain more connective tissue or breast ducts and lobules. There are many things that can influence the presence of dense breast tissue. A few of these are age, genetics, hormone use, and which phase of menses a woman is in. Dense breast tissue can make screening mammography more difficult. Therefore, it is felt that mammography may be best performed within the first two weeks after menses (monthly cycle) has started. In women who have dense breasts, supplemental screening techniques, such as whole breast ultrasound, may be used for better detection.

self examI panic anytime I feel anything in my breast tissue, which makes me want to avoid doing the self-exams. Are some lumps or bumps normal in healthy breasts?

Most lumps and bumps in the breast are usually normal and can come and go in response to the natural hormones in a woman’s body. The only advice I can give on self-exams is get instruction on how to do a proper self-exam. Know how your breasts feel and recognize changes that occur in your normal cycle. By knowing how your own breasts feel on a regular basis, you are more able to detect possible harmful changes.

What are the latest advancements in the detection and treatment of breast cancer?

Detection techniques have been improved with the age of digital, high-definition mammography. The use of MRI has also allowed for better detection in high risk women and in women who are already diagnosed with breast cancer. Computer-aided detection (CAD) can be used on digital mammography. The use of genetics and hormone testing on tumors are advancements in treatment that allow for targeted therapy as well as calculation of risk of recurrence.

I have a friend who hasn’t had a mammogram because she says that breast cancer doesn’t “run in her family.” Is there always a hereditary link with this disease?

No. Less than 10% of all breast cancers are related to an inherited genetic mutation. Therefore the vast majority of breast cancers are related to non-inherited factors. My advice is tell your friend to go get her mammogram.

Over the years, how has the prognosis changed for a woman with breast cancer who has detected the disease early?

Over the years, the incidence of breast cancer has increased. This has been because of the increased screening for breast cancer. Yet while the numbers have increased, the amount of breast cancers we are finding at earlier stages has increased. And prognosis for a woman with early stage disjames irwinease is almost always going to be much better than finding breast cancer at a more advanced stage. Also, as we come to know this disease better through research, we are able to better tailor our treatments to the needs of individual women.

Our thanks to Dr. Irwin for taking time out of a very busy schedule to answer our questions. For more information on breast cancer, mammograms and other women’s health issues, visit the Mercy website or schedule an appointment with your physician.

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What you and your husband need to know about men’s health

keep-calm-and-go-to-the-doctorWe all know a few men in our lives who are stubborn about doctor’s appointments and having medical tests done. But we also know that avoiding the doctor’s office — and especially avoiding life-saving medical screenings — can carry a huge price.

September is Men’s Health Month, so we interviewed Dr. Robert Zimmerman, who is a urologist with Mercy Health.

Please read the information below and get your husband to schedule an appointment if he needs to be screened or if he needs to talk through any issues with a doctor. (And by all means, if he won’t do it, schedule it for him and get him to that appointment!)

If you were talking to my husband today, how would you convince him that it’s important to come in for a check-up? (Because so far my nagging isn’t working.)

The key to men taking control of their own health care is empowerment. Historically, women have been better at assuming health care for their families.  Much marketing for health care is directed to women – even for men’s health. Women tend to lead lead their partners into the health care system.

Men must develop self-reliance for their health care. Empowering them through education is important. Helping men understand the need for heath maintenance and “taking charge” of their health care is paramount. I see education as a vital aspect for this. Helping men to understand this begins in the exam room and in the interactions with their physicians. Physicians should educate their patients on why they are doing what they are doing and foster an atmosphere where the patient understands their health care needs. That understanding is essential to men feeling empowered to take charge of their own health care.

What are the most common types of problems you treat in men ages 30 to 60? What are the symptoms men most often seek treatment for?

men restroom signAs men age their prostates continually enlarge. This enlargement is a normal part of the aging process for men and it results in reduced flow, increased urgency and frequency, increased trips to the restroom at night and, in extreme cases, cause urinary retention and the inability to void.

Approximately 60% of men at age 60 will display symptoms of an enlarged prostate. Benign Prostatic Hyperplasia (BPH) is not cancer. But it should be evaluated by a urologist who will typically offer prostate cancer screening simultaneously.

Treatment for BPH usually includes the use of medications as a first-line therapy. These medications relax the smooth muscle of the bladder neck allowing the prostate to open to allow better flow through it. Medications in this class are called alpha-blockers (terazosin, tamsulosin, e.g.).

Additional medications may be used which can assist in reducing the size of the prostate (finasteride, e.g.). If these medications do not give a satisfactory result, or if men are unable to tolerate the medications, then surgical options may be provided. There are some office-based procedures that can be done, however, most are offered a transurethral resection of the prostate (TURP). In this surgical procedure (which usually requires an overnight stay in the hospital) excess tissue is removed from the prostate allowing a larger channel for urine to flow through.

