Wednesday, 06 December 2017 19:40

IUDs May Cut Cervical Cancer by 30%

A new study suggests intrauterine contraceptive devices (IUDs) may fight off the virus that causes cervical cancer.

Researchers from the University of Southern California’s Keck School of Medicine found the small T-shaped device may stimulate an immune response against the sexually transmitted Human Papilloma Virus (HPV) virus which causes cervical cancer.

 

 

iud.jpg

T-SHAPED IUD SITTING WITHIN THE UTERUS

 

IUDs are a favorite among women as they do not involve taking a daily hormone pill and can provide contraceptive protection for years.  There are two main types:

The ParaGard IUD is a non hormonal implant made of copper. The copper wards of sperm allowing contraception up to 12 years.

Hormonal IUDs, such as Mirena, release progestin, a hormone similar to progesterone, to the local environment, thickening the cervical mucous to prevent sperm from reaching the egg.  Hormonal IUDs may also prevent ovulation. Additionally, IUDs can alter the lining of the uterus such that if a fertilized egg does occur, it may not be able to nest in the uterus without proper lining.

But both IUDs can stimulate an immune response that is both a deterrent to sperm and now suggested to viruses such as HPV.

Vaccines against the HPV virus exist and are given to 11-12 year old girls with the maximum age at which one could receive the vaccine, 26 years old.

If more research confirms this is the case, then those women who have not been vaccinated or are too old to receive the vaccine against cervical cancer may benefit from using an IUD.

What is the cervix and what is cervical cancer?

 

The uterus looks similar to a light bulb. The larger top portion being where the fetus develops, and the bottom, narrower area, the cervix. The cervix thins and dilates during childbirth, as you’ve heard in the movies “she’s only 7 cm!” and then after childbirth becomes narrow again.  It affects nearly 12,000 and kills 4,000 women each year. It can affect women of any age but is more common between 20 and 50.

 

375x321_cervix

HTTP://WWW.WEBMD.COM/WOMEN

 

What causes cervical cancer?

 

The most common cause is HPV (Human Papillomavirus), especially HPV-16 and HPV-18.  This is acquired through unprotected sex, so condom use is encouraged. Thus its one of the most preventable causes of cancer.  Additionally, there are 3 vaccines for HPV currently approved by the FDA, Gardasil, Gardasil 9, and Cervarix.

What are the symptoms of cervical cancer?

 

Early cervical cancer may not be symptomatic but as it develops it may cause an odor, pain with urination, pelvic pain and bleeding. This bleeding may occur after sex, a pelvic exam, or intermittent bleeding not associated with a menstrual cycle.

Is cervical cancer treatable?

 

Yes.  Early detection is key and can be done by a Pap Smear, explained below.  Multiple treatments are available including surgery, chemotherapy,  radiation therapy, and targeted therapy such as Bevacizumab (Avastin®) which prevents new blood vessel growth that can feed a tumor.

Who should get screened for Cervical Cancer?

The USPSTF (United States Preventive Services Task Force) recommends the following:

Screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women age 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years.

What is a Pap Smear?

 

It is the cytology (cell analysis) of the cervix. Years ago, a cytobrush would collect the cells and the medical provider would “smear” it onto a slide, place fixative, and then send it to the laboratory for the pathologist to analyze it. Now ThinPrep® Pap tests are used more commonly as the cells from the brush are placed into a container with fixative, and this vial is sent to the pathologist to spin down and analyze.

 

cervical-smear-test-equipment-97358274-575db1493df78c98dc633c53

TEK IMAGE/SPL / GETTY IMAGES

 

In order to obtain the cells from the cervix, the medical provider needs to use a speculum to open the vaginal canal and allow access to the uterus. A woman may be in the lithotomy position…lying on one’s back on the exam table with her feet in stirrups and knees bent. During the speculum exam, the medical provider may take cultures to test for common vaginal infections such as yeast, bacteria vaginosis, or sexually transmitted illnesses such as gonorrhea and chlamydia. After the speculum exam, the provider may perform a pelvic exam with her gloved hand to examine the uterus and ovaries, evaluating for tenderness, shape, size and masses.

How is an HPV test done?

 

An HPV test can be done with the cells obtained during the Pap Smear. The laboratory evaluates the cells to see if the HPV virus that causes cervical cancer is present.

