Healthy Living Summer 2017

HEALTHYliving SUMMER 2017

WASHINGTON DAILY NEWS

CANCER everything you should know to prevent and fight

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Does everything you eat cause you pain?

It could be your gallbladder.

Do you suffer from pain in the upper right or upper middle part of your stomach after eating? Have you been told that you have gallstones or should have your gallbladder removed? If you answered “yes” to either of these questions, then you owe it to yourself to schedule an appointment or get help. Larry Watson, M.D., Vincent Iannace, M.D., and Cameron Martin, PA-C, are dedicated to providing individualized care for the relief you need, including the use of minimally invasive techniques.

Call 252-809-6350 today to schedule an appointment, and we will coordinate with your primary care physician.

Vincent Iannace, M.D. General Surgeon

Larry Watson, M.D. General Surgeon

Cameron Martin, PA-C Certified Physician Assistant

310 S. McCaskey Road • Williamston, NC (3rd Floor of Martin General Hospital)

Members of the Medical Staff at Martin General Hospital.

Patient results may vary. Consult your physician about the benefits and risks of any surgical procedure or treatment.

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PUBLISHER

HEALTHYliving WASHINGTON DAILY NEWS

Ashley Vansant EDITORIAL

IS 40 THE NEW 50?

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Vail Stewart Rumley Caroline Hudson CONTRIBUTORS

Dr. Michael Crawford Dr. John Inzerillo Dr. Robert McLaurin Dr. Thomas Ruffolo Pam Shadle ADVERTISING DIRECTOR

David D. Singleton

GUIDELINES FOR EARLY DETECTION IN SMOKERS

WE ARE CURING CANCER — SPREAD THE WORD

MARKETING & SALES

Thomas Hall Cecilia Prokos Spencer Stanley Amy Whitaker DISTRIBUTION

Sylvester Rogers

SHEPARD CANCER FOUNDATION

BEAT CANCER BEFORE IT STARTS

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ART DIRECTION

Elizabeth Reed

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NEW THOUGHTS ON SKIN CANCER

P.O. Box 1788 Washington, NC 27889 ADVERTISING INQUIRIES

252-946-2144 HEALTHYliving is published four times a year by Washington Newsmedia, LLC. Copyright 2015 Washington Newsmedia, LLC

EVERYTHING YOU NEED TO KNOW ABOUT PROSTATE CANCER SCREENING

MEDICAL AND HEALTH DIRECTORY

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IS 40 THE NEW 50?

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or years, we’ve attention. been promoting The explanation for the need for regthese “younger” cancers ular colon cancer is not known. Some have screening. suggested it is related By now most people to poor dietary habits, already know that: including consuming •Colon cancer screening a lot of red meats and saves lives. processed foods (think • Early detection is the fast foods and ready-tobest prevention. eat frozen foods). Lack of DR. THOMAS RUFFOLO • Men and women are adequate fruits, vegetables equally at risk for colon cancer. and nuts in the diet may • Worrisome symptoms should not be important, too. Other theories be ignored. suggest that the bacteria and immune • Everyone needs to have a colonoscopy system in the colon of younger adults or other screening at age 50. have not been appropriately stimulated So, what’s new? during childhood. This may be a Well, the recommendations may be result of living in a highly developed changing. I’ll explain why. country where kids play in “sterile” Colon cancer has generally been environments and not in the “dirt.” a disease of middle to older age Research is looking into all these areas. individuals. Historically, 93 percent of Obviously, these are critical issues to colon cancers occurred in individuals resolve.

50 or older. Of the colon cancers It is important to realize that a developing in people younger than 50, delay in diagnosis was common the majority were felt to be genetically among young colon cancer patients. linked (occurring in people with a Many say that a cancer diagnosis was strong family history of colon cancer) never considered because they were or were part of hereditary cancer so young (and perhaps did not have a syndrome. worrisome family history). Many felt Recent data is showing that colon that their symptoms were ignored, or cancer is becoming more and more they were misdiagnosed. a disease of younger adults — many These are unfortunate situations and less than 50 years old. Now, 10 percent that is why discussing this topic is so of colon cancers are being detected in important. Patients, young and old, are younger adults. Often these cancers encouraged to speak up if something are discovered at a later stage when doesn’t feel right about their body. the disease has already advanced. Everyone should know their family This is alarming and deserves greater history and know the warning signs

and symptoms of colon cancer. Don’t ignore rectal bleeding or blood in the stool. Find out why you have recurring abdominal pain, a change in bowel habits, unexplained weight loss or chronic fatigue. The answer may not be colon cancer (and hopefully not), but until it is evaluated and explained, you just don’t know for sure.

