Leading Medicine Fall 2017, Houston Methodist West Hospital edition

LEADING MEDICINE FA LL 017

BREAST CANCER:

Is Prevention Possible?

QUIT SMOKING ON YOUR TERMS WHEN THE PROBLEM IS YOUR PROSTATE

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN WEST HOUSTON-KATY

FIGHTthe FLU! FLU FACTS

What you don’t know about the flu can make you sick. For most healthy people, catching this bug means a few miserable days in bed, but for children, elderly, people with chronic illnesses and those with a weakened immune system, the flu can be deadly.

PEOPLE WHO GET THE FLU Up to 20% of people in the U.S. get the flu each year

SYMPTOMS Flu symptoms can include: body aches diarrhea chills fatigue cough fever

Adults 18-64 make up almost 60% of flu hospitalizations headache runny or stuffy nose sore throat vomiting

Up to 56,000 people die each year from the flu You’re contagious starting 1 day before symptoms show and 5 to 7 days after. You can be sick up to 2 weeks

THE FLU SHOT BY THE NUMBERS weeks

2

3 to 4

How long it takes after vaccination for your body to develop antibodies that protect against the flu

5 million

Number of flu strains the vaccine protects against each year

Estimated number of flu-related illnesses prevented by the flu vaccine during the 2015-2016 season

WHAT YOU CAN DO

Get a flu shot!

Unless you’ve had Guillain-Barré syndrome or you’re under 6 months old, allergic to the flu shot or sick (wait until you get better).

Wash your hands

Avoid sick people

Don’t touch your eyes, nose or mouth

Practice healthy habits

for as long as it takes to sing “Happy Birthday” twice.

And stay home if you’re sick.

Flu viruses can survive on surfaces like telephones and doorknobs for up to 8 hours.

Get plenty of sleep and exercise, manage stress, drink fluids and eat healthy foods.

TAKE ACTION

Ready to get a flu shot?

Sources: The Centers for Disease Control and Prevention and the CDC Foundation.

2 LEADING MEDICINE IN WEST HOUSTON/KATY

To schedule your appointment with a primary care physician, visit houstonmethodist.org/pcg/katy or call 832.522.8751.

QUITTING ON YOUR TERMS T he average smoker tries to quit at least seven times before succeeding. “Many people find quitting so hard because of their body’s physical addiction to nicotine,” said Dr. Mir Alikhan, a pulmonologist at Houston Methodist West Hospital.

“That’s when nicotine replacement therapy, or NRT, can help.”

By replacing cigarettes with alternative sources of Dr. Mir Alikhan low-dose nicotine, you can stop smoking without the worst effects of withdrawal. And studies have found that NRT can increase your chance of quitting by 50 to 70 percent.

Ask your doctor about the nicotine replacement therapy options listed below to make the choice that’s best for you:

PATCH An over-the-counter option, nicotine patches deliver a small, steady amount of nicotine through the skin, and you can use either a 16-hour or 24-hour patch to alleviate withdrawal symptoms.

Some brands offer step-down patches, which have you progress from higher dosages of nicotine to lower dosages over several weeks.

GUM Nicotine gum is a quick-relief, over-the-counter NRT. It’s slowly chewed until the user notices a tingling feeling or peppery taste, at which point the gum is placed between the cheek and gums so the nicotine can be absorbed. Not only is the release of nicotine quicker than patches, but it can also help satisfy the oral urge of smoking.

LOZENGE Available without a prescription, nicotine is slowly absorbed through the mouth as the lozenge dissolves, similar to hard candy. It should take about 20 to 30 minutes for the lozenge to fully dissolve.

INHALER A nicotine inhaler is an NRT that can be obtained with a prescription. It looks like a plastic cigarette holder and comes with nicotine cartridges. You can “puff ” the inhaler over a period of 20 minutes or for just a few minutes at a time.

NASAL SPRAY Nicotine nasal spray is another prescription-only NRT. It immediately relieves withdrawal symptoms by providing nicotine rapidly. Most people are told to use one or two sprays in each nostril once or twice every hour, with at least eight doses per day when first starting.

Are You a Candidate for Lung Cancer Screening?

We all know that smoking increases your chance of lung cancer. It’s one of the many reasons you’ve tried to quit over the years.

As you work with your doctor to successfully beat your nicotine addiction, it’s also a good idea to schedule a lung cancer screening. To find out if you’re a candidate for a screening, visit houstonmethodist.org/cancer/lung-cancer/ screening or call 832.522.5522 to schedule an appointment.

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BREAST CANCER:

IS PREVENTION POSSIBLE?

