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Ocean Hematology & Oncology
Medical Professionals
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Medical Professionals 17
What You Need To Know
Did you know that lung cancer is the leading cause of cancer deaths in both men and women in the U.S.? Approximately 200,000 new cases are diagnosed each year and 27 percent of all cancer deaths are from lung cancer.
What causes lung cancer?
Smoking. Smoking is the number one risk factor for lung cancer. Even though non-smokers can also get lung cancer, the risk is much higher in those who smoke. The more you smoke, the higher your risk. The likelihood of getting lung cancer decreases after you quit smoking. Tobacco smoke damages cells in the lungs, causing the cells to grow abnormally. Regular exposure to smoke from someone else’s cigarettes, cigars or pipes (called second-hand smoking) can increase a person’s risk of lung cancer, even if they are non-smokers. # Exposure to asbestos. Certain jobs such as shipbuilding, asbestos mining, insulation or automotive brake repair may cause exposure to asbestos. Asbestos fibers can irritate the lungs and cause cancer. When combined with smoking, the risk of developing lung cancer is much higher. Radon. Radon is an invisible, odorless gas released by soil and some rocks. Exposure to higher levels of radon can cause cancer, especially lung cancer.
What are the types of lung cancer?
There are two different types of lung cancer: small cell and non-small cell. This difference is based on the type of cancer cells. Most lung cancers are non-small cell. Among the non-small cell lung cancers, there are several subtypes: adenocarcinoma, squamous cell and large cell.
What are the symptoms and signs?
Symptoms and signs include coughing, hemoptysis (coughing up blood), shortness of breath, chest pain, fatigue and weight loss. Most often, the symptoms do not manifest until the cancer is advanced. Sometimes lung cancer can be detected as a shadow in the lung on an X-ray done for other reasons.
How is it diagnosed?
Once your doctor suspects that you have lung cancer, you will be sent for CT scans and in some cases, a PET scan. A PET scan can detect cancer more accurately than other tests. The diagnosis is confirmed by taking a biopsy of the suspicious lesions seen on the X-ray or CT scans. The scans also help to see if the cancer has spread to any other organs, a process called metastasis.
Are there different stages?
Staging is different for small cell and non-small cell lung cancers. Small cell lung cancer has only two stages: limited stage (confined within the lungs) or extensive (spread outside the lungs). Non-small cell lung cancer has four stages: stages I to IV. Stage I is a small tumor that is confined to the lung, that has not spread to the lymph glands. Larger tumors and those that are spread to the lymph glands come under stages II and III. When the cancer has spread to other organs, it is stage IV.
What are the treatment options?
Treatment is based on the stage and the type of lung cancer. Small cell lung cancer is mainly treated with chemotherapy. In limited stage small cell lung cancer, radiation can be combined with chemotherapy. Early stage non-small cell lung cancer is best treated by surgical resection. An experienced surgeon removes the tumor, surrounding normal lung tissue and the lymph glands around it. Even after removing the tumor, cancer cells can remain and cause recurrent cancer, either in the lung itself or in other organs. Chemotherapy, radiation or both are used after surgery to reduce the chance of recurrent cancer. Advanced stage lung cancer is treated with chemotherapy. The types of chemotherapy drugs used are based on the type of lung cancer, age of the patient, other medical illnesses, etc. There is ongoing research to improve the outcome in patients with lung cancer.
What’s new in lung cancer?
Targeted agents: Medicines that target certain proteins or receptors on the cancer cells are being developed for the treatment of various cancers. These targeted agents attack the cancer cells specifically, sparing other cells. Targeted agents cause less severe side effects than chemotherapy. A few different targeted agents are found to be beneficial in lung cancer. Tarceva (erlotinib) is a drug that works in certain types of lung cancers carrying a mutation in a receptor called EGFR. A new drug called crizotinib was approved recently for the treatment of lung cancer that carries a gene called ALK fusion oncogene. No two tumors are alike! Even among lung cancers, there are different distinguishing features. Your oncologist chooses the type of treatment based on a number of factors, including the cell type, stage, different biological markers on the cancer cells, and your other medical problems.
November Is National Lung Cancer Awareness Month What you should know: • If you are a heavy smoker, and have been smoking for several years, ask your doctor if you need to do an X-ray or a CT scan. • Ask your MD about different methods to help you quit smoking. • If you are diagnosed with lung cancer, ask about the type of cancer you have, stage and other features such as EGFR mutation. • What is your treatment plan? • What are the side-effects of treatment? • Are there support services available? Immunotherapy in lung cancer.
