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Buford man first to receive "revolutionary" sound wave treatment Breast Cancer Awareness Movember and Prostate Cancer Awareness
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Buford man with terminal cancer becomes first in Georgia to receive ‘revolutionary’ treatment that uses sound waves to destroy tumors
Ben Anderson
The Times
Jeff Reid was in the prime of his life.
Healthy and vibrant in his 50s, he spent his free time doing things like hiking, kayaking, obstacle course races and going on ski trips.
He enjoyed his career at an engineering company and was even part of the wellness committee, encouraging his coworkers to be more active and lead healthier lifestyles.
He also had plans to tie the knot with the woman who would become his future wife.
Northeast Georgia doctor and cancer patient talk about the first histotripsy performed in Georgia
But about two years ago, he was stricken by digestive issues and persistent stomach pain.
Reid, who lives in Buford, booked an appointment with a gastroenterologist and tried to schedule a colonoscopy, but he was told that there was a months-long waiting list and never ended up getting the procedure.
Come January of 2023, he was able to eat only about half as much as normal, so he booked a second appointment, this time with his regular doctor.
“They thought initially, because I was healthy, that maybe I needed to alter my diet a little bit,” Reid recalled in his softspoken voice.
But his symptoms only worsened, and he started to lose a worrying amount of weight.
He went back to his doctor and insisted on more tests.
“They did an ultrasound, and they could see that there was some stuff going on in my liver and my colon,” he said.
It was now late March, and Reid had lost 30 pounds.
Realizing that his health issues were more serious than they first appeared, he connected with Nelson Royall, a surgeon at the Northeast Georgia Medical Center in Gainesville who specializes in diseases of the liver and pancreas.
Royall performed a biopsy on Reid’s liver, while his colleague performed a colonoscopy.
Even before the biopsy results came back, Royall’s years of professional experience allowed him to make a diagnosis.
“‘Let's just talk about the elephant that's in the room,’” Reid’s wife, Stephanie Garcia, recalled Royall saying.
“Dr. Royall was always straightforward with us,” Reid said. “He knew, and I think we had suspected as well, that I had colon cancer that had metastasized to my liver. It was Stage 4,
Jeff Reid is the first person in Georgia to undergo a new revolutionary treatment for liver cancer. The treatment performed at the Northeast Georgia Medical Center uses sound waves to destroy liver tumors - photos by Scott Rogers
so very serious, and we need(ed) to start treatment as soon as possible.”
The diagnosis came just a few days before their planned wedding.
“Finding this out right as we're about to get married, it just kind of honestly … you felt like everything's crashing,” Garcia said. “Takes your breath away, takes the wind out of you.”
On April 3, the couple tied the knot on Jekyll Island.
What is it like reciting your vows and saying “I do” with a Stage 4 cancer diagnosis looming overhead?
“Definitely pretty emotional,” Reid said.
“Yeah, very emotional,” Garcia said.
The following week, they traveled to Duke University to meet with an oncologist, who gave Reid more bad news: His cancer was terminal.
The cancer may have started in Reid’s colon, but the majority of the tumors were on his liver. All four quadrants of his liver, he said, were covered in “countless” tumors.
Reid began an aggressive chemotherapy regimen.
“Because of my age and because I was otherwise healthy, they were giving me three different types of chemo and then an antibody, which helps to keep the tumors from spreading any further,” he said.
He continued that treatment for about six months before scaling back to what he called “maintenance chemo” in October.
Then in March, he heard about a new liver cancer treatment called histotripsy that uses ultrasound waves to destroy tumor cells while leaving normal cells unharmed.
“We had done a little bit of research and thought, ‘Well, maybe we have to travel to … Chicago (or) the University of Michigan or someplace like that where they were already doing it,” Reid said.
Little did he know, the procedure would soon be offered at NGMC by a familiar doctor — Dr. Royall.
“He informed us that he was going to start doing it in April and he would take my case,” Reid said.
The FDA approved the procedure in October, and the Northeast Georgia Health System is now one of only eight medical centers in the nation to offer it.
Reid had the procedure on April 19, making him the first person in Georgia to receive it and Royall the first physician to administer it.
