Leading Medicine Fall 2015, Houston Methodist West Hospital edition

LEADING MEDICINE YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN WEST HOUSTON/KATY

FA LL 2015

BE A WISE GUY

Take action against these men’s health symptoms

WIN A KINDLE! Women: Test Your Breast Cancer Knowledge

SEE INSIDE FOR DETAILS.

Prostate Cancer: More Treatable When Found Early

From Fear to

Hope

Being diagnosed with any type of cancer is scary, but there is specialized treatment right here in our community

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eople are often shocked and disheartened when they first hear the word “cancer” — thinking of it as a death sentence. Women in particular hear stories about a loved one’s routine visit to her gynecologist that led to a late-stage, and often fatal, diagnosis of cancer.

Gynecologic cancers, including cervical, ovarian, uterine, breast and colorectal malignancies, often are treatable conditions. This is especially true when you undergo screenings for early detection or a host of effective treatments by leading doctors and state-of-the-art technology provided at Houston Methodist West Hospital.

“Early detection frequently is critical to effectively treat these cancers,” said Dr. Joshua Kilgore, a Houston Methodist West gynecologic oncologist.

“Get regular screenings and talk with your doctor about any family history of cancers.”

Doctors report that more women at higher cancer risk are seeking guidance

about reducing the possibility of getting the disease. After learning in 2012 that she carried the BRCA1 gene, which increases the risk for gynecologic cancers, actress Angelina Jolie had a double mastectomy. In 2014, a surgeon removed her ovaries and fallopian tubes. Jolie’s mother died of ovarian cancer; her aunt died of breast cancer.

“Researchers continue to investigate the role of genetics in gynecologic cancers,” Kilgore said. “More women will benefit from new technologies like diagnostic radiology, which can aid in early detection of precancerous and cancerous cells, as well as minimally invasive surgery and radiation oncology.”

If you’ve been diagnosed with cancer or are worried about symptoms, Houston Methodist West is the place to turn for the latest treatments, including minimally invasive surgery, state-ofthe-art chemotherapy and radiation therapy options, access to clinical trials, and the expertise to preserve a woman’s ability to have children. n

Join us Thursday, Oct. 29, from 4 to 7 p.m. for an open house. Call 832.522.5522 to register.

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Houston Methodist West doctors save the lives of numerous cancer patients through innovative treatments and compassionate care, while acknowledging that early detection is critical.

Follow these screening guidelines and learn more at houstonmethodist.org/west.

CERVICAL CANCER Ages 21–29 Annual pelvic

exam; Pap test every three years; HPV reflex testing 3 0–64 Annual pelvic exam; HPV and Pap test every five years or Pap test every three years 65+ Doctor directed; no screening if negative cancer history

BREAST CANCER Ages 29–39 Clinical breast

exam every three years 40–49 Mammogram annually after discussing with doctor 50+ Mammogram annually or biennially; BRCA mutation testing with doctor discretion for individuals at high risk

ENDOMETRIAL (UTERINE) CANCER Consult your doctor about your

risk and the appropriate type and frequency of screening.

OVARIAN CANCER Consult your doctor about your

risk and the appropriate type and frequency of screening.

COLON AND RECTAL CANCER A ges 20–49 Flexible sigmoidoscopy and colonoscopy exams at doctor discretion 50+ Flexible sigmoidoscopy every five years; colonoscopy every 10 years

PHOTO BY THINKSTOCK

Breast Care Center Open House

GET SCREENED …

SAVE YOUR LIFE

Test Your Breast Cancer Knowledge How well do you understand risks and prevention?

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ost of us know someone who has faced breast cancer, but many don’t understand what we can do to prevent the disease, diagnosed in one in eight American women. Take our quiz to see how much you know.

ANSWER: B. Annual breast exams at your doctor’s office and monthly breast self-exams can help identify lumps or changes in your breasts that could be signs of cancer.

While lying down, place a pillow under your right shoulder and your right arm behind your head. With your left hand, move the pads of your fingers around your right breast area and armpit, using circular motions.

Squeeze the nipple to check for discharge. Repeat for your left breast.

Standing in front of the mirror, look at your breasts with your arms at your sides and then raise your arms overhead.

steps can you take to 3What lower your risk of breast cancer?

Perform these checks monthly, looking for these signs: A lump in the breast Any unexplained change in breast size or shape Dimpling anywhere on the breast Nipple tenderness or discharge A nipple that is turned slightly inward or is inverted Skin that’s become scaly, red or swollen, or any change in skin texture

A. 60 B. 50 C. 40

ANSWER: C. These healthy behaviors can lower your risk. The other answers are myths.

These signs do not necessarily mean you have cancer, but you should see your doctor to discuss them.

