SPECIAL FALL EDITION 2016
Breast Cancer Awaren
e Month ss Issue
Dense
BREAST
Tissue
DOC’S TO KNOW Dr. Sara Crowder — One of the Top Gynecologic Robotic Surgeons in the World
Easing the Load Nurse Navigator helps patients through breast cancer journey
Genetics and
Breast Cancer STOP
Smoking... The benefits over time?
K N I es P Team thepag Brady Glass ide Ins
& Susan G. Komen The Race for the Cure is Personal
the
Contents 22
The Skinny on
Shrimp
On the Cover
SPEC I AL FALL C AN CER EDIT I ON 2016 FEAT URES BEAUTY
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WOMEN’S HAND & NAIL CARE By following a few simple steps every day, you can keep them looking and feeling young and supple.
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HEALTH & FITNESS
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TOP 10 MOST UNHEALTHY, CANCER-CAUSING FOODS Never eat these again!
PINK PAGES
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USING YOUR OWN FAT & STEM CELLS TO AUGMENT OR RECONSTRUCT YOUR BREASTS
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DENSE BREAST TISSUE Understanding what it means to have dense breast tissue.
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WHEN YOU FIND OUT YOU HAVE CANCER... Here are some questions to ask your doctor.
STOP SMOKING What are the benefits over time?
THE SKINNY ON SHRIMP Fresh vs. frozen, the nutritional skinny, the scoop on size—get the whole skinny here
TRIM YOUR CANCER RISK WITH EXERCISE It’s never too late to exercise! Follow these tips for fighting cancer with exercise.
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METASTATIC CANCER What is this cancer and how does it spread?
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FOOD & NUTRITION
BANISH DRY SKIN These tips for keeping skin soft and healthy can help all who battle dry skin, from chilly New England to balmy Hawaii and beyond.
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SPECIAL FALL EDITION CANCER AWARENESS ISSUE! In this special edition of The New You Magazine, Inside & Out, we focus on healthy topics that are relatable to breast cancer patients and survivors!
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GENETICS & BREAST CANCER Learn about genes, genetics and breast cancer.
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thenewyoumagazine.net SPECIAL FALL EDITION 2016
RESOURCE GUIDE
Welcome to the THE NEW YOU–Inside & Out... Dear Friends, October is Breast Cancer Awareness Month. The chance of a woman having invasive breast cancer is about 1 in 8. Breast cancer is one the most common cancer among American women. Getting mammograms regularly can lower the risk of dying from breast cancer. Most breast cancers are found in women who are 50 years old or older, but breast cancer also affects younger women About 10% of all new cases of breast cancer in the United States are found in women younger than 45 years of age. Here are a few things that can help lower your risk. It is important that you• Know how your breasts normally look and feel. If you notice change in the size or shape, feel pain, or have nipple discharge talk to your doctor right away. • Make healthy choices. Keeping a healthy weight, getting physical activity, breastfeeding babies can help lower your overall risk. • Talk to your doctor about your risk. If your risk is high, your doctor may talk to you about getting mammograms earlier and whether other screening might be right for you. Your doctor may also suggest that you get genetic counseling to determine if you should be tested for changes in your BRCA1, BRCA2, and other genes related to breast cancer. Every issue of “The New You – Inside and Out” is dedicated to my mother, Freida Hawkins, who fought Breast Cancer for 18 years before going home. Thank you mom, for continuing to guide me from above. I love you and miss you every day. A OGRAM MAMM D MY E SAV d LIFE an
Life is Good!
save it can R S! YOU
VOLUM E 6, I SSU E 3 THE NEW YOU PUBLISHING, L.L.C. 1260 B ar ron R oad Poplar Bluff, Missouri 573-631-9100 thenewyoumagazine.net
CEO/PUBLISHER Karen Hawkins 573-631-9100 or karen@islc.net EXECUTIVE EDITOR Michelle Cox MANAGING EDITOR Sharon Lewis DESIGN & PHOTO DIRECTOR NY Marketing & Creative SPECIAL PROJECTS EDITOR Karen Hawkins CONTRIBUTING WRITERS Kathleen Berchelmann, MD Raina Childers Davine Conover, Ozark Federal Michelle Cox Linda Franklin Julie Margenthaler, M.D.,FACS Terrence Myckatyn, MD, FACS, FRCs(C) Jessica Park Rachel Russo ADVERTISING COORDINATOR NY Marketing & Creative ACCOUNT EXECUTIVES Karen Hawkins ADVERTISING To place an ad or request a media kit, please call Karen Hawkins at 573-631-9100 or email to karen@islc.net
The New You–Inside & Out Publisher and Founder
“She stood in the storm and when the wind did not blow her way – she adjusted the sail” — author unknown
MARKETING/ADVERTISING AGENCY AND WEB PRODUCTION NY Marketing & Creative
Subscription Rates: $10 for one year • Frequency five issues per year • Single copies in office • Reprint requests must be made prior to the publishing of a specific issue • Reprints are $2.00 per copy • Reproduction in part or whole is strictly prohibited without the express permission of the publisher • Unsolicited manuscripts may be submitted but must be accompanied by a self-addressed stamped envelope • The New You–Inside & Out Magazine does not endorse any information contained in articles or advertisements and suggests consulting a health-care professional before beginning any therapy or medical treatment.
© 2016 by The New You–Inside & Out Magazine ALL RIGHTS RESERVED
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20 FINANCIAL HEALTH What is Your Shopping Filter System? Davine Conover of Ozark Federal Credit Union discusses, what, when, how, and with whom to share your purchasing habits can change the way you look at finances.
36 P INK PAGES Breastfeeding can help lower the risk of Breast Cancer. “In Touch Mom” is dedicated to providing this quality information and breastfeeding support for all women.
38 DOC’S TO KNOW “Doctor Sara Crowder, MD” Gynecologic oncologist Sara Crowder, MD performs surgery using the da Vinci surgical system. Hear her story and how for past two years, Dr. Crowder has performed more of these types of surgeries than anyone else in Missouri and is in the top one percent world-wide.
SPECIAL FALL EDITION 2016 thenewyoumagazine.net
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BEAUTY
hand & nail T
aking care of your hands and nails is as important as taking care of the skin on your face. It is often said that your hands reveal your true age, and that’s because the skin on your hands loses its firmness over time, leaving them susceptible to wrinkles, sun spots and other signs of aging. Yet your hands often don’t get the attention they deserve. By following a few simple steps every day, you can keep them looking and feeling young and supple. Washing your hands is a great way to curb the spread of germs. But some soaps can irritate your skin. Dermatologist Amy Derick, MD, of Barrington, Ill., recommends using a moisturizing liquid cleanser to wash hands if you have normal skin. If you prefer bar soap, look for moisturizing soap made with ingredients such as glycerin, petrolatum, sunflower oil, and soybean oil.
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Use Moisturizers and Hand Creams One of the best things you can do for your hands, especially as you get older, is to moisturize them throughout the day and before you go to bed. Any cream or lotion will do, but creams made for the hands have some advantages. One of the major ones, is that they are usually non-greasy and quick absorbing. Moisturizing creams can, at least temporarily, make your hands look plumper and more youthful by drawing water into the skin. For plumping, look for hand creams containing hyaluronic acid, which gives skin support and body. To moisturize the skin of your hands, look for hand creams with petrolatum, glycerin, shea butter, or safflower seed oil. Be sure to buy hand cream with a broad-spectrum sunscreen, SPF 30 or higher, to protect your hands from sun damage.
