Bladder cancer is the eighth most common cancer in the U.S., according to the American Cancer Society. While cancer symptoms can differ from person to person, you should give careful attention if you notice anything unusual, especially blood in the urine.
“Bladder cancer refers to any cancer that begins in the bladder,” explained Dr. Courtney Chang, urologic oncologist with Houston Methodist Urology Associates at Sugar Land.
“More than 90% of bladder cancers are called urothelial cell carcinoma (UCC), which is a cancer of the cells that line the urethra, bladder, ureters and renal pelvis.”
Bladder cancer symptoms vary depending on the stage, but any unusual or concerning symptoms should be checked as soon as possible.
The most common bladder cancer symptom is blood in the urine, either seen under a microscope or with the naked eye. “A urologist needs to evaluate any type of blood in the urine as it can be caused by an infection, kidney stone or a malignancy of the genitourinary tract,” Chang explained. Even if you aren’t experiencing any pain, consulting a doctor and getting tested will help rule out other conditions.
Staying hydrated and increasing your water intake will mean more trips to the bathroom. But if you find yourself running to the bathroom more than usual, and your liquid intake hasn’t changed, you should get evaluated. “We know urinating frequently can be a sign of a urinary tract infection (UTI),” Chang said. “But it can also be associated with overactive bladder, enlarged prostate, diabetes and certain other types of cancer, including bladder cancer.”
“Feeling that burning sensation or pain when urinating can be another symptom of a UTI,” Chang said. While associated with bladder cancer, this is also a symptom of diabetes, bladder infections, prostate conditions and certain sexually transmitted infections.
If your once-strong urine flow now feels like a weak trickle, or the flow is now stop-start-stop-start, or you’re heading to the bathroom often and can’t go, it’s time to consult a doctor.
A common and annoying side effect of aging is waking up to urinate during the night. Although bladder cancer can cause changes in your urination, this is also a symptom of UTIs, bladder stones, an overactive bladder or, for men, an enlarged prostate.
While many of the above symptoms can have less serious causes, getting them checked can give you access to more treatments if it turns out to be bladder cancer. “Early bladder cancer can be managed with minor outpatient surgeries and office visits, so the earlier it’s caught, the better,” Chang said. •
If you are experiencing any of these symptoms, it’s time to schedule an appointment. To find a urologist with Houston Methodist Urology Associates at Sugar Land, visit houstonmethodist.org/spg/urology/ sugar-land or call 281.276.5280.
Dr. Gabriela Orgeron
Many people aren’t even aware they are at risk of cardiovascular disease until they suffer a major health event, such as a heart attack, aneurysm rupture or stroke. Because cardiovascular disease can be accompanied by vague symptoms or none at all, learning your risk can save your life.
“There is good news,” said Dr. Gabriela Orgeron, cardiologist at Houston Methodist Cardiology Associates at Sugar Land. “You can help prevent life-threatening heart disease and other related conditions from developing and progressing by taking a few first steps.”
Those steps include:
■ Getting regular blood pressure and cholesterol checks
■ Leading a healthier lifestyle by being active and following a heart-friendly diet
■ Scheduling a heart scan and vascular screening
Houston Methodist Sugar Land Hospital offers heart and vascular screening services to help you understand your risk, which is one of the first steps toward prevention.
“The screenings use imaging technology, including CT scan and ultrasound, to test for signs like calcium buildup of plaque on the artery walls and thickness of the arteries, as well as checking for blockages and other potential signs of cardiovascular disease,” Orgeron explained.
But should you schedule a heart scan? Orgeron answered some common questions about these minimally invasive procedures.
Q: Should everyone have a screening test?
A: No. Screenings are beneficial for men between 40 and 65 and women between 45 and 70, or if you’re at intermediate risk. Risk
factors include family history, smoking, high cholesterol, high blood pressure and diabetes. This is a screening exam to assist in detecting potential diseases.
Q: If I have a known heart condition, can I still get these tests?
A: Heart scans are not necessary for those who have coronary artery disease, heart stents of any kind or have had coronary bypass surgery. For these patients, we recommend an evaluation by a cardiologist.
Q: How long will the test take?
A: Your test can take anywhere from 15 minutes to an hour depending on the scan.
Q: Why should I have my screenings at Houston Methodist Sugar Land Hospital?
A: Your results are processed in an accredited lab and evaluated by either a cardiologist, a vascular surgeon or a radiologist who specializes in heart and vascular conditions. Within seven business days, you and your doctor are sent the results. We suggest you also share the results with your primary care provider. •
If you are concerned about your heart health, it’s time to talk to a specialist. To schedule an appointment with Houston Methodist Cardiology Associates at Sugar Land, visit houstonmethodist. org/spg/heart-vascular or call
Osteoarthritis is often known as a wearand-tear disease. Unfortunately, when osteoarthritis strikes the knees, you may decide to take it easy and opt out of the activities you once enjoyed.
