Oncology

Q: How have the outcomes for cancer treatment changed over the last 10 years?

A:

Over the past decade, there are 16% fewer deaths from cancer in women. Some of this success is due to better screenings for common cancers and better promotion of healthy practices such as smoking cessation. Drugs introduced in the last decade have help control cancers such as early breast cancer and will lower incidence of cancers such as cervical cancer. With tremendous gains in molecular and genetic research, the cancer treatment are moving toward targeted therapies-attacking cancer cells and sparing normal cells and thus treatments today tend to be much more tolerable than they were a decade ago. With better techniques and technology, cancer surgeries are less disfiguring and traumatic. The outlook continues to improve for cancer treatment, but living a healthy lifestyle and getting appropriate screenings is the best thing you can do for yourself and your family.

Myo Min, MD
Hematology/Oncology

Q: When should I get my first colonoscopy and why is it important?

A:

A colonoscopy is a screening procedure to detect cancer or precancerous polyps in the colon. Guidelines recommend that you get your first colonoscopy as soon as possible after turning 50and then every ten years thereafter. Some individuals may need a colonoscopy earlier if there is a family history of colon cancer. A colonoscopy is not recommended after age 85.

Colon cancer is one of the most common cancers in the U.S. and it is highly curable if detected early. The purpose of a colonoscopy is to detect cancer or pre-cancer before symptoms arise, when it is most curable. According to the CDC, up to 60% of colon cancer deaths could have been prevented bya colonoscopy screening.

In addition to getting a colonoscopy regularly after age 50, you can further reduce your risk of colon cancer by decreasing the amount of red meat you eat, exercising regularly, giving up smoking and maintaining an ideal body weight.

Ashkan Bahrani, MD
Hematology/Oncology

Q: What can I do to lower my risk for breast cancer?

A:

Healthy lifestyle choices can help lower an individual’s risk of breast cancer. Eating a healthy diet, maintaining an ideal body weight, exercising, limiting alcohol use, and not smoking are all very important. In addition, limiting your exposure to unnecessary radiation and choosing to breastfeed are also recommended.

Early detection is critical to the successful treatment of breast cancer. Guidelines recommend women begin annual screening mammogram sat age 40. If there is a family history of breast cancer or other high-risk factors, you should speak with your physician about an individualized screening plan.

The Breast Center at the Kaufman Cancer Center offers screening and diagnostic mammography as well as multidisciplinary care for individuals who have been diagnosed with breast cancer. An entire team of specialists work together as a team to provide comprehensive and caring treatment to patients and their families

Meghan L. Milburn, MD

Medical Director, Breast Center
Assistant Professor of Surgery Division of Surgical Oncology
Department of Surgery University of Maryland School of Medicine

Q: If my doctor determines that I need to have a breast biopsy after an abnormal finding on my mammogram, what can I expect?

A:

Breast biopsies are an important step in the diagnosis of breast lesions. Samples of breast tissue are removed and the cells are analyzed to determine the nature of the abnormality. There are several types of breast biopsies and your physician will choose the type best suited to your circumstances. Needle biopsies are performed using ultrasound, specialized mammography, or MRI to guide a hollow needle to the exact location and then a small sample of breast tissue is extracted. With surgical biopsies, either a portion of the lump or the entire lump and some surrounding “margin” tissue are removed for analysis.

Biopsies are usually performed under local anesthesia. There may be some discomfort when the anesthetic is administered, but during the biopsy, you should be comfortable. After the procedure, you should apply ice; take a pain reliever such as acetaminophen and rest. With surgical biopsies, there are stitches in place and you will be instructed on care and return to activities.

The Breast Center at the Kaufman Cancer Center is a comprehensive center. All diagnostic and treatment services can be done in one location, easing the logistical burden on the patients and caregivers.

Meghan L. Milburn, MD

Medical Director, Breast Center
Assistant Professor of Surgery Division of Surgical Oncology
Department of Surgery University of Maryland School of Medicine

Q: Are blood disorders and cancers rare?

