Leading Medicine Fall 2016, Houston Methodist Clear Lake Hospital edition

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THE BEST WAYS TO PROTECT YOURSELF FROM

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COMMON CANCERS

Pregnant and Over 35?

What Your Joints Are Telling You

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE BAY AREA AND SOUTHEAST HOUSTON

YOU CAN’T GET PREGNANT

AFTER 35 And other misconceptions about conceiving later in life Whether you were climbing the corporate ladder, unsure if you wanted kids or were simply waiting for the right time, you’ve found yourself wanting to conceive after 35.

Dr. Asia Mohsin Unfortunately, a Google search on the topic has left you stressed and confused even before you’ve had a chance to fantasize about baby names. It’s true that there are some challenges that come with putting off pregnancy, but a lot of what you’ll read is not just inflammatory but flat out untrue.

“All women have a biological clock to contend with, but first pregnancy after age 35 is highly possible,” said Dr. Asia Mohsin, obstetrician-gynecologist at Houston Methodist St. John Hospital.

“Yes, it may take more time and effort — sometimes more than six months. However, I’ve assisted many of my patients with achieving healthy pregnancies after age 35.”

Here are three common miscon­cep­ tions about pregnancy after 35, and what’s true.

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MISCONCEPTION: Conceiving after 35 means you’ll likely have a baby with Down syndrome.

TRUTH: The risks of having a baby born with Down syndrome do increase with age, but the chances are still pretty low throughout the 30s.

“Many people are surprised to learn that most babies with Down syndrome are born to women younger than 35,” Mohsin said. “At age 30, the risk is one in 1,000. At age 35, it’s about one in 400.”

MISCONCEPTION: There is nothing a woman can do to affect her fertility.

TRUTH: Women can increase their chances of getting pregnant and having healthy pregnancies by scheduling a preconception physical, eating a healthy diet, being moderately physically active, maintaining a healthy weight, taking folic acid, avoiding smoking and drinking, reducing stress and seeing their doctors for routine prenatal visits. Egg-freezing is also an option.

“The American Society of Reproductive Medicine has shown that success rates with egg vitrification were equal to embryo vitrification,” Mohsin said. “This allows for elective egg freezing for women who plan to start a family later in life.” n

SAFE DELIVERY Because the risk for pregnancy complications rises with age, women who conceive after 35 are encouraged to deliver at a medical center that specializes in high-risk births. Houston Methodist Childbirth Center at St. John Hospital has the only level II neonatal intensive care unit in the Bay Area staffed by Texas Children’s Hospital neonatologists. You are welcome to tour the Childbirth Center.

Tours are scheduled twice monthly, at 4:30 p.m., or at your convenience.

Visit houstonmethodist.org/ events or call 281.523.BABY (2229) to register. For more information, please call 281.523.2020.

PHOTO BY THINKSTOCK

MISCONCEPTION: Women can’t conceive naturally after 35.

TRUTH: The 20s may be a woman’s most fertile decade, but that doesn’t mean she won’t be able to conceive after that.

“A woman’s fertility is still fairly high in her late 30s,” Mohsin said. “Real reductions come only after 40. The

study conducted by Duke University concluded that women who had sex twice a week became pregnant naturally within a year.”

Weight Loss Surgery Works Patients return to a healthy lifestyle

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ot long ago, physical therapist Nicole Bentley suffered from high blood pressure, high cholesterol, unbalanced hormones, reflux disease and pain in her feet, hips and back — all the result of excess weight.

“I was very athletic when I was younger, but I had gotten so heavy I could not even demonstrate many of the exercises I would recommend to my patients,” she said.

That all changed with a visit to boardcertified surgeon Dr. Kyle Stephens, a Houston Methodist St. John Hospital physician who specializes in weight loss surgery. Six months after her procedure, Bentley is 110 pounds lighter; her blood pressure, cholesterol and hormones have normalized; and the reflux and orthopedic pain she suffered are gone.