The treatment won’t cure Reid’s cancer given its advanced stage and the fact that it has metastasized to more than one organ, but it was able to remove an egg-sized tumor without the side effects or recovery time that normally accompany standard treatments like chemotherapy.
“There's so many (tumors) that they haven't counted how many are in my liver, but now I have one less, and apparently it was about the size of an egg,” Reid said.
Although most of the tumors are in his liver, it is still considered Stage 4 colon cancer because that’s where the cancer originated. Usually, Royall said, the tumors in the liver must be removed before moving on the colon.
“He had so many spots inside of his liver that we could not
CANCER AWARNESS
cure him using surgery or other techniques,” Royall said. “There was no cure for him, and there (were) no real treatment options available to him other than chemotherapy.”
Royall suggested that the promise of histotripsy can hardly be overstated, describing it as “groundbreaking,” “totally revolutionary” and “unheard of in medicine.”
“It's a unique technology because unlike everything else that we've ever had in the history of medicine — that requires sticking a needle in to burn something or cutting someone open to cut something out of the liver — this allows you to just target an area of the liver, destroy that tumor without … injuring the rest of the liver,” he said.
Histotripsy involves the use of ultrasound waves to create tiny “bubble clouds” that destroy the connections cancer cells use to hold themselves together.
“Imagine ocean waves hitting a rock,” Royall said. “As it hits that (rock), imagine that it creates just like a spray of water. That's kind of what's happening inside the body when
Jeff Reid and wife Stephanie Garcia talk about Reid's liver cancer treatment.
ultrasound waves are at the right energy and they hit the tumor. They generate this spray of air. … It looks like a little tiny bubble cloud that's about the size of a grain of rice, and that's actually the size of what is being destroyed at any given moment.”
“We're not burning cells, we're not cutting them out,” he said. “We're just rupturing them, so that the body can then digest those cells and get rid of them. … It's targeted to the strength of the cancer cells, which are weaker than normal cells in your body, so it avoids damaging normal cells.”
He compared histotripsy to the emergence of radiation as a treatment for cancer in the first half of the 20th century. But unlike radiation or chemotherapy, histotripsy seems to have few side effects or none.
“I had some pain as a result of the surgery, but it was very positive,” Reid said. “There's no downside to getting it.”
In fact, the procedure may even come with positive side effects.
For example, Royall said histotripsy may increase the effectiveness of immunotherapy drugs.
“That's one of the exciting areas with histotripsy where maybe that immunotherapy class of drugs didn't work great before, but what if we introduce dead cancer cells to it?” Royall said. “That may make it work even more effectively than we thought of before, so it opens up a list of possibilities that we never thought was possible.”
In patients whose cancer has not spread beyond the liver, histotripsy may ultimately prove to be a one-stop cure, obviating the need for invasive surgery, which is often followed by weeks of recovery in the hospital.
“When we talk about cancers that form inside the liver by itself, it may actually be the cure for that liver cancer,” Royall said. “So there are some people where this will be the only treatment they need.”
“Now, maybe I just come in and go to sleep and wake up and I'm treated,” Royall said, adding that he’s “very optimistic” about that prospect.
He said research is ongoing as to whether the procedure can be applied to other cancers. He is optimistic on that front as well.
When Reid was diagnosed with cancer in March of last year, the best-case scenario was that he would live another 18 months.
“It's weird to think that I know what's going to probably kill me,” he said, sitting next to his wife on the couch in his home. “But you also have to remember, I could be in an accident tomorrow. You drive in this traffic, so there's an accident every day.”
“We’re just hoping for extended lifespan,” he said of the histotripsy procedure. “I don't have a timeframe. We haven't talked about that, nobody's talked about that. So, I don't know that they know, but I'm not cured and I'm not going to be cured.”
“We’re kind of reaching for time,” his wife said.
Although this new treatment didn’t cure his cancer, he is grateful that it may have given him more time with his friends
and family and hopes it will help save lives in the future.
“I just am happy that it's something that can help me and other people,” he said.
Knowing that his time will eventually run out, Reid said he and his wife are trying to spend it doing things they enjoy.
