LEADING MEDICINE FA LL 017
BREAST CANCER:
Is Prevention Possible?
A PARENT’S GUIDE TO CONCUSSION GET THE FACTS ON CANCER
YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE BAY AREA AND SOUTHEAST HOUSTON
SEMINARS & EVENTS
Don’t Miss These Free Health Education Events! All events will be hosted at: Houston Methodist St. John Hospital Main Lobby 18300 St. John Dr. Nassau Bay, TX 77058 Register online at houstonmethodist.org/events or call 281.333.8899.
CHILDBIRTH CENTER NEWS
The birth of your child is one of the most significant events in your life. Whether you are thinking of starting a family or you are adding to your family, the Houston Methodist St. John Childbirth Center welcomes you.
CHILDBIRTH CENTER OPEN HOUSE
Join us for hors d’oeuvres and refreshments and meet the obstetrician-gynecologists and Childbirth Center team. Tour our renovated labor, delivery, recovery and postpartum rooms; and learn about the new services and amenities available to expectant moms. Date: Thursday, Oct. 19 | Time: 5:30–7 p.m.
CHILDBIRTH CENTER TOURS
PAINT THE NIGHT PINK
Bring someone you love to this celebration of breast health and breast cancer awareness. Meet our panel of breast health experts, enjoy giveaways, fun vendors and other surprises. Date: Thursday, Oct. 5 | Time: 6–8 p.m.
Dates: First and third Sunday of each month Time: 4:30–5:30 p.m. Private tours are also welcome and are available by appointment by calling 281.523.BABY (2229).
CHILDBIRTH CENTER CLASSES
Childbirth classes, and other helpful classes, are offered regularly. Register at houstonmethodist.org/patientclasses or call 281-333-8899.
A SALUTE TO VETERANS
Veterans and their families are invited to join us for a special reception to honor all who have served. Date: Thursday, Nov. 9 | Time: 5:30–7 p.m.
Dr. Patricia Choy
Dr. Peggy Taylor
Dr. Shree Visaria
WELCOME NEW OBSTETRICIAN-GYNECOLOGISTS WEIGHT LOSS SURGERY SEMINARS
If you are thinking about weight loss surgery, plan to attend a free seminar and learn about your weight loss options. Upcoming dates and times: Date: Wednesday, Oct. 11 | Time: 5:30–6:30 p.m. Date: Wednesday, Oct. 25 | Time: Noon–1 p.m. Date: Wednesday, Nov. 8 | Time: 5:30–6:30 p.m. Date: Wednesday, Nov. 22 | Time: Noon–1 p.m. Date: Wednesday, Dec. 6 | Time: 5:30–6:30 p.m. Date: Wednesday, Dec. 20 | Time: Noon–1 p.m.
2 LEADING MEDICINE IN THE BAY AREA AND SOUTHEAST HOUSTON
Houston Methodist St. John Hospital is pleased to welcome Drs. Patricia Choy, Peggy Taylor and Shree Visaria. The physicians are currently in practice together at Women M.D., where they provide pre- and postnatal care, well-woman care, laparoscopic gynecological surgery and more. They are now delivering babies at Houston Methodist St. John Childbirth Center and will begin seeing patients at Houston Methodist Obstetrics and Gynecology Associates at St. John, located on the hospital campus, on Monday, Dec. 4.
A Parent’s Guide to
CONCUSSION Signs to Watch for and Questions to Ask Your Child
I
t’s become increasingly clear that suffering a concussion is more serious than simply “having your bell rung.” And while young athletes comprise a significant portion Dr. Javier Rios of those sustaining these head injuries each year, many parents don’t know the most common signs to watch for, said Houston Methodist St. John Hospital’s Dr. Javier Rios, a sports medicine specialist and member of the Houston Methodist Concussion Center. Up to 40 percent of Rios’ patients are children ages 16 and younger — the majority being student-athletes who’ve suffered a blow or jolt to the head while playing soccer or football. According to Rios, the most common concussion symptoms include: Balance or coordination problems Dizziness Fatigue Headache Nausea Lesser-known signs are also important to watch for, including: Difficulty concentrating Memory problems “Kids may forget where they put their homework or even forget what their name is,” Rios added. “Sometimes emotional issues result, like sadness or irritability, or parents notice a behavior change in their kids, saying they’re just not acting the way they usually do.”