“Thanks to Dr. Stephens, I’ve got a whole new lease on life,” Bentley said.

Stephens uses minimally invasive surgical techniques to perform gastric sleeve and gastric bypass procedures.

Because there is no major incision, patients have less pain after surgery and recover more quickly.

“These procedures restrict food intake and limit calorie absorption, which help patients lose weight quickly and keep it off,” said Stephens.

“The end result is that patients’ overall health improves dramatically, and many find they no longer need medications for serious risks such

Nicole Bentley, before (above) and after (below) weight loss surgery.

as diabetes, high blood pressure or high cholesterol.”

Stephens’ program at Houston Methodist St. John Hospital includes pre- and post-surgery education on nutrition and exercise and a post-surgery support group to help patients maintain a healthy lifestyle.

“I couldn’t have asked for a better experience,” said Bentley. “Dr. Stephens and his staff made me feel comfortable right from the beginning and they helped me through every stage in the process. I would recommend Dr. Stephens to anyone who has health issues due to weight.” n

IS WEIGHT LOSS SURGERY RIGHT FOR YOU? Join board-certified surgeon Dr. Kyle Stephens for informative sessions on the benefits of minimally invasive weight loss surgery. Sessions are offered midday and evenings every two weeks, year-round. Upcoming event dates are Aug. 3, 17, 31 and Sept. 14, 28.

Stephens will explain how weight loss surgery can help patients regain control and reverse many of the most serious impacts of obesity. The session will be held from 5:30 to 6:30 p.m. in the Administration Boardroom at Houston Methodist St. John Hospital, 18300 St. John Drive in Nassau Bay. The seminar is free, but registration is required. To register, visit houstonmethodist.org/events or call 281.333.8899.

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THE

BEST WAYS to protect yourself from

5

COMMON CANCERS

I

t seems every time you check your email there’s another story or news alert about some household item or behavior that causes cancer.

“It can be challenging to determine which choices are the healthiest,” said Dr. Larry Watson, a surgeon with Houston Methodist St. John Hospital.

“There is conflicting data, so it’s important to do your research and decide what’s best for you.”

To help separate the signal from the noise, we’ve compiled the most important steps you should take to reduce your risk for developing the five most common types of cancer.

BREAST CANCER

PROTECTION STRATEGY

Get your mammogram Screening is important for detection of breast cancer. Mammograms can detect most breast cancers before symptoms occur.

PHOTO BY ISTOCK

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Houston Methodist recommends a yearly mammogram starting at age 40 for those who are at average risk. For those who are at higher risk due to a family history of breast cancer or from a personal history of other types of breast disease, screening may include additional or more frequent testing.

OTHER IMPORTANT STEPS TO TAKE

Steps you can take to help reduce your risk of breast cancer include making lifestyle changes that will improve your overall wellness. Body weight has been found to play a role in several types of cancer. In fact, the World Cancer Research Fund estimates one in five cancer deaths is related to excess body weight. Being overweight doesn’t seem to have an effect on breast cancer in premenopausal women, but it has been linked to an increased risk of breast cancer in women after menopause, according to the American Cancer Society.

PROSTATE CANCER

PROTECTION STRATEGY

Eat a heart-healthy diet Although researchers don’t yet understand why, diet seems to play an important role in prostate cancer. Some experts have estimated that eating a healthy diet could reduce the risk of prostate cancer by up to 30 to 50 percent, according to AARP. Past studies have shown that certain foods such as cruciferous vegetables and tomatoes may offer some protection against prostate cancer, but the American Cancer Society simply recommends eating a low-fat diet similar to the DASH diet for heart health.

OTHER IMPORTANT STEPS TO TAKE

“There is some evidence that too much calcium may play a role in prostate cancer,” Watson said. The Prostate Cancer Foundation recommends not taking any supplements that include calcium and aiming to get less than 1,500 mg per day.