Take Care of Your Cuticles Just like your hands need to be moisturized, so do your nails. While you have the moisturizer out, rub a little into the base and sides of your nails, including the cuticles, the protective barrier between your nails and the skin underneath. Moisturizing your nails and cuticles keeps those areas more pliable and less at risk for cracking, tearing and hangnails, which can open the door to skin infections. If your cuticles are very dry and prone to tears, you may want to consider applying nightly cuticle oil to offer an extra dose of moisture.
Wear Gloves During Chores When it comes to taking care of your hands, gloves offer two great benefits. Water, especially hot water, can strip your skin of its own natural oils, leaving your hands and nails dry and chapped. Exposure to the chemicals found in some cleaning products can cause contact dermatitis, which is a skin reaction that results in redness, itching and dryness. Wearing a pair of the cotton-lined rubber gloves while you clean, minimizes your contact with both water and chemicals, keeping hands shielded while you work.
Remove Polish A fresh coat of nail polish adds a pop of color to your hands, but you don’t want to leave it on for too long. In addition to unsightly chips, an old coat of polish (especially if you tend to prefer darker shades) can cause discoloration or yellowing and weakening of your nails. Aim to keep polish on for no longer than a week, and remove it with a cotton pad and non-acetone polish remover, which is gentler on nails than remover with acetone. Soak a cotton pad with remover then hold it on your nail for at least 10 seconds, then swipe upward toward the tip of your nail. This is less irritating to your nails and cuticles than rubbing vigorously in all directions. Once your nails are polish-free, check them for any irregularities, such as white spots, vertical lines or dark streaks. These changes can be caused by a variety of factors, from injury to certain diseases including melanoma, so they should not be ignored.
File Your Nails When it comes to the best length for your nails, think of yourself like Goldilocks with her porridge: Nails that are too long are more likely to split or tear, as well as harbor bacteria, while nails that are too short may not adequately protect your fingertips. Aim for nails that are “just right,” with tips that extend two to three millimeters beyond your fingertips. File nails in one direction only — using a sawing motion can create microscopic tears that make nails more likely to split. SPECIAL FALL EDITION 2016 thenewyoumagazine.net
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BEAUTY
dry skin D
ry skin occurs when skin doesn’t retain sufficient moisture. This can happen as a result of frequent bathing, use of harsh soaps, aging, or certain medical conditions. And for those in colder climates, it can stem from cold, dry winter air. At this time of year, those in the Northern Hemisphere may suffer from red, rough, raw, and itchy skin. This is because cold winter air means low humidity, both outdoors and indoors. The water content of the epidermis (the outermost layer of skin) tends to reflect the level of humidity around it. Fortunately, there are many simple and inexpensive things you can do to relieve winter dry skin, also known as winter itch or winter xerosis.
Even if you live in a part of the world where cold winter air is not currently — or ever — a concern, most people will need to manage dry skin at some point. These tips for keeping skin soft and healthy can help all who battle dry skin, from chilly New England to balmy Hawaii and beyond.
Keeping moisture in the skin Skin moisturizers, which rehydrate the top layer of skin cells and seal in the moisture, are the first step in combating dry skin. They contain three main types of ingredients. Humectants, which help attract moisture, include ceramides (pronounced ser-A-mids), glycerin, sorbitol, hyaluronic acid, and lecithin. Another set of ingredients — for example, petrolatum (petroleum jelly), silicone, lanolin, and mineral oil — helps seal
that moisture within the skin. Emollients, such as linoleic, linolenic, and lauric acids, smooth skin by filling in the spaces between skin cells. In general, the thicker and greasier a moisturizer, the more effective it will be. Some of the most effective (and least expensive) are petroleum jelly and moisturizing oils (such as mineral oil). Because they contain no water, they’re best used while the skin is still damp from bathing, to seal in the moisture. Other moisturizers contain water as well as oil, in varying proportions. These are less greasy and may be more cosmetically appealing than petroleum jelly or oils. Dry skin is usually not a serious health problem, but it can produce serious complications, such as chronic eczema (red patches) or bleeding from fissures that have become deep enough to disrupt capillaries in the dermis. Another possible complication is secondary bacterial infection (redness, swelling, and pus), which may require antibiotics. (Rarely, dry skin is associated with allergy.) Consult your clinician if you notice any of these symptoms or if measures you take at home provide no relief. For severe dry skin, your clinician may prescribe a cream containing lactic acid, urea, or corticosteroids. She or he may also want to rule out medical conditions that can cause dry skin, including hypothyroidism, diabetes, lymphoma, kidney disease, liver disease, psoriasis, and atopic dermatitis. Always use sunscreen — even in the winter — to protect your skin.
What can you do? Here are some ways to combat dry skin that are effective if practiced consistently: I Use a humidifier in the winter. Set it to around 60%, a level that should be sufficient to replenish the top layer of the skin. I Limit yourself to one - 5 to 10 - minute bath or
shower daily. If you bathe more than that, you may strip away much of the skin’s oily layer and cause it to lose moisture. Use lukewarm rather than hot water, which can wash away natural oils. I Minimize your use of soaps; if necessary,
choose moisturizing preparations such as Dove, Olay, and Basis, or consider soapfree cleansers like Cetaphil, OilatumAD, and Aquanil. Steer clear of deodorant soaps, perfumed soaps, and alcohol products, which can strip away natural oils. I To avoid damaging the skin, stay
away from bath sponges, scrub brushes, and washcloths. If you don't want to give them up altogether, be sure to use a light touch. For the same reason, pat or blot (don't rub) the skin when toweling dry. I Apply moisturizer immediately after bathing
or washing your hands. This helps plug the spaces between your skin cells and seal in moisture while your skin is still damp. I Never, ever scratch. Most of the time, a
moisturizer can control the itch. You can also use a cold pack or compress to relieve itchy spots. I Use fragrance-free laundry detergents and
avoid fabric softeners. I Avoid wearing wool and other fabrics that can
irritate the skin. SPECIAL FALL EDITION 2016 thenewyoumagazine.net
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2016 CYC Good and Evil E—Conducting Large Group
HEALTH & F ITNES S
Metastatic Cancer information from the National Cancer Institute
Key Points Metastatic cancer is cancer that has spread from the place where it first started to another place in the body. Metastatic cancer has the same name and same type of cancer cells as the original cancer. The most common sites of cancer metastasis are the lungs, bones, and liver. Treatment for metastatic cancer usually depends on the type of cancer and the size, location, and number of metastatic tumors. 12
thenewyoumagazine.net SPECIAL FALL EDITION 2016
What is metastatic cancer? Metastatic cancer is cancer that has spread from the place where it first started to another place in the body. A tumor formed by metastatic cancer cells is called a metastatic tumor or a metastasis. The process by which cancer cells spread to other parts of the body is also called metastasis. Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to the lungs and forms a metastatic tumor is metastatic breast cancer, not lung cancer.
Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the expression of certain proteins or the presence of specific chromosome changes.
Q Can any type of cancer form a metastatic tumor?
A
Virtually all cancers, including cancers of the blood and the lymphatic system (leukemia, multiple myeloma, and lymphoma), can form metastatic tumors. Although rare, the metastasis of blood and lymphatic system cancers to the lungs, heart, central nervous system, and other tissues has been reported.
Q Where does cancer spread?
A
The most common sites of cancer metastasis are the lungs, bones, and liver. Although most cancers have the ability to spread to many different parts of the body, they usually spread to one site more often than others. The following table on the right shows, in descending order from left to right, the three most common sites of metastasis, excluding lymph nodes, for several types of cancer.