Dr. Ashvin Dewan, board-certified orthopedic surgeon who specializes in robotic knee surgery at Houston Methodist Orthopedics & Sports Medicine at Sugar Land, doesn’t want to see you quit activities because of knee pain. With osteoarthritis, you may experience knee pain during exercise, but physical activity by itself is rarely the cause.
The real culprit for osteoarthritis is genetics or injury.
“If your parents both had knee replacements, chances are higher you’ll have a problem, too,” Dewan said. “I strive to help my patients manage their pain symptoms so they can stay active longer.”
Osteoarthritis is the disease process of losing the cartilage in your knee — the tissue that cushions the ends of bones to decrease friction with joint movement. This is different from rheumatoid arthritis, a condition where the immune system attacks joints and their lining.
You should consult a doctor who can diagnose your knee pain as a symptom of osteoarthrosis or something else. Osteoarthritis has hallmark signs, which may include:
■ Inflammation and swelling
■ Joint tenderness or a feeling of the joint giving out
■ Pain described as deep and aching
■ Stiffness at times, though more common with rheumatoid arthritis
■ Varying amounts of discomfort during an activity or prolonged inactivity
“While pain often occurs while standing, running or walking, it can also occur when sitting for extended periods. Symptoms are often most noticeable when using the stairs,” Dewan explained.
Family history, aging or injury are the common causes of osteoarthritis. While some studies indicate supplements such as glucosamine can help, there are actions you can take to reduce pain, including:
■ Building strength, especially in the quadriceps (muscles that control the knee) and hips
■ Managing weight to decrease stress on the joints
■ Quitting smoking, because it lowers blood supply and delays healing
“Maintaining a healthy weight is just as important as exercise and strength training,” Dewan said. “The mechanical forces across the knee joint are unique. One pound on your body is anywhere between four and nine pounds on your knee. If you’re overweight, any amount of weight loss can help reduce the stress on your knees.”
If your symptoms lead you to decreased physical activity, you may inadvertently add to the problem.
The good news? Your doctor can help you manage osteoarthritis pain by ensuring that your fitness routine builds muscles around the knees. With regular check-ins, your doctor will monitor your symptoms and, if needed, adjust your plan.
When medical care is needed, it often starts with these steps:
1. Topical ointments are available over the counter and deliver skin irritants that stimulate blood flow to decrease pain.
2. Oral medications, such as an over-the-counter acetaminophen or a prescribed anti-inflammatory can help with pain and swelling but require close monitoring of your kidney function by your doctor.
3. Injection therapies are administered by your doctor in the office. He or she will recommend corticosteroids, hyaluronic acid or platelet-rich plasma (PRP) injections, depending on your need.
There is no one-size-fits-all approach. Your doctor will help determine the best course of action for your knees. •
If you are ready to take control of your osteoarthritis or get back in the game of life, we can help. Talk with a doctor to learn more about whether joint replacement is right for you. To schedule an evaluation, visit houstonmethodist.org/jointpain or call
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Dr. Ashvin DewanIf osteoarthritis knee pain is coming between you and your fitness routine, consult your doctor. He or she may recommend exercise modifications to help build strength, manage weight and decrease pain symptoms, such as:
Joining a water aerobics class
Riding a bike on an even terrain
Starting a swim routine
Strength training with a professional trainer
Trying light elliptical or stationary bike exercises
Walking or hiking on a trail with soft ground
When these exercises no longer offer you relief, it’s time to talk to your doctor about injections or surgery.
Many people wait until something goes wrong to see the doctor. That’s not how it should work. A primary care provider (PCP) and patient should be partners in health.
“My job is to help you stay healthy,” explained Dr. Chisato Nishikawa, board-certified family medicine physician with Houston Methodist Primary Care Group in Aliana. “I can diagnose something when you might not feel right while also helping you achieve your health goals.” PCPs help prevent problems and work with you to find the best ways to maintain your health.
Nishikawa explained the four important health numbers to reduce your risk of health problems: high blood pressure, obesity, diabetes and heart disease.
Blood pressure measures the pressure of your blood pushing against blood vessel walls. High blood pressure can harm various organs of your body, including your heart, kidneys and brain. It is the leading cause of stroke. Blood pressure is measured by two numbers:
■ Systolic (the top number): The pressure in your blood vessels when your heart pumps blood out.
■ Diastolic (the bottom number): The pressure in your blood vessels when your heart rests between beats.
Healthy Target: Less than 120/80 mmHg.
To find your BMI, divide your weight in kilograms by the square of your height in meters. While BMI is not a perfect measurement, it is a tool to determine your healthy weight range. “A high BMI increases the risk of heart disease, high blood pressure, type 2 diabetes and certain cancers,” Nishikawa said.
Healthy Target: BMI between 18.5 to 24.9. If you are of Asian descent, then 18.5 to 22.9.