Over the last few decades, immunotherapy agents have been studied in the treatment of many cancers, including lung cancer. Several immunotherapy drugs are now approved for use. Our immune system fights cancer cells normally, and thus reduces the chance of Medical Professionals transforming normal cells into cancer cells. But this does not work always, as people with normal immune systems also develop cancer. The principle of immune therapy is based on What You Need To Know boosting the immune system so that it can efficiently destroy cancer cells. The use of immune checkpoint inhibitors has been a major breakthrough in cancer research. Did you know that lung cancer is the leading cause of cancer These drugs help to take the “brakes” off the immune system, so that they can recognize and kill cancer cells more effectively. deaths in both men and women in the U.S.? Approximately 200,000 new cases are diagnosed each year and 27 percent of all cancer deaths are from lung cancer. OPDIVO, KEYTRUDA, and TECENTRIQ are some of the immune checkpoint inhibitors that are used in lung cancer. Even though these drugs don’t have the typical side effects of What causes lung cancer? Smoking. Smoking is the number one risk factor for lung cancer. Even though non-smokers chemotherapy, they still can cause reactions such as inflammatory disorders.can also get lung cancer, the risk is much higher in those who smoke. The more you smoke, the higher your risk. The likelihood of getting lung cancer decreases after you quit smoking. Tobacco smoke damages cells in the lungs, causing the cells to grow abnormally. Regular exposure to To learn more about lung cancer and the treatment of smoke from someone else’s cigarettes, cigars or pipes (called second-hand smoking) can increase a person’s risk of lung cancer, even if they are non-smokers. other cancers, contact Dr. Sarah Easaw at 732-961-0010 or Exposure to asbestos. Certain jobs such as shipbuilding, asbestos mining, insulation or automotive brake repair may cause exposure to asbestos. Asbestos fibers can irritate the lungs visit www.oceanhemonc.com.and cause cancer. When combined with smoking, the risk of developing lung cancer is much higher. Radon. Radon is an invisible, odorless gas released by soil and some rocks. Exposure to higher levels of radon can cause cancer, especially lung cancer.
What are the types of lung cancer?
There are two different types of lung cancer: small cell and non-small cell. This difference is based on the type of cancer cells. Most lung cancers are non-small cell. Among the non-small cell lung cancers, there are several subtypes: adenocarcinoma, squamous cell and large cell.
What are the symptoms and signs?
Symptoms and signs include coughing, hemoptysis (coughing up blood), shortness of breath, chest pain, fatigue and weight loss. Most often, the symptoms do not manifest until the cancer is advanced. Sometimes lung cancer can be detected as a shadow in the lung on an X-ray done for other reasons.
How is it diagnosed?
Once your doctor suspects that you have lung cancer, you will be sent for CT scans and in some cases, a PET scan. A PET scan can detect cancer more accurately than other tests. The diagnosis is confirmed by taking a biopsy of the suspicious lesions seen on the X-ray or CT scans. The scans also help to see if the cancer has spread to any other organs, a process called metastasis.
Are there different stages?
Staging is different for small cell and non-small cell lung cancers. Small cell lung cancer has only two stages: limited stage (confined within the lungs) or extensive (spread outside the lungs). Non-small cell lung cancer has four stages: stages I to IV. Stage I is a small tumor that is confined to the lung, that has not spread to the lymph glands. Larger tumors and those that are spread to the lymph glands come under stages II and III. When the cancer has spread to other organs, it is stage IV.
What are the treatment options?
Treatment is based on the stage and the type of lung cancer. Small cell lung cancer is mainly treated with chemotherapy. In limited stage small cell lung cancer, radiation can be combined with chemotherapy. Early stage non-small cell lung cancer is best treated by surgical resection. An experienced surgeon removes the tumor, surrounding normal lung tissue and the lymph glands around it. Even after removing the tumor, cancer cells can remain and cause recurrent cancer, either in the lung itself or in other organs. Chemotherapy, radiation or both are used after surgery to reduce the chance of recurrent cancer. Advanced stage lung cancer is treated with chemotherapy. The types of chemotherapy drugs used are based on the type of lung cancer, age of the patient, other medical illnesses, etc. There is ongoing research to improve the outcome in patients with lung cancer.