W

hen it comes to breast cancer, certain risk factors are out of your control, such as your genes and age, as well as starting your first period young. Yet even more risk factors are within your control, and every day new research is emerging that suggests breast cancer may be more preventable than experts originally thought.

Dr. Candy “Women can take steps to mitigate their risk Arentz of developing breast cancer and increase their chances of survival if it occurs,” said Dr. Candy Arentz, breast surgeon at Houston Methodist West Hospital.

Here are some steps you can take to reduce your risk of breast cancer:

BE (REALLY) PHYSICALLY ACTIVE

Exercise, especially vigorous exercise, could be the single most important weapon in your arsenal. The American Cancer Society recommends that adults

4 LEADING MEDICINE IN WEST HOUSTON/KATY

get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.

“Exercise is a huge factor when it comes to reducing a woman’s risk of breast cancer,” Arentz emphasized. “Exercise decreases the levels of insulin and estrogen in the body.

Some studies estimate a 10–15 percent risk reduction with moderate exercise.” Doctors think the exercise-estrogen link may account for the reduced risk. Here’s why: The greater your lifetime exposure to estrogen, the greater your risk for breast cancer. Exercise also decreases inflammation and boosts the immune system.

MAINTAIN A HEALTHY WEIGHT

Being overweight increases your risk of developing a variety of serious diseases, and breast cancer is one of them. Obese and overweight women produce more estrogen and tend to have higher insulin levels, both of which are linked to an increased breast cancer risk.

“After menopause the ovaries stop producing estrogen, but gaining weight after menopause increases the risk of breast cancer because there are more fat cells to produce estrogen.

Maintaining a healthy weight is also important after a breast cancer diagnosis,” Arentz said.

LIMIT ALCOHOL In addition to exercise and maintaining a healthy body weight, limiting alcohol to three or less alcoholic drinks per week can lower a woman’s risk. Compared with nondrinkers, women who consume two to five alcoholic drinks a day have about 1.5 times the risk of developing breast cancer. “Alcohol may change the way the body processes estrogen. Since most breast cancers are responsive to estrogen, alcohol may increase the risk of developing breast cancer,” Arentz said.

CHOOSE TO BREASTFEED Arentz encourages new mothers to breastfeed their babies if they’re able. “Evidence suggests that breastfeeding reduces a woman’s risk of developing breast cancer,” she said. “We know that the longer a woman breastfeeds, the greater the protective effect.” The reasons why aren’t clear, but one possible explanation is that women who breastfeed have fewer menstrual cycles throughout their lives, and thus less exposure to estrogen.

CONSUME OLIVE OIL Studies have suggested that consuming more monounsaturated fats, such as olive oil, may help protect against breast cancer, too. Houston Methodist is conducting a clinical trial, led by Dr. Tejal Patel, examining how a major component of olive oil, hydroxytyrosol, affects breast density in women at high risk of breast cancer.

Women with higher breast density have a higher breast cancer risk.

TAKE PREVENTIVE MEDICATIONS If you’re at higher risk for breast cancer, your doctor may recommend medications such as tamoxifen and raloxifene to lower your risk. However, these medications can produce symptoms of menopause, so it’s important to discuss the risks and benefits with your doctor to make an informed decision.

GENETIC TESTING AND INTERVENTION If you have a strong family history of breast cancer, talk with your doctor about whether genetic testing is right for you. Mutations in certain genes, such as the BRCA genes, increase the risk of breast cancer. Women with this gene mutation may opt for more frequent screenings, chemoprevention or prophylactic surgery (breast removal).

Removing the ovaries and fallopian tubes is also an option; in addition to reducing the risk of ovarian cancer, it could help prevent breast cancer.

FACTORS THAT DON’T INCREASE THE RISK OF BREAST CANCER

There is some false information about what can cause breast cancer. These things do not increase your risk of breast cancer: wearing a bra, deodorant, cellphones, breast implants and caffeine.

EARLY DETECTION IS KEY

We have discussed some ways to help reduce your risk of developing breast cancer, but early detection is still most important. Getting regular mammograms catches breast cancer early while it is still treatable.

Schedule Your Mammogram

Mammography is the most effective tool available in diagnosing breast cancer at an early stage, long before tumors are large enough to be felt or to cause any symptoms. Houston Methodist Breast Care Center at West offers mammogram patients a comfortable experience in a relaxing environment.

If further testing is needed, the center has the latest in diagnostic imaging and biopsy procedures. The center also provides breast care education, support programs, self-care and other cancer prevention screenings and treatment.

To schedule an appointment at the Houston Methodist Breast Care Center at West, please visit houstonmethodist.org/breast-care or call 832.522.PINK (7465).