“We're not putting off taking time off or going places or doing things that we want to do, just even improvements to our home or our backyard, so that we can enjoy that more day-today,” he said. “A lot of times, we don’t do anything special, but it's just kind of hanging out. You appreciate it a little bit more.”
Dr. Nelson Royall used a new cancer treatment, histotripsy, to treat a patient with liver cancer. It was the first such treatment in Georgia. Histotripsy works by using targeted ultrasound waves to break apart the tumor from within.
STATISTICS UNDERSCORE THE PREVALENCE OF BREAST CANCER
Breast cancer affects millions of women and their family and friends every year. Each of those women has their own unique experience upon receiving a breast cancer diagnosis, and those journeys hopefully end with successful treatment. Because each woman's breast cancer journey is unique, data regarding the disease only tells part of the story. But recognition of key breast cancer statistics is still important, as data can compel support for women fighting the disease and underscore how vital it is for young women to prioritize breast health.
• A 2017 study from the American Cancer Society found that roughly 42 percent of cancer diagnoses and 45 percent of cancer deaths in the United States are linked to controllable risk factors for the disease. Breast cancer is no exception in that regard, as the Breast Cancer Coalition Foundation points to studies that have shown as many as 50 to 70 percent of breast cancers can be prevented if women adopt lifestyle changes early enough.
• The ACS estimates that approximately 30 percent of postmenopausal breast cancer diagnoses are linked to modifiable risk factors such as diet and physical activity levels.
• The World Health Organization reports 2.3 million women across the globe were diagnosed with breast cancer in 2022. WHO data also indicates 670,000 women lost their lives to the disease in 2022.
• Breast cancer poses a greater threat to women's lives in countries with a low Human Development Index (HDI), which is a metric used by the United Nations Development Programme to gauge a country's average achievement in areas such as healthy life and standard of living. WHO data indicates one in 12 women will be diagnosed with breast cancer in their lifetime and one in 71 women will die of the disease in countries with a high HDI. In countries with a low HDI, where access to medical care is more limited, one in 27 will be diagnosed with breast cancer and one in 48 will die from it.
• Five-year survival rates indicate that treatment is most effective when breast cancer is caught in its earliest stages. Data from the ACS indicates a 99 percent five-year survival rate for cancer discovered before it has spread beyond the place it started. When the cancer is considered regional, which the National Cancer Institute defines as cancer that has spread to nearby lymph nodes, tissues or organs, the five-year survival rate is 86 percent. The five-year survival rate for distant cancer, which indicates it has spread to distant parts of the body, is 30 percent.
• Survival rates differ considerably between Black women and White women diagnosed with breast cancer. According to the ACS, the five-year survival rate for Black women between 20122018 was 83 percent compared to 92 percent for White women during that same period.
2.3 million women across the globe were diagnosed with breast cancer in 2022
WHO data indicates 1 in 12 women will be diagnosed with breast cancer in their lifetime
ACS indicates a 99% five-year survival rate for cancer discovered before it has spread beyond the place it started
BREAST CANCER AWARENESS
PHYSICAL SYMPTOMS OF BREAST CANCER
The World Cancer Research Fund International reports that breast cancer is the second most common cancer across the globe, and the number one cancer in women. Nearly three million new cases of breast cancer in women are diagnosed across the globe each year.
Breast cancer poses a notable threat to women's health, but research and resulting advancements in treatment have made the disease more treatable than ever. Women also can play a part in ensuring better outcomes in relation to breast cancer by educating themselves about the disease, including its warning signs. The MD Anderson Cancer Center notes that most changes to the breast are a byproduct of hormonal cycles or conditions that are not as formidable as breast cancer. So women should not jump to any conclusions when spotting such changes. However, the MDACC recommends women visit their physicians if they notice any of the following signs and symptoms of breast cancer.
• LUMP: The MDACC notes that a lump in the breast or armpit is the most common symptom of breast cancer. Echoing assertions made by the MDACC, the American Cancer Society notes that most breast lumps are not cancerous. The ACS indicates a lump that is a painless, hard mass with irregular edges is more likely to be cancer, though cancerous lumps also can be soft, round, tender, or even painful. The lack of uniformity regarding cancerous lumps is one reason why it pays for women to be extra cautious and immediately report any abnormalities in the shape and feel of their breasts to their physicians.
