Leading Medicine Fall 2015, Houston Methodist Hospital edition

LEADING MEDICINE YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS FROM HOUSTON METHODIST

BE A WISE GUY

FA LL 2015

Take action against these men’s health symptoms

WIN A KINDLE!

A Better Imaging Experience

SEE INSIDE FOR DETAILS.

Test Your Breast Cancer Knowledge

Spotting

Lung Cancer Insurance-covered screenings may detect the disease early

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f you’re a current or former smoker, you may be eligible for lung cancer screenings that Medicare and private insurance now cover.

Following a U.S. Preventive Services Task Force recommendation, insurers this year began covering annual low-dose computed tomography (CT) scans for certain patients.

“Aside from stopping cigarette smoking, lung cancer screening with CT is the most significant development in reducing deaths from lung cancer treatment in my lifetime,” said Dr. Eric Bernicker, a medical oncologist at Houston Methodist Hospital. “We can detect lung cancer when it is small and long before it becomes symptomatic or spreads outside the lungs.”

Here are screening highlights to discuss with your doctor.

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WHO IS ELIGIBLE?

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WHAT DOES IT COST?

Lung cancer screening is covered by private insurance and Medicare for eligible patients.

Medicare requires providers to include smoking cessation counseling prior to the scan.

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WHAT HAPPENS DURING SCREENING?

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IS THE SCREENING RISKY?

An X-ray machine using low-dose radiation scans and takes pictures of the lungs while patients lie on a table and hold their breath for a few seconds.

Potential risks include the cumulative effects of radiation exposure and results that are false positive (a finding that looks like cancer but is not) or false negative (in which cancer is present but not detected). Positive results can lead to additional tests, including imaging studies or more invasive procedures such as biopsy. n

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In addition to not smoking, you can do more to protect your lungs from cancer, asthma and other conditions. Adopt these habits to keep your lungs healthy.

G et moving. Stay active to boost your lung strength.

Consider swimming, which requires rhythmic breathing, or yoga, which can improve respiratory function.

E at right. Dietitians say foods such as broccoli, cabbage, salmon and eggs support lung health.

G et a flu shot. Enhance the infection-fighting power of the flu shot by washing your hands often, and help others by covering your sneezes and coughs.

S trategize outdoor time. Air pollution and allergens are at higher levels at certain times and locations. Check alerts by ZIP code at airnow.gov.

Know Your Lung Cancer Risk

Houston Methodist Cancer Center is dedicated to researching, diagnosing and treating lung cancer. For more information or to schedule an appointment, visit houstonmethodist.org/cancer or call 713.790.3333.

PHOTO BY THINKSTOCK

For Medicare beneficiaries, it’s those ages 55 to 77 who currently smoke or have quit in the past 15 years; who have a tobacco smoking history of at least 30 “pack years” (an average of one pack a day for 30 years, two packs a day for 15 years, etc.); and who receive a written order from a physician or qualified nonphysician practitioner.

Under private insurers — which are required by the Affordable Care Act to cover lung cancer screenings — policyholders are eligible through age 80.

BREATHE RIGHT

A Better

Imaging Experience New technology offers patients more comfort and clearer pictures

PHOTO BY THINKSTOCK

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artnerships with the world’s leading health care innovators have brought exclusive imaging technology to Houston Methodist, providing timely, complete and accurate results in a comfortable, compassionate environment.

These advanced imaging systems use low-dose radiation and quickly produce high-quality scans of organs, bones and tissues, eliminating the need for additional tests and reducing discomfort. The technology improves the imaging experience, while providing doctors information needed to diagnose and treat patients in a timely manner.

“These systems simplify and improve the efficiency of the imaging process and alleviate possible side effects and anxiety patients experience,” said Angie McDonald, director of cardiovascular imaging at Houston Methodist Hospital. “The scanners provide physicians a more complete map to follow when offering patients the best treatment options.”

The board-certified radiologists at Houston Methodist’s imaging centers depend on the technology to provide doctors fast and accurate results, especially in emergencies involving serious injury or chest pain.

Doctors at Houston Methodist DeBakey Heart & Vascular Center use Siemens’ SOMATOM Force CT, a fast and versatile scanner to get a clear and

thorough heart scan within a second.

The exam is so fast and precise, patients who struggle to breathe don’t have to hold their breath to complete a scan.

The system is designed for patients with the most complex conditions, so it requires less contrast dye, plus reduces or eliminates the need for heart-slowing medicines, to produce exceptional images.

Radiologists also use GE Healthcare’s Revolution CT scanner to provide quick, high-quality results in a low-stress setting. The system performs a splitsecond scan, requires less contrast dye and often eliminates the need for more imaging.

Additionally, radiologists use tomosynthesis, a new low-dose 3-D mammogram system that produces high-resolution images from more angles, reducing the need for repeat mammograms. The system works best for women with dense breast tissue.

“On traditional mammograms, dense breast tissue appears white, which makes these areas difficult to evaluate and often leads to additional views,” said Dr. Luz Venta, the medical director of Houston Methodist Breast Care Centers. “With the new technology, possible problem areas in dense tissue are much easier to detect.”