This surgery is highly successful and provides lasting results, but it may need to be repeated for any “re-growth” of tissue. There are also laser techniques which can be used to accomplish the same results. These are done as an outpatient surgery and also require limited catheter drainage for a short period after the surgery similar to the TURP.  Men having urinary flow issues should seek advice from the health care provider and seek out a urologist if medical therapy is not accomplishing the desired effects.

What are the most common causes of E.D.? (Can an underlying heart problem be the cause of E.D.?) What are today’s leading treatments for this problem?

Erectile dysfunction affects millions of men. The incidence of erectile dysfunction increases with age. The major risks factors for erectile dysfunction are vascular disease (40%), diabetes mellitus (30%) and medication side effects (15%). For instance, a diabetic male who has a history of cardiovascular disease and who may be on offending medications may carry a nearly 85% risk of associated erectile dysfunction.

Treatment options for erectile dysfunction include oral medications (Viagra, Levitra, Cialis, e.g.). These medications increase vasodilation of the arteries supplying blood to the penile tissue – hopefully increasing the quality of the erection. Presently, the expense of these medications and the often limited coverage by prescription drug plans make these medications limited to patients.

If this first line therapy fails, there are multiple other modalities that can be tried including vacuum pump devices, penile injections and urethral suppository.  In the event of failure of these therapies, a penile prosthesis can be utilized. This is a medical implant which is completely self-contained in the patient which provides an “artificial” erection.

These devices are surgically implanted and are generally covered by most insurance plans including Medicare. Penile prosthesis carry very high patient and partner satisfaction rates of greater than 92%. Men seeking this form of therapy to restore erectile function should seek out a urologist who does a fair amount of this type of work.

What do my husband and I need to understand about the risk of prostate cancer?

Prostate cancer epidemiology, screening and treatment is a very large subject area – too large to be completely addressed here. Some basic facts of prostate cancer are that for Caucasian males, one out of every six males may be diagnosed with prostate cancer in their lifetime. If they have a first degree relative prostate-sticker(father or brother) with a prostate cancer history, this risk increases to one in two, or 50%.

Though highly treatable if detected early, more men die from prostate cancer than do women from breast cancer in the state of Arkansas, according to data provided by the Arkansas Prostate Cancer Foundation.

Screening for prostate cancer involves a simple blood test and a prostate exam. Though the blood test looking at Prostate Specific Antigen (PSA) is not a perfect test and its utility is debated, it is one of the best screening tools we have. We know that when done together with a simple prostate exam, detection rates are higher for prostate cancer.

The PSA test must be interpreted for each particular patient’s risk stratification. This includes family history, past values, voiding symptoms and physical exam to name a few. Presently, most urologists still advocate screening in men between the ages of 45 and 70. If the screening tests are suggestive of an increased risk, a prostate biopsy would be offered to the patient. This is a simple procedure performed in a clinic setting.

There has been recent research about the benefits of a “wait and see” approach to treating prostate cancer. How do you know when it’s more beneficial to treat it aggressively?

Treatment for prostate cancer involves many different possible modalities – all of which have good success rates when tailored to the individual’s disease state. Treatment options may include surgery which may be done through an open incision or via a minimally invasive technique utilizing the DaVinci robotic assisted surgical platform. Radiation – either alone or in conjunction with medications may also be utilized for excellent patient outcomes. The different treatment options for prostate cancer all carry some potential side-effects and risks. In minimal disease presentations, active surveillance options (also called the “wait and see approach” may be utilized.) All of these options must be discussed at length with a urologist.Robert_Zimmerman_1669420931

Our thanks to Dr. Zimmerman for taking time out of his busy schedule to answer our questions. To schedule an appointment with Dr. Zimmerman, call the Mercy Urology Clinic at 479-636-9669. He has offices in Rogers and Bella Vista. Or click HERE for more clinic information.

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7 Things You Need to Know About Sports Physicals

We moms spend our fair share of time in the bleachers or on the sidelines, watching our kids run, block, tackle, pass, shoot, kick, dance, cheer, swim, wrestle — and the list goes on. But before that happens, we should spend some time in the doctor’s office making sure our kids’ sports physicals are up to date.

stethoscopeMost school athletic programs require a sports physical before participation so, in most cases, it’s not optional. And it shouldn’t be because these types of physicals are designed to catch health problems that, if they go undetected, could cause serious health issues for young athletes. In most cases, a sports physical will only take about 15 to 20 minutes and they’re covered by most insurance programs. (If it’s not covered, cost is about $25.)

Here are 7 things you should know about why sports physicals are so important BEFORE your kid steps foot on the field or in the gym.

  • Doctors will ask about any past heat-related illnesses.
  • Doctors will educate the student and parent about how to avoid getting a heat-related illness.
  • Doctors will look at the child’s cardiovascular health and any potential problems.
  • Doctors will check lungs and blood pressure.
  • Doctors will check for any possible joint issues as well as flexibility.
  • Doctors will talk to you about family history, trying to determine if there is any link to people passing out during exercise or any incidences of sudden death.
  • Sports physicals can and do catch health complications that are capable of causing life-threatening conditions for athletes.