• SWELLING: The ACS notes that some women with breast cancer will experience swelling of all or part of a breast even if they do not feel a lump.
• DIMPLING: The MDACC reports that women with breast cancer may notice dimpling or puckering on the breast. According to the ACS, the dimpling can sometimes make the breast look like an orange peel.
• NIPPLE RETRACTION: The National Cancer Institute notes that nipple retraction occurs when a nipple turns inward into the breast or lies flat against the breast. Though nipple retraction can be a sign of breast cancer, the NCI notes that's not necessarily the case for all women. Some women experience nipple retraction due to aging, breastfeeding, injury, infection, surgery, or certain conditions of the breast.
• CHANGES TO THE SKIN AROUND THE BREAST: The ACS notes some women with breast cancer experience redness on the skin around the breast or on the nipple.
Regular self exams can help determine if you need further screening, including mammograms.
Additional changes may include dry, flaking or thickened skin around the breast and nipple.
• DISCHARGE FROM THE NIPPLE: The Mayo Clinic notes that it's normal to experience discharge from the nipple while pregnant and during breastfeeding. However, fluid coming out the nipple when a woman is not pregnant or breastfeeding could be a symptom of breast cancer.
• ADDITIONAL SYMPTOMS: The MDACC notes scaliness on the nipple that sometimes extends to the areola is another warning sign of breast cancer. The ACS also reports that swollen lymph nodes under the arm or near the collar bone can indicate that breast cancer has spread even before the original tumor in the breast has been felt.
Breast cancer is a formidable yet treatable disease. Women who recognize any signs and symptoms associated with breast cancer are urged to contact their physicians immediately.
strategies 3
Breast cancer affects millions of individuals each year. The World Cancer Research Fund International reports that breast cancer is the most commonly diagnosed cancer in women across the globe, affecting roughly 2.3 million women each year.
Despite the global prevalence of breast cancer, various organizations report high five-year survival rates, particularly among women whose cancers are detected in the earliest stages of the disease. In fact, a 2023 study published in the journal BMJ found that the risk for dying from breast cancer in the five years after an early-stage diagnosis fell to 5 percent in recent years, a notable improvement from the 14 percent risk of death that was reported in the 1990s.
Increased survival rates for breast cancer are welcome news for women and their families. The higher survival rates are a byproduct of the tireless efforts of cancer researchers, who also have discovered links between the disease and certain lifestyle factors. Though there s no way to eliminate one s risk for breast cancer entirely, the American Cancer Society notes certain variables are within women s control. With that in mind, women can consider these three strategies that can lead to improved overall health and might help women lower their risk for breast cancer as well.
1.
Reach and maintain a healthy weight. The benefits of maintaining a healthy weight include a lower risk for heart disease and stroke, and women should know that weight and breast cancer risk are linked as well. According to the ACS, increased body weight and weight gain as an adult are linked to a higher risk of developing breast cancer. That s particularly so among post-menopausal women. A 2023 study published in the journal BMC Women s Health found that the chances of developing breast cancer increase among postmenopausal women who are obese.
2.
Avoid a sedentary lifestyle. Exercise is one of the ways to achieve and maintain a healthy weight, so it makes sense that being physically active can reduce breast cancer risk. The National Cancer Institute reports that a 2016 metaanalysis of 38 cohort studies found that the most physically
that can lower
active women had between a 12 and 21 percent lower risk for breast cancer than women who were the least physically active. The NCI also notes that additional studies have found that women who become more physically active after menopause also have a lower risk for breast cancer than those who do not.
3.
Limit or eliminate alcohol consumption. The ACS urges women who drink to consume no more than one alcoholic drink per day, noting that consumption
breast cancer risk
of even small amounts of alcohol have been linked to an increased risk for breast cancer. Officials with the MD Anderson Cancer Center note that the link between alcohol consumption and breast cancer risk is low. However, the MDACC notes that alcohol can contribute to unwanted weight gain, thus increasing cancer risk. In addition, alcohol can increase levels of estrogen and other hormones associated with breast cancer.
It may be impossible to completely prevent breast cancer. However, women can embrace strategies that improve their overall health in ways that lower their risk for breast cancer.
