Awareness

Colorectal Cancer Awareness

Dr. Seth Rosen Colorectal cancer is the fourth most common cancer in both men and women in the United States. The American Cancer Society estimates there will be 95,520 new cases of colon cancer and 39,910 new cases of rectal cancer in 2017.

What is Colorectal Cancer?

Most colorectal cancers start as a growth, called a polyp, in the inner lining of the colon or rectum and slowly progresses through the other layers. Removing a noncancerous polyp early can keep it from becoming a cancerous tumor, which is why screening is such an important tool for preventing this disease.

Colorectal Cancer Symptoms

Colorectal cancer doesn’t always cause symptoms. It’s important to get screened regularly.

If you do have symptoms, they may include:

  • Stomach pain, aches, or cramps that don’t go away
  • Weakness and fatigue
  • Rectal bleeding
  • Blood in stool
  • Unintended weight loss

If you develop symptoms, it’s important to talk to your doctor immediately.

Colorectal Cancer Risk Factors

Your risk for developing colorectal cancer increases as you get older. Younger adults can get colorectal cancer, but more than 90% of cases occur in people who are 50 years old or older.

Other risk factors include:

  • Inflammatory bowel diseases
  • Personal or Family History of colorectal cancer or colorectal polyps
  • Tobacco use
  • Heavy alcohol use
  • Your racial and ethnic background
  • Type 2 diabetes
  • Lack of regular physical activity
  • A diet low in fruits and vegetables
  • A low-fiber and high-fat diet
  • Overweight and obesity

Colorectal Cancer Screenings

Several tests are used to detect colorectal cancers, one of the most commonly used tests is a colonoscopy. During this test, the doctor uses a colonoscope (a thin tube with a small video camera on the end) to look at the entire length of the colon and rectum. Special instruments can be passed through the colonoscope to biopsy or remove any suspicious-looking polyps.

Other tests include:

  • Double-contrast barium enema (DCBE)
  • CT colonography (virtual colonoscopy)
  • Guaiac-based fecal occult blood test (gFOBT)
  • Fecal immunochemical test (FIT)
  • Stool DNA test

When should I get screened? 

The U.S. Preventive Services Task Force (USPSTF) recommends that adults age 50 to 75 get screened for colorectal cancer. Adults age 76 to 85 should ask their doctor if they should be tested. However, you may need to get screened earlier than 50 if you meet certain risk factors.

If you believe you are at an increased risk for colorectal cancer, talk with your doctor to determine how often you should be tested and what screening is right for you.

Colorectal Cancer Treatments

There are many ways to treat colorectal cancer depending on its type and stage.

  • Some treatments may include local therapies such as: surgery, radiation therapy, ablation or embolization
    • These treatments are often used for earlier stage cancers
  • Systematic treatments including chemotherapy and targeted therapy may be used because they can reach cancer cells anywhere in the body

Next Steps

If you have been diagnosed with colorectal cancer, please call 404-778-1900 or 888-946-7447 to make an appointment or request an appointment online.

Winship Cancer Care

Your Winship multidisciplinary care team includes oncology surgeons, colorectal surgeons, radiologists, pathologists, pharmacists, nutritionists, social workers and advanced practice nurses with expertise in colorectal and gastrointestinal cancers. The benefits of our multidisciplinary and highly experienced teams include:

  • Access to doctors and surgeons who rank among the top colorectal cancer experts in the world
  • Weekly review of patient cases by the full team of experts
  • Coordinated scheduling for appointments among various specialties
  • Access to a nurse navigator to assist you throughout the treatment process
  • Access to support groups and education classes for you and your caregivers
  • Availability of new treatment options within our clinical trials program

Bio – Dr. Seth Rosen

Dr. Seth Rosen is a board certified colon and rectal surgeon. He’s an Assistant Professor in the Department of Surgery at Emory University School of Medicine. As chair of Emory Healthcare’s Robotic Institute Committee, Dr. Rosen leads a team that is tracking utilization of robotic surgery throughout Emory Healthcare, including outcomes, quality, cost, and efficiency; identifying areas for improvement; and initiating plans based on its recommendations.