Cancer type
Main sites of metastasis
Breast Colon Kidney Lungs Melanoma Ovary Pancreas Prostate Rectum Stomach Thyroid Uterus
Lungs, liver, bones Liver, peritoneum, lungs Lungs, liver, bones Adrenal gland, liver, lungs Lungs, skin/muscle, liver Peritoneum, liver, lungs Liver, lungs, peritoneum Bones, lungs, liver Liver, lungs, adrenal gland Liver, peritoneum, lungs Lungs, liver, bones Liver, lungs, peritoneum
Q How does cancer spread?
A
Cancer cell metastasis usually involves the following steps:
Local Invasion: Cancer cells invade nearby normal tissue. Intravasation: Cancer cells invade and move through the walls of nearby lymph vessels or blood vessels. Circulation: Cancer cells move through the lymphatic system and the bloodstream to other parts of the body.
Metastatic cancer cells invade lymph vessels and blood vessels near a tumor and migrate to other parts of the body. SPECIAL FALL EDITION 2016 thenewyoumagazine.net
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HEALTH & F ITNESS
Trim your cancer risk with exercise
[
IT IS NEVER TOO LATE TO EXERCISE
Exercise is one of the most important actions you can take to help guard against many types of cancer. Up to one-third of cancer-related deaths are due to obesity and a sedentary lifestyle, including two of the most common cancers in the United States, breast and colon cancer. Many people exercise to prevent heart disease, but exercise can also play a key role in preventing cancer. Most cancers are caused by lifestyle factors—not genes.
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Reduce your waistline and breast-cancer risk. More than two dozen studies have shown that women who exercise have a 30 to 40 percent lower risk of breast cancer than their sedentary peers. The female hormone estrogen seems to play a key role. Women with high estrogen levels in their blood have increased risk for breast cancer. Since exercise lowers blood estrogen, it helps lower a woman’s breast-cancer risk. Exercise also reduces other cancergrowth factors such as insulin. Even older women need to be concerned about estrogen, because after menopause the hormone is produced by fat cells. Women who exercise have less fat and therefore produce less estrogen. With more than 150,000 new breast-cancer cases reported in the United States each year, preventing cancer through exercise is one of the best ways a woman can take charge of her health.
Win the battle against colon cancer. Exercise plays a dramatic role in preventing cancer of the colon and rectum. Nearly 150,000 Americans are diagnosed with colorectal cancer each year, and nearly 50,000 die from the disease. Encouragingly, more than three dozen studies show exercisers reduce their risk of colon cancer by 20 percent or more compared to sedentary people, and the benefits are seen in both men and women, although the effect is greater in men. Changes in digestive acids and other substances also occur with exercise, and these changes are believed to provide some protection from colon cancer. Decreases in body fat, insulin and other growth factors also may contribute to exercisers’ lower colon-cancer risk. Current research is also uncovering new ways in which physical activity cuts cancer risk—from reducing chronic inflammation to improving DNA repair.
Get up off the couch! It’s easier than you think! A half hour of physical activity daily such as walking, slow swimming, leisurely bike riding or golfing without a cart will get you started. Here are some other ways to be more active: I Use stairs rather than an elevator. I Walk or bike to your destination, and walk around the
block after dinner. I Exercise at lunch with your family or friends. I Go dancing. I Wear a pedometer every day and watch your daily steps increase. I Join a sports team. I Walk to visit co-workers rather than send an e-mail.
I Use a stationary bike or do sit-ups, leg lifts and push-ups
while watching TV. I Park a little farther from your office, the store or the library for a nice walk. I When the weather is too poor to be outside, grab a partner and “walk the mall.”
I Vary your type of exercise so you won’t get bored or
think it’s a chore. Often people view exercise narrowly as a way to lose weight or to look better. These incentives can be effective, but exercise is really about a person taking charge of his or her health, preventing chronic diseases like cancer and living longer.
Women it’s never too late to start.
How much exercise is too much?
Even moderate activity can be critically important in helping menopausal women reduce their risk of cancer, heart disease and other chronic ailments. Exercise reduces fat deep in the abdomen (“intra-abdominal” fat), a hidden risk factor because it can raise insulin levels, which promote the growth of cancer cells as well as cholesterol levels. Most American women gain one to two pounds on average every year, and that adds up to dangerous levels over a lifetime.
According to national activity guidelines, a good goal is to exercise at least 30 minutes a day on most days of the week. To get the most benefit, though, aim for about an hour a day. Moderateintensity activities such as brisk walking may be sufficient, although there is more benefit with increased intensity.
The beauty of exercise as a method to reduce total and intra-abdominal fat — and therefore chronic disease — is that it can be done by most women at low cost and with low risk of side effects. It’s never too late to enjoy the health benefits of exercise!
For more information on this and other cancer-related topics, call the National Cancer Institute’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) or visit www.cancer.gov. SPECIAL FALL EDITION 2016 thenewyoumagazine.net
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HEALTH & F ITNESS
stop smoking what are the benefits > > > over time? 16
thenewyoumagazine.net SPECIAL FALL EDITION 2016
> > > >
> >
20 minutes after quitting Your heart rate and blood pressure drop. (Effect of smoking on arterial stiffness and pulse pressure amplification, Mahmud A, Feely J. Hypertension. 2003:41:183)
12 hours after quitting The carbon monoxide level in your blood drops to normal. (US Surgeon General’s Report, 1988, p. 202)
1 to 9 months after quitting Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) start to regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs and reduce the risk of infection. (US Surgeon General’s Report, 1990, pp. 285-287, 304)
1 year after quitting The excess risk of coronary heart disease is half that of a continuing smoker’s. (US Surgeon General’s Report, 2010, p. 359)
5 years after quitting Risk of cancer of the mouth, throat, esophagus and bladder are cut in half. Cervical cancer risk falls to that of a non-smoker. Stroke risk can fall to that of a non-smoker after 2-5 years. (A Report of the Surgeon General: How Tobacco Smoke Causes Disease - The Biology and Behavioral Basis for SmokingAttributable Disease Fact Sheet, 2010; and Tobacco Control: Reversal of Risk After Quitting Smoking. IARC Handbooks of Cancer Prevention, Vol. 11. 2007, p 341)
10 years after quitting The risk of dying from lung cancer is about half that of a person who is still smoking. The risk of cancer of the larynx (voice box) and pancreas decreases. (A Report of the Surgeon General: How Tobacco Smoke Causes Disease - The Biology and Behavioral Basis for SmokingAttributable Disease Fact Sheet, 2010; and US Surgeon General’s Report, 1990, pp. vi, 155, 165)
15 years after quitting The risk of coronary heart disease is that of a non-smoker’s. (Tobacco Control: Reversal of Risk After Quitting Smoking. IARC Handbooks of Cancer Prevention, Vol. 11. 2007. p 11)
These are just a few of the benefits of quitting smoking for good. Quitting smoking lowers the risk of diabetes, lets blood vessels work better and helps the heart and lungs. Quitting while you are younger will reduce your health risks more, but quitting at any age can give back years of life that would be lost by continuing to smoke.
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Let us do OUR JOB. So YOU focus on yours. Our CPA firm is in the business of providing accounting services to our clients. Measurement, analysis, and communication of economic events are our basic role and are also a concise definition of accounting.
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FINANCIAL HEALTH
What is Your By Davine Conover, Ozark Federal
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W
e spend our days thinking about what, when, how, and with whom to share our purchasing power... All of this costs money. What identifies how much we spend all comes down to our individual filter system. Our filter system identifies if we are spending money out of friendship, companionship/ acceptance, obligation, justification, or necessity, or a combination of these reasons.
