Leading Medicine Winter 2022, Houston Methodist Hospital edition

LEADING MEDICINE W INT ER 2022

Keeping Up With Cancer Screenings

Team Up With Your Doctor FOR BETTER HEALTH Are You Ready to Lose Weight?

Visit houstonmethodist.org/lmn/winter-2022 to read more online.

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS FROM HOUSTON METHODIST

GET HELP FOR BACK AND NECK PAIN

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f you suffer from back and neck pain, you have options when it comes to treatment.

The spine and nerve specialists at Houston Methodist are experts in treating back and neck pain — from everyday discomfort to complex conditions and injuries.

Dr. Sean Barber In addition, during the coronavirus outbreak, you can be confident that we are taking every necessary precaution to keep you safe during your visit.

“If you suffer from back or neck pain, an evaluation and treatment can help prevent some problems from becoming debilitating conditions that are more difficult Dr. Darrell to treat,” said Dr. Sean Barber, Hanson spinal neurosurgeon at Houston Methodist. “We will work with you to discover the source of the pain and recommend a therapeutic plan that’s unique to your circumstances.”

COORDINATING YOUR CARE

Dr. Paul Holman “Identifying the best management

See a Specialist Early

It’s important to see a doctor when back or neck pain interferes with your daily life. Our spine experts at Houston Methodist can help you return to enjoying your everyday activities with less pain.

Visit houstonmethodist.org/spine-tmc or call 713.790.3333 for more information or to find a doctor and schedule an appointment.

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plan for each specific spine issue is key,” said Dr. Darrell Hanson, orthopedic and spinal surgeon with Houston Methodist Orthopedics & Sports Medicine. “We then coordinate your care through the range of services your condition may need.”

Spine services at Houston Methodist feature: A team of board-certified specialists Advanced treatments ranging from nonsurgical options to minimally invasive surgery A dedicated clinical navigator to assist with scheduling appointments Expedited appointments (within two business days) “We spend time analyzing the underlying cause of your pain and then create a personalized treatment plan designed to solve the issue and improve your quality of life,” said Dr. Paul Holman, a boardcertified neurosurgeon and director of spinal neurosurgery at Houston Methodist. “Depending on imaging test results, we may recommend a surgical or less-invasive treatment option.”

Don’t Let Your Guard Down

Keeping Up With Cancer Screenings During the Pandemic

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he COVID-19 pandemic has taken a toll on our health in so many ways, and not only for those infected by the virus. Many of us faced health threats and Dr. Monisha financial hardships. We Singh shifted priorities and postponed plans for travel, school, health care and more. Unfortunately, cancer screenings were also on the list of things many people delayed or skipped altogether during the pandemic.

DECLINE IN CANCER SCREENING TRENDS

“We’ve seen a significant drop in cancer screening rates, with many people delaying their screening tests during the pandemic,” said Dr. Monisha Singh, board-certified hematologist-oncologist with Houston Methodist Cancer Center. A study published in the June 2021 issue of JAMA Oncology noted sharp declines in screening for breast, colorectal and prostate cancer, with an estimated deficit of 9.4 million screenings associated with the pandemic.

“We put many aspects of life on hold during the pandemic, but it’s important to remember that cancer doesn’t stop or slow down for anything,” Singh said.

Delayed cancer screenings may lead to later diagnoses of cancer and poor health consequences, because treatment for cancer in later stages can be more difficult.

DON’T SKIP SCREENINGS

The reasons for delaying screenings are different for everyone. Some people avoided going to hospitals and clinics to reduce exposure and prevent the spread of illness.

Others put off cancer screenings because they were busy juggling other priorities during the pandemic.

You can be confident that it’s safe to visit our facilities for cancer screening tests.

“At Houston Methodist, we’re taking every precaution to prevent the spread of illness and make your visit as safe as possible,” Singh added.

Some of the ways we’re protecting patients and staff include: S creening all patients when scheduling appointments and upon arrival.

W earing masks and other personal protective equipment.

S anitation processes for disinfecting equipment and surfaces.

Requiring vaccinations for doctors and staff.

EARLY DETECTION IS KEY

Early detection is one of the best ways to defend against cancer. “Cancer screening tests make it possible to identify cancer in early stages when it’s most treatable,” Singh said. If you’re due for a mammogram, colonoscopy or other cancer screening test, it’s time to take action.

