Leading Medicine Fall 2018, Houston Methodist The Woodlands Hospital edition

LEADING MEDICINE FA LL 2018

Your Journey for

CANCER

CARE Important Screenings for Women Top 3 Urological Problems in Men

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE WOODLANDS AND MONTGOMERY COUNTY

A Closer Look at Neurology

Neurologists Help Find Answers

I

f you or a loved one has unexplained symptoms that could be related to the brain or nervous system, you probably have a lot of questions. Your doctor may recommend a neurological exam with a specialist.

Neurologists are specialists who treat diseases of the brain and spinal cord, peripheral nerves and muscles. Neurological conditions include Dr. Nhu Bruce epilepsy, stroke, multiple sclerosis (MS) and Parkinson’s disease.

Dr. Nhu Bruce, a neurologist with Houston Methodist The Woodlands Hospital, commonly sees patients for uncontrolled headaches, memory loss, imbalance, numbness and pain.

NEUROLOGICAL EXAM

“A thorough neurological exam is the most important tool I have as a neurologist,” Bruce explained. “It can help differentiate and localize the causes of common complaints.”

During a neurological exam, instruments, such as lights and reflex hammers, may be used to assess the nervous system.

Motor skills, balance, coordination and mental status may also be tested.

A neurologist can help identify the cause of symptoms and create a treatment plan for both common and complex neurological conditions. MS is an example of a complex condition that may be best treated by a neurologist. “MS has various forms and the treatment options have changed significantly over recent years,” Bruce said. Patients benefit from the expertise of a neurologist who is familiar with the latest research and treatment options for MS and other neurological conditions.

LEARN MORE

Houston Methodist The Woodlands received its primary stroke certification less than a year after opening. It continues to build its comprehensive neurosciences team and is committed to providing advanced, minimally invasive care to patients suffering from chronic headaches to potentially life-threatening neurological conditions. Our specialties include: N eurology N euro-interventional radiology N euro-ophthalmology N eurosurgery V ascular neurology

Schedule an Appointment

Call 936.270.3333 for more information or to schedule an appointment.

2 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

6

REASONS TO VISIT A NEUROLOGIST

Here are six reasons you might want to make an appointment with a neurologist:

1

hronic or severe headaches – C Migraine headaches are a common reason to see a neurologist, especially when the symptoms are associated with neurological deficits or are refractory to tried treatments.

2

hronic pain – When pain is chronic, C and your primary care doctor can’t help you manage it, you should consider a referral to a neurologist because there could be another underlying reason for the symptoms.

3

Dizziness – Experiencing vertigo (feeling like you’re spinning) or having difficulty keeping your balance could be a sign of something more serious.

4

umbness or tingling – Numbness N or tingling, especially when it occurs on one side of the body or comes on suddenly could be a sign of a stroke or other serious condition.

5

ovement problems – Difficulty M walking, shuffling your feet, tremors and unintentional jerks, can all be signs of a nervous system problem.

6

emory problems or confusion – M Worsening memory problems, personality changes or mixing up words could be signs of Alzheimer’s or dementia.

PROTECT YOUR HEALTH Important screenings for women

P Dr. Patricia Laden

Dr. Magda Ghobashy

reventive screenings are an important part of developing good habits to protect your health. Yet with new and conflicting health information popping up, it can be hard to know what screenings you need and when. While it’s true that health screenings should be tailored to the individual, there are certain screenings that every woman needs. You can discuss the ‘when’ part with your primary care doctor.

Dr. Patricia Laden is an obstetriciangynecologist at Houston Methodist The Woodlands Hospital. “Screening tests reduce the risk of certain diseases occurring and decrease the severity and chance of dying from other diseases,” she said. “For example, Pap tests have decreased the number of cases of cervical cancer as well as the number of women who die from cervical cancer by 50 percent.”

Laden said the greatest impact is in the 50-65 age group. “Colon cancer can often be prevented with the removal of certain polyps found on a screening colonoscopy,” she said. “Hip and spine fractures can be prevented with treatment of osteoporosis when picked up on bone density examinations.”

Dr. Magda Ghobashy, medical director, Houston Methodist Breast Care Center at The Woodlands, agrees that screenings are one of the most important things a woman can do to protect her health. “Studies show that screening mammography can help reduce the number of deaths from breast cancer, especially for women over age 40.”