Schedule Your Scan Online

Houston Methodist makes booking your imaging appointment easy with online scheduling. Visit houstonmethodist.org/ online-scheduling to make an appointment.

A clear image, quickly and accurately evaluated by an experienced radiologist, can lead your doctor to the right diagnosis and treatment you need to maintain your health. It’s important to choose an imaging facility staffed by board-certified radiologists, like those at Houston Methodist, to get a reliable and accurate diagnosis. n

CHECK OUT OUR DIGITAL MAGAZINE AT HOUSTONMETHODIST.ORG/NEWSROOM/NEWSLETTERS 3

Test Your Breast Cancer Knowledge How well do you understand risks and prevention?

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ost of us know someone who has faced breast cancer, but many don’t understand what we can do to prevent the disease diagnosed in one in eight American women. Take our quiz to see how much you know.

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Most cases of breast cancer are diagnosed in women 50 and older.

At what age should you start getting annual mammograms that can reveal breast cancer in the earliest stages?

A. 60 B. 50 C. 40 D. 30

ANSWER: C. Most women should have an annual mammogram starting at age 40. If you are at high risk, ask your doctor about starting sooner.

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Are mammograms the only way to detect breast cancer at an early stage?

ANSWER: B. Annual breast exams at your doctor’s office and monthly breast

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PHOTO BY THINKSTOCK

A. Yes B. No C. Sometimes D. It depends on the woman’s age

self-exams can help identify lumps or changes in your breasts that could be signs of cancer.

steps can you take to lower 3What your risk of breast cancer?

A. Don’t use deodorant or antiperspirant.

B. Avoid wearing underwire bras.

C. Maintain a healthy weight and get regular exercise.

D. Avoid airport scanners that use X-rays.

ANSWER: C. These healthy behaviors can lower your risk. The other answers are myths.

race has the highest 4Which death rate from breast cancer?

A. African-American B. Caucasian C. Hispanic D. Asian-American/Pacific Islander

ANSWER: A. While race does not affect breast cancer risk, AfricanAmericans have a higher death rate from the disease than any other group: 31.6 percent, compared with 22.4 percent for Caucasian women and 14.9 for Hispanic women.

harmful mutations in 5Inheriting the BRCA1 or BRCA2 gene is one

of the main risk factors for breast cancer. Which of these other factors can also increase your risk?

A. Family or personal history of breast cancer B. Drinking alcohol C. Long-term use of hormone replacement therapy D. All of the above

Is It Genetic?

HOW TO PERFORM A BREAST SELF-EXAM

ANSWER: D. Other risk factors include dense breasts and having undergone treatment with radiation therapy to the breast and chest.

While lying down, place a pillow under your right shoulder and your right arm behind your head. With your left hand, move the pads of your fingers around your right breast area and armpit, using circular motions.

Squeeze the nipple to check for discharge. Repeat for your left breast.

Standing in front of the mirror, look at your breasts with your arms at your sides and then raise your arms overhead.

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Should I have a test to find out whether I carry the BRCA1 or BRCA2 gene mutation that can cause breast cancer?

A. Yes B. No C. M aybe, if you have a strong family history of breast cancer D. O nly if you know someone in your family carried the gene mutations ANSWER: C. “Strong family history” includes close relatives diagnosed before age 50, a family member with the gene mutations, or family members with multiple breast cancers, cancer in both breasts, or both breast and ovarian cancers. You should have counseling before deciding to have genetic testing.

Perform these checks monthly, looking for these signs: A lump in the breast Any unexplained change in breast size or shape Dimpling anywhere on the breast Nipple tenderness or discharge A nipple that is turned slightly inward or inverted Skin that’s become scaly, red or swollen, or any change in skin texture

If the disease is detected early, 7 what is the five-year survival rate for breast cancer?

A. 98 percent B. 85 percent C. 80 percent D. 75 percent

ANSWER: A. Stage 1 breast cancer, in which the cancer has not spread beyond the original cancerous cells, is highly treatable when detected early through a mammogram or other screening.

Women who have the abnormal BRCA1 or BRCA2 genes have a risk of up to 80 percent of developing breast cancer. A genetic counselor can help you understand your risk. To learn more, visit houstonmethodist.org/cancer or call 713.441.8571.

These signs do not necessarily mean you have cancer, but you should see your doctor to discuss them.

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How many breast cancer survivors are in the United States today?

A. 1 million B. 1.7 million C. 2.3 million D. 2.8 million

ANSWER: D. Although breast cancer remains the second leading cause of cancer death in women (behind lung cancer), far more women have survived the disease. n

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Be a

Wise Guy Take action against these men’s health symptoms

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uys, it’s not just the women in your life who frown on your tough-it-out approach to health problems.

Men are more likely than women to smoke and drink, make unhealthy choices and put off regular medical care, according to the National Institutes of Health.

The American Academy of Family Physicians reports that about a third of men don’t have a primary care doctor, and nearly 30 percent delay medical care as long as possible when they’re sick.