In summary the thousands of deaths that occur each year to cervical cancer can be prevented with simple testing, such as the Pap Smear. Discuss with your medical provider when cervical cancer screening is best for you.

----

 

 

 

Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

A new study out of Pennsylvania State University College of Medicine links textured breast implants to BIA-ALCL, anaplastic large cell lymphoma.

 

Although a rare cancer. researchers believe the lifetime risk is 1 out of every 30,000 women with breast implants and if the numbers are underreported, could be as common as 1 out of every 4000 women with implants.

 

Although the implants are used to augment breast tissue, the malignancy is not a breast cancer but rather a lymphoma.

 

Lymphomas make up the most common of the blood cancers.  The cancer begins in the lymphocytes, cells crucial for maintaining one’s immune system. Two main types of lymphoma are Hodgkin’s and Non Hodgkin's.  Non Hodgkins is more common, and anaplastic large cell lymphoma is a subset if it.

 

 

anaplastic-large-cell-lymphoma-[3-ln072-3].jpg

ANAPLASTIC LARGE CELL LYMPHOMA/PATHPEDIA.COM

In this study, researchers reviewed 115 scientific articles from 1997 – January 2017.  Unlike the report released earlier this year by the FDA, the researchers did not find a link between BIA-ALCL and smooth breast implants.  Of the articles reviewed, 93 cases were cited and the cancer appeared 10 years after the textured implants were placed.

 

According to the American Society of Plastic Surgeons, there are currently 160 cases in the US and a total of 391 worldwide as of September 2017.

 

Last March the FDA reported 9 women had died from anaplastic large cell lymphoma (BIA-ALCL) possibly associated with their breast implant use.  The FDA received 359 reports of BIA-ALCL,  a rare type of non-Hodgkin's lymphoma, 9 of whom died as of February 1, 2017.

This is not the first time a link has been suggested.  6 years ago the World Health Organization suggested a link.  Then in 2011, the FDA identified a possible association between the two.  In 2016, the  Australian Therapeutic Goods Administration reported 46 confirmed cases with 3 deaths relating to breast implants.

 

The report last spring suggested that BIA-ALCL affected both smooth and textured implants. According to the FDA report, 231 of the 359 cancer cases provided information on implant type.   203 were reported to be textured implants and 28 reported to be smooth implants. When it came to silicone vs. saline implants, the FDA said 312 of the 359 reports provided these specifics and of those 186 reported implants filled with silicone gel and 126 reported implants filled with saline.

 

TEXTURED.jpg

 

So neither implant type appeared immune to the risk of BIA-ALCL but it appears the silicone, textured implants carried the most risk.

 

Now the cancer occurred within the breast and the FDA advises physicians to consider the possibility of BIA-ALCL if there appears to be a seroma (fluid filled cavity around the implant) or a contracture (pulling of the skin and tissue) near the implant.

 

In most cases the cancer is treatable, with removal of the implant and the surrounding tissue curative.  In some cases however, radiation of the area or chemotherapy is required.

 

Although 50,000 cases of non-Hodgkin’s lymphoma occurs annually in the US, it is unknown how many cases of BIA-ALCL occur each year.  Moreover, many countries may not have avid reporting systems of breast implant related cancers as we do.  According to the American College of Plastic Surgeons, close to 300,000 women receive breast implants each year, some of which for breast reconstruction after mastectomy for breast cancer.

 

The FDA reminds us that BIA-ALCL is rare and prophylactic breast implant removal is NOT recommended. However we need to be aware and evaluate if one develops swelling, pain, new lumps or asymmetry in the breasts….just as we do for those without implants.

For more on the study, visit here.

 

----

 Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information
Thursday, 05 October 2017 19:16

October is Breast Cancer Awareness Month

Celebrities such as Julia Louise-Dreyfus, Olivia Newton-John, Christina Applegate and Rita Wilson have revealed their breast cancer diagnoses, helping raise awareness for the most common cancer to affect women.  It’s the second most common cause of cancer death in females.

How common is breast cancer?

 

1 in 8 women will develop invasive breast cancer of the course of their lifetime. According to BreastCancer.org, an estimated 252,710 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,410 cases of non-invasive breast cancer.

40,610 of these women are expected to die this year of breast cancer.