Guidelines for colon cancer screening currently suggest that it be done at age 50 for low-risk patients, and 45 for African-Americans. This may change as more is learned about these “younger” cancer patients.

There are many ways to get screened for colon cancers. Colonoscopy remains the “gold standard” as it is the only test to identify and remove the pre-cancerous growths. It also has the highest sensitivity for finding the polyps and tumors. This means with a colonoscopy you are not likely to miss as many growths in the colon as occur in all the other screening tests.

Beyond screening, everyone can lower cancer risk by maintaining a healthy weight, eating a balanced diet and avoiding the use of tobacco and excessive alcohol.

Let me close by saying: Fear the disease, not the screening. Talk to your doctor or provider about your risk factors. Colon cancer is one of the few preventable cancers, and that’s reason enough to schedule your evaluation.

T h o m a s R u f f o l o, M D, i s a gastr oenter ologist with Vidant Gastroenterology-Washington.

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Guidelines for early detection of lung cancer in smokers

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emember the old adage, “an ounce of prevention is worth a pound of cure?”

When it comes to cancer screening, we are headed in the direction of catching lung cancers earlier, giving smokers some hope. An estimated 45.3 million people, or 19.3 percent of all adults in the United States, smoke cigarettes. Cigarette smoking is more common among DR. JOHN men (21.5 INZERILLO percent) than women (17.3 percent). By region, in 2010, smoking prevalence was highest in the Midwest (21.8 percent) and South (21 percent) and lowest in the West (15.9 percent).

Cigarette smoking is the leading cause of preventable death in the United States, accounting for approximately 443,000 deaths, or 1 of every 5 deaths, in the United States each year. In the past few years, there has been increasing controversy as to whether continued smoking is due to nicotine addiction or the result of habitual behavior. We know that “never smokers” have the least risk of developing lung cancer. So, if you do not smoke, count your blessings.

For current smokers who fall into high-risk groups, it is now recommended that they undergo a

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special CT scan to look for signs of early lung cancer. These CT scans use lower doses of radiation to look for cancer cells. A lung cancer screening trial studied people aged 55 years to 74 years who had smoked at least one pack of cigarettes per day for 30 years or more (referred to as “30 pack years”). Heavy smokers who had quit smoking within the past 15 years were also studied. The trial used chest x-rays or low-dose CT scans to check for signs of lung cancer.

The CT scans were better than chest x-rays at finding early lung cancer.

Screening with LDCT also decreased the risk of dying from lung cancer in current and former heavy smokers.

The risk of dying from lung cancer was decreased by 20 percent in those screened using CT scans.

What are the benefits of being screened for lung cancer? The main benefit of screening is that it helps doctors find cancer early. In these cases, it should be easier to treat, and treatment may lower your chances of dying from lung cancer.

What are the drawbacks to being screened for lung cancer? The drawbacks include false positive results. This means that on the CT scan, it looks like there is cancer when in reality there is no cancer but maybe only inflammation. This can lead to more tests and anxiety about the results. More tests may mean more radiation, and this may lead to a need for a biopsy of the lung. A lung biopsy is a procedure to remove a small sample of lung tissue. This procedure

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can be painful and lead to problems such as bleeding or a collapsed lung.

Another drawback of lung cancer screening is that it exposes you to more radiation. All x-rays, including CT scans, expose you to some radiation. Although the radiation dose from the first screening CT scan is low, you would need to have a scan every year, so your exposure would add up. Plus, if you have an abnormal low-dose CT, you could end up having full-dose CT scans. Increasing doses of radiation from scans being done on a regular basis may lead to increasing your chances of developing certain cancers such as breast cancer.

Of note, exposure to secondhand smoke was not a risk factor that would warrant CT screening. For previous

smokers, those who had quit within the past 15 years or those with a 20 pack-year history (that is, a person who smoked one pack a day for 20 years, or who has smoked two packs a day for 10 years), with an additional risk factor (like diabetes, congestive heart failure or emphysema) could be screened.

If you or a family member are at risk for lung cancer, speak to your doctor about the risks and benefits of being screened. It would be helpful to have this or a similar article with you at the time of your discussion. Do not be timid about asking these important questions.

John Inzerillo, MD, is an oncologist at the Marion L. Shepard Cancer Center, a department of Vidant Beaufort Hospital.

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We are curing cancer­— spread the word!

