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Archive for the ‘Weight loss’ 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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Ovarian Cancer is deadly. It is the 4th leading cause of death in women and the leading cause of gynecological cancer death. The average lifetime risk is 1 in 70 with median age of diagnosis of 63years. Like most other cancers, Ovarian Cancer is highly curable if diagnosed at an early stage, but 75% presents with more advance disease, at stage III or IV. Early diagnosis is usually very difficult, because patients often present with vague abdominal symptoms and there is a lack of good screening test with initial presentation.

Sister Mary Joseph Nodule w/Ascites

Sister Mary Joseph Nodule w/Ascites

Common Symptoms:

  • Abdominal discomfort/pain/bloating
  • Increasing girth (increase size around waist/abdomen region)
  • Change in bowel (movements) habits
  • Early satiety (feeling full after eating small amount of food)
  • Nausea
  • Sister Mary Joseph Nodes (associated with ovarian cancer and of gastrointestinal tract)
  • Ascites (fluid just under the abdominal skin, that shifts like a wave when tapped)

In addition to the basic blood, liver and kidney evaluation, some specific labs (blood work) that may assist with ovarian cancer diagnosis includes:

  • CA125 – elevated in 80% of ovarian tumors
  • CA 19-9 – low sensitivity, but could be positive in other cancers
  • CEA – elevated in 58% of advance stage ovarian cancers
  • AFP & βHCG – Measure if <30years old to help rule out other types of tumors

Ovaries-hurt-when-sneezeBecause of its presentation, diagnosis usually involves quite a number of imaging as well: Transvaginal ultrasound, CT scan and/or MRI, cystoscopy, sigmoidoscopy, endometrial biopsy if patient has abnormal vaginal bleeding, assessment of any ascites fluid, etc., Surgical exploration is also necessary to complete staging of disease (find out how advance and how far it has spread).

Treatment: As with most cancers, the treatment for ovarian cancer is dependent on the final staging, but majority involves surgery followed by chemotherapy. If not a chemotherapy candidate, then Whole Abdomen Radiation Therapy (WART) may be considered after surgery. However, WART is falling out of favor, due to the toxicity and side effect profile.

Can it be detected earlier? See videos below.

Dr. Oz’ brief review of Ovarian Cancer

Patient Education video w/diagrams

SEPTEMBER is Ovarian Cancer Awareness Month. For additional information you may also contact:

National Ovarian Cancer Coalition
2501 Oak Lawn Avenue, Suite 435
Dallas, TX 75219
(888) OVARIAN (682-7426)
(214) 273-4200
nocc@ovarian.org
www.whyteal.org External Links Disclaimer Logo
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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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Earlier this year, we looked at “Why Your Thyroid Gland Matters” take a quick review HERE. For some, this may be a reason why there are issues with weight gain, fatigue, etc.,  As an Oncologist and being the cancer world, topics such as “over-diagnosis” always renders a reaction from me. If a life is being saved in the long run, can we truly quantify “over-diagnosis” in cancer?

thyroiddA new study published in the journal Academic Radiology lists reasons why thyroid cancer over-diagnosis.  Although there were an estimated 62,000 new cases of thyroid cancer in 2014, the number of fatalities was estimated at fewer than 1,900. Incidence rates have risen by 185% in 35 years, and surging rates and a mismatch between incidence and mortality signal a problem with over-diagnosis.

3 Key reasons considered for overdiagnoses of Thyroid cancer are:

  1. the imaging of incidental thyroid nodules. Such nodules are present on 16 to 25 percent of computed tomography (CT) scans, which is lower than other modalities. The malignancy rate of incidental nodules on CT and ultrasound is less than 12 percent.
  2. A second underlying reason is thyroid nodules are easy to biopsy. This suggests the biopsy threshold (reason to do a biopsy) is low and that decisions may not always comply with recommendations. The number of fine-needle aspiration biopsies for thyroid nodules doubled from 2006 to 2011, which was linked to a 31 percent gain in the number of surgeries for thyroid nodules.
  3. The third reason is routine processing of surgical specimens for other thyroid diseases such as goiter and thyrotoxicosis find incidental cancers in anywhere from 6 to 18 percent of patients.

Would you want to know if you have thyroid cancer or thyroid disease?

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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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JANUARY is Thyroid Awareness Month!

What is it? 

thyroidThe Thyroid is a butterfly-shaped gland located at the front of the neck and just below the laryngeal prominence (Adams Apple) – (see image).  The main function of the Thyroid is to produce hormones that maintain your body’s metabolism. It essentially breaks down nutrients to release energy. Your body is in need of energy constantly – even when at rest!

What if the Thyroid makes too much hormones? You may experience:

  • Increased heart rate
  • Sleep disturbances
  • Excess sweating
  • Unexpected weight loss

What if the Thyroid does not make enough Hormones? You may experience:

  • Gloomy
  • Colder
  • Tired
  • Unexpected weight gain

What are some of the common Thyroid disorders?

  • Thyroid goiter

    Thyroid Goiter

    Hyperthyroidism (abnormally high activity)

  • Hypothyroidism (abnormally low activity)
  • Thyroiditis (inflammation of the thyroid)
  • Thyroid nodules (may be benign or Thyroid cancer)
  • Goiter (any of the above may lead to an enlarged thyroid gland)

Additionally, in females, thyroid hormone levels must be checked beginning at age 35 (or sooner if symptoms are present) as thyroid can affect the menstrual cycle, and must also be normalized during pregnancy.

