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Archive for October, 2013

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information” Thanks in advance for your support!

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OCTOBER is Breast Cancer Awareness Month…and it is also Bullying Awareness Month!

When the term “Bully” is used, mental flashes of the playground, a cowering child, or someone being teased in the school setting is often imagined. However, over the past few years, with all the technological advances, the form of “Bullying” has also evolved. Bullying in the form of text messaging, video, or social media has become the new norm! The Health Effects from bullying begins with stress and can affect many organs causing symptoms (Headaches, sadness, muscle aches, feeling of despair, acne, stomach pain, rise in blood pressure, etc.,) noted in fig.1 below.

stress_2peg

Symptoms caused by stress

Are you the victim of Bullying at work? Tell someone (EEO, or other such entity)

What exactly is bullying? 

Bullying is the use of force, threat, or coercion to abuse, intimidate, or aggressively to impose domination over others. The behavior is often repeated and habitual. One essential prerequisite is the perception, by the bully or by others, of an imbalance of social or physical power.  WikipediA, The Free Encyclopedia

Bully verb : to frighten, hurt, or threaten (a smaller or weaker person) : to act like a bully toward (someone): to cause (someone) to do something by making threats or insults or by using force. Merriam-Webster

bul·ly  n. pl. bul·lies 1. A person who is habitually cruel or overbearing, especially to smaller or weaker people. 2. A hired ruffian; a thug. 3. A pimp. v. bul·lied, bul·ly·ing, bul·lies v.tr. 1. To treat in an overbearing or intimidating manner.   2. To make (one’s way) aggressively or by intimidation.The Free Dictionary (on the web)

HHS:Workplace Bullying is like Domestic Violence (see link to article)

HHS:Workplace Bullying is like Domestic Violence (see link to article)

In an article/blog by Jeryl Bier in the weekly standard headlined “HHS: Workplace Bullying is like Domestic Violence” in which he cites a study from the Health and Human Studies (HHS) which states that over one third of Americans reports being bullied at work. Read more HERE 

Anti-bullying rules to take effect in B.C. workplaces: New WorkSafe BC policies will redefine acceptable workplace behavior starting Friday (Click title to read more)

The Canadian Press Posted: Oct 30, 2013 6:19 AM PT Last Updated: Oct 30, 2013 6:24 AM PT

If you, or someone you know, are the victim of bullying, please notify your EEO or similar department, with your concerns! Your health depends on it!

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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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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information” Thanks in advance for your support!

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Please join me for the 4th Annual Breast Cancer Symposium brought to you by The American Cancer Society and Providence Hospital in Washington, DC on SAT 26 OCT 2013. The topic this year is Triple Negative Breast Cancer.  I will have the distinguished pleasure of speaking on Radiation Therapy and Breast Cancer. 

See you there and Thanks in advance for you support!

Please click HERE for more information (clearer poster)!

2013 Breast Cancer Symposium

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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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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information” Thanks in advance for your support!

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Treatment for Breast Cancer is considered to be 3 fold – Surgery, Chemotherapy and Radiation Therapy. Today, we will briefly review Radiation Therapy. Let us start with a basic review of a patient and indications for Radiation therapy.

  1. Lumpectomy and Node excision

    Lumpectomy and Node excision

    If a patient has an early stage breast cancer such as stage 1 that was treated with lumpectomy (removing only the area of cancer with a margin), then radiation is indicated (example: 56yo woman diagnosed with a 1.5cm Invasive Ductal Carcinoma, negative margins, 3 sentinel lymph nodes (from under the arm) negative for cancer). Background on why Lumpectomy and Radiation therapy goes hand in hand: In 1976-1984, a randomized trial was performed of 2163  women comparing Total Mastectomy, Lumpectomy and Lumpectomy plus Radiation therapy. The 20 year follow-up (in 2002) showed that for women who underwent lumpectomy ALONE there was a 39.2% chance of recurrence in the breast while those who had Lumpectomy + Radiation their recurrence was decreased to 14.3% (39% recurrence in the treated breast without Radiation vs 14% recurrence with Radiation). This is a significant local control! The author noted that Lumpectomy + Radiation was approximate to Mastectomy, hence the advent of offering Lumpectomy + Radiation together today.

  2. Mastectomy and Node excision

    Mastectomy and Node excision

    If this patient were to have a Mastectomy (removing the entire breast) with the same pathology results as noted above, then no radiation therapy would be indicated given the small size of the tumor and no lymph node involvement. However, post-mastectomy radiation would be indicated if certain aspects of the pathology changed (larger tumor, nodal involvement, close/positive margins, etc.,) and your Doctor should discuss the pathology results with you and whether Radiation therapy is indicated.

There are also different types of radiation therapy that can be offered after lumpectomy. However, only some patients are considered “suitable” for numbers 2 and 3, listed below. For the best type of treatment for you, please discuss with your Radiation Oncologist! Click HERE  or cut and paste this link  – http://legacyeducators.org/index.php/basics-of-radiation-therapy.html – to watch videos on the different types of Radiation Therapy.