Ask your doctor about cancer prevention and recommended screenings based on your age, health history and other factors.

“You’ll have peace of mind knowing you’re doing everything in your power to prevent and detect cancer,” Singh said.

CANCER SCREENING GUIDELINES Houston Methodist suggests the following guidelines for the early detection of cancer. Depending on your family history and other risk factors, your doctor may recommend a different screening schedule for you.

SCREENING TEST

AGE

FREQUENCY

Cervical cancer screening

Starting at age 21

Every 3–5 years

Colonoscopy

Starting at age 45

Every 10 years

Lung cancer screening

Current or former smokers ages 55–74

Every year

Mammogram for women

Talk to your doctor starting at age 40

Every 1–2 years

Prostate cancer screening for men

Talk to your doctor about the pros and cons of testing starting at age 45

Ask your doctor

Sources: American Cancer Society and American College of Obstetricians and Gynecologists

Connect with Your Doctor

Talk to your doctor about a screening schedule that is right for you. If you don’t have a primary care physician, you can find one by visiting houstonmethodist.org/pcg/central or call 713.394.6724.

CHECK OUT OUR DIGITAL MAGAZINE AT HOUSTONMETHODIST.ORG/NEWSROOM/NEWSLETTERS 3

BRAIN TUMOR TREATMENT OPTIONS Improved Outlook With Personalized Treatment

I Dr. David Baskin

Dr. Gavin W. Britz

t’s difficult to think of a health condition more ominous than a brain tumor. But while these tumors are challenging to treat, the outlook isn’t necessarily bleak. As advancements in brain surgery techniques and other therapies continue to evolve, there are more options for removing brain tumors, slowing tumor growth and preventing recurrence.

UNDERSTANDING BRAIN TUMORS

“No one knows what causes brain tumors; however, certain risk factors have emerged, such as having a family history of brain tumors and exposure to a type of radiation called ionizing radiation,” said Dr. Gavin W. Britz, director of the Houston Methodist Neurological Institute. Like other tumors, brain tumors are either benign (noncancerous) or malignant (cancerous).

Benign brain tumors tend to grow slowly and usually don’t invade surrounding tissues. But because they can place pressure on sensitive areas of the brain and cause serious health problems, they may require treatment as well.

Malignant brain tumors have cancer cells and are considered life-threatening, because they grow and invade healthy brain tissue. They may be either primary (tumor started in the brain) or secondary (tumor that spread to the brain). Most brain tumors are secondary, or metastatic, meaning that cancer cells migrated to the brain from cancer elsewhere in the body.

WARNING SIGNS

“A range of symptoms may suggest either a brain or pituitary tumor, and symptoms

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vary depending on the location and size of a tumor,” said David S. Baskin, director of the Peak Center for Brain and Pituitary Tumors at Houston Methodist Hospital.

General signs and symptoms may include: D ifficulty with balance or walking G radual loss of sensation or movement in an arm or a leg H eadaches that become more frequent and more severe H ormonal imbalance P ersonality or behavior changes S eizures S peech difficulties V ision problems or loss of vision These symptoms, however, are not sure signs of a brain tumor and may suggest other neurological disorders.

PATH TO DIAGNOSIS

Doctors perform a neurological exam to check for alertness, balance, coordination and reflexes as well as vision, speech and hearing. Depending on the results, the patient may undergo one or more tests using computed tomography (CT), MRI, positron emission tomography (PET) or other types of brain scans. The only way to confirm a brain tumor diagnosis is with a biopsy.

TREATMENT OPTIONS

Treatment for brain tumors is based on individual factors, such as age, overall health and medical history as well as characteristics of the tumor (type, location, size) and how likely the tumor is to spread or recur. Specialists in neurosurgery, and medical and radiation oncology all work

together to create a customized treatment approach to combat brain tumors.

“Therapies may include surgery, radiation, chemotherapy or a combination of these treatments,” said Britz. “If a brain tumor can’t be removed through surgery because of its size or nearness to critical areas of the brain, other types of treatment can be used to shrink it or slow down tumor growth.”

Advanced treatments and therapies for brain tumors may include: Surgery using intraoperative MRI to detect and remove as much of the tumor as possible, including minimally invasive endoscopic surgery for pituitary tumors.