Follow instructions in video below for self-examination. For more information, please see below!

thyroid exam

American Association of Clinical Endocrinologists

245 Riverside Avenue, Suite 200
Jacksonville, FL 32202
(904) 353-7878
(904) 404-4207 Fax
ajohnson@aace.com
www.thyroidawareness.com

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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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Every new year, brings new resolutions and 2015 is no different! Many listed “weight loss” and improving nutritional diet overall, as one of their top 3 priorities…including yours truly. There are many good reasons to try and attain these goals (of lower BMI/weight loss and healthier eating habits), but sometimes published data helps!

Read previous blog on the Obesity Epidemic in America and review definition for obesity/increase BMI by clicking HERE

“Body-mass index (BMI) and risk of 22 specific cancers: A population-based cohort study of 5.24 million UK adults”  – big title and a huge claim! (no pun intended). This was published in The Lancet medical journal AUG 2014. They noted that:

  • obesity antiPeople who were obese had a higher risk of Leukemia as well as cervical, colon, gall bladder, kidney, liver, ovarian, uterine and postmenopausal breast cancers than leaner people
  • People who were obese had a higher risk of esophageal cancer (after they took smoking into account)
  • People who were obese had a lower risk of premenopausal breast cancer and total prostate cancer (though there is controversy, because other studies have shown that advanced stage prostate cancers are linked to excess weight. This study did not review advance stage prostate cancer. Additionally, you may not be at risk for these 2, but increased risk for the other types of cancers remain elevated)
  • Underweight people had a higher risk of lung, mouth and throat cancer than leaner people, but the link was due to smoking, since it was absent in those who had never smoke.

obesity-epidemicTheir conclusion/Interpretation states: “BMI is associated with cancer risk, with substantial population-level effects. The heterogeneity (mixture of results) in the effects suggests that different mechanisms are associated with different cancer sites and different patient subgroups.”   The Lancet Vol 384, No.9945 Aug 2014

Bottom line: Everyone is different, but if you lose or avoid gaining excess weight (exercise, increase vegetable & fruit intake, etc.,), quit smoking, your weight control/improvement may be helpful overall, as it pertains to decreasing your cancer risk. Hhhmmm. Sounds familiar?

Watch video below for insight into the state of Obesity in America!

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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! 

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MAY is National Physical Fitness and Sports Month!

My Grand-father was 5’9″ and weighed approximately 160 pounds (considered a thin man) when he died of a Heart Attack in his Mid-60’s.  It is a prevalent myth, that if one is “skinny” then exercise is not important and a “skinny” person is not affected by many of the common diseases, such heart disease, cancer, diabetes, etc., Please do not believe that statement!

Exercise-bikeLegacy Health Educator is supporting the President’s Council on Fitness, Sports & Nutrition in honor of National Physical Fitness and Sports Month (healthfinder.gov). During the month of May, we challenge all adults to get 30 minutes of physical activity every day (Children too!).

Did you know that regular physical activity increases your chances of living a longer, healthier life? It also reduces your risk for high blood pressure, heart disease, and some types of cancer. Yet many children and adults do not get the recommended amount of physical activity.

The Physical Activity Guidelines for Americans recommend that adults:

  • Aim for 2 hours and 30 minutes of moderate aerobic activity each week.
  • Moderate activity includes things like walking fast, dancing, swimming, and raking leaves.
  • Do muscle-strengthening activities – like lifting weights and using exercises bands – at least 2 days a week.

Physical activity is for everyone. No matter what shape you are in, you can find activities that work for you. Together, we can rise to the challenge and get more active during the month of May!

Enjoy the video below … (I did this to the tune of “Happy” on the Mount Vernon trail about a month ago…not aware that this even existed! It was loads of fun and quite exhilarating! Not up to the video standards? Then just plain walking will do too! )

 

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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 Physicians Desk … Weekly Blog!

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Recently, I was traveling in Texas and was impacted by the snow storm on the East Coast which led to multiple airport closures – I was stranded! I was delayed without luggage/basic necessities, so I did what any sane person would do … I shopped!  I purchased a “red dress” pin for $2 that would render an additional 20% off for items bought that weekend. Super!

red dress ahaHowever, it was not known by many in the store the true significance of the “red dress” pin.

February is American Heart Month which is sponsored by the American Heart Association (AHA) – http://www.heart.org/HEARTORG/

Why is “The Heart” so important?

  • Heart Disease is the leading cause of death for men and women in the United States
  • Over 600,000 people die of heart disease – that is 1 in 4 deaths every year
  • Every year about 715,000 Americans have a heart attack. Of these, 525,000 are a first heart attack and 190,000 happen in people who have already had a heart attack

Those are staggering statistics…BUT you can do something about it! Heart disease can often be prevented when people make healthy choices and manage their health conditions. Like what?

  • Use spices to season your food instead of salt
  • Make physical activity a part of your school/work day
  • Monitor/eliminate trans fats from your diet
  • Stop smoking!

Learn more about Heart Disease and symptoms by clicking video below … it could possibly be the BEST few minutes of your day!

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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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