  1. External Beam Radiation Therapy via 3-Dimensional (3D) or  Intensity Modulated Radiation Therapy (IMRT) – external ( these treatments typically lasts for ~6wks or ~3.5wks)
  2. Brachytherapy/High Dose Radiation (HDR) – internal (twice/day for 5 days)
  3. Intra-0perative Radiation Therapy – internal (during the surgery x 1; however, the FINAL pathology may render the need to add External Beam Radiation therapy to the treatment as well)

PLEASE WATCH THIS VIDEO   – http://vimeo.com/21756060

Read more here about what to expect, side effects, your Radiation team, etc., by clicking HERE or cut and paste this link –  http://www.rtanswers.org/treatmentinformation/whattoexpect/index.aspx 

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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…

Read Full Post »

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information” Thanks in advance for your support!

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As noted last week, OCTOBER is breast cancer awareness month. I would like to continue on a series of blog to answer questions asked by my readers. This week it is Genetics.

I have received questions regarding BRCA1 and BRCA2 testing for breast cancer from some of my readers.  They wanted to know about Genetics and who should get these available genetic testing?

I cannot begin to discuss BRCA1 without first dissecting the acronym…and then speaking a little bit to the basics of Genetics.

BRCA stands for BReast CAncer gene and BRAC1 and BRAC2 are susceptible genes. Confusing ugh? What exactly does all of that mean?

GENES:  What are Genes? This is a simple question, and I think there is a simple answer, but nothing beats visual! (Great reading materials on   Genetics and Cancer and be found HERE on the National Cancer Institute Website)

Click below to watch the video

Click below to watch video…

So now you have an understanding of just how complicated your make-up truly is, some would say, that it is a miracle that more things do not go wrong! A miracle indeed!

WHAT IS THE RELATIONSHIP BETWEEN GENES AND CANCER?

cell-typesEverything goes back to our Genes … our DNA, our basic makeup. Cancer develops, when the orderly replication develops an “Error” and the cells “off switch” is left in the “on” position. How fast this “error” is perpetuated/grows depends on several factors, the most important is the type of cell (cell line).

SIMPLIFIED: Well, Ok Lord, help me keep it simple here…Hhhmm.  Let’s see. Everyone knows how to cook … ( I think:-) Let us use the example of preparing tea. So, If the intent is to boil water for tea,

  • 1st the water must be placed in the pot (error has occurred)
  • 2nd the stove must be lit (another error that causes further damage which is required for continued replication of damage)
  • 3rd the rate of heat (high, med, low) must be set … this would align with how fast the cancer grows; High heat, faster the water get to the boiling point (i.e., the faster the damaged cells will grow)
  • 4th … the water boils (cancer is manifested)

Please note: that the water can be placed in the pot (a DNA damage/error occurs) but if the stove is never turned on (other required cell changes) … then nothing happens and a person will not develop cancer (even though s/he has the susceptibility/damaged gene). This is an area of intense research – how can we stop the stove from being turned on (manipulate the process that causes the Cancer to manifest)!

If the above was a bit too basic, you may read a slightly more “Doctorese” version HERE! I aim to please **smile** (Any questions, please do ask!) You may also visit my website and watch video about the basics of Cancer HERE

COUNSELING:  Please discuss with your physician if you are at risk for breast cancer or ovarian cancer. This is usually determined based on your family history, or personal history. Having this mutation is uncommon and responsible for ~10% of ovarian cancer and ~5% of all breast cancer diagnosis.

TESTING: The BRCA test is obtained via a blood test that looks at your DNA to identify any changes that are harmful, (also called mutations) in either of the two known breast cancer genes – BRCA1 and BRCA2 (BReast CAncer gene 1 and BReast CAncer gene 2). Females who inherited either BRCA1 or BRCA2 are at a higher risk of developing breast cancer or ovarian cancer.

Click Below to watch Video

linkage-analysisClick HERE to visit website for image above. More information available  about “susceptibility genes”

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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…

Read Full Post »

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information” Thanks in advance for your support!

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October is breast Cancer Awareness Month! This year, I will attempt to review areas not commonly addressed; Breast Cancer in Men, Genetics and Breast Cancer, Radiation treatment for breast cancer and …. random pick based on past request by you, my readers! (Many thanks for your participation in making this Blog real and relevant to what you would like to discuss! This Blog is for YOU!)

Breast Cancer in our Males –

Breast Cancer Ribbon - MEN

BC Ribbon for MEN

Of all the Breast Cancer diagnosed in the United States, approximately 1% are males. The American Cancer Society (ACS) estimates that approximately 2,240 new cases of invasive breast will be diagnosed in 2013 and about 410 men will from breast cancer. This can be a very difficult diagnosis for males … mainly because publicity focuses on females (and some would say rightfully so, given that the larger percentage of women). However, Breast Cancer is NOT a women’s cancer….because men have breasts also.

  • For men, the lifetime risk of getting breast cancer is about 1 in 1000
  • The number of breast cancer cases has been fairly stable over the past 30yrs

Click below to watch video

Click below to watch video (please note that the lifetime risk is now 1:1000, per ACS)

Read more about breast cancer in men at the American Cancer Society website by clicking HERE 

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…

Read Full Post »