We have the technology. Now we need to get the message out that early detection saves lives. Doing so is the most promising pathway to saving even more lives.

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ecades ago, a diagno- fancy name for the machine that treats sis of cancer was most cancer patients). likely a death sentence.

These patients were suffering from These days, a rare form of lymphoma most of the people diagthat causes relentless nosed with cancer are itching of the skin over cured. Success in the fight the whole body. The new against cancer has been treatment proved to be nothing short of amazing. very successful, and many Almost 40 years ago, I patients were relieved of was a young college student their misery! majoring in physics at At that moment, I Emory University. I was decided to devote my fascinated by the scientific life to try to harness the aspects of nuclear power power of technology to DR. ROBERT MCLAURIN and rocket propulsion, but help cure cancer. I have I wanted to do something had the extreme good with my life that would benefit people fortune to be involved in the cutting in a more tangible way. edge of innovation in radiation My advisor introduced me to oncology for the past 40 years. Today, radiation oncology. I was able to get we have new equipment that routinely involved with a research project at the does things we could only imagine of university hospital. The research team before. was using a new type of radiationmeasuring device to check the accuracy Success story As the science has steadily advanced, of the dose to the skin of patients while they were getting treatment from the cure rate has steadily improved.

Forty years ago, the cure rate for a new type of linear accelerator (the

cancer was barely 25 percent, or 1 out of 4. Tremendous progress has been made in cancer care since then.

In fact, we have been able to achieve a complete reversal of fortune. The five-year relative survival of a patient diagnosed with cancer in 2015 was about 75 percent, or 3 out of 4!

And there is no reason to believe that progress will come to a halt any time soon. It is likely that progress will follow roughly the same trajectory in the next decade as it did in previous decades. As we strive to design the system of cancer care that will meet the needs of our communities into the future, and endeavor to identify the best ways to invest our resources, we must recognize that the five-year survival rate in the year 2020 is likely to be 80 percent, or 4 out of 5!

Progress necessitates adjusting priorities In this context, it is no longer sufficient to think about cancer treatment in terms of survival alone.

The old approach of “cure at

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Radiation oncology has improved vastly in the last 40 years, according to Dr. Robert McLaurin. Some of those improvements can be seen at Washington's Marion L. Shepard Cancer Center.

all cost� has given way to a more thoughtful consideration that places a premium on the quality of life after treatment. If 80 percent of the cancer patients are going to be cured, then 80 percent will have to live the rest of their normal life expectancy with the consequences and complications of the treatment.

As cancer specialists, we are not waiting for the future. We are already making significant adjustments in our traditional approach to this disease.

In breast cancer surgery, for instance, we are using a less damaging form of lymph node biopsy in place of the traditional axillary dissection.

The smaller procedure provides all the benefit of the more invasive surgery, but avoids the most serious complications, such as arm swelling and decreased range of shoulder motion.

Range of motion in the shoulder may seem like a trivial consideration when dealing with something as serious as cancer, but when you consider that many of these women will be working in their gardens, or swinging a tennis racket or golf club for decades afterward, being able to focus on quality of life issues is very satisfying.

The new generation of chemotherapy drugs is not only more

effective, but far less toxic, both in the short run and the long run.

Targeted therapy based on the genetic characteristics of an individual’s cancer is in its infancy. The pipeline of new, targeted therapies is set to explode with new possibilities.

In radiation oncology, the most significant improvement during the last two decades has been our ability to focus the lethal effects of the radiation more precisely on the cancerous target, while sparing the surrounding, sensitive normal structures. We have been able to increase cures rates while minimizing side effects and long-term complications of radiation.

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Changing the mindset We have accomplished fantastic technologic improvements, but our efforts to effectively communicate these successes have not kept pace. Now, the biggest barrier to further improvement is that many people don’t understand the progress that we have already made.

So, they still have a fear of cancer that might have been appropriate in the past, but has life-threatening consequences today. And they still have an equally formidable fear of cancer treatment itself, like chemotherapy and radiation, which used to be quite toxic, but is much easier to tolerate these days.

Fear prevents people from paying attention to early warning symptoms, and participating in recommended early detection and prevention programs like colonoscopies and annual mammograms. Eliminating fear and changing the public’s mindset about cancer is the most powerful

improvement we can make.

There is huge difference in the cure rate for early stage cancer compared to late stage cancer. The earliest cancers can be cured 95 percent of the time.

When we catch cancers in the late stages, we are lucky if we can cure them half of the time.