Radiation therapy (using X-rays, gamma rays or protons) to destroy tumor tissue.

Chemotherapy taken by mouth, by injection or intravenously to attack cancer cells.

Brachytherapy, the surgical placement of radiotherapy “seeds” after removing the tumor.

Intraoperative chemotherapy, which involves surgically implanting biodegradable devices in the brain to release anticancer drugs.

Targeted therapy using drugs that specifically target the molecules or pathways involved in cell growth.

The experts at Houston Methodist continue to explore new treatment options through novel research and clinical trials. “Today we are seeing tremendous success with experimental treatments for brain cancer with results better than ever seen before,” said Baskin. “Houston Methodist is truly leading medicine in this field with many exciting possibilities for the future.”

Schedule an Appointment At Houston Methodist Neurological Institute, our specialists work together to diagnose, treat and manage a range of brain tumors and other neurological conditions.

To schedule an appointment with Dr. Britz, Dr. Baskin or another specialist, visit houstonmethodist.org/peak-center or call 713.441.8500 for an appointment.

Calcium Score:

WHAT IS A CAC TEST AND DO I NEED ONE? WHAT TO Y EXPECT ou probably know your height and weight, your typical blood pressure readings and most recent cholesterol scores. But there’s another number that might be even more important for assessing your risk of heart attack or stroke.

A coronary artery calcium (CAC) score measures the amount of calcified plaque you have in your heart arteries, which is important because coronary plaque is the main underlying cause of atherosclerotic cardiovascular disease (ASCVD) events, such as heart attacks and strokes.

The traditional model of risk assessment looks at your demographic information (age, race, ethnicity and gender), family history, health conditions, lifestyle and bloodwork to help estimate your risk. It doesn’t measure the burden of plaque in your arteries the way a CAC score does.

Your calcium score can range from zero to infinity, and is proportional with

your risk of having such an event up to 15 years. People with no coronary artery calcium — even those with risk factors like diabetes, obesity or advanced age — have low absolute risk of ASCVD events, or the lowest among individuals with similar characteristics. People with high CAC scores have an elevated risk of ASCVD events, even if they’ve never had any symptoms of heart disease and appear to be the picture of health.

DO I NEED TO GET A CALCIUM SCORE TEST?

The test is recommended for individuals in the intermediate risk range over the age of 40: those who have at least one traditional cardiovascular risk factor, such as high blood pressure, high cholesterol, diabetes and obesity. Low-risk individuals with a strong family history of ASCVD should consider getting the test as well.

How Do I Get a Calcium Score Test?

If you fit the above profile, we recommend bringing up this conversation at your annual physical with your primary care provider or check-up with your cardiologist, when you are already discussing your health stats, risk factors and preventive medications your doctor wants you to take. Visit houstonmethodist.org/heartscans or call 713.DEBAKEY to schedule an appointment online.

DURING YOUR CAC TEST A CAC test is performed using a noncontrast CT scan.

It’s noninvasive, the radiation exposure is low (similar to a mammogram), and the cost to patient is $140.

You will change into a hospital gown and lie down on a special scanning table.

A technologist will clean three small areas of your chest and place sticky patches there.

The table will move into the scanner.

A high-speed camera will take multiple images of your heart within about 10 seconds.

The table will move back, and you get dressed and go home.

It should take only a few minutes and be pain and discomfort free.

A computer program and CV radiologist will measure calcium deposits and calculate a score.

The results will be sent to your doctor, who will go over what they mean to you.

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Team Up With Your Doctor for Better Health W hen it comes to your health, your primary care provider is your quarterback. They have a big-picture view and understanding of Dr. Nooreen your overall health, and Baig they can help you make the right moves to stay healthy.

A good relationship with your primary care provider is essential for your health.

“Partnering with your primary care provider can help you tackle health problems and stay healthy throughout your life,” said Dr. Nooreen Baig, an internal medicine physician with Houston Methodist Primary Care Group.

IT’S A TEAM EFFORT

Here are some ways to make the most of your health visits and build a winning relationship with your provider.

Find a primary care provider. Look for a doctor who is board-certified, speaks your preferred language,

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and offers convenient appointments in a location near you. Above all, you should choose a doctor you trust who listens and makes you feel comfortable.