START WITH AN ANNUAL WELLNESS CHECKUP

Seeing your primary care doctor for an annual wellness checkup is a good place to start. Then schedule age-appropriate screenings as recommended by your doctor (see accompanying chart). From preventive care to tailored treatments, receiving comprehensive care in one location is a significant benefit.

What

When

Why

Pap test and HPV test

Every 3 years, beginning at age 21.

Testing for HPV should begin at age 30 or sooner if you’ve had an abnormal Pap test.

Pap tests screen for abnormalities that could indicate precancerous changes or early cervical cancer. An HPV test helps identify your risk for developing cervical cancer.

Mammogram

Annual screening mammograms starting at age 40. If you’re at high risk, talk to your doctor about when you should begin screening.

To identify early signs of breast cancer.

Colonoscopy (and/or other screening tests for colorectal cancer, such as fecal occult blood testing or flexible sigmoidoscopy)

Starting at age 50. Talk to your doctor about getting screened earlier if you have a family history of colorectal cancer.

To identify precancerous polyps or early cancers.

Bone mineral density test

At least once beginning at age 65, or earlier depending on your risk factors for osteoporosis.

Bone density screenings identify bone loss early, enabling you to start treatment and prevent further bone loss.

Schedule an Appointment

The doctors and specialists at Houston Methodist The Woodlands Hospital can provide the guidance, screenings and resources you need to help you stay healthy at every age. For more information or to schedule an appointment, call 936.270.3333.

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

Support for Your Journey

from Diagnosis to Survivorship Choosing a hospital for cancer care

H

1

START YOUR SEARCH

Choosing where to go for cancer treatment is a big decision, and you want to feel secure about your choice.

Most of all, you’re focused on finding the best path to treatment — as quickly as possible.

If you live in the Houston area, you have choices about where to go for cancer care, with convenient access to top-ranked physicians and cancer specialists, advanced treatments and research, and comprehensive services and support. Within Houston Methodist Cancer Center, our specialists are renowned for their research and treatment of cancer, and we are dedicated to providing each patient with the most advanced and collaborative care, all in a compassionate environment. In 2017, more than 2,000 patients from all over the United States and 37 countries traveled from outside of the Greater Houston area to Houston Methodist for their cancer treatment.

“Patients come from all over the world because we have leading cancer experts integrating the latest research and treatments on the forefront of the battle against cancer. Our commitment to providing high-quality and compassionate care comes through in everything we do,” said Dr. Peter Morgan, a radiation oncologist and medical director of Houston Methodist Cancer Center at The Woodlands.

4 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

Morgan is board certified in radiation oncology by the American Board of Radiology.

2

STEP

STEP

earing the news that you or a loved one has been diagnosed with cancer can turn life upside down. A thousand questions, worries and what-ifs may come to mind. Knowing where to turn for support after a cancer diagnosis can help you move forward with confidence, which includes the following: Dr. Peter M eet with your doctor to ask questions about Morgan your diagnosis and make sure you understand his or her recommendations for treatment.

C onsider getting a second opinion so you can feel well-informed and confident with your treatment decisions.

T alk to family and friends about your diagnosis and how this may impact family life and work or school schedules.

F ind support to help you navigate next steps. Before you even begin treatment, a support group can help you learn how to share the news with your loved ones or give you an idea of what to expect throughout treatment.

CONNECT WITH YOUR CARE TEAM

The doctor who diagnosed your cancer might refer you to a medical oncologist or surgeon who specializes in treating certain cancers. Before you visit a specialist, write out a list of questions and bring a support person or loved one who can help you take notes on the doctor’s advice. If there’s something you don’t understand, make sure to ask. It’s important that you feel comfortable communicating with the doctors and nurses involved in your care.

LUNG CANCER SCREENING SAVES LIVES

There’s no question you want the best team on your side when fighting cancer. At Houston Methodist, top-ranked physicians and cancer specialists have a high level of expertise and input on your treatment plan. Whether your cancer diagnosis is common, rare, or in an early or advanced stage, you can benefit from the leadingedge research, knowledge and experience of an academic medical center. “If you have multiple health complications or conditions, it is even more critical to have a team of specialists working together on a treatment plan for your unique needs,” Morgan said.

