Leading Medicine Fall 2016, Houston Methodist The Woodlands Hospital edition

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THE BEST WAYS TO PROTECT YOURSELF FROM

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COMMON CANCERS

Finding Hope for Migraines What Your Joints Are Telling You

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN NORTH HOUSTON

MEET OUR NEW PHYSICIANS Dr. Laura Bonds Clinical Expertise Board certified in Neurology Professional Activity American Academy of Neurology American Headache Society Texas Neurological Society

When Pain Is a Real

HEADACHE Finding hope for migraines

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health disorder such as infection, hydrocephalus, hemorrhage or head injury.

“Among the many types of headaches, migraines are the most common,” Bonds said. “They can cause a throbbing sensation, nausea, and vision or sensory disturbances. They tend to run in families and are more common in women than in men.”

WHAT’S NEW IN MIGRAINE TREATMENT?

Bonds says there is hope for migraine patients beyond daily medication for preventive measures or pain medications. “Patients who suffer from intractable migraines — headaches 15 days of the month, four hours or more in duration — are having success with new Botox methods.”

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Dr. Andrew Marky Clinical Expertise Neurosurgery Professional Activity American Association of Neurological Dr. Andrew Marky Surgeons Congress of Neurological Surgeons North American Spine Society

• Botox injections are approved by the Food and Drug Administration for patients with intractable migraines and may reduce headache frequency by up to 50 percent. Botox is injected into the muscles over and between the eyebrows, in the forehead, both temples, back of the head, upper neck and both shoulders.

Bonds recommends an injection 12 weeks later to determine whether the treatment is promising for an individual who has migraines. n

Need Headache Relief?

Learn more about headache diagnosis and treatment at Houston Methodist The Woodlands Hospital. Call 713.790.3333 or visit houstonmethodist.org/appointments today.

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ou’re stressed, and you suddenly feel like a vise grip is tightening around the top of your head. Or your headaches occur with nausea, a change in your vision or increased sensitivity to light or sound. Maybe you are involved in a routine, non-stressful task when you’re struck by head or neck pain.

Sound familiar?

The National Institutes of Health reports that nearly two out of three children will have had a headache by age 15. More than nine in 10 adults experience headaches. Headache is the most common form of pain and a major reason cited for days missed from work or school and for visits to the doctor. Without proper treatment, headaches can be severe and interfere with daily activities.

Dr. Laura Bonds, a neurologist at Houston Methodist The Woodlands Hospital, says headaches fall within two main categories. Most are primary, not due to underlying disease conditions and often genetic. Migraines are the most common, while others are cluster and tension headaches. Secondary headaches are symptoms of another

Dr. Laura Bonds

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

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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, about 30,000 American men will die from the disease, says Dr. Brian Miles, a urologist at Houston Methodist Hospital. 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.

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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 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

Leading Care for Prostate Cancer

Houston Methodist 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 or call 713.790.3333.

can be identified for a particular organ. A measurement of elevated PSA levels alerts the physician or urologist 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 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 thought to be possibly cancerous.

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BEST WAYS to protect yourself from

5

COMMON CANCERS

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

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.

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BREAST CANCER

PROTECTION STRATEGY

Lose weight Body weight plays a role in several types of cancer, including breast 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 affect 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.

OTHER IMPORTANT STEPS TO TAKE:

Houston Methodist recommends women get annual mammograms beginning at age 40. At 55, women can get them every two years if they are not at high risk. “If hormone therapy is necessary for treating symptoms of perimenopause, take the smallest dose for the shortest amount of time,” said Dr. Loren Rourke, FACS, breast surgical oncologist and Houston Methodist regional breast care program director.

PROSTATE CANCER

PROTECTION STRATEGY

Eat a heart-healthy diet Although researchers don’t quite 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,” said Dr. Suzanne Stovall, family medicine, Houston Methodist Primary Care Group. The Prostate Cancer Foundation recommends not

taking any supplements that include calcium and aiming to consume less than 1,500 milligrams per day. Men at average risk for prostate cancer should talk to their doctor at age 50 about screenings. Men at increased risk should have this discussion sooner.

five-year colon cancer survival rate is 90 percent, and that’s largely because of early detection,” said Dr. Diego C. Marines, colon and rectal surgeon at Houston Methodist The Woodlands Hospital. If you’re 50 or older, talk to your doctor about getting screened.

LUNG CANCER

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. Limit alcohol use and avoid smoking.

PROTECTION STRATEGY

Don’t smoke Almost everyone has heard a story of someone who’s had lung cancer who never smoked.

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. “But it’s really never too late to cut your risk,” said Dr. Mary K. Henson, family medicine, Houston Methodist Primary Care Group. Talk to your doctor about effective ways to quit.

OTHER IMPORTANT STEPS TO TAKE

SKIN CANCER

PROTECTION STRATEGY

COLON CANCER

Be sun safe Sun damage is the No. 1 cause of skin cancer, with about 90 percent of nonmelanoma skin cancers 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 15 or higher can reduce the risk of developing melanoma by as much as 50 percent.

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

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,” said Dr. Adrienne L. Blessing, family medicine, Houston Methodist Primary Care Group. n

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.