Schedule an annual exam. It’s important to schedule an annual checkup even when you feel fine health-wise. Annual checkups help you stay on top of your health, making it possible to prevent and detect problems early. “If you have diabetes or another chronic condition, an annual exam allows us to check in and make sure your health numbers are on track,” Baig said.

Identify communication barriers.

Resources are available if you or a loved one struggles with hearing, understanding or remembering what is said in your health visits. Bringing a loved one along to your appointment may help you better understand the information shared by your doctor while providing emotional support, if needed. Contact the doctor’s office to let them know if you need help with communication or would like to have a family member or friend join you for your appointment.

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Memorial City

Memorial Green

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Prioritize your health by making an appointment with a primary care provider. Convenient appointments are available at a location near you. Schedule an appointment with a doctor at Houston Methodist Primary Care Group by visiting houstonmethodist.org/pcg/central or calling 713.394.6724.

6 LEADING MEDICINE FROM HOUSTON METHODIST

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Put Your Health First

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A CHECKLIST FOR YOUR NEXT CHECKUP

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Share your health history.

Managing your health is easier when you build a relationship with a primary care provider who knows you and your health history. Your doctor may recommend health screening tests based on your age, personal or family health history, and other factors. For example, if you have a family history of heart disease, stroke, diabetes or cancer, your doctor may emphasize ways to prevent disease and recommend screening tests to help detect disease early.

Be open and honest. There’s no reason to hold back information because you’re worried or embarrassed. “Your primary care provider is there to support you in improving your health, not to pass judgment on your decisions,” Baig said. The doctorpatient relationship is ironclad in its confidentiality, with many ethical, professional and legal standards that protect it. Having open and honest conversations about your health helps

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your doctor better serve your health care needs.

Talk about mental health. Your primary care doctor can help with mental health concerns, including screening and treatment for depression and anxiety. Your doctor can also connect you with referrals to therapy, counseling or specialized care.

Ask about vaccines. Your primary doctor can be a great resource to help you understand which vaccines are recommended for you and when to get them. It’s important to have these conversations with your doctor so you can make informed decisions based on the latest medical guidance.

Set goals for your health. If you want to lose weight, quit smoking or make other healthy changes, your doctor can help you get started.

Your chances of success improve when you have medical support for making big changes to your health.

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Going to the doctor for a yearly checkup is an important part of your health routine.

Here’s a checklist to help you prepare for your next visit: Ask about screenings or vaccinations.

When scheduling your appointment, find out whether you’re due for any shots or tests. Knowing in advance helps so that you’re mentally and physically prepared — especially if there are any special instructions to follow, such as fasting before a cholesterol test.

Review your family medical history. Your doctor may ask about any new diseases or conditions that have occurred in your close relatives since your last visit. If needed, write down notes about your family health history to share with your doctor.

Write down a list of questions. When you’re in the doctor’s office, it can be hard to remember everything. Having a list of questions prepared ahead of time can help you make sure you get answers to all your questions.

Bring a list of medications. Your doctor’s office will ask about the current medications you’re taking, including all prescription and over-thecounter medications as well as herbs, vitamins and other dietary supplements.

HOUSTONMETHODIST.ORG 7

HEARING LOSS HAPPENS: TECHNOLOGY CAN HELP

H Dr. Kenny Lin

Dr. Jeffrey Vrabec

earing loss can happen gradually — you might not even realize that it is happening. You may struggle to keep up with conversations in a group or on the phone. Hearing loss is common, and an estimated 48 million Americans have some degree of hearing loss.* But you don’t have to miss life’s important moments because of hearing loss. Treatment for hearing loss can make a difference in your quality of life.

WHAT CAUSES HEARING LOSS?

There are two types of hearing loss, conductive or mechanical hearing loss and sensorineural or nerve hearing loss. Conductive hearing loss is due to problems with the ear canal, ear drum, or the little bones in the ear. “Problems such as a perforated ear drum, or a stapes bone that is stuck, can be repaired surgically.

This usually corrects the hearing loss,” said Dr. Jeffrey Vrabec, board-certified otolaryngologist (ENT) and neurotologist with Houston Methodist Hospital.

Sensorineural hearing loss is more of a problem since it persists. The hair cells are highly specialized cells in the inner ear for detecting sound information. If they are damaged, they do not repair themselves, thus the hearing loss is permanent.