Identifying your filter system can change the way you look at money. You can learn to have a tremendous respect for the choices you make, and they will become wiser choices. To identify your filter system, review the options below: Friendship- is when you have the opportunity to spend resources on enjoyment, with or without someone else. It could be the thrill of the hunt or even the chance to spend time with someone while shopping, entertaining, or eating out. Acceptance- is typically gift giving... Many people give with the desire to have you include them in your time. They give personal possessions or money to have you in-clude them in your activities or visit more often. They see money as power to control behavior. Obligation- is required, acceptable spending... i.e. Christmas, birthdays, graduations, and weddings. Justification- usually starts with “I need this because...” You justify every purchase you make before making it. Necessity- is spending when you know it is a need, and not a want (i.e. food, electricity, gas, etc.) These are not excessive items, but needed items. Entitlement's- when you spend money because you have earned it, and/or you deserve it.
Shopping Filter System? Once you have identified the filter of why you shop, think about when you like to shop. You can click on an app for any of your favorite stores and put that special item in the cart right from your phone. The UPS driver becomes your best friend. If you shop for the thrill of it, you can choose to use your spending power over the web, phone, or face to face. It could be that you like the feeling of accomplish-ment, of “saving money” because it was on sale. Or, you could shop because you are lonesome and love visiting with your favorite clerk. Whatever the reason you spend, just remember every-thing is better with balance. You can re-train your bad shopping habits by: • Understanding your filter system of why you shop • Adding safety guards to your spending habits, like carrying cash instead of using credit cards • Setting limits to your spending • Waiting 24 hours before making a purchase • Starting a wish list and saving up for the purchase • Paying attention to your emotional state before and after shopping • Keeping a written record of your spending You have the opportunity to change your spending habits and take control of your finances. There will always be a sale and styles will change regularly, but every good deci-sion has a goal. Stick with your plan, and you will reap big rewards.
FOOD & NUTRITION
Shrim The
FRESH VS FROZEN
It’s not worth paying a premium for socalled fresh shrimp, as it probably has been thawed. Most commercially caught shrimp are frozen quickly on the boat – which helps maintain the flavor and texture as well as the nutrients.
THE NUTRITIONAL SKINNY A 3-ounce serving of cooked shrimp has 19 grams of protein (the same as in three large eggs), 10 percent of your daily iron needs and more than 20 percent of your vitamin B-12 needs (to keep nerve and blood cells healthy) – all for under 100 calories and 1.5g fat
THE SCOOP ON SIZE Miniature, medium, large, super colossal – there's no industry standard when it comes to labeling shrimp based on its weight. Instead the size is determined by how many unpeeled shrimp make up to 1 pound.
Shrimp Sizes Decoded! Learn what he different sizes of shrimp actually mean when it's time to start cooking. Miniature, medium, large, super colossal—there’s no industry standard when it comes to labeling shrimp based on its weight. Instead the size is determined by how many unpeeled shrimp make up 1 pound. Here’s a look at some sizes you’re likely to find in your local market. Larger—usually more expensive—shrimp are not necessarily better quality. If a recipe calls for a large size because shrimp is the star of the dish (such as shrimp cocktail), then it’s best to go big. But for grilling, sautéing, salads and other dishes where there are a lot of flavors and textures at play, you can choose almost any size.
Shrimp Color Shrimp’s color is related to its species, its diet, the season and other environmental factors. The natural color isn't a marker for freshness. All shrimp turns pink or reddish when cooked.
Factor in Shell Weight The shell can make up for about a third of the shrimp’s weight. For 1 pound of peeled shrimp, buy 1 1/3 pounds unpeeled.
Thawing Shrimp Because most shrimp is frozen soon after being caught, you are better off buying shrimp that is still frozen instead of shrimp that has been thawed at the market for your convenience. Shrimp is highly perishable, and you don’t really
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mp Skinny on
GREEN SALAD W I TH SHRI M P AND FETA
know how long the thawed stuff has been thawed. If you buy frozen shrimp, you can thaw it yourself just before you need it. Let it thaw overnight in the fridge, or for faster thawing, take the shrimp out of its’ package, put it in a bowl of cold water, and let a trickle of cold water run into the bowl while excess water goes down the drain. The shrimp should be ready to cook in about 15 minutes.
Decode the Labels Best Aquaculture Practices: At least 85 percent of the shrimp eaten in the United States is farmed, and most of those shrimp are imported from Mexico or Asia. The U.S. Department of Commerce has established the voluntary Seafood Inspection Program to help ensure that imports meet quality standards. One indication that you're buying safe, quality shrimp is to look for the Best Aquaculture Practices mark on the packaging. BAP standards, set by the Global Aquaculture Alliance, address animal welfare and environmental and social responsibility, as well as food safety and traceability. Compliance is voluntary.
OIL & VINEGAR SALAD DRESSING Ingredients • 1/4 cup extra virgin olive oil • 2 tablespoons red wine vinegar • 2 teaspoons fresh lemon juice • 1 teaspoon fresh minced rosemary salt, freshly ground pepper
SALAD Ingredients • 12 ounces prepared mixed salad greens • 4 green onions, thinly sliced • 1/4 lb cooked shrimp, split in half lengthwise • 24 cherry tomatoes, halved • 1/2 cup crumbled feta cheese
Directions 1. For dressing, combine oil, vinegar, lemon juice, rosemary, salt and pepper in a small jar with a tightfitting lid; cover and shake to combine. 2. Dressing can be made several days in advance and refrigerated, shake well before using. 3. Combine remaining ingredients in a large salad bowl; chill until serving time. 4. To serve, add dressing and toss lightly to combine. Add additional freshly ground pepper to taste.
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FOOD & NUTRITION
SHRIMP PASTA SALAD SEA ISLAND SHRIMP SALAD
Ingredients
Ingredients
• 8 ounces peeled and deveined shrimp • 8 ounces scallops • 2 tablespoons butter • Juice of 1 lemon • 1 - 5 ounce package saffron rice, cooked • 1 pint grape tomatoes, halved • 1 small cucumber, seeded and chopped • 2 tablespoons cilantro, chopped • 1 green onion, diced • Dijon dressing • Salt and pepper to taste
• 3 cups spiral shaped pasta, uncooked • 1 cup mayonnaise • 1⁄2 cup ranch dressing • 1⁄3 cup seafood cocktail sauce • 2 tablespoons fresh lemon juice • 1 teaspoon worcestershire sauce • Salt and pepper • 1 lb medium cooked shrimp, peeled & deveined • 1⁄2 cup chopped fresh tomato • 1⁄2 cup sliced green onion • 1⁄4 cup chopped sweet red pepper • 2 tablespoons chopped fresh parsley
Directions 1. Saute` shrimp and scallops in butter. Remove from heat and sprinkle with lemon juice. Transfer to small bowl and chill 2-3 hours. 2. Combine rice and next 4 ingredients with shrimp mixture. 3. Toss with enough Dijon Dressing to coat well. Salt and pepper to taste. Cover and chill overnight.
DIJON DRESSING Ingredients • 1/3 cup red wine vinegar • 1/3 cup olive oil • 2 teaspoons dijon mustard • Hot pepper sauce to taste • 1 teaspoons worcestershire sauce • 1 teaspoon sugar
Directions 1. Combine ingredients in small bowl, mixing well.
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Directions 1. Cook pasta according to package directions; drain. 2. Rinse with cold water to cool quickly; drain well. 3. Meanwhile, in a large bowl, whisk together mayonnaise, ranch dressing, seafood cocktail sauce, lemon juice, Worcestershire sauce and salt & pepper. 4. Stir in cooled pasta and remaining ingredients. 5. Serve immediately or cover and refrigerate.