More questions about sports physicals? Click HERE to see an interview with Dr. Steve Goss of Mercy about this important exam.

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Check out Mercy’s new mobile health bus!

mobile unitWe all know people who are reluctant to go to a doctor’s office, right? And some people live so far out in the country that a trip to the doctor is a real challenge. So what if the doctors and nurses come to you?

Mercy has a new mobile health bus valued at $650,000 that will be used to reach rural communities and under-served patients throughout Northwest Arkansas and beyond. The 40-foot long bus is 8-feet wide and can provide everything from mammograms to heart screenings, giving people immediate test results. The bus may also be used for charity care services.

The bus is part of a $1 million dollar investment Mercy is making to reach more patients in need.

If you’d like to see the bus in person, you can get a tour of the new motor coach next week on Tuesday, July 29th at 10 a.m. at the General Mills office, which is located at 3605 Southern Hills Boulevard, Suite 300, in Rogers. (If your kids or teens are interested in the medical profession, this would be a cool experience for them to see this kind of mobile medical facility in person.)

Healthy Mama: When to treat a child’s fever

By Kimberly Steed, nurse and mother of 2

Every parent has battled a child’s fever. It often happens after the doctors’ offices have closed, in the middle of the night or on the weekend. As parents, we’re often left wondering, “What should I do, or should I do anything at all?

feverFever in a healthy child is usually not serious. Fever by itself is usually harmless and just the body’s way of fighting an infection. For healthy, normal-acting children with a rectal temperature lower than 102° F (38.9° C), medication is usually not required. If your child’s fever is making him or her uncomfortable, try giving acetaminophen or ibuprofen but be sure to follow the package directions.

As a mother, I’ve been there. My son had several fevers as an infant and early toddler. He was fine and playing one minute, and the next minute he was fussy, crying & inconsolable. Except for a few throat infections, Glyn has been a healthy child and eventually I started to recognize other symptoms such as a strange smell on his breath, a grimacing when he swallowed, pulling at his ears, not eating/drinking normally, or a red throat.

My husband (who is also a doctor for Mercy) recommends getting medical attention for a fever for the following situations:

  • Infants who are less than three months of age and who have a rectal temperature of 100.4° F (38° C) or greater, regardless of how the infant appears (Even the infant that looks well should be evaluated by a medical professional.)
  • Children who are three months to three years who have a rectal temperature of 100.4° F (38° C) or greater for more than three days or who appear ill (other symptoms might include being fussy, clingy and/or refusing to drink fluids).
  • Children 3 to 36 months who have a rectal temperature of 102° F (38.9° C) or greater.
  • Children of any age whose oral, rectal, tympanic membrane, or forehead temperature is 104° F (40° C) or greater or whose axillary temperature is 103° F (39.4° C) or greater.
  • Children of any age who have a febrile seizure. Febrile seizures are convulsions that happen when a child (between six months and six years of age) has a temperature greater than 100.4° F (38° C).
  • Children of any age who have recurrent fevers for more than seven days, even if the fevers last only a few hours.
  • Children of any age who have a fever and have a chronic medical problem such as heart disease, cancer, lupus or sickle cell anemia.
  • Children who have a fever as well as a new skin rash.

Besides treating a fever with medications like acetaminophen and ibuprofen, a parent should make sure their child is drinking more fluids because it’ll decrease the risk of dehydration. Also, be sure your child is getting enough rest.

One of the less effective methods of bringing a fever down is “sponging” or baths. Alcohol sponging is NOT a good idea, though, because of the risk of toxicity throfever articleugh skin absorption. If you’re ever in doubt on whether to treat a fever or what a fever might mean, or if your child appears ill and it concerns you, call your doctor for advice.

Last summer while Matt was in Alaska, Glyn developed a fever. He was playing with his trains, and this is how I found him. His temp was 103° F degrees. But after an injection of “vitamin R” (Rocephin) and oral antibiotics, he was ready to welcome daddy home. :-)

Kimberly is wife to Dr. Matthew Steed, whose number one passion is to care for the pregnancy and birthing needs of women. You may call him at the Mercy clinic at 479-338-5555 to begin your prenatal care and let him help you enjoy your pregnancy journey. His office is located in the Mercy Physician’s Plaza just off Interstate 540 in Rogers.

NWAMotherlode.com does not provide medical advice, diagnosis or treatment. This content is for informational purposes only and isn’t a substitute for professional medical advice. Always talk to your doctor if you have questions about a medical condition. Don’t delay getting professional medical advice because of something you read online. This website doesn’t necessarily recommend or endorse any specific tests, doctors, products, procedures or opinions discussed on the site.

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