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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information”

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Thanksgiving is here…yeah!  For some its about the food, for others its about family and for some its about the shopping afterwards or football game. The tradition of asking everyone to name 2-3 christmas-vs-thanksgivingthings they are thankful for at the dinner table, seem to have fallen by the way side. Worse yet, when asked what they are grateful for, many seem to stumble about what to say. The horror!

Learning to be grateful, can start by looking at your life, where you are now, where you have been, the things you overcame this year, the things you were allowed to do this year, etc., See video below for motivation.  A varied sample of what I am GRATEFUL for include:

  • Waking up this morning – I recently heard of someone in my age group, who came home tired from work. Went upstairs to take a nap before dinner and just never woke up…dying in her sleep.
  • (What I think are…) My ugly toes – I recently did a presentation on healthcare cultural competence in taking care of disabled veterans. There are many wounded warriors who are able to function with the assistance of prosthesis…what do I have to complain about?thankful-printable
  • My truck – I grew up in the islands and walking over a mile to catch the bus to school was the norm. A sturdy vehicle that can handle well in the rain and snow, is indeed a blessing!
  • Relationship with my Mom and Dad – a miracle, but I think they have finally come around to realize I am an adult (smile). Our relationship and understanding have grown in leaps and bounds over the past decade.
  • Ability to give – though it is often said it is better to give than to receive, many have the desire to give, but is not able to do so. I thoroughly enjoy being a blessing to others.
  • Travel opportunity – visiting 6 international countries this year, mostly for work, but able to take a few vacation days to enjoy the area too. WOW, absolutely awesome!

What are you grateful for? Still not sure? See the video below.

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information”

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winter-exercise

There is Dedication and then there is this….??

It is getting really cold outside and I absolutely love it! Growing up in the Caribbean islands there are only 2 seasons – summer and hurricane season…giggles. However, for me, there is nothing like experiencing the 4 seasons…it always brings me wonder and joy! The beauty of autumn, the wonder in a snowflake, the life in spring…and the beautiful long days of summer!

Unfortunately, millions of people are usually depressed, disappointed, or in despair during the holiday season. Either because it reminds them of a loved ones’ death, seemingly having no love  in their lives, being lonely and/or alone, or due to seasonal depression.  Season Affect Disorder (SAD) is a type of depression that is related to changes in seasons, usually in the winter. It is often referred to as “The Winter Blues” or “Seasonal Depression”. See video below to learn about treatment approaches for SAD.

SADSmile at someone today, give someone a hug if the opportunity arises (a friend, child, parents, etc.,). As my God-father told me…. “Camille, your smile is a blessing. You just don’t know, but your smile and warmth may be the only genuine greeting someone may see or have that day, or in weeks!”  Hard to believe ugh?! Sad, but you can help make a change…

There are some things that a tweet, text, Instagram or email cannot do (too impersonal). Break the media-only-relationship chain.  Make an effort to reach out to someone today, this month, or for the season. If you cannot be there in person, pick up the phone and give a call. You never know! You may be someone’s sunshine during a gloomy situation!

Sending Hugs and Sunshine your way!

 

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information”

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Recently, I was asked to speak on Health Care Disparities. No problem. As a “triple minority” I stand ready to assist in this area whenever called upon (triple = immigrant, black, female). However, the audience interest lies in the healthcare disparities as it relates to the disabled. Oh?! That is different. Truth be told, I really never thought of the disabled as a “diverse” population per say, or one with a different culture. Have you? I had the privilege of treating physically and mentally challenged patients for cancer, but had no difference in treatment (adjusted to minor requirements)….so, I did not take into account Healthcare Disparity for this minority group. Not blinded to the possibility…just not confronted with it.

disabled vet

Living above limitations!

Diversity at its roots simply means “differences”, and an attempt to understand and incorporate these difference in different facets of life, leads to “cultural awareness and/or cultural competency.” Of course, this should be applied to any place of business (for profit companies, not-for profit business, hospitals, etc.,)

Diversity, Health disparity and cultural awareness has a long history of association with under-served population, minorities, race, gender, religion, etc.,

Disabled diversityThere is a wide array of diversity among the disabled, as well as different types of disabilities, as well as different degrees of disabilities. There appears to be 3 main disability groupings: Genetics (be it from childhood or adulthood), Accident caused (civilians) and the Disabled Veterans. It was surprising to learn that many who are disabled do not necessarily identify with with each other (disabled), but may choose to identify with other parts of their culture.

We are forever grateful to our Veterans!