GRILLED MIXED-SEAFOOD SALAD
Ingredients • Shallot-Thyme Vinaigrette • ½ cup olive or vegetable oil • ¼ cup balsamic vinegar • 2 tablespoons white wine vinegar • 1 tablespoon finely chopped shallot
• 1 tablespoon Dijon mustard • 1 tablespoon chopped fresh thyme leaves or • 1 teaspoon dried thyme leaves • ¼ teaspoon salt
SALAD Ingredients • 1 lb marlin, swordfish or tuna steaks, 3/4 to 1 inch thick • 12 uncooked large shrimp, peeled and deveined • 1 medium fennel bulb, cut crosswise into 6 slices • 10 leaves romaine lettuce, coarsely shredded
• 1 small bunch arugula, torn into bite-size pieces • 1 can (14 oz) artichoke hearts, drained • ½ small red onion, thinly sliced • 12 cherry tomatoes • 12 kalamata or pitted ripe olives
Directions 1. In small bowl, mix all vinaigrette ingredients until well blended. 2. In shallow glass or plastic bowl, place fish steaks, shrimp and 1/4 cup of the vinaigrette; turn fish and shrimp to coat with marinad. 3. Cover and refrigerate 1 hour. Reserve remaining vinaigrette. 4. Heat coals or gas grill for direct heat. Remove fish and shrimp from marinade; reserve marinade. Cover and grill fish and fennel over medium heat 5 minutes; brush with marinade. Add shrimp. 5. Cover and grill 5 to 15 minutes, turning and brushing fish, fennel and shrimp with marinade 2 or 3 times, until shrimp are pink and firm, fish flakes easily with fork and fennel is tender. Discard any remaining marinade. 6. Arrange romaine and arugula on serving platter. Cut fish into bite-size pieces. Arrange fish, shrimp, fennel and remaining ingredients on romaine mixture. Serve with remaining vinaigrette.
SPECIAL FALL EDITION 2016 thenewyoumagazine.net
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Top 10 most unhealthy,
FOOD & NUTRITION
cancer-causing foods never eat these again! By Jonathan Benson Staff Writer – Natural News
The statement “everything causes cancer” has become a popular hyperbole, and one that some people use as rhetorical fodder to excuse their own dietary and lifestyle failures, particularly as they pertain to cancer risk. But the truth of the matter is that many common food items have, indeed, been scientifically shown to increase cancer risk, and some of them substantially. Here are 10 of the mostunhealthy, cancer-causing foods that you should never eat again
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Regular Potato Chips: They’re full of artery-clogging trans fats, high glycemic carbohydrates, sodium, artificial flavors, colors, and preservatives. High temperatures used to cook them typically cause the formation of carcinogenic substances like acrylamide, which is also found in cigarettes. Clark University professor Dale Hattis is quoted as saying, “I estimate that acrylamide causes several thousand cancers per year in Americans.” Even those with reduced trans fat may contain acrylamide.
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Processed meats. Most processed meat products, including lunch meats, bacon, sausage, and hot dogs, contain chemical preservatives that make them appear fresh and appealing, but that can also cause cancer. Both sodium nitrite and sodium nitrate have been linked to
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thenewyoumagazine.net SPECIAL FALL EDITION 2016
significantly increasing the risk of colon and other forms of cancer, so be sure to choose only uncured meat products made without nitrates, and preferably from grass-fed sources.
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Microwave popcorn. They might be convenient, but those bags of microwave popcorn are lined with chemicals that are linked to causing not only infertility but also liver, testicular, and pancreatic cancers. The U.S. Environmental Protection Agency (EPA) recognizes the perfluorooctanoic acid (PFOA) in microwave popcorn bag linings as “likely” carcinogenic, and several independent studies have linked the chemical to causing tumors. Similarly, the diacetyl chemical used in the popcorn itself is linked to causing both lung damage and cancer.
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Soda pop. Like processed meats, soda pop has been shown to cause cancer as well. Loaded with sugar, food chemicals, and colorings, soda pop acidifies the body and literally feeds cancer cells. Common soda pop chemicals like caramel color and its derivative 4-methylimidazole (4-MI) have also specifically been linked to causing cancer).
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‘Diet’ foods, beverages. Even worse than conventional sugar-sweetened soda pop, though, is "diet" soda pop and various other diet beverages and foods. A recent scientific review issued by the European Food Safety Authority (EFSA) of more than 20 separate research studies found that aspartame, one of the most common artificial sweeteners, causes a range of illnesses including birth defects and cancer. Sucralose (Splenda), saccharin and various other artificial sweeteners have also been linked to causing cancer.
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Conventional apples, grapes, and other 'dirty' fruits. Many people think they are eating healthy when they buy apples, grapes, or strawberries from the store. But unless these fruits are organic or verified to be pesticide-free, they could be a major cancer risk. The Environmental Working Group (EWG) found that up to 98 percent of all conventional produce, and particularly the type found on its “dirty” fruits list, is contaminated with cancer-causing pesticides
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Farmed salmon. Farmed salmon is another highrisk cancer food, according to Dr. David Carpenter, Director of the Institute for Health and the Environment at the University of Albany. According to his assessment, farmed salmon not only lacks vitamin D, but it is often contaminated with carcinogenic chemicals, PCBs (polychlorinated biphenyls), flame retardants, pesticides, and antibiotics.
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Refined ‘white’ flours. Refined flour is a common ingredient in processed foods, but its excess carbohydrate content is a serious cause for concern. A study published in the journal Cancer Epidemiology, Mile Markers, and Prevention found that regular consumption of refined carbohydrates was linked to a 220 percent increase in breast cancer among women. Highglycemic foods in general have also been shown to rapidly raise blood sugar levels in the body, which directly feeds cancer cell growth and spread.
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Refined sugars. The same goes for refined sugars, which tend to rapidly spike insulin levels and feed the growth of cancer cells. Fructose-rich sweeteners like high-fructose corn syrup (HFCS) are particularly offensive, as cancer cells have been shown to quickly and easily metabolize them in order to proliferate. And since cookies, cakes, pies, sodas, juices, sauces, cereals, and many other popular, mostly processed, food items are loaded with HFCS and other refined sugars, this helps explain why cancer rates are on the rise these days.
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Hydrogenated oils. They are commonly used to preserve processed foods and keep them shelfstable. But hydrogenated oils alter the structure and flexibility of cell membranes throughout the body, which can lead to a host of debilitating diseases such as cancer. Some manufacturers are phasing out the use of hydrogenated oils and replacing them with palm oil and other safer alternatives, but trans fats are still widely used in processed foods.
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!"#"$%&'%"($%#)"* ++,-...* /01#)$* '&&"* 213"4%51)5&/$* IDFLOLW\ KRXVHV FRQFHUWV EXOO ULGLQJ FDJH ¿JKWV IDPLO\ /(&6/-*")#7$*/(&6/-*8&9'$)$98$/-*:#901$"/-*#97*#9* $973$//*;#)4$"<*&'*$;$9"/=* Box Office Hours >&97#<*?*@)47#<**A**BC..*#2%,C..*52 Box Office & General Information D*,EF=GBG=B..+**A**@*,EF=GBG=B..B F.+*!&1"(*,"(*!")$$"**A**D&53#)*H31''-*>I*GFJ.+ 49'&K:3#8L)4;$)8&34/$12=8&2 Swimming Pool & Fitness Center D*,EF=GBG=B..J**A**($#"($)K:3#8L)4;$)8&34/$12=8&2 BlackRiverColiseum.com 56 | THE NEW YOU | SUMMER 2014
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P I N K PA G E S
Using Your Own Fat & Stem Cells to Augment or Reconstruct Your Breasts – What Is The Scoop? ecently, some physicians have started offering women the opportunity to enlarge and contour their breasts with their own fat. On the surface, this would seem like a clever idea – take fat away from an area where you don’t want it and transfer it to an area that you do such as the breasts. This concept has been developed even further, with some physicians offering to enrich the transferred fat with stem cells to enhance their regenerative properties. These techniques have been alternatively termed “fat grafting”, “lipofilling”, “fat transfers”, and “stem-cell enriched fat transfers”, among others.