Dr. Rosen is a Fellow of The American Society of Colon and Rectal Surgeons and a current member of the Medical Association of Georgia.

He’s also a member of the Cancer Prevention and Control Research Program at Winship Cancer Institute of Emory University.

Kick Butts Day’s Effort to End Smoking

Did you know that over 3,000 kids under 18 try smoking for the first time every day? According to Kick Butts Day, 700 of these 3,000 kids will become regular smokers. Kick Butts Day takes place every March 15th to encourage American youth to speak out against this tobacco use in hopes of eliminating and preventing nicotine addiction in teens. It is extremely important for teens to learn about the side effects and consequences of using tobacco primarily because it is the leading preventable cause of death in the United States.

Facts about Smoking Cigarettes from the CDC

  • Causes 480,000 deaths each year in the U.S.
  • Increases the risk for coronary heart disease and stroke, which leads to death
  • Causes about 90% of all lung cancer deaths in men and women
  • Makes it harder for women to become pregnant and can affect the baby’s health
  • Reduces the fertility of men’s sperm
  • Causes tooth loss
  • Decreases the immune system

Steps to Quit Smoking Cigarettes

The CDC recommends taking three steps to quit smoking. The first is to build a quit plan. In this preparation stage, you will determine your quit date, identify your reasons to quit, and develop coping strategies. In the next stage, you will learn to manage your cravings. This can primarily be done by staying active. For example, former smokers recommend chewing gum to keep your mouth busy or going for a walk to boost your energy. Lastly, find support. Listen to motivating stories from former smokers or watch YouTube videos of smoking campaigns to find the encouragement you need to get through the tough days.

6+ Reasons to Quit Smoking on November 17th

acspc-048514More than 40 million Americans smoke cigarettes, despite the fact that tobacco use is the single largest preventable cause of death in the U.S. To help lower this number and the heightened risk for disease caused by cigarette smoking, the American Cancer Society’s Great American Smokeout is Thursday, November 17. The event is held each year to encourage smokers to set a quit date with a community of peers and support.

Along with the Great American Smokeout event, November is Lung Cancer Awareness Month, meaning there are multiple opportunities to make a change and choose to quit smoking today. If the momentum and support created through these events and efforts aren’t enough, there is plenty of data to prove the benefits of quitting smoking today.

According to the American Cancer Society:

  • Within 20 minutes of quitting, your blood pressure and heart rate are reduced to almost normal.
  • Within 12 hours of quitting, the carbon monoxide level in your blood drops to normal.
  • Within 2 week to 2 months, your circulation improves, and your lung function increases.
  • Within 10 years of quitting smoking, the risk of dying from lung cancer is about half of a person who is still smoking. The risk of cancer of the larynx (voice box) and pancreas decrease
  • Smoking can reduce your good cholesterol (HDL) and your lung capacity, making it difficult to get the physical activity you need to stay healthy.
  • Quitting smoking today will lower your risk for heart disease, aneurysms, blood clots, stroke and peripheral artery disease (PAD). More details.

For more information on the Great American Smokeout, check out the American Cancer Society’s website on the event.

New Mammography Guidelines

mammogramAlthough the American Cancer Society (ACS) confirms that mammography saves lives, the organization issued new breast cancer screening guidelines on Oct. 20 that recommend women at average risk for breast cancer start getting annual mammograms at age 45. The previous recommendation was to start at age 40, and I will continue to recommend that women get yearly screening mammograms starting at age 40.

Evidence shows that the most lives are saved when screening starts at age 40. Although breast cancer is a little less common in women aged 40 to 44, this group receives the same life-saving benefit from screening mammography that older women do. As a radiologist specializing in breast cancer detection and diagnosis, I see this first-hand. My colleagues in the American College of Radiology agree and are also continuing to recommend that yearly screenings begin at age 40.