Many of the health risks men face can be prevented or treated successfully if identified early. But warning signs aren’t always obvious — and symptoms that seem minor can indicate a larger health problem. Here are five to take seriously.

SYMPTOM: SKIN CHANGES HEALTH RISK: SKIN CANCER

White men older than 50 are more than twice as likely as women to develop and die from skin cancer, the Skin Cancer Foundation says.

Yet nearly half of men said in a foundation survey that they hadn’t used sunscreen in the past 12 months, and 70 percent didn’t know skin cancer warning signs.

Red flags can be subtle and include new growths, spots, bumps and patches, plus slow-to-heal sores and shaving cuts. Remember this ABCDE guide when checking for skin cancer: • Asymmetry: Is one half of the mole shaped differently than the other?

• Border: Are the edges of the mole irregular, ragged or blurred?

• Color: Is the mole more than one color?

• Diameter: Is the spot larger than a pencil eraser?

• Evolving: Has the mole changed in shape, size or color?

SYMPTOM: LOWER LEG PAIN, POPPING OR SNAPPING NOISE HEALTH RISK: ACHILLES TENDON RUPTURE

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PHOTO BY THINKSTOCK

The Achilles tendon connects the calf muscle to the heel bone at the back of the leg. A tear or rupture occurs when the tendon is overly stretched, typically during sports involving jumping, pivoting or sudden accelerations.

See a doctor if you feel sudden pain in your lower leg or hear a pop or snap. Treatment, which may involve surgery, depends on the severity of the rupture.

SYMPTOM: BACK NUMBNESS, TINGLING HEALTH RISKS: HERNIATED DISK, SPINAL STENOSIS

The spine is a superhighway that transports information from your brain to the rest of your body. Pay attention to the messages it sends.

Are you experiencing numbness or tingling? These may be signs of herniated disks or spinal stenosis, which share symptoms but have different causes.

Over time, the rubbery disks between the spine’s vertebrae may rupture, or herniate. The jelly-like center of the disk then leaks, irritating nearby nerves and sometimes causing persistent pain along the sciatic nerve from the lower back to the lower leg. Treatment may include rest, therapy or surgery.

Spinal stenosis is a narrowing of the open spaces inside the spine. The condition puts pressure on the nerves and spinal cord, sometimes resulting in pain or numbness in the neck, back, arms or legs as well as problems with bladder and bowel function. Treatment may include medication, physical therapy, braces or surgery.

SYMPTOM: SHORTNESS OF BREATH

HEALTH RISK: HEART ATTACK

Heart attacks don’t always announce themselves with sudden, intense pain or squeezing in the center of your chest.

Sometimes they masquerade as pneumonia, for example, or asthma, fatigue or chronic obstructive pulmonary disease (COPD).

Shortness of breath may be your only signal to call 911 for lifesaving emergency treatment.

Men — who are at greater risk for heart attack and at earlier ages than women — should be especially alert to the possibility if they smoke, are physically inactive or overweight, or have high cholesterol, high blood pressure or diabetes. Those factors increase heart attack risk.

SYMPTOM: URINARY CHANGES

HEALTH RISKS: ENLARGED PROSTATE OR PROSTATE CANCER

Have you been going more frequently or urgently? Do you have trouble emptying your bladder? The prostate gland could be to blame.

Although the conditions sometimes share symptoms, an enlarged prostate does not necessarily signal prostate cancer. Both conditions are common in men starting at midlife.

“The most common culprit for an enlarged prostate is benign prostatic hyperplasia (BPH), a condition common to almost all aging males. It’s caused by increasing growth of prostatic cells along the urinary tube (urethra), which leads to increasing difficulty with urination,” said Dr. Brian Miles, a urologist and the medical director of robotic surgery at Houston Methodist Hospital.

See your doctor about troubling symptoms — immediately if you have bloody urine, pain or burning with urination or are unable to urinate, recommends Miles.

For either problem, doctor-monitored watchful waiting may be the initial response. n

AN OUNCE OF PREVENTION Even the healthiest men need regular screenings to ensure they stay at their best. Men should schedule a physical exam every two years until age 50 and annually after that, along with the following screenings: B LOOD PRESSURE: Every two years, more often if it’s high.

CHOLESTEROL, HEART DISEASE: Every five years after age 34, more often with high cholesterol or certain other conditions.

D IABETES: Every three years after age 45, earlier if you’re overweight.

COLORECTAL CANCER: Starting at age 50, earlier with inflammatory bowel disease, polyps or family history of colon cancer or polyps. Frequency depends on test performed and your risk factors.

PROSTATE CANCER: Talk with your doctor starting at age 50 (45 if you’re African-American or have a family history of prostate cancer).

LUNG CANCER: Yearly starting at age 55 if you have a 30 “packyear” smoking history and currently smoke or have quit within the past 15 years.

Be Proactive

Houston Methodist is here to keep you and your family healthy. Visit houstonmethodist.org or call 713.790.3333 to schedule an appointment with one of our physicians.

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