ANSWER: C. Most women should have an annual mammogram starting at age 40. If you are at high risk, ask your doctor about starting sooner.

Inheriting harmful mutations 4 in the BRCA1 or BRCA2 gene is one of the main risk factors

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Most cases of breast cancer are diagnosed in women 50 and older. At what age should you start getting annual mammograms that can reveal breast cancer in the earliest stages?

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Are mammograms the only way to detect breast cancer at an early stage?

A. Yes B. No C. It depends on the woman’s age

A. D on’t use deodorant or antiperspirant.

B. A void wearing underwire bras.

C. M aintain a healthy weight and get regular exercise.

for breast cancer. Which of these other factors can also increase your risk?

A. F amily or personal history of breast cancer B. L ong-term use of hormone replacement therapy C. All of the above

Breast Care Center Is Moving

PHOTO BY THINKSTOCK

HOW TO PERFORM A BREAST SELF-EXAM

Our center is moving to provide you even greater service. Located on the first floor Medical Office Building 2, you’ll have designated parking, convenient evening and Saturday appointments and a second tomosynthesis unit for higheraccuracy readings—all in a beautiful, healing environment.

Schedule an appointment online at houstonmethodist.org/ online-scheduling or call 832.522.1234.

ANSWER: C. Other risk factors include dense breasts and having undergone treatment with radiation therapy to the breast and chest.

I have a test to find 5Should out whether I carry the BRCA1

or BRCA2 gene mutation that can cause breast cancer?

A. Yes B. No C. Maybe, if you have a strong family history of breast cancer ANSWER: C. A “strong family history” includes close relatives diagnosed before age 50, a family member with the gene mutations, or family members with multiple breast cancers, cancer in both breasts, or both breast and ovarian cancers. You should have counseling before deciding to have genetic testing. n

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

Spotting

Lung Cancer Insurance-covered screenings may detect the disease earlier

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f you’re a current or former smoker, you may be eligible for lung cancer screenings that Medicare and private insurance now cover.

Following a U.S. Preventive Services Task Force recommendation, insurers this year began covering annual low-dose computed tomography (CT) scans for certain patients.

“Lung cancer screening with CT scans allows for the detection of lung cancer at an earlier stage, when it is more treatable, and potentially curable,” said Dr. Phat Le, medical oncologist at Houston Methodist West. “As a result, the number of deaths from lung cancer can be reduced in certain highrisk patients.”

“We can detect lung cancer when it is small and long before it becomes symptomatic or spreads outside the lungs.”

Here are screening highlights to discuss with your doctor.

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WHO IS ELIGIBLE?

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WHAT DOES IT COST?

Lung cancer screening is covered by private insurance and Medicare for eligible patients.

Medicare requires providers to include smoking cessation counseling prior to the scan.

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WHAT HAPPENS DURING SCREENING?

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IS THE SCREENING RISKY?

An X-ray machine uses low-dose radiation scans and takes pictures of the lungs while patients lie on a table and hold their breath for a few seconds.

Potential risks include the cumulative effects of radiation exposure and results that are false positive (a finding that looks like cancer but is not) or false negative (in which cancer is present but not detected). Positive results can lead to additional tests, including imaging studies or more invasive procedures such as biopsy. n

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In addition to not smoking, you can do more to protect your lungs from cancer, asthma and other conditions.

Adopt these habits to keep your lungs healthy.

G et moving. Stay active to boost your lung strength.

Consider swimming, which requires rhythmic breathing, or yoga, which can improve respiratory function.

E at right. Dietitians say foods such as broccoli, cabbage, salmon and eggs support lung health.

G et a flu shot. Enhance the infection-fighting power of the flu shot by washing your hands often, and help others by covering your sneezes and coughs.

S trategize outdoor time.

Consider staying indoors when pollution and allergens are at higher levels. Check alerts by ZIP code at airnow.gov.

Are You at High Risk?

Find out if you are a candidate for the Lung Cancer Screening Program, which helps those at high risk for developing lung cancer receive a diagnosis at an early stage.

To schedule an appointment, call 832.522.5522.

PHOTO BY THINKSTOCK

For Medicare beneficiaries, it’s those ages 55 to 77 who currently smoke or have quit in the past 15 years; who have a tobacco smoking history of at least 30 “pack years” (an average of one pack a day for 30 years, two packs a day for 15 years, etc.); and who receive a written order from a doctor or qualified non-physician practitioner.

Under private insurers — which are required by the Affordable Care Act to cover lung cancer screenings — policyholders are eligible through age 80.

BREATHE RIGHT

A Primer on Prostate Cancer

Prostate cancer is one of the most common cancers, but it’s also one of the most treatable when detected early

O

ne of the important aspects of men’s health is awareness about prostate cancer, the second most common cancer among men in the United States. This year, approximately 30,000 American men will die from the disease, said Dr. Wesley Ekeruo, a urologist at Houston Methodist West. But when detected early, prostate cancer can be treated successfully. According to the American Cancer Society, the 10-year survival rate for the disease is 99 percent with appropriate treatment.