How is breast cancer staged?

 

Breast cancer is staged based on size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body.  Prognosis varies greatly on the stage.

Screen-Shot-2012-09-27-at-9.59.51-AM.png

IMAGE ABOVE FROM JOHNSTON HEALTH

 

Is family history a huge factor?

 

85% of breast cancer cases occur in women with NO family history.

Screening of breast cancer

 

Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74.  However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.

FullSizeRender (1)

3-D MAMMOGRAM IMAGE

What are the risk factors for breast cancer?

 

Risk factors for breast cancer include:

  • Age greater than 50

  • Family History

  • BRAC1 and BRAC2 genetic mutations

  • Alcohol use

  • Never been pregnant or becoming pregnant for the first time over 35 years old

  • Early menarche at age 11 or younger

  • Obesity, especially after menopause

  • Dense breasts

  • Lack of physical activity

  • Use of oral contraceptives

  • Previous “precancerous” tumors such as atypical hyperplasia

  • DES exposure

  • Previous radiation therapy

 

----

 Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

The Seinfeld and Veep iconic comedian is battling breast cancer.

 

On social media, Julia Louise-Dreyfus revealed that she was diagnosed with breast cancer the day after she won her 6th consecutive Emmy.

 

“1 in 8 women get breast cancer. Today, I’m the one,” Louis-Dreyfus, 56, wrote. “The good news is that I have the most glorious group of supportive and caring family and friends. The bad news is that not all women are so lucky, so let’s fight all cancers and make universal health care a reality.”

At this time no further details have been revealed of her cancer staging, which would come after further testing.

How is breast cancer staged?

Breast cancer is staged based on size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body.  Prognosis varies greatly on the stage.



Screen-Shot-2012-09-27-at-9.59.51-AM.png

Image above from Johnston Health

How common is breast cancer?

1 in 8 women will develop invasive breast cancer of the course of their lifetime. According to BreastCancer.org, an estimated 252,710 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,410 cases of non-invasive breast cancer.

 

40,610 of these women are expected to die this year of breast cancer.

Is family history a huge factor?

 

85% of breast cancer cases occur in women with NO family history.

Screening of breast cancer

Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74.  However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.

 

FullSizeRender (1)

3-D Mammogram image

What are the risk factors for breast cancer?

 

Risk factors for breast cancer include:

  • Age greater than 50

  • Family History

  • BRAC1 and BRAC2 genetic mutations

  • Alcohol use

  • Never been pregnant or becoming pregnant for the first time over 35 years old

  • Early menarche at age 11 or younger

  • Obesity, especially after menopause

  • Dense breasts

  • Lack of physical activity

  • Use of oral contraceptives

  • Previous “precancerous” tumors such as atypical hyperplasia

  • DES exposure

  • Previous radiation therapy

 

This is a developing story.

 

----

 Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

Media giant, Larry King, reveals he underwent surgery this summer to treat lung cancer.

The 83-year-old veteran broadcaster and TV host said, in an interview with US Weekly, that a routine check up revealed an abnormal chest x-ray that was followed up with a CT scan and later PET scan.  The result was early stage lung cancer.

 

In July, King had a stage I cancerous mass removed at Cedars-Sinai Medical Center in Los Angeles and was back to work within a week.

 

King suffered a heart attack in 1987 and hadn’t smoked since.  Prior to quitting he had been smoking three packs a day.  Since then, he’s been diligent with his annual check-ups stating, “I’ve gone through a lot in life – I’ve had a heart attack and heart surgery. Part of my checkup is the chest X-ray, and that is the protocol.”  King referred to his bypass surgery after his heart attack, managing diabetes, and undergoing radiation treatment for prostate cancer over the years.

 

King suggests the cancer was not a metastasis to the lung but rather a primary lung cancer.  In the US interview, he stated, “the doctor said that tobacco from 30 years ago is still related to this lung cancer.”

 

It’s true. Although lung cancer risk drops dramatically the longer one avoids tobacco products, the resulting tissue damage, injury to one’s immune response, and genetic mutations may persist.  Moreover, lung cancer can occur even in non-smokers.

 

Early lung cancer can be silent.  As it progresses, however, symptoms such as chronic cough, wheeze, blood in sputum, lethargy and weight loss can ensue.