This is where the geographic and socioeconomic differences come into play. In affluent, urban communities, with easy access to proper medical care, most cancers are caught in the early stages, and are therefore cured in the vast majority of the cases. In poorer, rural areas, where access to medical care is more difficult, cancers are too often found late, and the cure rate drops dramatically.

contribution I could make would be to improve the technology of radiation delivery systems. So much progress has been made in that realm that I now believe that we may be nearing the point of diminishing returns.

In contrast, there is a great deal of further progress that we can accomplish by making the advanced technology available earlier, and to more people. I am now devoted to trying to convey the message of hope to as many people in eastern North Carolina as possible. I can use all the help I can get!

We have the technology. Now we need to get the message out that early detection saves lives. Doing so is the most promising pathway to saving even more lives.

Focus on education Dr. Robert McLaurin is the radiation Forty years ago, as I looked out oncologist at the Marion L. Shepard Cancer over the landscape of cancer care as it Center in Washington. For more information, existed then, I thought that the greatest visit cancercare.vidanthealth.com.

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Shepard Cancer Foundation supports cancer patients and families

The Shepard Cancer Foundation works to fund many services provided to cancer patients through the Marion L. Shepard Cancer Center, from chemotherapy and radiation, to a meditation garden and yoga classes.

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or the past Center, Dr. Jennie Crews.

10 years, the Crews and fellow Shepard Cancer oncologist, Dr. John Fo u n d a t i o n Inzerillo, and their team has been impacting the wanted to do more lives of cancer patients, than just medically sur vivors and their treat cancer patients. caregivers all across It was their vision to Beaufort and surrounding provide complimentary counties. The Foundation therapies, educational was formed in 2007 by programs and financial PAM SHADLE a group of community assistance to help members who cancer patients and their passionately supported the vision of families along their cancer journey. oncologist and then medical director And thanks to the generosity of of the Marion L. Shepard Cancer our community, the Shepard Cancer

Foundation has helped our local Cancer Center staff do just that.

From the relaxing and healing effects of massage and yoga, to visits from local pets and their owners, to educational programs, to financial assistance to help relieve the financial burden that a cancer diagnosis can cause — the lives of many families have been impacted.

Although the initial mission of the Foundation was to improve the mind, body and spirit of cancer patients, survivors and caregivers, it has always supported the Cancer Center and Vidant Beaufort Hospital

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in their efforts to provide free cancer screenings and educational programs to promote early detection of cancer.

But in 2016, the Foundation board of directors made prevention, early detection and early treatment of cancer more of a priority by officially adding it to its mission statement.

The Foundation provides funding to help provide much-needed screenings for breast, cervical and lung cancer.

Earlier this year, the Foundation decided to provide funding to the Beaufort County Health Department’s Breast and Cervical Cancer Control Program.

Through BCCCP, women 40-64 years of age who do not have Medicaid, Medicare Part D or private insurance, and who meet certain financial criteria, can get a breast exam, pap smear and referral for a mammogram at no cost.

The Foundation also provides financial assistance to help patients who qualify get a low-dose CT scan to screen for lung cancer. Lung cancer is

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the leading cause of cancer death in the country. It accounts for 30 percent of all cancer deaths in America, killing more than 150,000 people a year.

When detected early, lung cancer is easier to treat and has a higher survival rate. The Foundation hopes to remove barriers to detecting lung cancer early.

Knowing about signs, symptoms and screenings for early detection of cancer is key. That is why the Foundation supports the Cancer Center’s “Knowledge is Power” and “Dinner with a Doc” programs. Each year, Cancer Center staff and local providers team up to provide programs to share information with the community about the importance of screening for the early detection of colon, prostate, ovarian, lung and breast cancer.

Unfortunately, cancer is the leading cause of death in Beaufort County.

We are blessed to have the services of the Marion L. Shepard Cancer Center to provide excellent care in

the treatment of cancer, but we see it as our responsibility to also share the message about healthy lifestyles to prevent cancer all together. Healthy diets, regular exercise, refraining from smoking and protecting oneself in the sun are all ways to help prevent cancer.

Supporting families through a cancer diagnosis journey has been and always will be at the forefront of the Shepard Cancer Foundation’s mission, but it is our belief that if cancer can be prevented in the first place or detected early and treatment started early, then we are improving the lives of our community.

The Foundation is grateful for the many generous donations that have been made throughout the years to help support our mission.

Pam Shadle is the manager of marketing, public relations, development and community outreach at Vidant Beaufort Hospital and serves as ex-officio member of the Shepard Cancer Foundation board of directors.