The new ACS guidelines note that the “harms” associated with screening may outweigh the benefits in women age 40-44. It is vital that women compare the magnitude and implication of the harms versus benefits associated with screening mammography. The harms they identify are about getting false positive readings from mammograms that can result in women being called back in for more imaging or an ultrasound. About 10% of women are recalled for these additional tests and the vast majority are cleared at that point. About 1 – 2% of patients who are recalled receive a needle biopsy using local anesthetic.

The benefits include saving lives and finding cancers smaller and earlier so that less aggressive treatment is required. I believe most women will agree that the drawbacks pale in comparison to the benefits of screening, and will choose to proceed with yearly screening. In fact, the ACS declares that yearly screening is beneficial and something that the majority of women would want, as long as they are healthy and have a 10 year or longer life expectancy. It is vital that we preserve a woman’s access to this life-saving technology so that she may choose to screen.

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About Dr. Newell

Newell_MaryMary S. Newell, MD, began practicing with Emory Healthcare in 2001 where she is a board certified radiologist specializing in breast cancer imaging and diagnosis. Dr. Newell has interests in emerging imaging technologies, teaching, and healthcare policy.

Dr. Newell chairs the American Board of Radiology Maintenance of Certification (MOC) Breast Committee and the American College of Radiology Joint Practice Guidelines and Technical Standards and Appropriateness Committee on Criteria. She is Head of Curriculum Assessment for the Society of Breast Imaging and Special Consulting Editor for CME for the American Journal of Roentgenology. She also serves as the treasurer for the Georgia Radiologicial Society, is a councilor to the American college of radiology representing the state of Georgia, and serves on numerous committees institutionally and nationally.

Dr. Newell earned her medical degree from the University of Michigan Medical School. She then completed her residency in diagnostic radiology and fellowship in body imaging at the St. Francis Hospital in Illinois. Dr. Newell’s research focuses on discovery and evaluation of new imaging modalities for future use in breast cancer screening and detection.

Pancreatic Cancer: Incidence and Outlook

Pancreatic cancer increases with age and most people are between 60 to 80 years old when diagnosed. Early pancreatic cancer often does not cause symptoms. Pancreatic cancer can affect anyone. People with a family history of pancreatic cancer in first degree relatives have an increased risk.

Pancreatic cancer specialist, Dr. David Kooby from Winship Cancer Institute of Emory University talks about why the disease is so prevalent and why it is so difficult to treat.

Learn more about Winship Cancer Institute of Emory University.

Winship Cancer Institute Expands Hospital Access

winship expands sign picWinship Cancer Institute has expanded access to its high quality cancer care in alignment with its broad clinical research program at both Emory Saint Joseph’s Hospital (ESJH) and Emory Johns Creek Hospital (EJCH). In addition, Winship has established the Winship Cancer Network as a means to improve access to such vital services throughout Georgia and the Southeast.

Longstanding and continued support from the Robert W. Woodruff Foundation has enabled Winship to advance cancer care and access to services like these for tens of thousands of patients throughout Georgia and beyond.

In addition to expanding services at ESJH and EJCH, the Woodruff Foundation’s most recent grant will be used to expand and improve Winship’s Shared Resource portfolio with special emphasis on its Cancer Prevention and Control Research Program. Researchers in this program are continually evaluating the best methods to reduce and eliminate the development of cancer among high-risk individuals across Georgia and the Southeast.

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Recurrent Prostate Cancer: Where is it?

Tiffany Dunphy and Van Jackson, radiation therapists at Winship at Emory Saint Joseph's Hospital, work with prostate cancer patients undergoing radiation treatment.

Tiffany Dunphy and Van Jackson, radiation therapists at Winship at Emory Saint Joseph’s Hospital, work with prostate cancer patients undergoing radiation treatment.

“It’s a lot easier to plan the attack, if we know where the enemy is,” says Winship urologist Peter Nieh, MD. “If a cancer is still localized, we may want to try salvage therapy, either radiation or surgery, before advancing to something systemic.”

Depending on how primary treatment took place, a prostate cancer often comes back in the prostate bed (where the prostate gland was), and may appear in nearby lymph nodes. In advanced cases, the cancer may spread to the bones.