A NIGHT OF POSITIVELY PINK Friday, Oct. 13 | 6–9 p.m.

LaCenterra at Cinco Ranch Courtyard 23501 Cinco Ranch Blvd.

Katy, TX 77494 Join us and bring your family for a night of Positively Pink, a breast cancer awareness celebration. At the event: M eet our breast care specialists and staff Receive breast health information Enjoy music and other family activities Visit houstonmethodist.org/events or call 832.522.5522 to register.

HOUSTONMETHODIST.ORG/WEST 5

How to Sidestep

SPORTS INJURIES

W

hether you’re the parent of a young athlete or a weekend warrior yourself, it’s important to play it smart to avoid sports injuries. Dr. Alex Dr. Alex Schroeder, orthopedic Schroeder surgeon at Houston Methodist Orthopedics & Sports Medicine at West, encourages athletes to balance their training by playing a range of different sports instead of focusing on one sport for long periods of time.

“Athletes may push too hard for performance in one specific skill set — swinging, throwing, running or weightlifting, for example. Baseball, softball and tennis players may suffer from shoulder overuse injuries or elbow pain from throwing too hard or too frequently.

Runners may develop pain around the knee cap or shin splints from overdoing it,” Schroeder said.

Athletes who play sports that involve sudden stops, jumps and changes in direction are at risk for knee injuries.

“It’s common to have knee injuries such as meniscus tears or anterior cruciate ligament (ACL) tears in sports like football, basketball and soccer. With meniscus tears and ACL tears, it’s

best to seek medical care right away,” Schroeder added.

Treatment for shoulder and knee injuries may include physical therapy, anti-inflammatory medicines, steroid injections, and in some cases, surgery.

PREVENTION IS KEY

Heading off a sports injury before it happens can be one of the best ways you can stay active and in the game. Schroeder offers the following advice to help athletes and parents prevent sports injuries: Wear well-fitting shoes and use proper equipment designed for the sport.

Start out slow with a new training regimen, periods of rest are important too.

Warm up and stretch before and after exercising.

Incorporate cross-training activities for a balanced workout routine.

Avoid playing when you’re tired or in pain. Listen to what your body tells you and you can avoid pushing too far.

Schroeder also reminds parents of young athletes to be careful not to push them too hard. “It’s better to have your child sit out for a short period of time with an injury and heal up completely, than to deal with recurring injuries. Encourage kids to have fun with a mix of different sports,” he said.

CONCUSSION MANAGEMENT: WATCH FOR WARNING SIGNS “Suffering a concussion is a serious problem that can be dangerous for young athletes,” said Dr. P. Timothy Sprockel, a Dr. P. Timothy primary care Sprockel sports medicine specialist at Houston Methodist Orthopedics & Sports Medicine at West and member of the Houston Methodist Concussion Center.

Parents and athletes should be aware of common symptoms of a concussion, such as: B alance or coordination problems Dizziness Headache Nausea Tiredness Also watch for problems with concentration and memory.

“Sometimes emotional issues result, like sadness or irritability, or parents notice a behavioral change in their kids, saying they’re just not acting the way they usually do,” Sprockel added.

If your child shows signs of a concussion, contact a health care professional trained in concussion evaluation and management.

Expert Care for Sports Injuries To schedule an appointment with a sports medicine specialist at Houston Methodist West Hospital, visit houstonmethodist.org/ find-a-doctor or call 832.522.BONE (2663).

6 LEADING MEDICINE IN WEST HOUSTON/KATY

When the Problem

IS YOUR PROSTATE

M

ost men probably don’t think about their prostate, the walnutshaped gland under the bladder, until they get older and begin Dr. Wesley experiencing problems Ekeruo with it,” said Dr. Wesley Ekeruo, a urologist with Houston Methodist West Hospital. “Such problems can include a frequent need to urinate, painful urination, incomplete emptying of the bladder and more.”

The three most common problems men face with the prostate include prostatitis, benign prostatic hyperplasia (BPH) and prostate cancer.

PROSTATITIS

Prostatitis is inflammation of the prostate usually stemming from an infection. It’s a common condition that can lead to difficulty passing urine, sexual problems and more.

How it’s treated: Depending on whether the infection comes on suddenly (acute) or is more chronic, antibiotics may be needed for one to two weeks or longer.

Anti-inflammatory medication and medications that relax prostate muscle tissue to ease urine passage may also be recommended if the prostatitis is chronic.

BPH OR ENLARGED PROSTATE

Many men experience prostate enlargement as they age. This condition can cause a squeezing of the urethra and eventual weakening of the bladder, which can result in urine being left in the bladder.