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WASHINGTON DAILY NEWS

Beat cancer before it starts

BY CAROLINE HUDSON

“Cancer” is a word no one wants to hear or think about, but there are preventative measures people can take before it strikes.

Doctors tend to harp on “eating right” or “getting some exercise,” and never is that advice more warranted than when it comes to preventing cancer. Especially when it comes to people with a family history of the disease, or those who have fought it before, simply living a healthful life can make a significant difference in whether cancer raises its head.

One’s risk for cancer increases with smoking, alcohol use and obesity, according to exercise program specialist Russ Sohooli.

Sohooli, who works at Vidant Wellness Center in Washington, said

a high body mass index (a measure of the body’s fat based on height and weight) is proven to contribute to esophageal, colon, breast, endometrial and kidney cancers.

“The obesity epidemic is growing.

People are getting bigger, and they are living more unhealthy lifestyles,” Sohooli said. “If you’re diagnosed with cancer, being overweight, not being physically active, can attribute to cancer coming back.”

Twenty-one to 57 percent of the cancers listed above can be attributed to obesity, according to the American College of Sports Medicine.

Cancers of the gallbladder, liver, pancreas, ovaries and prostate may also be attributed to obesity, although the research is not as conclusive,

Sohooli said.

“Cancer and exercise is relatively new,” he said. “We’re learning more and more about it.”

Sohooli suggested that residents should start their exercise plan by taking a brisk walk every day for at least 30 minutes, building up over time, as well as maintain a BMI between 18.5 and 24.9 throughout life.

Exercise specialists recommend a minimum of 150 minutes of moderate cardio each week, and strength training for two to three non-consecutive days a week.

Although exercise is an important part of maintaining a good weight, another factor to consider is eating healthfully.

Colleen Bucher, a registered

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dietician at the Vidant Wellness Nutrition Clinic, said one rule of thumb is to stick to plant-based foods, especially darker berries and leafy greens.

“If somebody has a strong family history, or even if they’ve had cancer in the past … they’ll come to us and want to prevent any further cancer,” Bucher said. “Really, it’s just pushing fruits and vegetables.”

People should also avoid foods high in salt and fat and stay away from processed foods, according to Bucher.

Bucher said dieticians can also help clients understand what vitamins and minerals are important for preventing cancer and/or fighting the spread.

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Vitamin D promotes bone growth and repair, as does calcium, and vitamin C has anti-inflammatory, immune-boosting properties, she said. Vitamins A and B are other important nutrients, and drinking more water is always a positive.

Bucher said purchasing these healthful options is a more expensive commitment, but dieticians can also help someone navigate the financial component.

It’s about taking control of one’s health and making that commitment to oneself and to loved ones, Sohooli said.

“You make time for things that you want to do, no matter what,” he said. “It’s for you, but it’s not all about you.”

SUPERFOODS

What should I eat?

•Fish •Nuts (almonds, peanuts, walnuts) •Light margarines •Flaxseeds and sesame seeds •Whole grains •Eggs •Soy beans •Kiwis and oranges •Olive and canola oil •Sweet potatoes •Spinach or dark greens •Wheat germ •Low-fat dairy •Cocoa •Broccoli and cauliflower •Onions •Tomato sauce •Avocado

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New thoughts on skin cancer...

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e have all heard about you have to, get a slow tan while using the dangers of too the appropriate rated sunscreen. Besides, much sun, sunburns it is the ultraviolet light that also causes and tanning beds that that wrinkled, brown, leather-like skin we put us all at higher risk for skin cancer, es- see in lifelong sunbathers. pecially the most dreaded of skin cancers More news that we will not — melanoma. Taking a different tack, I commonly see advertised is information will use this space to enlighten readers on that was published in the Journal of many new ideas from thought leaders on the American Medical Associationskin cancer that most of us were just not Dermatology. It also concerns the use aware of. Keep reading for of indoor tanning beds and some very surprising inforis equally shocking. Just to mation and pay attention to set the mark, the number the number of times you of new lung cancer cases tell yourself, “I didn’t know a year is just over 224,000 that!” in the United States Let’s face it; everyone alone. Here it comes: The wants to look good. We number of skin cancer spend a lot of time and cases due to tanning is money buying clothes, higher than the number make-up, skin products, of lung cancer cases due DR. JOHN hair care and restoration to smoking.

INZERILLO products and razor blades, In the U.S. alone, just to keep looking attractive. For those 419,254 cases of skin cancer are due to who worship the sun, yet do not have the indoor tanning, of which 6,199 are of leisure to sunbathe, the tanning booth is the life-threatening melanoma type. their route to the cherished golden tan.