Oncologists, surgeons, pulmonologists, pathologists, radiologists, internal medicine doctors and other specialists at Houston Methodist collaborate and consult on treatment plans for patients, and this team aspect is a powerful tool in the fight against cancer.

STEP

3

Lung cancer — the deadliest form of cancer in the U.S. — is often not found until the cancer is at an advanced stage. Screening for lung cancer makes it possible to identify nonsmall cell lung cancer at an early stage when it is more treatable. The U.S. Preventive Services recommends that high-risk individuals be screened for lung cancer every year.

Your doctor may recommend a low-dose CT scan for lung cancer screening if you’re age 55 to 77 and have a history of heavy smoking. This includes current and former smokers who have a history of smoking at least one pack a day for 30 years or two packs a day for 15 years.

If you’re a current or former smoker, have a discussion with your doctor about your individual lung cancer risk factors and whether you’d benefit from a lung cancer screening.

LEARN ABOUT TREATMENT OPTIONS

With an experienced team on your side, you’re ready to review your treatment options. “We treat common and complex cases of cancer that touch every organ of the body — and every aspect of your life. Our specialists customize treatment plans to fight your cancer so we can achieve the best outcomes possible; that’s part of being a top hospital in Texas,” Morgan said.

Treatment options may include: A dvanced treatments in I maging technology immunotherapy advancements Bone marrow transplantation Latest radiation techniques Chemotherapy Leading surgical techniques Clinical trials Targeted therapies

STEP

4

START YOUR TREATMENT PLAN

Moving into the treatment phase of your journey takes courage, stamina and patience. The various components of a treatment plan may be spread out over weeks or months — and timing is key. That’s why it helps to choose a hospital system with convenient access to appointments for radiation therapy, infusion therapy and other treatments you may need.

“The specialists at all of our cancer center locations are connected with the same research, treatments and technology available throughout Houston Methodist,” Morgan shared.

You keep your physician throughout your journey and receive treatments at the location that’s most convenient for you.

To find out if you qualify for the Houston Methodist Lung Cancer Screening Program, visit houstonmethodist.org/lung-screening or call 713.441.LUNG (5864).

“When you receive care locally, you benefit in many ways — being close to work, home, family and friends can minimize the interruption to your life. Our goal is for you to be able to get back to yourself so you can focus on your life. Your cancer should not be the center of your life. That’s what we’re trying to accomplish,” Morgan said.

5

STEP

Choosing a research-focused hospital system opens the door to new therapies that are not available outside of a research setting. For example, you may decide that you want to participate in clinical trials that involve medications as well as gene and cell therapy.

“We offer immunotherapy clinical trials to stimulate a stronger immune response to kill cancer cells in lung cancer, gastrointestinal cancers, breast cancer and brain tumors. We also have a triple-negative breast cancer clinic, sarcoma of the heart program and other programs designed for specific types of cancer,” Morgan explained.

“In addition to the research and clinical trials offered at our campus in the Texas Medical Center,® we have research programs at our community cancer center locations, and we are dedicated to bringing research and clinical trials closer to home.

Our researchers are actively working on every aspect of cancer treatment and bringing that integration to the communities across Houston,” Morgan said.

Do You Qualify for Screening?

BEYOND CANCER TREATMENT

Care for cancer patients doesn’t end when treatment does. At the end of treatment, you’ll have a survivorship care plan to help continue your ongoing care and help you follow your doctor’s recommendations. The Houston Methodist Cancer Survivorship Program addresses common quality-of-life issues related to cancer treatment so you can focus on surviving, thriving and living your best life.

Learn More To learn more about the innovative cancer treatments offered at Houston Methodist The Woodlands Hospital, visit houstonmethodist.org/ cancer-woodlands today or call 936.270.3480 to find an oncologist.

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TOP 3 UROLOGICAL PROBLEMS IN MEN

U

rological conditions, such as incontinence and difficulty urinating, kidney stones and prostate cancer are the most common Dr. Miguel urological complications Mercado experienced by male patients.

“While these problems can range from mild to serious, they are all highly treatable,” said Dr. Miguel Mercado, urologist at Houston Methodist The Woodlands Hospital. Here’s a quick reference guide to the symptoms, risk factors and treatment methods of these common conditions.

URINARY INCONTINENCE

Urinary incontinence is the leaking of urine that you can’t control. It may also include urgency incontinence, a sudden and immediate need to urinate, or overflow incontinence when the bladder doesn’t empty properly.