Adding a variety of movements to your work out routine is an excellent way to ensure you are hitting all your muscle groups and keeping interest in your fitness goals.
Men's Health
November
MOVEMBER
CHANGING THE FACE OF MEN'S HEALTH
Studies have found that men might be more tightlipped about their health than women. According to Kaiser Permanente, men sometimes don't talk about their health because of cultural attitudes, fear or pride. As a result, men may not be able to catch illnesses at their earliest stages, which can reduce their life expectancy.
The Movember® movement was established as an effort to raise awareness about men's health and wellness. Movember® gets men involved in their personal health in a fun way: by growing mustaches.
The Movember® movement began in 2003 as a way to champion men's health. Since its inception, Movember® has helped fund more than 1,320 men's health projects around the world, including changing the way health services reach and support men. Travis Garone and Luke Slattery devised the idea for Movember® when they met up for a beer in their native city of Melbourne, Australia. Since mustaches had all but
took up the challenge to grow mustaches and promote men's health in the initial Movember effort. Today, Movember® has expanded exponentially and internationally.
The main focus of Movember® 'beyond growing a mustache' involves significant issues affecting men: mental health and suicide prevention, prostate cancer and testicular cancer. Participants are urged to be more physically active and host fundraising events to raise awareness about the effect these issues have on men. Much like Breast Cancer Awareness Month in October serves to spur more women to get mammograms and take breast health seriously, Movember® is a chance for men to make doctor's appointments and discuss key issues like prostate health. In fact, the Prostate Cancer Foundation is an official beneficiary partner with Movember® for their U.S. campaign. To date, Movember® has donated more than $56 million to PCF to support innovative prostate cancer research. From humble Australian beginnings, Movember® has
PROSTATE CANCER AWARENESS
FACTS ABOUT PROSTATE CANCER ALL MEN SHOULD KNOW
One in eight men will be diagnosed with prostrate cancer in his lifetime.
Preventive health care encompasses a host of strategies designed to reduce individuals' risk for conditions and diseases that can adversely affect their quality of life. Routine exercise and a commitment to a nutritious diet are two such strategies, and each can go a long way toward protecting an individual's long-term health.
Education is another key component of preventive health care. By educating themselves about their own family histories and additional variables that may increase their risk of developing certain conditions, individuals can take steps to mitigate that risk.
The World Health Organization reports that roughly one in five people across the globe develop cancer in their lifetime. Prostate cancer poses a unique threat to men. The WHO notes prostate cancer is the second most commonly occurring cancer in men, and recognition of that threat may compel men to learn more about the disease. Data does not tell the whole story of prostate cancer, but some fast facts about the disease can serve as a springboard to learning more about it and what, if anything, can be done to prevent it.
• The Prostate Cancer Foundation reports that one in eight men will be diagnosed with prostate cancer in his lifetime.
• Rates of prostate cancer are higher among Black men. According to the PCF, one in six Black men will develop prostate cancer in his lifetime. In addition, Black men are more
than twice as likely to die from the disease.
• Estimates from the PCF indicate just under 300,000 men will be diagnosed with prostate cancer in 2024, and roughly 35,000 men will die from the disease.
• Men with first-degree relatives who have had prostate cancer may be twice as likely to develop the disease. Firstdegree relatives include a father, brother or a son. Men are urged to learn their family medical histories so they can identify their own individual risk for prostate cancer.
• The American Cancer Society reports that roughly six in 10 prostate cancers are found in men older than 65. However, the ACS also notes that the chances of being diagnosed with prostate cancer increase significantly after age 50. And while instances of prostate cancer in men younger than 40 are rare, men 39 and younger can still develop the disease.
• Five-year survival rates for prostate cancer are high when the disease is detected in the localized or regional stages. Localized indicates there is no sign the cancer has spread beyond the prostate, while regional means the cancer has spread to nearby structures or lymph nodes. The five-year survival rate for these stages is greater than 99 percent.
Prostate cancer poses a notable threat to men. Understanding that threat and what can be done to mitigate it is an integral component of preventive health care.
Pictured: Dr. Matthew Vaughn, DMD