For the golfers out there, here is One not very well-known, but painful some news to think about while driving, fact is that those who use a tanning bed wedging and putting. Sixty-five percent before the age of 35 increase their risk of melanoma cases are associated with of melanoma by 75 percent. Ultraviolet UV radiation from the sun. Men over radiation such as the radiation given 40 have the highest annual exposure to off by the sun and the radiation one is UV light. White men over 50 have the exposed to in a tanning bed is the key highest incidence of melanoma than any factor that causes skin cells to mutate other group. And lastly, melanoma is one and multiply, thus leading to the various of only three cancers with an increasing types of skin cancer. Why do you think mortality rate for men. This is not to we give radiation to those with cancer? It discourage anyone from getting out there is because it damages cells. If you need and playing golf, but like everything else to look good in a bikini at the beach, it in life, it should be done mindfully. Keep is safer to get your tan in a bottle, and if reading to find out how.

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The following prevention guidelines apply to everyone, not only golfers.

• Seek the shade, especially between 10 a.m. and 4 p.m.

• Do not burn.

• Cover up with clothing, broad -brimmed hat, long sleeves and shirts with built-in SPF. • Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.

• Apply 2 tablespoons of sunscreen 30 minutes before going outside, and reapply every two hours. If swimming, reapply right after coming out of the water.

• Examine your skin every month.

Remember to check between the toes also.

• Have your physician examine your skin yearly.

This all sounds like a great deal of trouble to go through just to save your skin. But look at it this way: whatever you can do to prevent cancer in the first place will keep you out of the surgeon’s, dermatologist’s and oncologist’s offices.

Just think how much trouble it would be possibly fighting for your life if and when a potentially preventable cancer did occur. I agree, it can be a hassle to follow all of these rules, but like everything else in life, the more we do it, the easier it gets. We are all creatures of habit. Let’s pick up some good habits from these recommendations.

For further useful information, I refer you to the Skin Cancer Foundation website at skincancer.org/.

John Inzerillo, MD, is a hematologist/ oncologist with the Marion L. Shepard Cancer Center at Vidant Beaufort Hospital.

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What you need to know about prostate cancer screening

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t seems that every month, there is more controversy in the media about prostate cancer screening.

Believe me, medical professionals are just as confused as is the public.

Depending on which medical advice you l i s t e n t o, DR. MICHAEL screening CRAWFORD is either a good idea and recommended, or it is not reliable and should not be performed. What should you do?

There is unfortunately no easy answer, but the more you know about prostate cancer and the risks and benefits of screening, the better you will be able to make your own decision. I have this discussion with patients several times a week, and I will give you the same advice that they receive. I thought it might be most useful to do this as a question-and-answer format, much as it would be at an office visit.

Should I be screened for prostate cancer?

This is the most common question and the most difficult to answer.

Why? Because not even the different medical societies can agree. Obviously, those at increased risk should strongly consider being screened. This would

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include those with a close family member with prostate cancer such as a father or brother. These individuals carry a genetic risk to develop prostate cancer earlier and a more aggressive type. African-Americans also have a higher risk of prostate cancer. These individuals should consider having at least a baseline PSA at age 45. As urologists, we recommend all patients have a baseline PSA starting at age 50. Previously, the U.S. Preventative Task Force has recommended to not perform routine screening in the general population. However, earlier this year it revised its recommendation.

It now state that men 55 to 69 should discuss screening with their physicians. Screening men over 70 is not recommended. The Task Force states that to find one “significant” cancer, 1,000 men must be screened. Note that I said “significant.” This means a cancer that would potentially be lethal if untreated. Screening would find more cancers, but some of these would be slow growing and in men who, because of their advanced age or poor health, may well die from other causes before their prostate cancer would ever grow.

The American Urologic Association has since revised its guidelines on screening. Although screening is still recommended, the frequency and timing of PSAs has changed.

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patients want to know if they can’t just skip the rectal exam. Unfortunately, not all cancers raise the PSA level, and the only way they can be diagnosed is by examining the prostate. I will find a few cancers every year in this way. The good news is that this only has to be done once a year. Believe me, I moan and groan just as much as the next guy when it is my turn. It’s just one of those things we have to do.