Here’s what you need to know about prostate cancer.

PHOTO BY THINKSTOCK

ABOUT THE PROSTATE The prostate, part of the male reproductive system, is a walnut-sized gland that rests below the bladder.

The purpose of the prostate is to produce seminal fluid that provides nutrients for the sperm.

RISK FACTORS • Age: Prostate cancer is most common in men older than 50, and the risk increases with age.

• Race: African-American men have a greater risk for prostate cancer.

• Obesity • Family history of prostate cancer

THE SYMPTOMS Prostate cancer usually grows slowly, often not causing signs or symptoms until it is more advanced. Symptoms may include: • Inability to pass urine • Difficulty starting or stopping the urine flow • Pain or burning during urination • Blood in your urine • Pain in the lower back, upper thighs or hips • Erectile dysfunction ELEVATED PSA LEVELS, EXPLAINED If you are a man older than 50, your urologist should conduct a prostatespecific antigen (PSA) test. PSA is an enzyme produced by prostate cells. An antigen is simply a protein that can be identified for a particular organ. A measurement of elevated PSA levels

Leading Care for Prostate Cancer

Houston Methodist West urologists are leaders in minimally invasive and robot-assisted surgery for prostate cancer. Our physician-researchers also lead more than two dozen clinical trials focused on prostate cancer. To learn more or find a urologist, visit houstonmethodist.org/ west or call 832.522.5522.

alerts the doctor to the possibility the patient may have prostate cancer.

TREATMENT OPTIONS For men diagnosed early, treatment may not be necessary immediately.

Active surveillance or regular follow-ups may be recommended.

Other treatment options include: • Radiation therapy • Hormone therapy • Surgery • Chemotherapy n

ADVANCED TECHNOLOGY FOR DIAGNOSING PROSTATE CANCER Houston Methodist West uses enhanced technology to detect and diagnose prostate cancer. MRI-ultrasound fusion decreases the number of biopsies needed to make a diagnosis, which allows for a more precise treatment plan.

By merging an MRI image onto an ultrasound image, the technology helps urologists see areas of the prostate that are suspected of being cancerous.

HOUSTONMETHODIST.ORG 5

Be a

Wise Guy Take action against these men’s health symptoms

G

uys, it’s not just the women in your life who frown on your tough-it-out approach to health problems.

Men are more likely than women to smoke and drink, make unhealthy choices, and avoid regular medical care, according to the National Institutes of Health.

The American Academy of Family Physicians reports that about a third of men don’t have a primary care doctor, and nearly 30 percent delay medical care as long as possible when they’re sick.

Many of the health risks men face can be prevented or treated successfully if identified early. But warning signs aren’t always obvious — and symptoms that seem minor can indicate a larger health problem. Here are five to take seriously:

SYMPTOM: SKIN CHANGES HEALTH RISK: SKIN CANCER

White men older than 50 are more than twice as likely as women to develop and die from skin cancer, the Skin Cancer Foundation says.

Yet nearly half of men said in a foundation survey that they hadn’t used sunscreen in the past 12 months, and 70 percent didn’t know skin cancer warning signs.

Red flags can be subtle and include new growths, spots, bumps and patches, plus slow-to-heal sores and shaving cuts. Remember this ABCDE guide when checking for skin cancer: • Asymmetry: Is one half of the mole shaped differently than the other?

• Border: Are the edges of the mole irregular, ragged or blurred?

• Color: Is the mole more than one color?

• Diameter: Is the spot larger than a pencil eraser?

• Evolving: Has the mole changed in shape, size or color?

SYMPTOM: LOWER LEG PAIN, POPPING OR SNAPPING NOISE HEALTH RISK: ACHILLES TENDON RUPTURE

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PHOTO BY THINKSTOCK

The Achilles tendon connects the calf muscle to the heel bone at the back of the leg. A tear or rupture occurs when the tendon is overly stretched, typically during sports involving jumping, pivoting or sudden accelerations.

See a doctor if you feel sudden pain in your lower leg or hear a pop or snap. Treatment, which may involve surgery, depends on the severity of the rupture.

SYMPTOM: BACK NUMBNESS, TINGLING HEALTH RISK: HERNIATED DISK, SPINAL STENOSIS

The spine is a superhighway that transports information from your brain to the rest of your body. Pay attention to the messages it sends.

Are you experiencing numbness or tingling? These may be signs of herniated disks or spinal stenosis, which share symptoms but have different causes.