What’s new in lung cancer?
Targeted agents: Medicines that target certain proteins or receptors on the cancer cells are being developed for the treatment of various cancers. These targeted agents attack the cancer cells specifically, sparing other cells. Targeted agents cause less severe side effects than chemotherapy. A few different targeted agents are found to be beneficial in lung cancer. Tarceva (erlotinib) is a drug that works in certain types of lung cancers carrying a mutation in a receptor called EGFR. A new drug called crizotinib was approved recently for the treatment of lung cancer that carries a gene called ALK fusion oncogene. No two tumors are alike! Even among lung cancers, there are different distinguishing features. Your oncologist chooses the type of treatment based on a number of factors, including the cell type, stage, different biological markers on the cancer cells, and your other medical problems. The County Woman Magazine www.TheCountyWoman.com November/December 2018
Prostate Cancer: What every man should know
Among the cancers that only affect men, the most important one is prostate cancer. Other than skin cancer, prostate cancer is the most common cancer among men. One out of eight men will be diagnosed with prostate cancer sometime during his lifetime. Anatomy: What is the prostate gland?
The prostate gland is one of the reproductive organs in males. It is a small walnutshaped gland located below the urinary bladder and in front of the rectum. Seminal vesicles, the glands that produce semen, are located just behind the prostate. Urine from the urinary bladder and semen from the seminal vesicles enter a hollow tube called the urethra. The urethra goes through the middle of the prostate gland. November Is National Lung Cancer Awareness MonthEnlargement of the prostate can cause a blockage in the passage of urine. Tumors or cancers originating from the prostate can also give similar symptoms.
What are the symptoms of prostate cancer? What you should know:
Common symptoms are: • If you are a heavy smoker, and have been smoking for several years, ask your doctor if you need to do an
• Difficulty in urination X-ray or a CT scan. • A weak stream of urine • Ask your MD about different methods to help you quit smoking. • Waking up many times in the night to urinate • If you are diagnosed with lung cancer, ask about the type of cancer you have, • Blood in the urine or semen stage and other features such as EGFR mutation. • What is your treatment plan? • Erectile dysfunction • What are the side-effects of treatment?
Some of these symptoms can also be seen in benign enlargement of the prostate • Are there support services available? Immunotherapy in lung cancer.(BPH). It is important to see a doctor if any of these symptoms are present. Over the last few decades, immunotherapy agents have been studied in the treatment of
If not diagnosed and treated early, prostate cancer can spread to other places such many cancers, including lung cancer. Several immunotherapy drugs are now approved for use. Our immune system fights cancer cells normally, and thus reduces the chance of as the bones, urinary bladder, rectum, and lymph nodes. Bone pain, pain during transforming normal cells into cancer cells. But this does not work always, as people with normal immune systems also develop cancer. The principle of immune therapy is based on urination, bleeding from the rectum, and back pain are other possible symptoms in boosting the immune system so that it can efficiently destroy cancer cells. later stages. The use of immune checkpoint inhibitors has been a major breakthrough in cancer research. These drugs help to take the “brakes” off the immune system, so that they can recognize and kill Who gets prostate cancer? cancer cells more effectively. OPDIVO, KEYTRUDA, and TECENTRIQ are some of the immune checkpoint inhibitors
Men over 50 are at a higher risk of getting prostate cancer. It is very rarely seen in that are used in lung cancer. Even though these drugs don’t have the typical side effects of men under 40 years of age. Sixty percent of prostate cancer occurs after the age of 65. chemotherapy, they still can cause reactions such as inflammatory disorders. Having a father or brother with prostate cancer increases a man’s risk of developing prostate cancer. There are some inherited genetic changes that will increase the risk To learn more about lung cancer and the treatment of other cancers, contact Dr. Sarah Easaw at 732-961-0010 or visit www.oceanhemonc.com. of developing prostate cancer in some families. Examples are the BRCA1 or BRCA2 genes (commonly known as the breast cancer genes) and Lynch syndrome.
Early diagnosis can lead to cure
Diagnosing prostate cancer at an early stage is very important in planning the right treatment and to prevent cancer from spreading to other organs. A simple blood test called PSA (prostate-specific antigen) is used as a screening test for prostate cancer.