PROTECTION STRATEGY

OTHER IMPORTANT STEPS TO TAKE

Our Breast Care Center Is Now Open To schedule a mammogram, visit houstonmethodist.org/appointments or call 936.270.3600.

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

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 controlling jaw movement, sometimes accompany fibromyalgia.

The jaw’s temporomandibular joints

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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 as if it’s 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 blacklegged tick. Pain can shift, and other symptoms may include fever, headache, fatigue and skin rash. n

Need a Specialist?

We Can Help General orthopedics and sports medicine Carpal tunnel syndrome Hand and upper extremity surgery Joint replacement Shoulder, elbow, wrist, knee and ankle arthroscopy Neck and spine surgery To learn more, visit houstonmethodist.org/orthopedics or call 281.737.0999 to schedule an appointment.

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If your joints could talk, you’d get an earful.

Instead, they pop, they creak, they crackle. They just plain ache.

And you could Dr. Eric Price use a translator.

With hundreds of joints in the human body, deciphering their messages can be challenging, says Dr. Eric Price, who is board certified in orthopedic surgery and fellowship trained in sports medicine and joint replacement surgery at Houston Methodist The Woodlands Hospital.

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

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.

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

A SPORTING

CHANCE

Get your student-athlete ready for success with a comprehensive physical

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ost students may never reach professional athlete status, but they deserve all-star treatment nonetheless.

This starts with paying attention to youth athletes’ health even before their first team practice.

A two-part, preparticipation process — completing a medical history and undergoing a physical exam — can identify potential health issues, point to simple adjustments and, of course, make mom and dad rest a bit easier.

“Don’t dismiss the medical history as another annoying form to fill out,” said Dr. John Seaberg, a sports medicine orthopedist at Houston Methodist Orthopedics & Sports Medicine.

“Instead, think of it as one more way to protect your kids, just like you did when they were little and you buckled them into their car seat,” Seaberg suggested. In Texas, the University Interscholastic League requires an annual medical history and physical exam before student-athletes can participate in sports.

Students and parents fill out the medical history together. This is information doctors don’t want to get wrong. They use the history in concert with the physical exam to assess a potential team member’s risk of having a heart condition, for example, or to note medications used for allergies.

“This health history can help us diagnose many medical or musculoskeletal problems that, if not spotted and managed, could compromise a student’s well-being on the field or on the court,” said Seaberg.

Houston Methodist Orthopedics & Sports Medicine provides physical exams that include checks of students’

height, weight, vision, blood pressure, pulse, ears, nose, throat, heart, lungs, abdomen, spine and joints in the upper and lower body.

During the exams, medical profes­ sionals might ask how a student deals with asthma and can offer suggestions for better management of the condition while playing sports. They could spot a curvature of the spine or elevated blood pressure or even suggest that a student with mild knee pain wear running shoes with greater support.

As needed, the medical team consults with parents and refers students to specialists.

In many intramural sports, injuries are inevitable. In 2009, the Agency for Healthcare Research and Quality said that among kids ages 5 to 17, sports activity caused 22 percent of injury-related visits to hospital emergency departments.

More than 98 percent were superficial “treat-and-release” injuries, the agency found. The remainder ranged from fractures to traumatic brain injuries.

But with proper attention, most student athletes will find that benefits derived from sports — from lower rates of obesity and diabetes to better academic and career performance — outweigh the risks, says Seaberg.

For details on upcoming physicals, visit houstonmethodist.org/ orthopedics or call 281.737.0999.

Print the UIL medical history (uiltexas.org/files/athletics/forms/ PrePhysForm15.pdf) and bring it to the physical. n

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MORE QUESTIONS? Female athletes will hear a few more questions than their male counterparts when they receive a student physical.

The questions are prompted by growing awareness of a syndrome known as the female athlete triad, any of three harmful effects women athletes may encounter when they train or diet too zealously. The triad’s conditions are: 1. Disordered eating. Low calorie intake, gimmicky diets or excessive exercise deprive the body of needed nutrients.

2. Amenorrhea (menstrual dysfunction). Too much exercise and not enough nutritious food may lower levels of the hormones that regulate periods.

3. Osteoporosis (weakened bones). Disrupted periods and poor nutrition interfere with the body’s bone-building processes.

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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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HOSPITALS . Houston Methodist Hospital

5. Houston Methodist West Hospital

2. Houston Methodist San Jacinto Hospital

6. Houston Methodist Willowbrook Hospital

3. Houston Methodist St. John Hospital

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. Houston Methodist Sugar Land Hospital

SPECIALTY HOSPITAL . Houston Methodist St. Catherine Hospital

EMERGENCY CARE CENTERS 713.441.ER24 (3724)

. Houston Methodist Kirby Emergency Care Center 0. Houston Methodist Pearland Emergency Care Center . Houston Methodist Sienna Plantation Emergency Care Center 2. Houston Methodist Voss Emergency Care Center

3. Houston Methodist Cinco Ranch Emergency Care Center . Houston Methodist Cypress Emergency Care Center 5. Houston Methodist Spring Emergency Care Center

IMAGING CENTERS 7. Houston Methodist Breast Care Center at The Woodlands

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

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