BPH is not cancerous but can lead to difficulty voiding, bladder or kidney infections, urinary blockages or kidney failure. However, many of these symptoms can be similar to prostate cancer.

How it’s treated: Not all men will need treatment for their BPH; for some, lifestyle changes, such as limiting alcohol or caffeine, can lessen symptoms. For others, medication or surgery can help with symptoms related to discomfort and urine flow. Several noninvasive therapies are now available including green light laser procedures, transurethral resection of the prostate (TURP) or the Button procedure.

These therapies allow for minimal trauma to the body and a quick recovery.

PROSTATE CANCER

Prostate cancer can be a slow-growing cancer that, for many men, will never cause symptoms or threaten their health. For some, however, the cancer can be aggressive and definitive treatment may be in order.

How it’s treated: Prostate cancer treatment depends on the cancer’s location, whether it has spread, the man’s age and overall health. Some treatments can lead to side effects, such as erectile dysfunction and bladder control issues — men should weigh options with their doctor before making a treatment decision. Watchful waiting (regularly monitoring symptoms), surgical removal of the prostate, high-intensity focused ultrasound (HIFU) treatment, radiation therapy and medications including chemotherapy, and testosterone-blocking hormone therapy may be options. Many treatment options have advanced in recent years, allowing patients to experience quicker recovery times and significantly fewer side effects. Patients are encouraged to discuss their options with their doctor before making a treatment decision.

HIGH-INTENSITY FOCUSED ULTRASOUND Get the latest in prostate cancer treatment at Houston Methodist West Hospital. High-intensity focused ultrasound (HIFU) is a minimally invasive, outpatient procedure that destroys cancer cells while keeping healthy tissue intact. This allows for a faster recovery with fewer side effects and complications.

You’re more likely to qualify for HIFU if: You’re newly diagnosed with early cancer You’re an older adult with aggressive cancer that presents a higher incontinence risk You’re concerned about the risks of radiation therapy You have recurrent prostate cancer unsuccessfully treated with radiation therapy

Concerned About Prostate Symptoms?

To schedule a preventive prostate screening with a Houston Methodist West Hospital urologist, call 832.522.8300.

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LEADING MEDICINE IN GREATER HOUSTON

HOUSTONMETHODIST.ORG/WEST

MAKING TIME FOR YOUR MAMMOGRAM MAY ADD YEARS TO YOUR LIFE. At Houston Methodist Breast Care Centers, scheduling your mammogram online is an important first step for early detection. It’s easy, and — with eight locations across the Greater Houston area — more convenient than ever.

Our Breast Care Centers offer: • Specially trained breast imaging radiologists • Advanced technology in a spa-like atmosphere HOSPITALS SPECIALTY HOSPITAL EMERGENCY CARE CENTERS IMAGING CENTERS COMPREHENSIVE CARE CENTERS

Just around the corner

• Access to our breast specialists at Houston Methodist Cancer Center Visit houstonmethodist.org/breast-care and schedule your mammogram at a location near you.

Houston Methodist has locations throughout the Greater Houston area to best serve you near your home or workplace.

HOSPITALS

SPECIALTY HOSPITAL

1. Houston Methodist Hospital . Houston Methodist San Jacinto Hospital . Houston Methodist St. John Hospital 4. Houston Methodist Sugar Land Hospital 5. Houston Methodist The Woodlands Hospital Now Open . Houston Methodist West Hospital 7. Houston Methodist Willowbrook Hospital

8. Houston Methodist St. Catherine Hospital

IMAGING CENTERS 9. Houston Methodist Breast Care Center 17. Houston Methodist Imaging Center

COMPREHENSIVE CARE CENTERS 18. Houston Methodist Comprehensive Care Center in Conroe 19. Houston Methodist Comprehensive Care Center in Pearland

EMERGENCY CARE CENTERS

TEXAS MEDICAL CENTER • BAY AREA • BAYTOWN • SUGAR LAND THE WOODLANDS • UPPER KIRBY • WEST HOUSTON • WILLOWBROOK

713.441.ER24 (3724) 9. Houston Methodist Emergency Care Center at Kirby 10. Houston Methodist Emergency Care Center at Voss 11. Houston Methodist Emergency Care Center in Cinco Ranch 1. Houston Methodist Emergency Care Center in Cypress 1. Houston Methodist Emergency Care Center in Pearland 14. Houston Methodist Emergency Care Center in Sienna Plantation 15. Houston Methodist Emergency Care Center in Spring 1. Houston Methodist Emergency Care Center in The Woodlands

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