R
Within the scope of plastic surgery, fat grafting, as I will call it here, is not a complicated procedure. Liposuction is performed to get the fat out from an undesirable area like the abdomen, flanks, or thighs. The fat is then processed by one of several methods to separate the fat cells from other tissue that is sucked out. In some cases, the fat is “enriched” with stem cells or other agents, and then reinjected into the breast to add volume or treat concerning contours. Fat grafting has been applied to four main scenarios in the breast: 1. breast augmentation 2. reconstruction of an entire breast with fat grafting 3. reconstruction of part of a breast after lumpectomy 4. refining a breast that has been reconstructed with some other technique The most pressing concern related to fat grafting to the breast is its long term safety. Your own fat naturally contains a small percentage of stem cells, also known as adipose-derived stem cells. A stem cell is an immature cell that has the potential of developing into several other cells including cells that would stimulate
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repair and regeneration – which is good, but also rapidly dividing cancer cells – which is bad. In animal studies, when placed next to active breast cancer cells, these stem cells from fat can make the breast cancer more aggressive. So far, the human studies have not been able to address these safety issues with certainty. Still, in one study from Europe, women who had fat grafts for lumpectomy did have a higher cancer recurrence rate while women who had a mastectomy and then fat grafts did not have a higher cancer recurrence rate. Patients who have already had a mastectomy – or complete removal of the breast – likely have little to worry about in terms of the safety of fat grafting. This is because the fat graft material has no true breast tissue to aggravate. Their cancer doctors carefully follow women who have had a lumpectomy and then fat grafting. As such, they may be able to more quickly deal with any suspicious areas of the breast. Women that undergo fat grafting for breast augmentation, however, should proceed with caution. Fat grafts are frequently marketed as being safer than breast implants since the fat is yours while the implant is a foreign body. On closer inspection, however, patients considering breast augmentation should realize that breast implants have been around since the 1960s and millions of women have breast implants. Breast implants are definitely not perfect. They can leak, develop scar tissue shells around them known as capsular contractures, and will usually need to be replaced at some point. However, 1 in 8 women will get breast cancer. The concern with fat grafting to the breast for cosmetic augmentation is that if an unsuspecting women, who has never even considered she could get breast cancer, is susceptible, then placing some fat stem cells in the
thenewyoumagazine.net SPECIAL FALL EDITION 2016
susceptible area may trigger a breast cancer. Importantly, laboratory research does not always predict what will happen in a real person. But it does raise some important questions that need to be answered before the widespread use of fat grafting to the breast for cosmetic augmentation is considered mainstream. Safety is not the only aspect of fat grafting that plastic surgeons are investigating. They are also working to determine what the most effective technique is, how long fat grafting lasts, what the largest volume of fat grafting can effectively and safely be, as well as a number of other questions. So, for now, fat grafting remains a promising technique with multiple possible applications. Based on the facts, the American Society of Plastic Surgeons considers it a safe technique for breast reconstruction, but does not yet endorse it for breast augmentation. With more experience and research, we will be able to better advise our patients on when to use fat grafting effectively, but also when not to use it. If you are considering cosmetic or reconstructive breast surgery it is always important to ensure that your plastic surgeon is certified by the American Board of Plastic Surgery. Dr. Terence M. Myckatyn MD, FACS, FRCSC Associate Professor, Plastic and Reconstructive Surgery West County Plastic Surgeons Washington University School of Medicine www.westcountyplasticsurgeons.wustl.edu
Understanding What it Means to Have Dense Breast Tissue
Megha Garg, MD
our mammogram results are in, and you’ve been told that you have dense breasts. Now what? While this term might leave room for confusion, there’s no need to be alarmed.
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Dense tissue appears white on a mammogram. Lumps, both benign and cancerous, also appear white, so mammograms can be less accurate in women with dense breasts.
“Dense breast tissue is not a condition or abnormality,” said Megha Garg, MD, director of the breast imaging program at Ellis Fischel Cancer Center. It simply refers to the ratio of fibroglandular tissue to fat in your breast on mammograms. But knowing whether you have dense breasts is important because dense tissue might make cancer detection more difficult on mammograms.”
“If you have been told you have dense breasts, it is to raise your awareness and should be seen as a conversation starter to assess your risk for breast cancer,” Garg said. “You’ll want to talk to your physician about the presence of other risk factors as breast density alone has a small impact on breast cancer.
In 2015, Missouri became the 19th state to enact a breast density notification law. The law requires health care facilities that perform mammograms to inform patients about breast density. Your physician will get your breast density numbers as part of the mammogram and will then be able to go over your readings with you and explain if you have dense breast based on where you are on the density scale.
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“If your mammogram and risk assessment reveals you have dense breast tissue and an overall high risk for getting breast cancer, you could benefit from supplemental screening in addition to mammograms,” Garg said.
If you have questions or concerns about breast density or to schedule a mammogram call 573-882-8511 SPECIAL FALL EDITION 2016 thenewyoumagazine.net
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P I N K PA G E S
Questions toAskYour Doctor When You Find Out You Have Cancer
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earning that you have cancer can be a shock, and you may feel overwhelmed at first. When you meet with your doctor, you will hear a lot of information. These questions may help you to find out more about your cancer and what to expect going forward.
Questions about the cancer What type of cancer do I have? Can you explain my test results to me? Will I need more tests before treatment begins? ■ What is the stage of my cancer? Has my cancer spread to other areas of my body? ■ What is my chance of recovery? ■ How will cancer and its treatment affect my body? ■ ■
Questions about finding a specialist and getting a second opinion How do I decide where to go for treatment? Will I need a specialist(s) for my cancer treatment? ■ Will you help me find a doctor to give me another opinion on the best treatment plan for me? ■ ■
Questions about clinical trials Would a clinical trial (research study) be right for me? ■ How do I find out about studies for my type and stage of cancer? ■
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Questions about lifestyle, finances, and resources How will my daily activities, such as work or school, change? ■ How can I get help if I feel anxious or upset about having cancer? If I need help coping with family responsibilities? ■ What costs will my insurance cover? Who can answer my questions about how to pay for treatment? ■ How can I get help with financial and legal issues (for example, getting financial assistance, preparing a will or an advance directive)? ■ How can I get help with my spiritual needs? ■ Can you suggest a support group that might help me? ■
For more information visit the National Cancer Institute, http://www.cancer.gov/cancertopics/cancerlibrary/questions/diagnosis
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NATIONAL LEADERS IN ORTHOPEDICS:
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Center Center ffor or A Advanced dvanced M Medicine edicine - S South outh C County ounty Washington Washington Univ University ersity O Orthopedics rthopedics 5201 M Midamerica idamerica P Plaza, laza, Suit Suitee 1500 St. St. Louis, Louis, MO 63129
Genetics and
P I N K PA G E S
What Are Genes?
BRCA gene mutations are not only found in women. Men can also carry these mutations and pass them on to their children. Men with a BRCA2 mutation have an increased risk of breast and prostate cancer.
Mutations may be inherited or spontaneous. Inherited are those you were born with. They are passed on to you by one of your parents. Spontaneous are those that may occur during your lifetime. There are many ways this can happen. We do not yet know how, or if, these are related to a woman’s lifestyle (such as diet and exercise). Also, chemical changes inside the body and contact with environmental toxins such as radiation or chemicals are under study. We don’t know if we can prevent these mutations.
Who Has Mutations In BRCA1 & BRCA2?