“Most hearing loss is due to genetic factors altering hair cell function. These problems typically increase with age and can be exacerbated by noise exposure,” said Dr. Kenny Lin, board-certified otolaryngologist (ENT) and neurotologist with Houston Methodist Hospital.

Symptoms of hearing loss include: Difficulty distinguishing sounds, especially “s” and “th” Problems hearing conversations, especially in a crowd or with background noise Asking others to speak more loudly, clearly or slowly Turning up the volume on the TV or radio Ringing in the ears Withdrawing from conversations and avoiding social situations

TECHNOLOGY FOR HEARING LOSS

Correction of hearing loss may be accomplished with surgery or by using one of many different devices.

Cochlear implants are electrical stimulators of the hearing nerve to help those with severe sensorineural hearing loss. This device requires surgery to place wiring inside the cochlea. “Acoustic sound waves are converted into an electrical signal which directly stimulates the cochlear nerve,” said Lin. “This is the only technology that restores hearing to an ear with severe to profound hearing loss.” Most cochlear implant recipients report a significant improvement in understanding speech.

Hearing aids and assistive listening devices make sounds louder and easier to hear. These amplifiers may fit behind the ear or in the ear and are customized for your hearing loss. Technological advances include directional microphones to help preferentially amplify the speaker’s voice relative to background noise and Bluetooth connectivity to improve hearing with your cell phone.

Bone conduction implants are used for correction of advanced conductive hearing loss. Individuals with problems of the ear canal or ear bones who cannot wear a conventional hearing aid can benefit from these devices.

PROTECT YOUR HEARING

Be smart about wearing earplugs in loud environments to help preserve your hearing longer and encourage your loved ones to do the same. * Source: Hearing Loss Association of America

How’s Your Hearing?

If you or someone you care about has hearing loss, our Houston Methodist ENT doctors can help you. Visit houstonmethodist.org/hearing-loss for more information or call 713.441.1368 to schedule an appointment with an ENT specialist.

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PROSTATE PROBLEMS: WHY YOU SHOULDN’T IGNORE THEM

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ost men don’t start thinking about their prostate until they begin experiencing problems with it. The prostate is a walnutshaped gland under a Dr. Brian Miles man’s bladder that plays a critical role in the male reproductive system. But, given its location, changes in the prostate gland can affect other important functions — like urination.

“Prostate problems can include a frequent need to urinate, painful urination and incomplete emptying of the bladder,” says Dr. Brian Miles, urologist with the Houston Methodist Men’s Health Center.

“Prostate problems can be serious.” The three most common prostate problems men face include: P rostatitis B enign prostatic hyperplasia (BPH), or enlarged prostate P rostate cancer

HOW IS PROSTATITIS TREATED?

Prostatitis is prostate inflammation usually caused by infection. It’s a fairly common condition that can lead to difficulty passing urine as well as sexual problems.

“Prostatitis is typically treated with antibiotics, with the duration of treatment

extending two weeks or more in some cases — depending on whether the infection is sudden or chronic,” Miles said. Anti-inflammatory medication as well as medications that relax prostate muscle tissue, may also be recommended to ease urine passage.

HOW IS BPH TREATED?

“Many men experience prostate enlargement as they age. The condition can cause a squeezing of the urethra as well as bladder weakening, which can leave urine in the bladder,” Miles said.

Although BPH is not cancerous, many of its symptoms are similar to those of prostate cancer. And, BPH can lead to lifedisrupting and life-threatening problems, such as: Voiding difficulty Bladder or kidney infections Urinary blockages Kidney failure Lifestyle changes, such as limiting alcohol or caffeine, can lessen BPH symptoms. Medication, or sometimes surgery, may be recommended to ease discomfort and urine flow issues. In some cases, noninvasive options can be considered, including: Green-light laser procedures Transurethral resection of the prostate (TURP) Button procedure

Next Steps To learn more about how our urology doctors can help you or to schedule an appointment, visit houstonmethodist.org/prostate or call 713.441.6455.

HOW IS PROSTATE CANCER TREATED?

Prostate cancer can slowly grow and never cause symptoms or threaten a man’s health. Or, it can aggressively attack and require treatment.