What is a PSA? Simply put, PSA is a protein in the bloodstream. Normal prostates make it in small amounts; prostate cancer makes it in large amounts. The normal range is from 0 to 4. Any number above 4 is abnormal, but does not necessarily mean you have cancer. PSA is a wonderful test in that we can pick up a cancer very early with it, often months to years before we would find it on a rectal exam. However, that sensitivity comes at a price. Other things can affect PSA. Recent sexual activity, prostate problems such as difficulty voiding, and particularly infection, may affect the level.

If the PSA is not reliable, why even do one?

At the present, this is the only way we have of detecting prostate cancer early. Although the data is not clear, most urologists feel that in the PSA era, we have been able to increase What does screening our cure rates and treat the disease at mean?

We recommend a PSA blood test an earlier stage. Unfortunately, some as well as a rectal examination. Many studies are starting to demonstrate a

rising mortality rate of prostate cancer as well as an increased rate of diagnosis of advanced cancers which many feel is due to delayed screening. I feel that some of the controversy about PSA has to do with how your doctor interprets the test. What that means is that you have to interpret the PSA level as it applies to each individual. A PSA of 4 in a 41-year-old means something totally different than it does in a 77-year-old.

Unfortunately, you cannot apply the 0 to 4 scale the same for each patient. This is where you should discuss your PSA with your physician. Not everyone who has a PSA over 4 needs or should have a biopsy.

I have heard that almost all men, if they live long enough, will get prostate cancer.

Your lifetime risk of developing prostate cancer is about 1 in 9. Does that mean that all those men will need treatment? No. Again, each individual must be individually considered. Your age, any additional medical problems, family longevity and aggressiveness of your cancer all weigh in on the decision to treat your cancer. Many patients who have prostate cancer will never require treatment, and their cancer will never be a threat to them. That is a discussion your urologist and you would need to have.

What is the downside to screening?

For most, the worst things will be the needle stick for the blood test and the rectal exam. If your PSA is

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high, you might need a biopsy. This is about a 10-to 15-minute procedure performed in the office. An ultrasound probe is inserted in the rectum, a local anesthetic is administered and a needle is used to take prostate tissue. The risks include bleeding and infection.

Opponents to screening point out that some individuals will have biopsies who don’t need them because they don’t have cancer. Unfortunately, that will always be true because nothing in life is 100 percent. I try to be as sure as I can that when I do a biopsy, it is as absolutely

necessary as possible. However, the between you, your urologist, possibly happiest patients are those with a oncologist or radiation oncologist. negative biopsy.

Prostate cancer, in general, is a slowgrowing cancer, and the one luxury you If I have cancer, what can have is time to make a fully aware and be done? educated decision about your treatment.

The good news is that today there is The best advice I can give you is to even more that can be done than ever. discuss prostate cancer screening with From watchful waiting to surgery, to your health care provider. They are bestultrasound to radiation to robotics, the suited to help you make a decision about choices are numerous. Once again, every prostate cancer screening. patient is different, and what might be Dr. Michael Crawford is a urologist at best for your neighbor may not be best Vidant Urology in Washington. Dr. Crawford for you. This requires a long discussion can be reached by calling 252-946-0136.

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MEDICAL AND HEALTH DIRECTORY

cardioloGy Vidant Cardiology

608 E. 12th Street, Washington

252-758-3211

www.VidantHealth.com

GastroenteroloGy Vidant Gastroenterology-Washington 608 East 12th Street, Washington

252-946-1573

HearinG care

endocrinoloGy Vidant Endocrinology

2460 Emerald Place, Greenville, NC

252-830-2021

www.VidantHealth.com

www.VidantHealth.com

“Hear a Better Day!”

149 N. Market Street, Washington, NC 27889

252-656-9430

eye care

www.miracle-ear.com/locations/washingtonnc

Home HealtH & Hospice Eye Care Center 1100 W. 15th Street, Washington

252-975-8040

Kindred at Home

Family medicine Vidant Family Medicine–Aurora 151 3rd Street, Aurora

252-322-4021

www.VidantHealth.com

1638 Carolina Ave., Washington, NC

252-946-7145

Great healthcare has come home®

Vidant Home Health and Hospice 1211 Highland Drive, Washington

1-252-847-2000

Vidant Multispecialty Clinic - Belhaven & 24/7 Care

Hospitals

598 W. Old County Road, Belhaven

252-943-0600

www.VidantHealth.com/Belhaven

Vidant Family Medicine–Chocowinity 740 Bragaw Lane, Chocowinity

252-946-9562

www.VidantHealth.com

Vidant Family Medicine– Washington 501 West 15th Street, Washington

252-975-2667

www.VidantHealth.com

www.VidantHealth.com

Vidant Beaufort Hospital-Washington 628 East 12th Street, Washington

252-975-4100

www.VidantHealth.com

insurance Farm Bureau Insurance Get Real Auto • Home • Life • Health 601 Hackney Ave., Washington