 

But Larry King won’t let this hold him back. He’s currently working on the sixth season of Larry King Now.

 

larry king and I.jpg

Larry King and Dr. Daliah Talkers Los Angeles 2011


 

--

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs is a guest contributor to GCN news.  Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information

Last week, when we were told Senator John McCain (R-AZ) was being treated for a blood clot above his left eye, we suspected a tumor could have been involved, as he was a cancer survivor and tumors are thrombogenic, meaning clot forming.

 

Unfortunately, the 80 year old melanoma cancer survivor has been diagnosed with primary glioblastoma. However, it's been reported that the whole tumor was removed when the doctors performed a craniotomy (opening of the skull) to remove the blood clot. A statement from his office reports Senator McCain is home and recovering “amazingly well.”

What is Primary Glioblastoma?

 

Primary Glioblastoma Multiforme is a type of brain tumor that arises in the brain and spinal cord and is very aggressive in nature. “Primary” suggests the tumor is not secondary to another cancer, such as the melanoma Senator McCain successfully battled.

 

In 1993, 2000 and 2002, McCain had three malignant melanoma lesions removed, and the 2000 lesion was close to his left temple.

 

Those diagnosed with a glioblastoma may have a poorer prognosis compared to other cancers as the 5-year survival rate is only 10%. Its median survival is less than 15 months. However, with his lesion removed, and chemotherapy and radiation set to begin once his incision has healed, many medical teams are optimistic.

 

According to his daughter, Meghan McCain, her father is “confident” and “calm”. CNN reports that when the Senator awoke from surgery he was “cracking jokes” and ready to go home and get to work.

 

This is a developing story.

--

 

LearnHealthSpanish.com / Medical Spanish made easy.

 

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information
Wednesday, 17 May 2017 19:39

Vaping Linked to Bladder Cancer

Dr. Sam Chang of Vanderbilt-Ingram Cancer Center in Nashville, reported in an American Urological News release, “We’ve known traditional smoking raises bladder cancer risk, and given the surge in popularity of e-cigarettes, it’s imperative we uncover any potential links.”

Chemicals in cigarettes and electronic cigarettes, such as nicotine, are excreted through the urine. Researchers examined the urine of e-cig users vs. those of non-smokers and found 92% of those who vaped had at least two of the five chemicals tested.

The University of Minnesota in 2015 identified chemicals commonly found in e-cig vapor to include:

Formaldehyde (human carcinogen)

Acetaldehyde (carcinogen related to alcohol drinking)

Acrolein (highly irritating and toxic)

Toluene (toxic) NNN, NNK (tobacco carcinogens related to nicotine)

Metals (possible carcinogens and toxicants)

In a second study, researchers looked at bladder tissue to see what nicotine and some of the chemicals in vapor could do. They found nicotine, nitrosamines and formaldehyde not only damaged lining but blocked the DNA repair, hence increasing risk of bladder cancer.

Although exact causes of bladder cancer are unknown, tobacco smoke has been the single greatest risk factor.  Other risk factors for bladder cancer include diets rich in fried foods, arsenic, radon, occupational exposure to aromatic amines in textile, rubber and paint plants, and some medications such as pioglitazone used in diabetes. Being exposed to a worm causing schistosomiasis can also put one at risk for bladder cancer.

Symptoms of bladder cancer include blood in the urine (hematuria), difficulty urinating due to obstruction, pain/burning with urination (dysuria), and sometimes no symptoms at all.

Bladder cancer is treated by surgery, radiation, chemotherapy or immunotherapy.  The earlier it's diagnosed, the easier it is to treat.

According to the American Cancer Society they project for 2017:

  • About 79,030 new cases of bladder cancer (about 60,490 in men and 18,540 in women)

  • About 16,870 deaths from bladder cancer (about 12,240 in men and 4,630 in women)

How many of these being related to electronic cigarettes is unknown.

LearnHealthSpanish.com / Medical Spanish made easy.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

Published in News & Information

Warning: mysqli_close(): Couldn't fetch mysqli in /home/gcnlive/httpdocs/JW1D/libraries/joomla/database/driver/mysqli.php on line 209

Warning: mysqli_close(): Couldn't fetch mysqli in /home/gcnlive/httpdocs/JW1D/libraries/joomla/database/driver/mysqli.php on line 209