Prostate cancer screenings are also very important. Screenings include a rectal examination and a lab test called prostate specific antigen or PSA. Men with an average risk for prostate

cancer should talk to their doctor at age 50 about screenings. For men with increased risk, they should have this conversation earlier.

LUNG CANCER

PROTECTION STRATEGY

Don’t smoke Almost everyone has heard a story of someone who’s had lung cancer and never smoked a day in their life. But the reality is 90 percent of lung cancers can be attributed to smoking, according to the Centers for Disease Control and Prevention. Smokers and former smokers are 15 to 30 times more likely to develop lung cancer than nonsmokers. “You are never too old to quit smoking and reduce your risk,” Watson said. “Talk to your doctor about effective ways to quit.”

According to the American Cancer Society, screening for lung cancer with a low-dose CT scan is recommended for relatively healthy people 55 to 74 years old who have at least a 30-pack-year smoking history and currently smoke or who have quit in the last 15 years.

OTHER IMPORTANT STEPS TO TAKE

Not smoking isn’t always enough.

Secondhand smoke leads to nearly 3,000 lung cancer-related deaths per year, according to the National Cancer Institute. Also avoid carcinogens at work and test your home for radon.

COLON CANCER

PROTECTION STRATEGY

Get your colonoscopy Most colorectal cancers start out as polyps — small growths — inside the colon. During a colonoscopy, a screening test for colon cancer, doctors can actually remove polyps before they turn cancerous.

Today’s five-year colon cancer survival rate is 90 percent, and that’s largely because of early detection. If you’re 50 or older, talk to your doctor about getting screened.

OTHER IMPORTANT STEPS TO TAKE

Talk to your doctor about starting a low-dose aspirin regimen, which has

been found to reduce the risk of colon cancer by up to 40 percent, according to the American Cancer Society. Also, adjust your diet by eating more fruits and vegetables while also limiting red and processed meats. Limit your alcohol consumption and avoid smoking.

SKIN CANCER

PROTECTION STRATEGY

Be sun safe Sun damage is the No. 1 cause of skin cancer, with about 90 percent of nonmelanoma skin cancers being attributed to ultraviolet radiation exposure, according to the Skin Cancer Foundation. Avoid the sun during peak hours of the day (between 10 a.m. and 4 p.m.) and wear protective clothing, including long-sleeve shirts, long pants, a widebrimmed hat, and sunglasses when outside. And don’t forget to apply sunscreen every day. Daily use of SPF 30 or higher can reduce the risk of developing melanoma by as much as 50 percent.

OTHER IMPORTANT STEPS TO TAKE

Check your skin monthly for new or changing moles and have your doctor perform a skin check annually. “And of course, stay away from tanning beds,” Watson said. n

MAMMOGRAMS ARE A MUST Early intervention is key to effective breast cancer treatment. Meet our dedicated breast radiologist and learn more about how mammograms save lives at our free women’s event at Houston Methodist St. John Hospital from 5:30 to 7 p.m. on Wednesday, Oct. 5. Registration is required at houstonmethodist.org/events or call 281.333.8899. You can schedule your mammogram online at houstonmethodist.org/onlinescheduling or call 281.333.8858.

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What Your Joints Are Telling You Joint pain is common — but what’s causing it?

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ARTHRITIS

For pain in the hands, knees, hips and spine, osteoarthritis is a possible culprit. Weight-bearing joints are most commonly affected by this wearand-tear arthritis, but others can fall prey, too. You might hear creaking or grinding, experience worse pain in the morning and notice stiffness or swelling in the affected joint.

Also consider autoimmune diseases: Rheumatoid arthritis affects multiple joints, usually the same ones on both sides of the body and often in the hands, wrists, feet, ankles and knees.

Psoriatic arthritis is characterized by joint pain, stiffness and swelling in the fingertips, spine and elsewhere.