QUESTIONS TO ASK YOUR CHILD IF YOU SUSPECT CONCUSSION If you suspect your child may have suffered a concussion during sports
SATURDAY SPORTS INJURY CLINICS OFFERED Houston Methodist’s world-class sports medicine specialists are offering Saturday Injury Clinics: When: Every Saturday, 8–10:30 a.m., through Nov. 18 Location: 2020 NASA Pkwy., Suite 230, in Nassau Bay. The clinics are open to athletes and weekend warriors of all ages who have suffered an injury and require prompt evaluation, including on-site X-ray and imaging capabilities. Evening appointments are also available until 7 p.m. every Monday. Youth, high school and adult athletes can be seen immediately by a boardcertified Houston Methodist Orthopedics & Sports Medicine specialist. Visit houstonmethodist.org/athlete to learn more.
practice or another competition, Rios suggests asking “orientation questions” such as: What’s your name? What month and year is it? Do you remember what happened just before your injury? How do you feel? If their answers seem off, it’s imperative to have your child seen by a health care professional trained in concussion evaluation and management, Rios said.
Depending on each case, the child may be held from school and sports for a period of time to allow the brain to rest. “The best cure for concussion is prevention, so stress the importance of playing by the rules of their sport. They should also wear appropriate equipment and demonstrate good sportsmanship,” Rios said. “If your child does experience any concussion symptoms, they should immediately report it to the coach, referee or athletic trainer.”
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BREAST CANCER:
IS PREVENTION POSSIBLE?
W
hen it comes to breast cancer, certain risk factors are out of your control, such as your genes and age, as well as starting your first period young. Yet even more risk factors are within your control, and every day new research is emerging that suggests breast cancer may be more preventable than experts originally Dr. Arti Jonna thought. “Women can take steps to mitigate their risk of developing breast cancer and increase their chances of survival if it occurs,” said Dr. Arti Jonna, dedicated breast radiologist at Houston Methodist Breast Care Center at St. John. Here are some steps you can take to reduce your risk of breast cancer:
BE (REALLY) PHYSICALLY ACTIVE
Exercise, especially vigorous exercise, could be the single most important weapon in your arsenal. “Exercise is a huge factor when it comes to reducing
4 LEADING MEDICINE IN THE BAY AREA AND SOUTHEAST HOUSTON
a woman’s risk of breast cancer,” Jonna emphasized. “Some studies estimate a risk reduction with moderate exercise with a greater benefit seen in those who perform more vigorous exercise compared to their inactive peers.” Doctors think the exercise-estrogen link may account for the reduced risk. Here’s why: The greater your lifetime exposure to estrogen, the greater your risk for breast cancer. Exercise suppresses estrogen production by promoting lean body mass.
MAINTAIN A HEALTHY WEIGHT
Being overweight increases your risk of developing a variety of serious diseases, and breast cancer is one of them. Women who have more fat cells produce more estrogen and tend to have higher insulin levels, both of which are linked to an increased breast cancer risk. “Maintaining a healthy body weight throughout a woman’s lifetime, with a body mass index of 18.5–24.9, has many health benefits,” Jonna said.
LIMIT ALCOHOL
In addition to exercise and maintaining a healthy body weight, limiting alcohol to three or less alcoholic drinks per week can lower a woman’s risk. Compared with nondrinkers, women who consume two to five alcoholic drinks a day have about 1.5 times the risk of developing breast cancer. Jonna suggests that women who don’t want to abstain from alcohol intake can consider taking a daily multivitamin with folate (folic acid). Studies have shown that there may be a link between low folate levels and breast cancer risk, particularly in those individuals who have a high level of alcohol consumption.
CHOOSE TO BREASTFEED
Jonna encourages new mothers to breastfeed their babies if they are able. “Evidence suggests that breastfeeding reduces a woman’s risk of developing breast cancer,” she said. “We know that the longer a woman breastfeeds, the greater the protective effect.” The reasons why aren’t clear, but one possible explanation is that women who breastfeed have fewer menstrual cycles throughout their lives, and thus less exposure to estrogen.
CONSUME OLIVE OIL
Studies have suggested that consuming more monounsaturated fats, such as olive oil, may help protect against breast cancer, too. Houston Methodist is conducting a clinical trial, led by Dr. Tejal Patel, examining how a major component of olive oil, hydroxytyrosol, affects breast density in women at high risk of breast cancer. Women with higher breast density have a higher breast cancer risk.
