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Archive for the ‘Talking with your Doctor’ Category

From the Physician’s Desk … Weekly Blog!

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

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October is Breast Cancer Awareness Month. Although breast cancer is only one of many cancers, I am pleased of the exposure that the many “pink” ribbon brings. It gives me hope that other cancers can have a similar banner of awareness…in the near future. Despite our many progress and technological advances in medicine, cancer remains the second leading cause of death in the United States. For example, Breast Cancer has over 220,000 new diagnosis annually, and over 400,000 deaths each year. Many are surviving a longer time thank in the past.

  • Overall, cancer has taken on a more “chronic” long term debilitating effect, for those who survive initial treatment and are then diagnosed with recurrence/metastatic disease.
  • One the most feared symptom in this category of patients is pain. Overall, 50% to 70% of people with cancer experience some degree of pain, which usually intensifies as the disease progresses.
  • Less than 50% of these patients receive adequate relief of their pain, either because they are afraid to ask because they fear “addiction”, or physicians are unlikely to prescribe adequate medication to attain relief that will allow the patient continued good quality of life.
  • Suboptimal pain control can be debilitating and caregivers are often times unsure how to address this issue.

pm_general_cp_pain_approachThe World Health Organization program for cancer pain control recognizes that 1 in 5 patients with cancer has uncontrolled pain and has a ‘three-step ladder’ for the rational use of analgesics including morphine (recommended adaption to 4-step-ladder – see HERE).

Analgesic pain 4Morphine has long been the ‘gold standard’ for the treatment of severe cancer pain. However, its side-effects, particularly sedation/drowsiness, and cognitive impairment have led to ‘opioid rotation’ to alternatives such as methadone and hydromorphone. The one I like to use most in uncontrolled pain situation is the 72-h transdermal patch for Fentanyl, which offers advantages of reduced side-effects and increased convenience over oral morphine. Another novel pain medication is Intravenous (IV) strontium-89 and bisphosphonate therapy which are effective for both short- and long-term control of metastatic bone pain.

Pain Management Physician Review

Patient Discusses Pain

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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 … http://www.LegacyEducators.org and click on “Cancer Information”

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Last week we began on the topic of cancer recurrence. Usually, this is covered during workshops or one-on-one counseling sessions. This is an extensive and important topic for survivors.

It is difficult to address the fear of cancer recurrHopeence and give a definitive prescription on how to treat it. Every patient is different, and therefore, their needs in handling the tough topic of a cancer recurring will also be different. In order to individualize a patient’s care, the patient MUST be involved and willing to become their own advocate, though a love one may also be just as helpful.

  1. The Fear of the cancer coming back once treatment is complete, is absolutely normal.
  2. The Fear of cancer recurrence is usually link to one’s outlook on “Death and Dying”, so it is very important to openly discuss your thoughts about this topic (even if it is with yourself…first, to thine own self be true)
  3. Do not compare your treatment process with someone else’s or try to identify with someone else with a similar cancer (someone will always be doing better or and someone will always be worse)
  4. Be honest with yourself. Say out loud what your needs are…and then get it! Need a hug, need to laugh, need to cry, etc., These are normal range of emotions and needs. Don’t be afraid to fulfill them.
  5. Be ready and willing to let go of the fear. This will allow for healing and make the concerns and associated symptoms less traumatic each year. This too, takes time…
  6. Do not be afraid to seek help. Counseling and guidance from a professional, will ease the (perceived) burden of sharing with friends and family continually. It will also allow for venting, and provide personalized strategies on how best to handle anxiety, depression, etc., without repercussions.  Most cancer centers have such services available…please do ask!
  7. Know that your family and friends DO love and care for you. If they become tired, it is not just you. The care and concern for your well being also weighs heavily on them – in addition to work and other life stressors. Not communicating with them or not sharing, will not make their concern go away…it’s all a part of loving and caring for someone else.

hope-life-people-quotes-Favim.com-426177_largeThe Process: The process is rather extensive for this blog. However, I invite you to please take a moment to read and share this link from the American Cancer Society by clicking HEREThey did a great job of tackling different aspect of the fear of cancer recurrence.

Peace and Blessings!

 

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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 … http://www.LegacyEducators.org and click on “Cancer Information”

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Lung Cancer is the leading cause of cancer death among Americans and claimed ~160,000 precious lives in 2014. The Center for Medicare and Medicaid Services (CMS) has now mandated coverage for lung cancer screening and we are on the way to saving many lives! However, many “high risk” patients are not aware if their “risk” status and availability for lung cancer screening is available.