252-946-0169

www.ncfbins.com

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iNTerNal MediciNe

Massage Therapy Market Street Massage

Vidant Internal Medicine-Washington 1380 Cowell Farm Road, Washington

252-946-2101

Angie Shiflett

www.VidantHealth.com

Massage Therapist LMBT 07151 141 N. Market St., Washington

252-946-8989

MaMMography

Eastern Radiologists Washington 630 E. 11th Street, Washington, NC 27889 252-946-2137 easternrad.com

M-F 8 am-5 pm Mammography Available at 7:30 am No Referral Needed for Screening Mammogram with 3D Images

Neurosurgery Vidant Neurosurgery - Greenville 2325 Stantonsburg Road, Greenville, NC

252-847-1550

www.VidantHealth.com

NursiNg & rehabiliTaTioN

Eastern Radiologists Breast Imaging Center Rivertrace Nursing & Rehabilitation Center 2101 W. Arlington Blvd., Suite 100 Joyful Healing. Physical, Occupational & Speech Therapy Greenville, NC 27834 Offered 7 days a week. Specialized Wound Treatment.

252-752-5000 easternrad.com 250 Lovers Lane, Washington 252-975-1636 M-F 8 am-5 pm Late Hrs Tues. until 7 pm Experienced Fellowship Trained Breast Imagers oNcology Offering Hologic 3D Mammography ™, 3D™ Breast Marion L. Shepard Cancer Center Biopsy, Breast Ultrasound and MRI 1209 Brown Street, Washington 252-975-4308

orThopedics

Vidant Women’s Care-Washington 1204 Brown Street, Washington

252-974-9204 or 252-946-6544 www.VidantHealth.com Now scheduling 3D Mammography

www.VidantHealth.com

Vidant Orthopedics-Washington 1207 Highland Drive, Washington

252-946-6513

www.VidantHealth.com

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SUMMER 2017 23

rheUmatology

orthotiCs East Carolina Orthotics & Prosthetics 405 West 15th Street, Washington

252-940-1203

Vidant Rheumatology-Washington 628 East 12th Street, Washington

252-948-4990

www.VidantHealth.com

Pain management

sUrgery

Vidant Pain Management Center - Greenville 2010-A W. Arlington Blvd., Greenville

1-866-910-5222

www.VidantHealth.com

PUlmonology

Vidant General Surgery-Washington 615 E. 12th Street, Washington

252-946-0181

www.VidantHealth.com

Vidant Pulmonology

608 E. 12th Street, Washington

252-974-7500

www.VidantHealth.com

radiology

Urology Vidant Urology-Washington 1202 Brown Street, Washington

252-946-0136

www.VidantHealth.com

Vision imPairment

Eastern Radiologists Washington 630 E. 11th Street, Washington, NC 27889 252-946-2137 easternrad.com M-F 8 am - 5 pm

Eastern Radiologists Greenville MRI 2101 W. Arlington Blvd., Suite 110 Greenville, NC 27834 252-752-5000 easternrad.com M-F 7 am - 9 pm S/S 8 am - 8 pm

Eastern Radiologists Interventional Radiology 2090-A W. Arlington Blvd.

Greenville, NC 27834 252-754-5253 easternrad.com M-F 7:45 am - 4 pm

Uniforms

Wellness/fitness Vidant Wellness Center

1375 Cowell Farm Road, Washington

252-975-4236

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Women’s Care Vidant Women’s Care-Washington Gynecology and Primary Care

1204 Brown Street, Washington

252-946-6544

www.VidantHealth.com

Vidant Women’s Care-Washington Obstetrics and Gynecology

1210 Brown Street, Washington

252-975-1188

www.VidantHealth.com

This happy moment brought to you by early detection When cancer is part of your life, even everyday moments become extra special. The Marion L. Shepard Cancer Center is committed to making more magical memories possible for the people of eastern North Carolina by finding cancer early and saving lives.

Marion L. Shepard Cancer Center 1209 Brown Street, Washington

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When we detect cancer in its initial stages, it’s easier to treat. So together, Vidant Beaufort Hospital, Marion L. Shepard Cancer Center and the Shepard Cancer Foundation collaborate to bring free cancer screenings, events and educational workshops to Beaufort County and surrounding communities.

We believe working together makes us stronger, and that’s what we do.