The first step in treating an incontinence problem is to visit a urologist and get an accurate diagnosis.

“I first make sure a patient doesn’t have a urinary tract infection, which can cause similar symptoms,” Mercado said. “Then I’ll perform an ultrasound to determine if it’s a flow problem or an overactive bladder problem.”

Treatment options typically include lifestyle changes, such as bladder training and losing weight, medication and, if those treatments don’t work, surgery.

“There are minimally invasive, in-office procedures we can do, such as a prostate lift that don’t require a catheter, and the effects are felt right away,” Mercado said.

INJECTION FINDS RECURRING PROSTATE CANCER Axumin (fluciclovine F-18) is an imaging agent doctors can use with a PET scan to help find the recurrence Dr. Robert of prostate cancer. “Knowing where the new cancer Malone is located means we can treat patients faster and with greater accuracy,” said Dr. Robert Malone, radiologist at Houston Methodist The Woodlands Hospital.

If you have elevated PSA levels following prostate cancer treatment, ask your doctor about Axumin or call 936.270.3333 for more information.

KIDNEY STONES

Kidney stones are caused when high levels of minerals, such as calcium, form in the kidneys. Symptoms include intense pain, blood in urine, nausea, vomiting and a frequent need to urinate.

“Most kidney stones are due to patients not drinking enough water,” Mercado said.

“They can also be caused by high protein and high-salt diets. However, some people are genetically predisposed.”

While treatment varies depending on the patient, Mercado advises drinking two liters, or about 68 ounces, of water a day to increase urine frequency to help pass the stones. Surgery may be required in the rare case that a stone is too large to pass, or an infection occurs.

PROSTATE CANCER

Prostate cancer is one of the most common types of cancer in men. It usually grows slowly, and in its early stages, may not cause any symptoms. That’s why it’s important to get screened.

“I recommend men begin screening for prostate cancer at age 55, unless they have a family history of prostate cancer,

6 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

in which case, I suggest starting at 45,” Mercado said. “It’s a simple blood test and rectal exam. You can have it done at your doctor’s office.”

According to Mercado, when detected early, prostate cancer is curable. “In many cases, we don’t even need to remove the prostate because low-grade prostate cancer won’t get worse.”

There is also a new advancement in detecting recurring prostate cancer (read more in “Injection Finds Recurring Prostate Cancer”).

Take Charge of Your Health

If you or your loved one is experiencing a urological problem, the urologists at Houston Methodist The Woodlands Hospital can help. Call 936.270.3333 for more information.

PREDIABETES: A HIDDEN THREAT

P

rediabetes is a silent condition that can take a toll on your body — even if you feel normal and healthy. Having prediabetes increases your risk for type 2 diabetes, but you still have the power to change course.

“Prediabetes can be treated and reversed if you take steps now to protect your health,” said Dr. Cathy Hart, a family medicine physician with Houston Methodist Primary Care Group in The Woodlands.

Dr. Cathy Hart

PREDIABETES = A stage when blood sugar levels are higher than normal, but not high enough to be called diabetes.

84 MILLION

TYPE 2 DIABETES = A chronic condition where the body doesn’t use insulin effectively to control blood sugar.

American adults have prediabetes.

9 OUT OF 10

PREVENT DIABETES V isit preventdiabetesstat.org and take the Prediabetes Risk Test.

Ask your doctor about testing your blood sugar.

Learn if you have a history of type 2 diabetes in your family.

Lose weight, if needed.

Talk to your doctor about getting physically active or if you need to increase your activity level.

Visit houstonmethodist.org/ diabetes to learn more.

people who have prediabetes don’t know they have it.

“Many people with prediabetes will develop TYPE 2 DIABETES within FIVE YEARS if they don’t make healthy lifestyle changes, such as losing weight and becoming more physically active,” Hart said.

Focus on foods that are high in nutrition and low in fat, calories and sugar.

Grab a glass of water instead of sugar-sweetened beverages.

Add more movement to your day.

Talk to your doctor about healthy and safe ways to

Take the First Step

To find a primary care physician and get checked for prediabetes, visit houstonmethodist.org/pcg or call 281.276.0653.

lose weight.

Source: Centers for Disease Control and Prevention

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Schedule an appointment to discuss your options with a specialist.

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