Should you have Lung Cancer Screening? You may be a candidate for lung cancer screening if you answer “YES” to ALL of the following:

  • Are you 55 to 74 years old?
  • Are you in fairly good health (no symptoms of disease)?
  • Do you have a long or heavy smoking history? (use this link HERE calculate packs per year smoking history- http://smokingpackyears.com/calculate)
  • Are you still smoking or have quit smoking within the last 15 years?

lung_anatomy_rizwan_nuraniThe National Lung Screening Trial (NLST) was a large clinical trial that looked at using a type of CT scan known as low-dose CT to screen for lung cancer. The cost for a low-dose CT scan as a screening test for lung cancer is generally about $300 for each test, but prices vary widely at different centers.

Medicare recently decided to cover the cost of lung cancer screening, but if you are privately insured ask if your insurer covers lung cancer screening – they just might!

If all of the criteria for lung cancer screening listed above was answered “YES”, then you and your doctor (or other health care provider) should talk about starting screening. I would encourage you to also discuss screening, even if only some of the criteria listed are met, especially if you are concerned. Discussion should include what you can expect from screening, possible benefits and harms, as well as the limitations of screening.

The main benefit is a lower chance of dying of lung cancer, which accounts for many deaths in current and former smokers.

CAN LUNG CANCER BE PREVENTED?

  • Not all lung cancers can be prevented, but there are some ways you can reduce your risk of getting lung cancer
  • The best way to reduce your risk of lung cancer is not to smoke and to avoid breathing in other people’s smoke
  • If you stop smoking before a cancer develops, your damaged lung tissue gradually starts to repair itself
  • No matter what your age or how long you’ve smoked, quitting may lower your risk of lung cancer and help you live longer
  • People who stop smoking before age 50 cut their risk of dying in the next 15 years in half compared with those who continue to smoke

After watching the videos below, you will know more about lung cancer and lung cancer screening than most. Take the time to become an advocate for yourself, family and your community!

Great Video: Learning About the Lungs and Lung Cancer

Is Lung Cancer Screening Right For You?

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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 … http://www.LegacyEducators.org and click on “Cancer Information”

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JUNE IS MEN’S HEALTH MONTH!

(Please see video below and share with family and friends!)

While there are many types of cancers, Prostate Cancer, is one of the few that has a somewhat “predictable” blood indicator: the Prostate Specific Antigen (PSA). Please Note: only men have PROSTATE  – women do not have a prostate gland!

prostate normalSo what’s the fuss? Men – your brother, husband, uncle, boyfriend, grandpa, cousins, friends – are dying needlessly from this disease. Prostate cancer is the second leading of cause of death in men in the United States.

There are debates among medical professionals that we may be “over-treating” prostate cancer, leading to some clinics no longer testing for PSA.  However, that concern may be a bit premature, as over 27,000 men die annually from prostate cancer…still. African Americans/Black male are at greater risk and many are not being tested and many others do not know their number, or what it (PSA) means.

KNOW YOUR NUMBER!

KNOW YOUR PSA!

psa-adjusting

If you are an African American/Black male over 40 or other race over 50, someone in your family had prostate cancer, etc., you should know your number. Ask your doctor about it!

The prostate gland gets larger with age…so the PSA will increase. However, you should be referred to Urology if:

  • prostate abnormal1The PSA number is above age range specified above
  • The Digital Rectal Exam (DRE) is abnormal (lump felt, see pic above) – this occurs in ~20% of cases
  • The PSA number doubles or increase drastically from base line (therefore MUST know baseline)
  • Incidental abnormality on scan taken for other reasons

Now that you know more, speak with your physician to know what’s best for you. Tell your family and friends to do the sam – spread the word!)

Please watch this video and share!

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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 … http://www.LegacyEducators.org and click on “Cancer Information”

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It use to be that a cancer diagnosis lead to high mortality (death) rates and survivorship came at an extreme cost of post-surgical disfiguring features, neuropathy and other late effects from chemotherapy and radiation therapy as well.  With improved technology and clinical applications of (bench) research, many patients are surviving and doing much better than generation past. As survival continues to improve, quality of life, including fertility preservation has become increasing important to patients and their families.

fertility-preservation

Sperm Banking

I recently received my seasonal St. Jude magazine with the featured topic of preserving fertility. It was great to know that fertility preservation options are now being offered to children undergoing cancer treatments or those who are survivors.  Per their report, “…[it is] estimated that half of adolescent and young adult male cancer patients are at increased risk for infertility, with about 10% of female childhood cancer survivors having acute ovarian failure and an additional 15% entering menopause prematurely.”

fertility

Egg Harvesting

It was noted in their report, that St. Jude Children’s Research Hospital is currently the only hospital in the U.S. to cover the expense associated with harvesting and storing sperm and eggs until patients reach age 35. That policy eliminates one of the greatest barriers to fertility preservation for many childhood cancer patients:cost. This is GREAT news!