Testing your blood sugar level helps to determine if your blood sugar is high or low. Fasting blood sugar level is the amount of glucose (sugar) in your blood after fasting for 8 to 12 hours. “Over time,
high blood sugar (hyperglycemia) can damage the blood vessels and nerves of your body. It can also lead to type 2 diabetes,” Nishikawa stressed.
Healthy Target: 99 mg/dL or lower.
Measuring your total cholesterol or fat content in your blood is important to know if you have any increased health risks. It’s determined by your total high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides in your blood.
“Excess cholesterol can build up in the walls of the arteries, leading to narrowing or blockages in your vessels, which then increases your risk of heart attack and stroke. Therefore, a good understanding of your cholesterol numbers can potentially be lifesaving in the long run,” Nishikawa explained.
Healthy Target: Total cholesterol of 200 mg/dL or lower.
As your health partner, your PCP can help you make a personalized plan to get back within a healthy range. “While some risk factors are out of your control, such as family history, age and sex, there’s still a lot you can do to get to a healthy range,” Nishikawa added.
Your PCP may suggest healthy lifestyle changes such as:
■ Checking and managing blood pressure
■ Eating healthy foods
■ Getting more exercise
■ Limiting alcohol
■ Quitting tobacco
“We can help you make a manageable plan to live a healthy life,” Nishikawa said. •
Houston Methodist Primary Care Group provides care that’s personalized to you and your unique needs. To make an appointment, visit houstonmethodist.org/pcg/ southwest or call 713.441.7965.
A gynecologist is an important partner who specializes in women’s health. They have expertise with issues that affect a woman’s reproductive system. Aliyya Childs, obstetrician-gynecologist at Houston Methodist Obstetrics and Gynecology Associates at Sugar Land, explained a few ways to know when it’s time to see your gynecologist:
1. ABNORMAL OR PAINFUL PERIODS
Whether it’s cramping, bleeding or something else, period symptoms never really feel “normal.” But when are they truly abnormal?
An abnormal period may look and feel like:
■ Bleeding that comes, unexpectedly, on other days or weeks
■ Bleeding that lasts longer than a week
■ Heavier-than-usual bleeding
■ Heavy cramping before and with the cycle
“If several periods in a row are significantly worse than usual, it could be a sign that something else is going on,” Childs explained.
2. IRREGULAR VAGINAL BLEEDING
Bleeding between periods isn’t always cause for alarm.
You may have spotting with each ovulation or missed a dose of your birth control pill. During the years leading into menopause, lots of women will have cycle irregularity.
“In particular, we take bleeding after menopause very seriously,” Childs noted. “Post-menopausal bleeding doesn’t always mean cancer, but it can — so we don’t take any chances.”
If you have pain in your pelvis during exercise or intercourse, it’s time to see a gynecologist. This can be a sign of an ovarian cyst. Other symptoms include feeling bloated in the abdomen, fever and vomiting.
“An ovarian cyst is a fluid-filled sac that can form in the ovaries,” Childs explained. “Many women will wait until the pain is severe enough to send them to the emergency room, where usually a CT scan or pelvic ultrasound will then show the presence of an ovarian cyst.”
“I often talk with my patients about symptoms that should be brought to my attention, including bleeding abnormalities or debilitating hot flashes,” Childs said. “If a cycle length becomes shorter than 21 days or bleeding lasts longer than seven days, we should evaluate that further.”
Ideally, a woman’s hormones are tested before consulting a gynecologist about perimenopause, so the appointment is dedicated to how best to manage the hormonal findings and most significant symptoms.
A mammogram or breast ultrasound can determine if breast pain or a lump is serious. Your gynecologist can evaluate you to learn how urgently you should get imaging.
“Most breast issues need follow-up evaluation by a radiologist,” Childs said, “but we can feel the lump and assess the pain to help you understand the next steps.”
Urinary tract infections (UTIs) are common in women, and your gynecologist is well-versed in helping manage this uncomfortable, annoying issue.
Your doctor can assess UTI symptoms and prescribe antibiotics over the phone. “But if you’ve taken your antibiotics and don’t feel like you are improving, that’s worthy of a trip to the clinic,” Childs added.
A well-woman exam may include a Pap test, breast exam and pelvic exam depending on your age, screening guidelines and risk factors.
“With HPV testing and vaccination, we don’t do a Pap smear every single year for every woman,” Childs said. “Sometimes every three or five years is sufficient and is determined based on your age and individual risk.” •
To schedule an appointment with Houston Methodist Obstetrics and Gynecology Associates at Sugar Land, visit houstonmethodist.org/ obgyn-sl or call 346.874.2060
At Houston Methodist Orthopedics & Sports Medicine, we know that joint pain affects every part of your life. With treatment plans customized for you, our specialists in Sugar Land offer a full range of advanced nonsurgical and surgical techniques. Our expert joint care includes:
• Innovative pain control methods
• Physical therapy to improve mobility and range of motion
• The latest technology, including minimally invasive surgical techniques that help reduce recovery time
Schedule an appointment: houstonmethodist.org/jointpain