A:

Blood disorders encompass a large number of conditions from common ailments like anemia and chronic nosebleeds to the more rare such as immune disorders and hemophilia. Blood cancers can affect all types of blood cells, leading to cancers of bone marrow and the lymphatic system.

This includes leukemia, lymphomas such as Hodgkin’s and non-Hodgkin’s, and myelomas. According to the National Cancer Institute, in 2012, nine percent of all newly diagnosed cancers in the United States were blood cancers. In Harford County, the incidence rates for blood cancers seem to mirror the national incidence rates with non-Hodgkin’s lymphomas being the most common, followed by leukemia and myelomas and Hodgkin’s lymphoma, respectively.

The good news is that NCI statistics show that the 5 year survival rates for these cancers has increased greatly over the last 50 years and likelihood of death has decreased from 1998 to 2008.

Myo Min, MD
Hematology/Oncology

Q: What is lymphoma and how can it be treated?

A:

Lymphoma is a type of cancer that develops in the lymphatic system, which is part of the body’s immune system. The most common type is a group of lymphomas referred to as non-Hodgkin’s lymphoma.

Symptoms of lymphoma include fevers lasting two weeks or more, unexplained weight loss of more than 10 percent of body weight, and enlarged lymph nodes in the neck, underarm and/or groin. If you are experiencing symptoms you should see your primary health care provider for an exam and appropriate referral.

Treatment decisions for lymphoma are complex and depend greatly on the type and stage of the disease, the rate of growth and the age and general health of the individual. One treatment option includes chemotherapy, in which drugs are given either by mouth and/or injected directly into the bloodstream and travel throughout the body killing the cancer cells. Chemotherapy is typically given in several cycles with a rest period in between each cycle.

Radiation is another option and can be used in combination with chemotherapy. High-energy rays are used to damage cancer cells and stop their growth. Radiation can be done in an outpatient setting, typically five days a week for three to six weeks.

Advances in these and other cancer therapies and combinations of therapies have increased the survival rate of non-Hodgkin’s lymphoma to about 50 percent.

Venkata Parsa, MD
Hematology/Oncology

Q: What is the difference between palliative care and hospice care?

A:

Hospice care is part of the larger medical specialty called palliative care. Palliative care is focused on providing pain and symptom management to individuals with serious medical illnesses. It can begin right after diagnosis and works alongside the treatments to cure the condition. It provides the extra support and communication for the patient and his or her family.

Hospice care deals specifically with end of life care. This type of specialized care is available when a physician certifies that a patient has an anticipated survival of less than six months. Hospice care focuses on making the individual as comfortable as possible, enhancing the quality of the remaining life by providing physical, emotional and spiritual support to both the patient and his or her family. It involves nursing, social workers, home healthcare workers and, in many cases, chaplain services. Specialized care can be given in the home setting or in a residential hospice setting, assisted living or long-term care facility.

Angela Poppe Ries, MD
Director, Palliative Care

Q: What is Brachytherapy and how does it work for breast cancer?

A:

Brachytherapy literally means “close or near therapy.” It involves placing a radiation source internally within the breast to get as close to the tumor bed as possible. This precise approach allows for radiation delivery direct to the target area, sparing surrounding healthy tissue and minimizing side effects. It also provides excellent cosmetic results. In appropriately selected women this treatment option allows for a complete course of radiation therapy to be delivered in a week rather than the standard treatment of 6 weeks.

Brachytherapy treatment requires special physician training and expertise. In addition, experienced physicists help the physician in delivering the radiation safely and correctly. To allow for an appropriate dose of radiation to the tumor and maintain very low doses to normal tissues, specialized software and imaging provide an accurate picture of the tumor’s size and location. This subsequently allows for a highly targeted and individualized radiation dose. Radiation doses are calculated to provide optimal treatment and outcomes.

Brachytherapy has produced excellent patient outcomes and can be used in combination with other treatments such as surgery or chemotherapy. When discussing treatment options, it is important to ask your doctor what side effects may occur and how they can best be managed.

Navesh K. Sharma, DO
Radiation Oncology