Over time, the rubbery disks between the spine’s vertebrae may rupture, or herniate. The jelly-like center of the disk then leaks, irritating nearby nerves and sometimes causing persistent pain along the sciatic nerve from the lower back to the lower leg. Treatment may include rest, therapy or surgery.

Spinal stenosis is a narrowing of the open spaces inside the spine. The condition puts pressure on the nerves and spinal cord, sometimes resulting in pain or numbness in the neck, back, arms or legs as well as problems with bladder and bowel function. Treatment may include medication, physical therapy, braces or surgery.

SYMPTOM: SHORTNESS OF BREATH

HEALTH RISK: HEART ATTACK

Heart attacks don’t always announce themselves with sudden, intense pain or squeezing in the center of your chest.

Sometimes they masquerade as pneumonia, for example, or asthma, fatigue or chronic obstructive pulmonary disease (COPD).

Shortness of breath may be your only signal to call 911 for lifesaving emergency treatment.

Men — who are at greater risk for heart attack and at earlier ages than women — should be especially alert to the possibility if they smoke, are physically inactive or overweight, or have high cholesterol, high blood pressure or diabetes. Those factors increase heart attack risk.

SYMPTOM: URINARY CHANGES

HEALTH RISK: ENLARGED PROSTATE OR PROSTATE CANCER

Have you been going more frequently or urgently? Do you have trouble emptying your bladder? The prostate gland could be to blame.

Although the conditions sometimes share symptoms, an enlarged prostate does not necessarily signal prostate cancer, nor does it increase odds for developing the cancer. Both conditions are common in men starting at midlife.

The most common culprit for an enlarged prostate is benign prostatic hyperplasia (BPH), a condition in which abnormal cell growth causes the enlarged gland to press against the bladder and urethra.

See your doctor about troubling symptoms — immediately if you have bloody urine, pain or burning with urination or are unable to urinate.

Treatment options can be complex. For either problem, doctormonitored watchful waiting may be the initial response. n

AN OUNCE OF PREVENTION Even the healthiest men need regular screenings to ensure they stay at their best. Men should schedule a physical exam every two years until age 50 and annually after that, along with the following screenings: B LOOD PRESSURE: Every two years, more often if it’s high CHOLESTEROL, HEART DISEASE: Every five years after age 34, more often with high cholesterol or certain other conditions D IABETES: Every three years after age 45, earlier if you’re overweight COLORECTAL CANCER: Starting at age 50, earlier with inflammatory bowel disease, polyps or family history of colon cancer or polyps; frequency depends on test performed and your risk factors PROSTATE CANCER: Talk with your doctor starting at age 50 (45 if you’re African-American or have a family history of prostate cancer) L UNG CANCER: Yearly starting at age 55 if you have a 30 “packyear” smoking history and currently smoke or have quit within the past 15 years

Get Him to the Doctor

To find a doctor, visit doctors. houstonmethodist.org or call 832.522.5522.

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713.790.3333 713.790.3333

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HOSPITALS

Just around the corner Houston Methodist has locations throughout the Greater Houston area to best serve you near your home or workplace. Our locations include hospitals, and emergency care and imaging centers.

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5. Houston Methodist West Hospital

2. Houston Methodist San Jacinto Hospital

6. Houston Methodist Willowbrook Hospital

3. Houston Methodist St. John Hospital

7. Houston Methodist The Woodlands Hospital Opening in 2017

4. Houston Methodist Sugar Land Hospital

SPECIALTY HOSPITAL

HOSPITALS

8. Houston Methodist St. Catherine Hospital

SPECIALTY HOSPITALS EMERGENCY CARE CENTERS

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1. Houston Methodist Hospital

IMAGING CENTERS

EMERGENCY CARE CENTERS 713.441.ER24 (3724)

9. Houston Methodist Kirby Emergency Care Center 10. Houston Methodist Pearland Emergency Care Center

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11. Houston Methodist Sienna Plantation Emergency Care Center 12. Houston Methodist Voss Emergency Care Center

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13. Houston Methodist Cinco Ranch Emergency Care Center NOW OPEN! 14. Houston Methodist Cypress Emergency Care Center Opening in Fall 2015 15. Houston Methodist Spring Emergency Care Center Opening in 2016

IMAGING CENTERS 9. Houston Methodist Breast Care Center

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Taking care of the entire family With primary care physicians located throughout Greater Houston, Houston Methodist is dedicated to providing care for the entire family and proud to ensure efficient access to specialty and hospital services whenever the need arises.

To schedule an appointment, call 713.790.3333.

If you prefer not to receive future communication from Houston Methodist, please email optout@houstonmethodist.org or call 713.790.3333.

16. Houston Methodist Imaging Center

For more information about Houston Methodist or for a physician referral, please visit houstonmethodist.org or call 713.790.3333.

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