Prostate-specific antigen is a protein made by the cells in the prostate gland. A very Compassionate Cancer Care, Close to Home small amount of PSA is normally found in the blood. In patients with prostate cancer, this level is elevated. Having a high PSA level will raise suspicion about cancer and will Sarah J. Easaw MD, FACP have to be followed up with more diagnostic tests. Board Certified Hematology & Oncology
PSA levels under 4 ng/ml are usually seen in benign conditions. If the PSA level is specialist more than 10 ng/ml, the chance of having prostate cancer is more than 50 percent. It Serving Monmouth and Ocean Counties is more important to follow PSA levels annually to see if there is an increase compared for more than 15 yearsto the baseline levels. Some other factors can also elevate PSA levels, such as benign enlargement of the prostate (BPH), inflammation or infection of the prostate, strenuous physical activities • Clinical expertise in the treatment of Cancer and Blood Disorders • State-of the-art Cancer Care, in a warm and personalized like cycling, some urological procedures, and certain medications. atmosphere
Examining the prostate through a digital rectal examination is also an important • Easily accessible location, close to GSP measure in diagnosing prostate cancer. This is done as part of an annual physical • Affiliated with RWJ /Barnabas Health Medical Group, a examination in men over 50. The size of the prostate gland as well as the shape, and multispecialty physician network. presence of any nodules or tumors can be assessed through this.
Confirming the diagnosis requires biopsy of the prostate gland. This can be done Treating Patients and Families with Respect and Care… by cystoscopy (tube through the urethra) or through the rectum. When should we test for prostate cancer? Ocean Hematology & Oncology
For those at average risk, screening for prostate cancer should start at age 50. Those who are at increased risk by having a first-degree relative with a diagnosis of prostate cancer should start undergoing screening at age 45 or even 40 if the risk is higher. 1255 Route 70, 31S • Lakewood, NJ 08701
Treatment of prostate cancer 732-961-0010
Treatment depends on the stage of cancer, age of the patient, and other medical illnesses that may affect life expectancy. Visit our website: www.oceanhemonc.com
Observation (watchful waiting)
Prostate cancer often grows very slowly and some men, especially older men with serious health issues, may never need treatment for early-stage prostate cancer. They may be observed with periodic monitoring of PSA and rectal examination.
Surgery
Removing the prostate and surrounding tissues by surgery is one of the common treatments for prostate cancer that is confined to the prostate. This procedure is called radical prostatectomy and can only be done by skilled urologic oncologists with expertise.
Radiation
Radiation to the prostate yields similar results as surgery in early-stage prostate cancer. If surgery cannot be done for any reason or if the patient does not want to do surgery, radiation would be an option.
Hormone therapy
The prostate gland is responsive to the male hormone testosterone. Giving medications that decrease testosterone will decrease the growth of prostate cancer cells. This mode of treatment is called androgen deprivation therapy (ADT). This can be done by an injection given once a month or at 3-to-4-month intervals. Some patients, depending on the stage of cancer, may need these injections even after surgery or radiation.
Chemotherapy
Chemotherapy is used to treat prostate cancer in the later stages, where it has spread to other organs.
After definitive treatment with surgery or radiation, blood PSA levels are checked periodically. If PSA levels increase, more tests should be done to see if cancer has relapsed or spread to other organs.
By regular physical examinations, annual PSA tests and being watchful of any new urinary symptoms, prostate cancer can be diagnosed and treated early; early-stage cancer is curable in more than 95 percent of patients.
3D Mammography Mammogram Recommendations
Breast cancer is the second leading cause of death among women. One in 8 women will develop breast At what age should I start getting screening cancer in her lifetime. Each year it is estimated that over mammograms?
252,710 women in the United States will be diagnosed The American College of Radiology (ACR) and Society with breast cancer and more than 40,500 women will die from the disease. This is why early detection is so of Breast Imaging (SBI) recommend that women start important. With early detection, the five-year survival getting annual mammograms at age 40. The American rate is nearly 100%. The latest weapon in the fight against Cancer Society (ACS), US Preventive Services Task Force breast cancer is 3D mammography (also known as breast (USPSTF), ACR and SBI agree that this approach saves tomosynthesis). This new technology has increased early detection over traditional mammograms, especially in the most lives.
women with dense breasts. Greater accuracy means better breast cancer detection. But the USPSTF recommended starting at age 50 and only getting mammograms every other year?