TAKE PREVENTIVE MEDICATIONS
If you’re at higher risk for breast cancer, your doctor may recommend medications such as tamoxifen and raloxifene to lower your risk. However, these medications can produce symptoms of menopause, so it’s important to discuss the risks and benefits with your doctor to make an informed decision. The use of birth control pills has been shown in some studies to increase a woman’s risk of developing breast cancer. However, Jonna said the risk is slight. “Some consider this slight risk worth the benefit of prevention against other types of cancer, such as ovarian and endometrial,” Jonna said.
GENETIC TESTING AND INTERVENTION
If you have a strong family history of breast cancer, talk with your doctor about whether genetic testing is right for you. Mutations in certain genes, such as the BRCA genes, increase the risk of breast cancer. Women with this gene mutation may opt for more frequent screenings or prophylactic surgery (breast removal). Removing the ovaries and fallopian tubes is also an option; in addition to reducing the risk of ovarian cancer, it helps prevent breast cancer by eliminating a source of hormones that can fuel some types of the disease.
CLINICAL TRIALS OFFER HOPE Houston Methodist is conducting numerous clinical trials to improve care for women suffering from triple-negative breast cancer (TNBC), a highly aggressive form of the disease that can be especially challenging to treat. Scientists from Houston Methodist and Weill Cornell Medical College have pinpointed a gene previously unassociated with breast cancer that plays a pivotal role in the growth and progression of TNBC. The research suggests that targeting the gene may be a new treatment approach. A drug once used to improve blood flow in damaged hearts is also being studied as a possible treatment option for TNBC. Researchers recently identified two proteins responsible for predicting overall patient survival and validated a therapeutic compound in animal models that slows tumor growth and increases the efficacy of chemotherapy. In addition, Houston Methodist researchers are reviewing results of a clinical trial that evaluated three new drugs used in combination for the treatment of HER2-positive breast cancer. According to Jonna, the initial results look promising and could mean better outcomes for women with this form of breast cancer. Visit houstonmethodist.org/research/clinicaltrials to learn more about breast cancer clinical trials at Houston Methodist.
Schedule Your 3-D Mammogram
Houston Methodist St. John Hospital is proud to offer the gold standard in mammography — 3-D digital mammography — one of the most effective tools available in diagnosing breast cancer at an early stage, before tumors are large enough to be felt or cause any symptoms. This type of mammography reduces the rate of false-positive readings, ensures fewer callbacks for additional images and enables doctors to more accurately locate an abnormality in the breast. To schedule a 3-D mammogram at the Houston Methodist Breast Care Center at St. John, please visit houstonmethodist.org/breast-care or call 281.333.8858.
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GET THE FACTS ON
CANCER
Dr. Jitesh Joshi Answers Common Questions About Cancer
V
irtually everyone has been touched in some way by cancer — either themselves or through a family member or friend. Cancer affects about half of all men and one-third of all women in the United States during their lifetimes, but myths and misconceptions still swirl around this much-feared disease. To help set matters straight, Houston Methodist St. John Hospital’s Dr. Jitesh Joshi, a medical oncology and hematology specialist, answers some common questions about cancer.
DOES FAMILY HISTORY OF CANCER DETERMINE MY RISK?
If a family member is diagnosed with cancer, you may wonder what this means for your own risk. Genetics play a role in your risk for cancer, but having a parent or other family member with cancer doesn’t mean you’ll definitely develop cancer. Be sure to share family history information at your next checkup so your doctor can help assess your risk.
WHAT CAN I DO TO PREVENT CANCER?
Certain lifestyle and environmental factors can raise your risk for cancer — diet, tobacco and alcohol use, obesity, physical inactivity or exposure to ultraviolet rays, chemicals or infections. You can’t control every risk factor, but you can take action against cancer by making healthy choices when it comes to diet, exercise, wearing sunscreen, avoiding tobacco and limiting alcohol.
WHAT SCREENING TESTS DO I NEED?
Screenings help detect cancer in the earliest stages, when it’s most treatable and survival rates are best. That’s why it’s important to stay on top of cancer screening tests recommended based on your age and other factors, such as colorectal screenings, mammograms, cervical cancer screenings and more. Your doctor may recommend a screening schedule based on your personal and family health history or other risk factors.
WHAT DO I NEED TO KNOW ABOUT GETTING A BIOPSY? Typically, doctors will run a variety of tests to be sure, including blood tests, imaging scans or a biopsy. A biopsy involves taking a piece of tissue (or bone marrow, in the case of blood cancers) and analyzing it for malignant cells. If it’s cancer, a pathologist can determine its type and how fast it’s likely to grow. Imaging scans can tell if a cancer has spread to other parts of the body. All of this information helps determine the best approach to treat each cancer.