Disability Identity defined – “The population of people who experience disability is extraordinarily diverse and, therefore, the idea of a common disability identity isolates disability artificially from intersecting identities related to race, gender, and other axes of social significance” from Gill C, Cross W (2010). Disability Identity and Racial-Cultural Identity development: Points of Convergence, Divergence and Interplay. Rehabilitation Science and Practice

diversityThere is no simple relationship between race and disability, gender and disability, religion and disability, etc., So, what should a healthcare provider take into consideration when addressing the needs of a 30 year old, Hispanic female, left below the knee amputee, veteran? Is there a difference? Should there be a difference?

How do you relate to people with disabilities? Take a look at the videos below and see if any of the information rings true…for you.

See Me….talk to me! 

No excuses!

Disability Attitudes

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

A Right To Die??

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information”

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As a physician, I take the Hippocratic Oath seriously – First Do No Harm.  So, without thinking about it, I sometime assume that it is automatic that patients will not harm themselves either. I am proven wrong time and time again….and it saddens my heart. I recently blogged about Robin William when he unfortunately committed suicide…he was loved by many and I am a great admirer of his work.

A recent headline caught my attention, “29-year-old Newlywed with Brain Cancer, Brittany Maynard, writes own obituary before taking her life on Sat.”  WHAT?? Did I read that correctly?  (read more HERE ) This brought more questions to the forefront that is suitable for “active debate/discussion?”

The Beautiful Brittany

The Beautiful Brittany

 

  • Is Robin William’s case of suicide any different from Brittany Maynard’s?
  • What lesson is there for our community from both cases?
  • Do parents discuss this kind of event with their children? Should they?
  • How does this affect children diagnosed with Cancer? (normal age for pediatric cancer is usually 2-21 – so conversely, if they are old enough to vote or drive or be independent from their parents by court, is there provision for such a decision if terminally ill also?)

I do not believe in suicide.  But as proven here … this is made a personal decision based on situation…and residence. On immediate survey of colleagues sitting close by at a conference, the responses were very diverse (great conversations…).

What I do believe in, is the frank discussion of life and death with everyone. Yes, everyone. Seize the opportunity when the gold fish dies, when the family dog dies, when grandparents dies…death is a part of life. As Mr. Anonymous states, “Being born is a death sentence. After birth, you are slowly dying…each…and every…day.”  Should a person  be able to choose how and when to die if terminally ill? The debate and controversy continues…

“I do not fear death. I had been dead for billions and billions of years before I was born, and had not suffered the slightest inconvenience from it.”
― Mark Twain

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

SURVIVORS!

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information”

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As October comes to an end and breast cancer awareness publicity winds down…many continue to live with, and fight this disease. Often, I am asked, “when can I say I am a survivor? When can I say I am disease free?” I use to think this was a difficult question. But, with maturity and experience comes wisdom. The answer is not a generic one…

Survivor JeannineWalston500

“I did not think I’d still be alive after diagnosed with a brain tumor in the spring of 1998 at age 24, 15 years ago.” Says Jeannine Walston in her blog.

During a recent cancer walk, the buzz was all about being a cancer  “over-comer” and not a “survivor” … Hhhmm.  I say, whichever phrase empowers you most…use it! The Merriam Webster dictionary defines both as:

Survive: To remain alive or in existence; live on. To continue to function or prosper; to continue to function or prosper despite … (Merriam-Webster)

Overcome: to defeat something. To successfully deal with or gain control of (something difficult). To affect (someone) very strongly or severely

Strong terms!

About 7 years ago while wrestling with the different faces and phases of cancer…I chose to express myself on paper (not sure I would call it a poem though). It never gets easier to handle…as physician, we need an escape too. I choose to download to Jesus daily…and leave it at the alter. Yes…I pray for my patients in private…

 

The identity of cancer1

 

To ALL the Survivors and Over-comers – Blessings, Peace and Love!

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information”

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malebreastRecently, I have noted a commercial about Men Against Breast Cancer (MABC), that advocate providing “caretakers” information to males who are taking care of their female love ones, who are diagnosed with breast cancer. How Marvelous! We cannot have enough advocacy relating to Cancer…period.  Breast Cancer is leading the way in publicity, support, advocacy and outreach that should be emulated by less commonly diagnosed cancers.

male breastWhat about men WITH breast cancer? Breast Cancer has been painted so pink (feminine) …that when a male is diagnosed with Breast Cancer, to some, it can be emasculating. Some have presented with advance stage breast cancer, simply because of refusal to believe that the growth on the chest was “breast cancer”…they would not have any part of that diagnosis.