Every cell in your body contains genes. Genes are the blueprints for your body. For example, they decide the color of your eyes. They also affect other functions of your body, such as when cells grow, divide and die. Sometimes, genes do not work like they should. This is due to an error in one or more genes, called a mutation.
What Are BRCA1 & BRCA2?
The two most well-known genes linked to breast cancer are BRCA1 and BRCA2 (BReast CAncer genes 1 and 2). Everyone has these genes, but some have inherited a mutated form of one or both. Inheriting a mutated form of BRCA1 or BRCA2 increases a woman’s risk of breast and ovarian cancer.
Most breast cancers are not linked to inherited mutations. Only about 5 to 10 percent of all cases of breast cancer in the United States are due to inherited gene mutationts. 34
thenewyoumagazine.net SPECIAL FALL EDITION 2016
What About Men?
Most women who get breast cancer do not have an inherited BRCA1 or BRCA2 gene mutation. The chance that you have a BRCA1 or BRCA2 gene mutation is greater if one or more of these statements is true: You were diagnosed with breast cancer at an early age. Your mother, sister or daughter was diagnosed with breast cancer at an early age or ovarian cancer at any age. A woman in your family has had breast and ovarian cancer. A woman in your family has had breast cancer in both breasts. Your family is of Ashkenazi Jewish descent.
A male in your family has had breast cancer.
All women should be screened for breast cancer with routine mammograms and clinical breast exams.
BRCA1 (BReast CAncer type 1 susceptibility, BRCT domain) protein
Breast Cancer
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P I N K PA G E S
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MAMMOGRAPHY
Our focus is clear.
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Please call 573.472.7330 to schedule your annual screening mammogram appointment. For additional information, please visit www.missouridelta.com.
SPECIAL FALL EDITION 2016 thenewyoumagazine.net
Our focus
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DOCS TO KNOW
Dr. Sara Crowder
One of theTop Gynecologic Robotic Surgeons in theWorld
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And she resides in our own backyard by Madison Burke Boone Hospital Center, Multimedia Marketing Specialist
ynecologic oncologist Sara Crowder, MD recently performed her 1,000th surgery using the da Vinci surgical system. For the past two years, Dr. Crowder has performed more of these types of surgeries than anyone else in Missouri and is in the top one percent world wide. Boone Hospital Center bought the equipment in 2011. It offers 3D imaging and 360-degree movement of instruments. It allows surgeries to be minimally invasive, leading to shorter hospital stays and quicker recovery times.
What did it feel like hitting the 1000 mark?
Well in some ways it felt just like any other day, and the case went great so that made me happy. In other ways, it was a moment of pride in looking back and seeing how far we've come. Then, finding out the significance of 1000 cases was really overwhelming. I was just amazed.
And what was the significance of 1000 robotic cases?
1000 cases put me in the top 1% of gynecologic robotic
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surgeons in the U.S. and worldwide. That made me feel like my commitment to this skill has been worth it. And, I think it's amazing that in the middle of the country, in a town the size of Columbia – my home town – you can have surgery with the level of expertise in the top 1% in the world.
Explain robotic surgery to a layperson who’s not familiar with the technology.
Minimally invasive surgery is surgery done through smaller incisions. This is typically done with standard laparoscopy equipment which has some limitations. Robotic surgery has capabilities that overcome many of those limitations. The benefits basically boil down to visualization and ease of motion.8 For the visualization, the camera is much stronger so you see the anatomy in a very magnified way. The camera actually has two camera heads, so it gives a threedimensional view. 3-D sounds fancy and exciting but it truly has a practical application. It allows you to judge the depth of your motions. To see the difference between visualization with standard laparoscopy and robotics, reach for something and grab it with both of your eyes open. Then, close one eye and reach for it. You'll see how your brain has
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DOCS TO KNOW to work harder to judge how far to reach when one eye is closed. Standard laparoscopy is like that. Robotics allows you to operate with both eyes open, in a sense.8
The ease of motion is due to the robotic instrumentation being wristed, so it has a full range of motion such that when you are dissecting, you can move the instruments much more like you move your hands and fingers naturally. I think if you've ever had to wear a cast and then do things with that arm, that's kind of a good analogy for what standard laparoscopic surgery would be like. You wouldn't have complete range of motion of your arm. You could adjust your body and grab what you need to grab, but again, it's going to take a lot more effort and you may not always grab it exactly the way you want to. Comparing robotic surgery to standard laparoscopy feels like getting your cast off.8
When and why did you become interested in pursuing robotic surgery?
I began in 2011. I was not one of the earliest adopters of the technology. I'd known about it for years. In 2001, I was doing my fellowship in Texas and our institution had one of the first robotic systems in the country when it was undergoing its preliminary clinical use. I didn’t really do robotic surgery at that time, but one of my mentors, Conception Diaz-Arristia, was one of the first physicians in the U.S. to do robotic cases. So I was very aware of the technology in its infancy. Many years later, when robotics first came to Columbia, I was approached multiple times but declined because I was too busy with other things, one of which was completing my board certification in gynecologic oncology. I thought if I was going to do pursue robotics, I wanted to put my best effort into it. There is pretty rigorous training steps you have to go through just to start doing cases. I was interested to use the technology for my cancer cases who needed more extensive surgery like lymph node removal. Robotics was a safer way to do these kinds of complex cases with much more precision. Robotics essentially equalizes the playing field, allowing patients who otherwise wouldn’t be candidates for minimally invasive surgery to benefit from it as well. So I initially was planning to only use it for a subset of my patients. As I used it more, I really realized the benefits of the technology and became a believer that it’s truly the future of surgery. 40
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To what do you attribute your success?
Overall, having a great mother. In robotic surgery, I’d say focus and dedication. I’m kind of an “all or nothing” person. If I commit to something, I like to give it my all. I also have benefitted greatly from a strong team in the OR — nurses, scrub techs, and anesthetists – they can really make your job easier.8
What has surprised you the most about robotic surgery?
The complexity of procedures that I can do through tiny incisions. That's the beauty of experience. The more surgeries you do, the more you find ways to work around roadblocks.8
I’ve also been so pleased at how it’s changed my patient’s lives. They recover from surgery so much faster and with less pain. That is more profound than it initially sounds. The less pain you have, the less pain medicine you take, the sooner you're up doing your normal
activities. But this also means you are less likely to have postoperative complications like blood clots, pneumonia, constipation, etc. And for many of my patients, it means moving on to the next phase of your treatments that much sooner, like radiation or chemo therapy for patients who need these things.
What do you most enjoy about being a surgeon?
The satisfaction of the case that goes perfectly. The challenges of complex cases and successfully meeting those challenges. I’m fascinated by anatomy and physiology and the endless complexity of the human body. I’m humbled by the strength and resilience of the human spirit and the body’s capacity both to mutate and to heal itself.
What practical advice would you give to someone who’s facing surgery?
Ask questions. Bring someone with you to your appointment. Find out about your surgeon’s expertise if you can. Listen to your gut. If you're not comfortable, that may be a red flag. You have to put a lot of trust in your surgeon so you have to feel like you can communicate with them. Don’t be afraid to get a second opinion. Oh, and of course, follow the doctor's advice! Do’s and don'ts about your post op care can make a big difference in your recuperation.8
“I think it’s amazing that in the middle of the country, in a town the size of Columbia – my home town – you can have surgery with the level of expertise in the top 1% in the world.”
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PINK PAGES RESOURCE GUIDE Cancer MICA
Diet, Nutrition & Cancer Prevention
The cancer MICA allows the user to create tables showing cancer incidence by year, age, sex, race, cancer site, stage, grade, and geographic area down to county (with some restrictions to protect confidentiality; see below). This MICA provides the user with valuable cancer incidence data. It is intended to be used by the general public, as well as researchers, local public health agencies, and others.