WHAT HAPPENS AFTER A CANCER DIAGNOSIS?
You may have a whirlwind of questions and heightened anxiety following a cancer diagnosis for you or a loved one. More treatment options are available now than ever before, including surgery, radiation, chemotherapy, hormone therapy, immunotherapy and targeted drugs that zero in on a tumor’s gene mutations or other molecular characteristics. You want to understand all of the options — and it certainly helps when you’re supported by a health care team recognized for expertise and compassion in cancer care.
LEADING CANCER CARE CLOSE TO HOME
Dr. Jitesh Joshi
Both inpatient and outpatient cancer services are available at Houston Methodist Cancer Center at St. John. Our oncology team, led by Dr. Jitesh Joshi, takes a collaborative and holistic approach to cancer care, working as partners with each patient and their families to promote the best possible outcomes.
6 LEADING MEDICINE IN THE BAY AREA AND SOUTHEAST HOUSTON
Joshi recently joined Houston Methodist Cancer Center at St. John, advancing the hospital’s cancer program. He is board certified in both hematology and medical oncology, and he comes to the Bay Area from the Arkansas Cancer Institute in Pine Bluff, where he also served on the teaching staff at the University of Arkansas for Medical Sciences. For information or to schedule an appointment, call 832.783.1190.
HEADING OFF HEARTBURN Determine and Prevent Your Reflux Triggers
A
lmost everyone knows the chestburning pain that comes with an occasional bout of heartburn. But what if you can’t escape this peculiar agony — also known as gastroesophageal reflux disease, or GERD — and deal with its near-constant presence? “About 20 million Americans take antacids Dr. Kyle or other heartburn medications regularly — Stephens meaning even greater numbers suffer from this condition,” said Houston Methodist St. John Hospital’s Dr. Kyle Stephens, a surgeon specializing in gastrointestinal procedures. Usually, heartburn stems from certain triggers, although genetics also plays a role in the propensity for stomach acid to splash up into the esophagus. According to Stephens, common heartburn triggers include acidic foods, such as tomato sauce, peppermint, chocolate, onions, peppers or spicy dishes; beverages, such as orange juice, cola, coffee or others containing caffeine; and lifestyle factors, such as smoking, obesity, overeating or eating too close to bedtime. “A large group still suffers from reflux despite lifestyle modifications or medication use,” Stephens explained. “In addition to how miserable they feel, it can also cause voice changes, coughing and choking, and even aspiration pneumonia.”
FIGURING OUT YOUR TRIGGERS
Pinpointing your individual triggers can help prevent recurrent heartburn. How to accomplish that? Stephens suggested two strategies: Keep a heartburn journal: Write down what you eat, drink and do each day and log your symptoms. Pay attention to the timing — whether heartburn occurred after a big meal, for instance, or if you consumed a particular food or drink.
T ry an elimination diet: Start with a basic, bland diet — such as bread and water for a day — and start adding foods back one at a time. When a specific food or drink leads to heartburn, you know that’s a trigger and can reduce or eliminate it. Losing weight, sleeping with the head of the bed elevated, and not eating for three hours before bed can help, too,” Stephens said.
ANOTHER OPTION FOR RELIEF FROM ACID REFLUX Significant numbers of chronic heartburn sufferers don’t find relief from lifestyle changes or antacid medication use. For them, Houston Methodist St. John Hospital now offers innovative, minimally invasive surgery that has proven widely successful nationally at ending constant gastroesophageal reflux. Recent Houston Methodist research on the dangers of reflux drugs make this surgery an even more important option. The procedure, using the LINX reflux management system, keeps stomach acid in place with a quarter-sized titanium “bracelet” around the base of the esophagus. Houston Methodist St. John is the only hospital in southeast Houston to offer LINX surgery. To learn whether you’re a candidate for LINX surgery, call to make an appointment with Dr. Kyle Stephens at 281.333.1703.
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At Houston Methodist Cancer Center, our teams of nationally recognized specialists are finding new ways to outsmart cancer, while delivering the most advanced treatments and comprehensive care available. From screenings to diagnosis and treatment, every aspect of our cutting-edge cancer care is available at all seven locations across Greater Houston, so you can focus on healing, surviving and thriving. Visit houstonmethodist.org/outsmartcancer or call 713.790.2700 to find a doctor in your area.
11. Houston Methodist Emergency Care Center in Cinco Ranch
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