Of a Certain Age? Time for a Colonoscopy

Posted by Brigham and Women's Hospital December 16, 2016

The American Cancer Society recommends that both men and women undergo a colonoscopy every 10 years, beginning at age 50.

Colorectal cancer is the third most common cancer in both men and women in the United States. The gold standard screening procedure for colon cancer is a colonoscopy, a test that allows your doctor to examine the inner lining of the large intestine (rectum and colon) for polyps, ulcerations, diverticulosis and early signs of cancer.

“Unlike other screening tests, a colonoscopy actually prevents cancer by allowing us to find and remove lesions before they become problematic,” said Dr. Jessica R. Allegretti, a gastroenterologist in the Division of Gastroenterology, Hepatology and Endoscopy at Brigham and Women’s Hospital (BWH).

In fact, due to increased awareness about screenings, the death rate from colorectal cancer has been dropping for more than 20 years. Read More »

What Are Carcinoid Tumors?

Posted by Brigham and Women's Hospital December 14, 2016

Carcinoid tumor cells.

Carcinoid tumor cells.

Carcinoid tumors are rare, often slow-growing tumors that form from neuroendocrine cells found throughout the body. Carcinoid tumors most commonly arise in the gastrointestinal system, including the appendix, small intestine, or rectum, but may occur in other sites, including the lungs.

In most cases, there is no clear cause of carcinoid tumors. There does not appear to be a strong association between cases of these tumors and typical cancer risk factors such as smoking and exposure to environmental toxins. In rare cases, carcinoid tumors can be linked to hereditary conditions such as multiple endocrine neoplasia types 1 and 2 and Von-Hippel Lindau disease.

Read More »

Finding Happiness Despite Stage IV Lung Cancer

Posted by Brigham and Women's Hospital November 29, 2016

joann-and-girls

Joann (center) with her daughters, Mei and Lia.

Today’s post is written by Joann Totten, a patient at Dana-Farber/Brigham and Women’s Cancer Center.

As a non-smoker, I never imagined I would be diagnosed with stage IV lung cancer, let alone at age 50. But that’s what happened on Aug. 5, 2015, just six weeks after I started experiencing a non-productive cough. The doctors felt certain it was bronchitis, but as a radiation therapist for more than 20 years, I advocated for myself and insisted on a chest x-ray, which came back a bit abnormal. After additional testing for tuberculosis and pneumonia, I began experiencing shortness of breath and had another chest x-ray and CT scan. When I saw the scan, which was hard to believe was mine; I knew immediately I had cancer. A few days later, a biopsy confirmed my diagnosis: non-small cell lung cancer, stage IV.

Although it’s been more than a year, it’s still so hard to believe I have lung cancer. I never smoked, I exercise, and I eat very healthy; I thought I took pretty good care of myself. But cancer doesn’t discriminate; all you need are lungs to be diagnosed with this disease. Read More »

Breast Reconstruction – New Surgical Approaches

Posted by Brigham and Women's Hospital November 11, 2016

Innovative flap procedures offer breast reconstruction options to patients who are not candidates for implant-based breast reconstruction.

Contributor: Dr. Matthew Carty is Co-Director of the Microsurgical Breast Reconstruction Program at Brigham and Women’s Hospital and Associate Professor of Surgery at Harvard Medical School. His clinical interests include advanced reconstructive and cosmetic procedures of the body and face.

Many women who have lost a breast to cancer cannot undergo common breast reconstruction procedures, because they have had abdominal surgery, or lack sufficient donor tissue in their abdomen.

However, with advances in surgical reconstruction, many have new options. “We can now use the patient’s own tissue to rebuild the breast,” says Dr. Matthew Carty.

The innovative reconstructive options involve transferring tissue, known as flaps, from one part of the body to the chest without compromising muscle functioning.

“After the surgical procedure, patients can still run, ride bikes, swim, do ballet, yoga, all the general activities that people like to do,” says Dr. Carty. Read More »

Managing Oral Side Effects of Cancer Treatment

Posted by Brigham and Women's Hospital November 8, 2016

oral-side-effects-blog-post

Cancer treatments such as radiation and chemotherapy may cause mouth sores and dry mouth, while some newer targeted therapies may lead to taste changes and oral sensitivity.

Oral problems such as mouth sores, dry mouth, jaw pain, and sensitive gums are a common complaint for cancer patients, because the very treatments that target fast-growing cancer cells can also affect healthy cells in the mouth. Treatments such as radiation and chemotherapy may cause mouth sores and dry mouth, while some newer targeted therapies may lead to taste changes and oral sensitivity. Patients with head and neck cancers are particularly likely to experience oral problems, because treatments often focus on areas near the mouth and jaw.

Here are some tips for dealing with common oral side effects of cancer treatment: Read More »

Why is Breast Density Important?

Posted by Brigham and Women's Hospital October 31, 2016

screening-mammo-negative

This image shows a negative screening mammogram of 45-year-old woman with dense breast tissue.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). In recognition of Breast Cancer Awareness Month, we are publishing a three-part Breast Imaging Series throughout October. Today’s post, the final in our series, discusses breast density.

Breasts contain fibrous, glandular, and fatty tissue. Generally, breasts are considered dense if they contain a lot of fibrous and glandular tissue and less fat. Breast density is classified on a mammogram report in one of four ways:

  • Almost entirely fatty
  • Scattered areas of fibroglandular density
  • Heterogenously dense
  • Extremely dense

According to the American College of Radiology, 80 percent of women in the United States fall into one of the middle two categories, 10 percent have almost entirely fatty breasts, and the remaining 10 percent have extremely dense breast tissue.