Q: What is a 3D mammogram? How is it different from Published analysis shows that following these USPSTF regular mammograms?guidelines would miss approximately a third of cancers A: 3D mammogram--also called breast tomosynthesis--is one of the most advanced forms of breast cancer detection. It uses a very low level of radiation to and result in 6,500–10,000 additional breast cancer take multiple pictures of the breast. The x-ray tube moves over the breast in an deaths each year.” arc, capturing multiple images of each breast from different angles. A computer reconstructs these pictures to create a 3-dimensional picture of the breast. A regular mammogram takes a single picture of the breast. What is screening breast ultrasound for? Q: What is the advantage of 3D mammogram? A: One of the challenges of interpreting mammograms is normal dense breast tissue hiding breast cancer. Additionally, overlapping areas of normal dense breast Many women, especially younger women, have dense breast tissue. This normal breast tissue can hide small cancers. There are some cancers that cannot be tissue can look suspicious. This is why detecting breast cancer in women with dense seen on mammograms that can be detected with breast breasts is more difficult. The 3-dimensional images of breast tomosynthesis help decrease the tissue overlap that can obscure cancers. It also helps distinguish normal ultrasound. Women who have been told that they overlapping breast tissue from breast cancer. have dense breasts may benefit from a screening breast
Studies have shown that 3D mammograms significantly improve the ultrasound in addition to their annual mammogram. This detection of breast cancer, especially in women with denser breast tissue. It also picks up breast cancer at an earlier stage, which may be missed by traditional can be discussed with your primary care physician. mammography. 3D mammograms find 20-65% more invasive breast cancers compared to traditional 2D mammograms, with an average increase of 41%.
Would I benefit from getting a 3D-mammogram?
3D-mammography, or tomosynthesis, is a new type of digital mammography that produces 2D and 3D images. Tomosynthesis has been shown to noticeably increase the ability of radiologists to detect cancers and reduce the need for return imaging for findings that turn out to be benign. All mammograms at Toms River X-ray are performed using high- quality 3D tomosynthesis and are interpreted by our radiologists with the assistance of computer-aided detection technology. And to get all the benefits of a 3D-mammogram, the patient doesn’t have to do anything differently at the visit compared with the traditional mammogram!
Q: Is there increased radiation performing a 3D mammogram?
A: Mammograms expose patients to very low levels of radiation. The level of radiation exposure from a 3D mammogram is the same as that from a traditional mammogram. So a patient receives all the benefits without any increased risk.
With traditional mammograms, when a radiologist finds an area that is suspicious, patients need to be called back for additional views. The multiple images created by 3D mammograms have such increased accuracy that there is decreased need for this. On average 3D mammograms reduce callbacks by up to 40% compared to traditional mammograms. This means less radiation exposure, increased convenience for our patients, and more peace of mind.
Dr. Paul Fang
Cancer in this breast is difficult to detect on this standard mammogram.
Q: What can I expect when having a 3D mammogram?
A: The process of having a 3D mammogram is the same as a conventional 2D exam. The technologist will position you, compress your breast, and take images from different angles. There’s no additional compression required, and it only takes a few extra seconds.
Q: Do insurance companies cover 3D mammograms?
A: Medicare, and many private insurers, cover 3D mammograms. In the past, not all private insurance companies covered 3D mammograms. However, in August 2018, New Jersey enacted a mandate requiring nearly all the major health insurers to cover 3D mammograms.
Toms River X-ray has been performing mammograms and serving the community for over 30 years. Our 3D mammogram is the latest on the market and has the most advanced technology. It is our mission to provide the very best for our patients. We thank you for trusting us with your health and the health of your loved ones. We look forward to offering you this significant advance in breast cancer screening.
Using 3D mammogram technology, the cancer was able to be clearly seen. If you have additional questions or would like more information, Cyrus Khorrami, M.D. Medical Director please call our office at 732-244-0777.
PARVIZ KHORRAMI, M.D. Founder
CYRUS KHORRAMI, M.D. Medical Director PARVIN MOTEMADEN
KHORRAMI, M.D.
732-244-0777
PET/CT Ultrasound CT Scan Diagnostic X-Ray
1.5 T and 3 T High Field Open Bore MRIs 3-D Mammography Nuclear Medicine Bone Densitometry Deer Chase Professional Park • 154 Route 37 West • Toms River, NJ 08755 • Fax: 732-244-1428
5www.TomsRiverXray.com5