I remain and avid supporter of St. Judes Research Hospital!  Hope to be a visiting professor/clinician there one day. If you are looking for a charity to support, please consider St.Judes!

stjude1

 

 

Fertility Preservation for Young Women with Cancer

Fertility Preservation Options

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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 … http://www.LegacyEducators.org and click on “Cancer Information”

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Seeking a second opinion is often exercised in many areas of life. It is often quoted that:

  • 70% of people consider a 2nd opinion for home improvement
  • 55% of people would consider a 2nd opinion on vehicle repairs.
  • What about Cancer diagnosis? How many get another opinion?

second-opinion-cartoonWhen it comes to cancer diagnosis and other serious chronic diseases, a second opinion is not only ok, it is recommended!

Your treating physicians should not mind, and in most cases, a good physician may even recommend that a second opinion be obtained. This recommendation is NOT a bad thing! As physicians, we are often very comfortable with our recommendations, but understand that there may be other ways of accomplishing what is best for you, the patient.

***Cancer is often a scary and frightening diagnosis! It is my recommendation to NEVER go to an appointment alone, if at all possible.***

PREPARING FOR A 2nd OPINION

Don’t wait too long after diagnosis – time is of the essence! Once you have completed your 1st set of appointments (or even during the process):

  • Tell your physicians that you would like to have a 2nd a opinion. They may recommend another hospital or physician and may assist with arranging an expedient 2nd opinion appointment. Alternatively, you may do this on your own, by seeking recommendations elsewhere/trusted sources
  • Sign release forms and/or gather all of your relevant medical records—including biopsy/pathogloy/test results, blood work, or any imaging test (CT scans, MRI, US, Mammograms, etc.,). This will prevent the need to repeat these exams – save time and money!
  • Create a list/time line of all the symptoms that lead to your diagnosis, if any was experienced
  • Write down and bring a list of all the medications you are currently taking (prescription and over the counter)
  • Write down and bring a list of all your questions. If you do not know what to ask, consider the things discussed at your first oncology appointment…AND please bring someone with you!

WHAT TO EXPECT

  •  The hospital/clinic may repeat their review of the pathology report to confirm the diagnosis
  • They will provide additional details about the type of cancer and its overall stage (a description of where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body)
  • Perspective from experts in different oncology disciplines, such as medical oncology, radiation oncology, and surgical oncology
  • Discussion treatment options (sometimes doctors may disagree with the original diagnosis or the previous proposed treatment plan – different chemotherapy, different radiation therapy approach, no chemotherapy or radiation, different type of surgery, etc.,)
  • The availability of clinical trials that you may want to consider
  • The favorite question most of my patient like to ask me – “What would you recommend if I was your…___(fill in the blank/relative)” … It never hurt to ask the same!

This is by no means an exhaustive list of recommendations in preparing for a 2nd opinion, but it is a start – for a blog *smile*.  Apply these recommendations to any other serious diagnosis. If possible, ask  questions before any surgeries or serious treatment. Oh, by the way, your research on the internet does not count as a second opinion!

Again, take someone with you on your appointments!

God’s speed!

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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”

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The U.S. population is always on the go! Things to do, people to see, meeting to attend, business to conduct,  kids recital to attend, kids sporting events, church events….sitting in traffic…falling asleep behind the wheel. Siesta anyone? Fatigue is simply a chronic state of tiredness…being tired…all the TIME!

tired_eyes_800pxAmericans are tired.  It seems to be an “expected” badge of honor  in the National Capital Region (DC, MD, VA). If you are not multi-tasking and dashing to and-fro, complaining about traffic, the weather, politics, or a myriad of other things – something must be wrong with you! OR maybe you are just normal?

Fatigue literally came over me as I wrote the above – because I too, have been caught up in the world wind. I handle stress well and do take at home vacations (stay-cation) and vacations to recuperate, but is that enough? What if we just do not allow ourselves to get so TIRED in the first place? Is that possible? YES!

Fatigue/Tiredness can be manifested as:

  • Difficulty or inability initiating activity (generalized weakness)
  • Reduced capacity maintaining activity (easy fatiguability)
  • Difficulty with concentration, memory, and emotional stability (mental fatigue)

tiredA cross-sectional survey of US workers found that the 2 week period of prevalence of fatigue to be 38%! Additionally, 21-33% of patients seeking attention in the primary care settings report significant fatigue. The statistics for work place injury and motor-vehicle accidents due to fatigue is devastating!

HOW TIRED ARE YOU?? Some disease processes cause/or lead to chronic fatigue. Duration of fatigue can be recent (less than one month), prolonged (more than one month), or chronic (over six months) – talk to your doctor about your state of fatigue.

Fatigue should be distinguished from somnolence, dyspnea, and muscle weakness, although these symptoms may also be associated with fatigue. Patients may use the terms fatigue, tiredness, lack of energy, and excessive sleepiness interchangeably.

TIRED IM SO

PLEASE, GET SOME REST – it is good for YOUR health (and sometimes others too)! See videos 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…

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