Breast density is important for several reasons. Dense breast tissue may increase a woman’s chance of developing breast cancer. Also, detection of breast cancer using mammography is more difficult in women with dense breast tissue. Read More »

Who is Reading Your Mammogram?

Posted by Brigham and Women's Hospital October 21, 2016

Radiology technician examens mammography test on location

When choosing a location for your mammogram, it is important to look for a center that performs a high volume of mammograms and has radiologists who are dedicated to breast imaging.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). In recognition of Breast Cancer Awareness Month, we are publishing a three-part Breast Imaging Series throughout October. Today’s post, the second in our series, discusses the importance of specialized training in reading mammograms.

When choosing a location for your mammogram, it is important to look for a center that performs a high volume of mammograms. Preferably, the radiologists in the center should be dedicated to breast imaging. Breast imaging specialists devote their time exclusively to breast imaging, including mammography, breast MRI, and breast ultrasound.

The detection of very subtle changes in early breast cancer can be very challenging. Studies have shown that radiologists specializing in breast imaging outperform non-specialist radiologists in detecting breast cancer.  Furthermore, the more mammograms and other breast images that radiologists read, the better they become at identifying these subtle changes, with higher accuracy. Read More »

Stem Cell Transplants Rise Among Older Patients

Posted by Brigham and Women's Hospital October 18, 2016

Dana-Farber/New Hampshire Oncology-Hematology (DF/NHOH). Patient Shirley Clark (consent # 6228) with Garrick Johnson, PA.

Stem cell transplantation has grown among older patients largely due to the development of reduced-intensity transplants.

Stem cell transplantation following chemotherapy can extend survival and potentially cure certain advanced cancers. Although these demanding procedures were once considered too risky for older patients, advances in transplant methods are challenging that assumption.

“In transplants involving donor cells, there was concern that older patients wouldn’t be able to tolerate the high doses of chemotherapy traditionally used,” explains Joseph Antin, MD, chief of the Adult Stem Cell Transplantation Program at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC)

“Older patients were also thought to be more at risk from graft-versus-host disease,” a sometimes severe condition in which immune system cells in the transplanted tissue attack the patient’s own tissue, Antin adds.

Now, due largely to the development of reduced-intensity transplants, which use lower doses of chemotherapy than standard transplants, greater numbers of older people nationwide are getting transplants. At Dana-Farber/Brigham and Women’s Cancer Center, for example, 1,627 patients 55 and older underwent transplants between 2011 and 2015, compared to 964 between 2006 and 2010.

Read More »

Breast Cancer Screening: Understanding the Guidelines

Posted by Brigham and Women's Hospital October 4, 2016

Digital 3D mammography (digital breast tomosynthesis), the latest technology used in mammography, takes multiple images of each breast from different angles. It has been shown to improve earlier detection of breast cancers and reduce the number of call backs for repeat imaging.

Contributor: Dr. Catherine Giess is Chief of the Division of Breast Imaging at Brigham and Women’s Hospital and Assistant Professor of Radiology at Harvard Medical School.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). This post is designed to outline breast cancer screening guidelines.

“Mammography is a very important screening tool for early breast cancer detection, but there are several different guidelines for when to start and how often to undergo mammography,” says Dr. Giess.  “This can be confusing for many women.”

The American College of Radiology recommends annual screening mammography beginning at age 40.  The ACS guidelines (outlined below) emphasize screening based on a woman’s individual risk of developing breast cancer and her personal preferences.

 

When should I start?

A woman’s first mammogram serves as a baseline to compare results of subsequent mammograms.

  • Women should begin discussing breast cancer screening with their health care providers at age 40. From 40-44 years of age, women have the option to begin annual screening if they choose to do so.  All women should begin yearly mammograms by age 45.
  • Women who are at higher risk for developing breast cancer, such as women with a family history of breast or ovarian cancer, should discuss their own personal risk factors with their health care providers, and may need to start screening earlier.

Read More »

Can Cocoa Extract and a Multivitamin Help Prevent Heart Disease and Cancer?

Posted by Brigham and Women's Hospital October 3, 2016

The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is the most extensive study to date testing the roles of cocoa extract and a multivitamin in improving health.

Contributor: Dr. JoAnn Manson is Chief of the Division of Preventive Medicine at Brigham and Women’s Hospital (BWH). She is leading the COSMOS trial with BWH Dr. Howard Sesso, an associate epidemiologist at BWH.

Researchers at Brigham and Women’s Hospital and the Fred Hutchinson Cancer Research Center are collaborating in a new research study, known as the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), for the most extensive study to date testing the roles of cocoa extract and a multivitamin in improving health, including preventing heart disease and cancer.

Previous studies of cocoa flavanols conducted by researchers at BWH and other institutions have found that cocoa may reduce the risk of heart disease (including a short-term decrease in blood pressure), as well as slow age-related cognitive decline. BWH researchers have also previously found that multivitamin use modestly reduced cancer risk in a trial of more than 14,000 male physicians.

“COSMOS will allow us to further explore these promising nutritional supplements in both men and women as part of a large-scale national clinical trial,” said Dr. JoAnn Manson, Chief of the Division of Preventive Medicine at BWH and Co-Director of COSMOS with BWH epidemiologist Dr. Howard Sesso.

Read More »