Men With Factor V Leiden Can Still Receive Testosterone Therapy

DEAR DR. ROACH: I have Factor V Leiden, but I have been wanting to do testosterone replacement therapy. I have heard that testosterone causes blood clots. Obviously, with FVL, that would be a huge deal for me. Is this true? Does it cause clots, or is it safe for me to do? -- R.C.

ANSWER: Factor V Leiden is a common genetic variant that increases a person’s risk for developing a blood clot. However, a person who has never had a blood clot, but who is identified as heterozygous (meaning they only have one copy of the gene) for factor V Leiden, is still not likely to have a blood clot during their lifetime and is not recommended for treatment to prevent a blood clot.

Testosterone replacement therapy in men with FVL does increase the risk of blood clots in some studies, but not in others. In the studies that have shown an increase in risk, the risk has been estimated as approximately one person per thousand treated with testosterone each year. However, the risk occurs mostly during the first three months, and after two years on treatment, there is no additional risk. Thus, roughly one man per 500 who has FVL and gets treated with testosterone will get a clot, according to the studies that show an increase in risk. This is a small risk, but a blood clot is a significant potential problem. So, the risk of getting a clot should certainly go into the discussion about whether to give testosterone replacement to a man with FVL and symptomatic low testosterone levels. Most of the men I have seen with this issue have elected to take the replacement.

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Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

© 2023 North America Synd., Inc. All Rights Reserved

Participants Needed

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• Be 40 years or older

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Innovative Technology Improves Patient Experience For Women Undergoing Breast Cancer Treatment

(NAPSI)—A mother, a sister, a friend…many of us know someone who has been touched by breast cancer, the most common cancer among women, affecting an astonishing one in eight women in the United States. Thanks to technological advances in detection and new treatment approaches, women diagnosed with early-stage breast cancer can opt to keep their breast with less invasive surgery and with breastconserving treatments. In fact, the American Cancer Society estimates that 59 percent of women with an early breast cancer diagnosis (Stage 1 or 2) undergo breast-conserving surgery (lumpectomy) versus 36 percent of women who decide to have a total mastectomy. Research has shown that breast-conserving surgery followed by radiation therapy is as effective as a mastectomy in decreasing the risk of local cancer recurrence for most women*.

“One way that breast-conserving surgery is now easier is due to a new innovation in breast cancer treatment—SAVI SCOUT® Radar Localization. This resolves one of the most difficult aspects of breast conservation surgery by eliminating the need to place a wire inside of the breast tissue to locate a tumor,” said Dr. Barry Rosen, Chairman of Department of Surgery at Advocate Illinois Masonic Medical Center, Chicago; and Assistant Professor, University of Illinois College of Medicine. “Many of my patients who have undergone a procedure with SCOUT® are impressed with the benefits, including shorter procedure times and decreased anxiety.”

Prior to 2015, surgeons generally relied on wire localization to locate a tumor during a lumpectomy procedure. With wire localization, a radiologist guides a thin, hooked wire through the skin and into the tumor on the day of surgery. The surgeon then uses the wire to identify the area of tissue targeted for removal. This resulted in long days of surgery for women, with two procedures performed on the same day. With SCOUT, a tiny reflector, the size of a grain of rice, is placed at the tumor site at any time during the patient’s treatment and well in advance of surgery.

The SCOUT Wire-Free Radar Breast Localization System uses safe, nonradioactive, radar technology to provide real-time and precise surgical guidance during the surgery.

The ability to precisely locate tumors increases the probability of complete cancer removal and reduces the likelihood of needing follow-up surgery, allowing any additional treatments to occur sooner. In addition, the ability to strategically plan the incision may result in better cosmetic outcomes.

SCOUT is also used to effectively localize lymph nodes and tumors prior to neoadjuvant chemotherapy (chemotherapy administered prior to surgery) and can be used with any type of imaging over the course of a patient’s care. More than 350 hospitals have implemented the SCOUT System, and to date, over 45,000 women have had a wire-free localization experience. Learn More: If you would like to learn more about SAVI SCOUT or the SCOUTCare™ program, visit www.ciannamedical.com.

*American Cancer Society. Cancer Treatment and Survivorship Facts & Figures, 2014−2015. Atlanta: American Cancer Society; 2014

Preowned Items Can Be Good For The Environment

Visit consignment stores: Consignment shops and Goodwill(R) stores are popular places to buy preowned items. These stores take donations or offer items for sale on consignment, which means once sold the person who provided the item gets a portion of the sale.

When browsing the racks of these stores, it’s possible to discover highend items mixed in with less expensive items. Shoppers may find designer handbags and clothing for much less than they would sell at retail, especially if the pieces are one or two seasons old. Relying on these stores to supplement classic wardrobe pieces is cost-effective and beneficial to the environment. If you regularly shop consignment stores, you can develop a rapport with the shopkeeper, who may alert you when new items are available.

How To Support Students Interested In The Arts

Research local performing arts schools. Children who exhibit an especially strong interest in the arts may benefit from enrolling in a school that specializes in performing arts. Such schools may be open to kids as young as five and extend all the way through high school. Some performing arts schools require prospective students to audition or apply. Arts high schools still offer instruction in core academic subjects, but parents should explore each school’s curriculum before deciding if a given school is right for their children.