How prostate cancer is treated depends on the tumor’s location, whether the cancer has spread, the man’s age and his overall health. Treatment options include: Watchful waiting and symptom monitoring Surgical removal of the prostate gland High-intensity focused ultrasound (HIFU) treatment Radiation therapy Chemotherapy Testosterone-blocking hormone therapy Side effects of prostate cancer treatment can include erectile dysfunction and bladder control issues, so men should talk to their doctors before making a treatment decision.

HOUSTONMETHODIST.ORG 9

ARE YOU READY TO LOSE WEIGHT?

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fter the holidays, people everywhere resolve to lose weight. Rather than taking a long-term approach to weight loss, you might feel like a celebrity preparing for the Oscars® — ready to try anything if it will help you drop pounds quickly.

Unfortunately, fad diets that promise dramatic weight loss results in little time are unhealthy Dr. Rodolfo J. and can do more harm than good. Your best Oviedo chance for long-term success is to develop healthy behaviors built on a two-fold foundation of a nutritious diet and adequate physical activity.

CRUNCH THE NUMBERS

“One of the most important keys to successful weight loss is a healthy dose of reality,” said Dr. Rodolfo J. Oviedo, bariatric surgeon and director of robotic general surgery at Houston Methodist. “It’s wise to set a realistic total weight loss goal that accounts for your gender, age, bone size and other factors.”

You can start by calculating your body mass index at bit.ly/hm-bmi. Keep in mind that this calculation may not be accurate for everyone, so talk to your doctor about finding a target weight that is appropriate for you.

Once you’ve calculated your target weight, break your overall weight-loss goal into smaller goals. Most experts recommend losing no more than 1 to 2 pounds per week. This may seem slow and tedious, but remember: You didn’t gain the weight overnight, and losing it successfully and healthfully shouldn’t happen overnight, either — especially if you want to keep the weight off permanently. To burn 1 pound of fat, you need to create a deficit of roughly 3,500 calories. You can achieve this by reducing the number of calories you consume, increasing the number of calories you burn through physical activity or both.

Consider tracking your eating habits and caloric intake for at least a couple of weeks. This can help you get a sense of appropriate portion control, prevent emotional eating and make you think twice about dining on high-calorie, low-nutrient foods. You’ll quickly realize which foods keep you feeling full longer.

We Can Help

MOVE IT TO LOSE IT

“Physical activity can burn calories, curb your appetite and give you an emotional boost; all important when you’re trying to avoid relapsing into old habits,” Oviedo shared. “The best kind of physical activity for successful weight loss is one that you enjoy and will stick with.”

By inviting friends and loved ones to be active with you, you can make exercise a fun social activity, while also making yourself accountable. The American Council on Exercise® recommends that people trying to lose weight strive to be physically active four or more times a week for 45 minutes or longer. Consult your doctor before beginning any new exercise regimen.

AVOID HIDDEN CULPRITS

Fatigue and dehydration can mask themselves as hunger, so be sure to get adequate sleep and drink plenty of water as you work toward healthier life practices.

WHEN DIET AND EXERCISE AREN’T ENOUGH If you suffer from weight-related health problems and are unable to lose pounds with a healthy diet and exercise, you may be ready to look at other options. Bariatric surgery can help you achieve significant weight loss and improve weight-related comorbidities. To learn more about surgical weight loss options, register for an upcoming virtual weight loss orientation session by calling 832.667.LOSE (5673).

If you’re looking to embark on a weight loss journey and need help creating healthy habits, the Houston Methodist Center for Weight Loss & Bariatric Surgery can help. Visit houstonmethodist.org/weightmanagement for more information on weight loss services and programs available to you.

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Feeling sick?

GET CARE NOW

Houston Methodist offers safe, quick access to high-quality care — so you can feel better now.

Sniffles got you down? Whether you’re suffering from the flu, a cold, a skin rash or even pink eye, we are here for you with a variety of ways to get care quickly, including:

VIRTUAL URGENT CARE 24/7 on-demand video visits through the MyMethodist app

SAME DAY CLINICS Same-day sick visits for many common health conditions

PRIMARY CARE GROUP Quick access to primary care doctors for existing patients

And, with enhanced safety measures in place at all our locations, you can rest assured your safety is our priority. houstonmethodist.org/care-options

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