American Social Health Association
CDC - Cancer Prevention & Control
National HPV & Cervical Cancer Prevention Resource Center
Division of Cancer Prevention & Control conducts, supports and promotes efforts to prevent cancer and to increase early detection of cancer.
American Cancer Society Provides facts, risk factors and prevention of cancers. Information on volunteer opportunities and research funding.
American Institute for Cancer Research (AICR)
Avon Breast Cancer Crusade Funding access to care and finding a cure for Breast Cancer Breast & Cervical Cancer: Find out about the free breast and cervical cancer screening services available through the Missouriâ&#x20AC;&#x2122;s Show Me Healthy Women program. Guidelines for eligibility, services provided and the list of providers in Missouri is included. Excluding all cancers of the skin, breast cancer is the most common cancer among women in Missouri and accounts for nearly one-third of all cancers diagnosed in women. According to the Surveillance, Epidemiology and End Results (SEER) program, an average of 3,951 cases of breast cancer per year were diagnosed among Missouri women between 1996 and 2000. The American Cancer Society estimate of new breast cancer cases for Missouri women in 2004 are 4,680. The American Cancer Society 2004 estimate of breast cancer deaths for Missouri women is 870.
CDC: The National Breast & Cervical Cancer Early Detection Program: At-A-Glance The NBCCCEDP provides funding for breast & cervical cancer screening services to low income and underinsured women. NCBBEDP operates in all 50 states, District of Columbia, 6 U.S. territories and 12 American Indian/Alaska Native organizations.
Intercultural Cancer Council The Intercultural Cancer Council (ICC) promotes policies, programs, partnerships and research to eliminate the unequal burden of cancer among racial and ethnic minorities and medically underserved populations in the United States and its associated territories.
Kansas City Cancer Information Project The Breast Cancer Foundation of the Ozarks
BRFSS Data
The KcCancer.info website is a joint production of The Kansas City Cancer Coalition and The Kansas City Cancer Information Project. These resources are unique, designed for Kansas City area cancer patients and their families, where content is managed by representatives from every sector within the Kansas City cancer community.
This is the Behavioral Risk Factor Survey where you can produce tables based on cancer and other disease specific data.
Living Beyond Breast Cancer
Provides local resources and support for individuals and their families in the local area who are and have been affected by breast cancer and are concerned with women's health issues.
Cancer Inquiry Investigates, through a team effort, concerns initiated by the public about perceived high rates of cancer in a community or neighborhood. Informs public that cancer is more common than most people realize; contrary to public perception, cancer is not usually caused by pollution or other environmental factors; and most of the causes of cancer that we know about are related to lifestyle.
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LBBC offers educational information to women affected by breast cancer. Programs include conferences, teleconferences, newsletters, Survivors' Help Line (888-753-LBBC), website (lbbc.org), young survivors' and outreach programs.
MammaCareÂŽ The only scientifically validated system for teaching physical examination of the breast.
Missouri Cancer Consortium
National Ovarian Cancer Coalition
The Missouri Cancer Consortium is a leader in cancer control in Missouri. Members are groups and individuals. They come from all walks of the cancer fight. New members are always needed and welcome. The work of cancer control and the Missouri Cancer Consortium is comprehensive.
The website for the National Ovarian Cancer Resource Center takes you through some of the issues most commonly faced by cancer patients.
National Alliance of Breast Cancer Organizations (NABCO) NABCO provides information to medical professionals and their organizations and to patients and their families, and advocates for beneficial regulatory change and legislation.
Native American Cancer Research This is a community-based, American Indian, non-profit resource. We seek to help reduce cancer incidence and mortality in Native Americans.
R.A. Bloch Cancer Foundation, Inc R.A. Bloch Cancer Foundation is dedicated to help all cancer patients in the process to successfully conquer their disease.
National Breast Cancer Coalition - NBCC Susan G. Komen Breast Cancer Foundation
The National Breast Cancer Coalition Fund is a grassroots organization dedicated to ending breast cancer through the power of action and advocacy.
To eradicate breast cancer as a life-threatening disease by advancing research education.
National Cancer Institute
WISEWOMAN
National funding for cancer research. Provides credible, current, comprehensive cancer information for public and professional use.
(Well-Integrated Screening and Evaluation for Women Across the Nation) funding expands the prevention services provided for women participating in the National Early Breast and Cervical Cancer Control Project (NBCCCEDP), known in Missouri as the Show Me Healthy Women program. WISEWOMAN is a CDC-funded program that helps underinsured, low-income women gain access to health screenings and lifestyle education that can reduce the risk of heart disease and stroke. To be eligible for WISEWOMAN services, women must be participants in the Show Me Healthy Women breast and cervical cancer control project and be 40-64 years of age.
National Cervical Cancer Coalition Enhance awareness of cervical cancer prevention, the Pap smear and proper follow-up, HPV, new technology and treatment options.
National HPV & Cervical Cancer Public Education Program You Need to Know, National HPV & Cervical Cancer Campaign.
Women's Cancer Network
National Coalition for Cancer Survivorship
Physicians dedicated to preventing, detecting and conquering cancer in women.
The only survivor-led advocacy organization working exclusively on behalf of people with all types of cancer and their families, is dedicated to assuring quality cancer care for all Americans.
Y-ME National Breast Cancer Organization: Through peer support no one faces breast cancer alone.
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PINK PAGES MID-MISSOURI RESOURCES Mid-Missouri Breast Cancer Awareness Group Breast cancer patients and survivors can gain insight and strength to better cope with their disease and life changes through interaction with others undertaking similar journeys. The Mid-Missouri Breast Cancer Awareness Group meets monthly from 6 to 7 p.m. on the second Wednesday at various locations.
The Harris Breast Center also has a longstanding commitment to being a leader in technology. The center is ACR accredited with licensed, certified, professional and well-trained radiology staff, technologists and associates ready to attend to patient needs. To schedule your next mammogram call 573.815.8150.
Group Liaison and Contact Information: Kathy Windmoeller 573-999-4195 573-443-0622 This support group meets in various locations. Please contact Kathy Windmoeller to confirm the location.
Mid-Missouri Ellis Fischel Cancer Center Ellis Fischel Cancer Center’s team of physician specialists and other trained professionals work together with a common goal: to provide the latest cancer treatments and improve quality of life for thousands of people each year. Named after Dr. Ellis Fischel, a physician who envisioned a statewide plan for controlling cancer, the hospital was dedicated on April 26, 1940, as the first cancer center west of the Mississippi River. At Ellis Fischel Cancer Center we are dedicated to providing comprehensive cancer care, which means we diagnose and treat all types of cancers. 573-882-2100 One Hospital Drive, Columbia, MO 65212
Mid-Missouri Harris Breast Center Boone Hospital’s Harris Breast Center is conveniently located inside the hospital’s Outpatient Services wing. With convenient parking and registration, the Harris Breast Center combines the ease of a freestanding center with the technology, expertise and resources of a hospital-based provider. Choosing the Harris Breast Center gives our patients the best of both worlds.
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Mid-Missouri American Cancer Society Find Support & Treatment Learn about making treatment decisions, coping with side effects, handling financial matters, caregiving and living well after cancer. The American Cancer Society also has programs and services to help you manage cancer treatment and recovery and find the emotional support you need. And best of all, our help is free. http://www.cancer.org/index 1-800-227-2345
Susan G. Komen: For the Cure Whether you need information, assistance, emotional support or just someone to talk to, we can help. Learn more through the links below, by calling the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) or by contacting a local Affiliate.
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