Lupus is known as “the great imitator” because symptoms often

resemble those of rheumatoid arthritis, fibromyalgia, Lyme disease and other conditions. Signs include pain, stiffness and swelling in foot, leg and hand joints.

BURSITIS

Pain in the shoulder, elbow, hip or other joints that perform repetitive motions may point to bursitis. Knees and toes also are targets.

FIBROMYALGIA

This can be tough to identify, because it’s characterized by generalized, widespread, sometimes intermittent body pain, especially in the arms and legs. Pain occurs on both sides of the body, above and below the waist.

Temporomandibular joint disorders, which cause pain in joints and muscles

PHOTO BY ISTOCK

If your joints could talk, you’d get an earful. Instead they pop, they creak, and they crackle. They just plain ache. And you could use a translator.

With hundreds of Dr. Kenneth joints in the human Brooks body, deciphering their messages can be challenging, says Dr. Kenneth Brooks, a fellowshiptrained orthopedic surgeon.

“Unlocking the mystery is worth the effort, though,” Brooks said. “Early diagnosis and treatment can help prevent, minimize or delay joint damage and pain and enhance quality of life.”

Here’s a guide to common ailments for which joint pain can be a symptom.

JOINT PAIN BY THE NUMBERS More than 63 million adults, or 26.3 percent of the population, suffer from chronic joint pain, according to a 2014 report from the U.S. Bone and Joint Initiative.

Knee pain is the most common, at 16.7 percent, followed by pain in the shoulder (7.8 percent) and hip (6.4 percent). Fingers, ankles, wrists, elbows and toes are other common targets.

CONSIDERING JOINT REPLACEMENT? Meet Dr. Kenneth Brooks, orthopedic surgeon and joint replacement specialist, and learn more about joint replacement surgery and the Orthopedics & Sports Medicine joint rehabilitation program at Houston Methodist St. John Hospital. Register for this free event at houstonmethodist. org/events or call 281.333.8899.

IS JOINT REPLACEMENT YOUR BEST OPTION? We break down the top four signs it might be time for a joint replacement Aches and pains are just a part of getting older, right? Not necessarily.

For many adults, joint pain can be a thing of the past thanks to joint replacement surgery. Read on to find out if it’s time to talk to your doctor about upgrading your joints.

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controlling jaw movement, sometimes accompany fibromyalgia. The jaw’s temporomandibular joints work together and are humans’ most used joints.

GOUT

If pain in your big toe wakes you, gout is a likely suspect. The joint may be so hot and swollen that it feels on fire.

Pseudogout, however, usually causes painful swelling in the knee or other joints. It’s a form of arthritis.

LYME DISEASE

Severe pain and swelling in the knees or other joints may be your first hints of this disease. It’s transmitted through the bite of an infected black-legged tick. Pain can shift, and other symptoms may include fever, headache, fatigue and skin rash. n

Your joint pain has started affecting your quality of life.

When the pain in your knee, hip or shoulder becomes so bad that it limits everyday activities like walking, bending, climbing stairs and getting in and out of a chair, it could be time to seek a surgical solution.

Also, if the pain continues even when you’re resting or sitting down, or wakes you up at night, go ahead and call in the pros.

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You’ve tried other treatments but nothing seems to help.

Ibuprofen can only do so much. The same goes for prescription medications, cortisone injections and physical therapy. For some people, these treatments can delay joint replacement, but for others, they just don’t cut it when it comes to relieving the pain of osteoarthritis.

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You’ve lost the weight, but you’re still in pain.

Every extra pound you carry around puts an extra four pounds of pressure on your knees, so it’s a no-brainer that losing excess weight can ease joint pain. But if you find that you’re still suffering, it may be time to consider surgery.

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You’re ready to make a few changes.

To get the most out of joint replacement, you’ll need to put in work after the operation. Doing physical therapy, maintaining a healthy weight and getting daily exercise will help keep your new joint working well for years to come.

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