So what to do? It is my belief, that ANY advocacy, publicity, support or outreach, about breast cancer should make it their responsibility to make it known that MEN ARE ALSO DIAGNOSED WITH BREAST CANCER! This would go a long way in removing the stigma.

Male-breast-cancer-man

After Mastectomy – removal of cancer from breast tissue

Yes…Men do have breast. There is “under-developed” breast/fatty tissue just below the nipple area in ALL males (see diagram above). The breast growth was stunted by hormones (lack of certain hormones) during puberty. Have you noticed any men with a “little extra tissue” below the nipple area? This is called “Gynecomastia” which simply means enlargement of a man’s breast, usually due to hormone imbalance, or hormone therapy.  Gynecomastia is just an overgrowth and is a benign condition (it is not malignant/cancerous) and can be seen temporarily during puberty or in overweight men.

Breast cancer in men is a rare disease. However, in 2014, about 2, 360 men are expected to be diagnosed with breast cancer (<1% of total breast cancer diagnosis). Many thanks and deepest gratitude to all who support breast cancer efforts! Let us take one more step and be more inclusive of ALL breast cancer diagnosis and survivors for BOTH sexes – Men and Women!

Thank you for all you do! Until next week …

Please share with the men in your life!

 

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information”

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TRIPLE NEGATIVE BREAST CANCER

Females are VERY vocal. If you were ever in doubt about the strength in numbers and just how vocal females can be regarding a cause of mutual interest … take a look at Breast Cancer.  Everyone knows pink = breast cancer.

However, despite the awesome global attention and exposure and the many research underway, there still exist a problem; patients are still not certain of the “labels” that physicians use in describing certain aspect of Breast cancer and are often times terrified by the information found on the internet – especially as it relates to triple negative breast cancer. The questions I am often asked are;

  1. What are receptors?
  2. What does “triple negative” breast cancer mean?
  3. Is “Triple Negative” breast cancer a good or bad thing?
Receptors - Complicated?

Receptors – Complicated?

What are receptors?  There are currently 3 receptors of interest in Breast Cancer: Estrogen Receptors (ER), Progesterone Receptor (PR) and Herceptin receptors (Her-2-neu)

Receptors are often times describe as, “little antennae’s” on the surface of cells that controls behavior, such as rate of growth, of the cell.  Clear as mud? Apologies, that is still “Doctor talk” that would not make sense to my non-medical Mom…so probably not for you either.

Uuhhhmmm….thinking, thinking…Lord Help me here…Hhhmmm. Got it! A bit overly simplified…but,

Think of Breast Cancer Growth being similar to a plant. There are 3 things required to make a plant grow;

  1. Soil
  2. Water
  3. Sun

Think of each of these components as a receptor, and things that make a cancer grow,

  1. Soil   (Estrogen receptor or ER)
  2. Water (Progesterone receptor or PR)
  3. Sun (Her2neu receptor)

When all 3 are present, the Plant grows (cancer grows).  We also have the ability to “block” each of these components in hopes of preventing the Cancer from growing.

  • If the soil is removed, the plant will be destroyed. (ER+, PR-, Her2Neu-)
  • If water is taken away from the plant, it will be destroyed. (ER-, PR+, Her2neu-)
  • If  Sun exposure is removed, the plant will be destroyed. (ER-, PR-, Her2neu+)

When there are positive receptors, we have available medications that will block the growth of cancer cells in addition to the regular treatment of surgery, radiation therapy and chemotherapy. Oncologist like this, because there are more options of Medications to use, and the more different types of drugs we have, it is believed that the chance of controlling the cancer, will theoretically improve. You may be familiar with some of these drugs Tamoxifen, Arimidex,  Herceptin, etc.,

Triple Neg How ChemoIn Triple Negative Breast Cancer (ER-, PR-, Her2neu-) … The example would be a plant that is not sustained by any identifiable component…yet it is growing; a plant in a dark room, without soil or water available…grows. What is causing it to grow? Other factors that are not hormone receptor related (Well research are ongoing in this area).  However, we are still able to offer the same Surgery, Chemotherapy and Radiation Therapy as for hormone positive tumors…we just lack that “extra arsenal” of hormone/Antibody blockade that we have for positive receptor tumors.  For this reason, triple negative breast cancer is sometimes considered more aggressive. BUT, others sees it as a Breast Cancer without the hormone treatment options…3 out of 4 still remains (surgery, chemotherapy, radiation therapy). Glass half empty or half full?

Now that you understand the basics, more will be explored next time! Questions? Let me know!

Click below to watch.

Robin Roberts speaks on Triple Negative Breast Cancer

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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