Emory radiologist and Winship member David Schuster, MD and radiochemist and Winship member Mark Goodman, PhD have been developing a PET (positron emission tomography) imaging probe that shows considerable potential for detecting recurrent prostate cancer.

Usually in PET imaging, radioactive glucose is injected into the body, and since cancer cells have a sweet tooth, they take up a lot of the radioactive tracer. But the tracer also appears in the urine, complicating prostate cancer detection efforts since the prostate is so close to the bladder. In contrast, the probe 18F-FACBC, based on amino acids, is taken up by prostate cancer cells but doesn’t appear as much in urine.

FACBC has its limitations. It also may be taken up in benign prostate hyperplasia or inflammation. This means it probably won’t be as useful by itself for evaluating primary prostate cancers, but it has a lengthening track record in recurrent cancer.

In a 2011 publication, Schuster and his colleagues compared FACBC to ProstaScint, a commercially available probe. FACBC showed superior sensitivity and specificity in detecting tumors outside the prostate bed. Schuster is now collaborating with Winship radiation oncologist Ashesh Jani, MD to study FACBC’s benefits in designing radiation treatments for patients with recurrent prostate cancer after prostatectomy.

In Jani’s clinical trial study for recurrent prostate cancer, which lasts until 2017, one group of patients is examined using FACBC, while another gets conventional imaging. The question is whether using information gleaned from FACBC to direct the radiation results in a longer lasting remission than with the control group.

Marble countertop salesman Paul Reckamp, who was a participant in Jani’s study, keeps a file on his phone noting his PSA levels for the last several years. Reckamp had a radical prostatectomy in July 2010 at Emory Saint Joseph’s Hospital, but the cancer appeared to come back a year and a half later. FACBC imaging confirmed that the cancer had appeared in nearby lymph nodes but not elsewhere, and doctors could then plan radiation treatment that drove his PSA levels back down again.

“I couldn’t have been more pleased with the study,” he says. “It told me and the doctors what we wanted to know.”

As a National Cancer Institute (NCI) designated cancer center, Winship Cancer Institute of Emory University’s participation in clinical trials ensures our prostate patients have access to progressive resources and technology. For men with recurrent prostate cancer, there are newer methods of imaging such as magnetic resonance imaging (MRI) and positron emission tomography (PET). 

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Scientists of the Next Generation

As children we have all been to the doctor, visited the dentist, perhaps even sat in the cockpit of a plane. Anyone ever sit in front of a cryo-electron microscope, play with the dials on a mass spectrometer, or manipulate the genetic code? Most of us probably did not have that opportunity. I surely did not. So how will children, that is, our next generation of scientists, even consider being a scientist without ever knowing what a scientist does?

I am a cancer biologist with a lab focused on cancer metastasis (spread of the cancer). We study how cancer metastasis occurs in subtypes of patients to develop new treatments designed for these particular patients. On the side, I have also traveled throughout Georgia visiting over 3,000 students in K-12th grade to teach them about science and scientists. I have had the fortunate experience of visiting over 40 schools ranging from urban to rural, and public to private. I can state with 100% certainty that children are extremely interested in real science. Whether it has been high school assemblies or elementary school STEM fairs, students (adults too) are excited, enthusiastic, and most of all curious. They are curious not just about science itself, but what a scientist is and what a scientist does.

This signals to me that we need to make science more accessible. City wide science fairs, STEM fairs in school, career days, Twitter chats (#scistuchat), and experiential science in the classroom are excellent approaches. But scientists too need to open up their labs to reach out as well. We, as a professional group, need to show that we are not a bunch of mad scientists in the lab running through billows of smoking Erlenmeyer flasks trying to cure cancer. Instead we are well-coordinated teams of researchers and clinicians, working in fields that include math, engineering, informatics, surgery, and genetics that share a common goal of helping humans.

So, to all scientists out there, I propose to just take out your phone and record a 1-minute, impromptu lab tour, and send it to social media (#labtour). This gives anyone access through the locked lab doors to see what we do and who we are. My lab’s really quick video is posted here and embedded below.

The next generation of scientists are sitting out there right now learning in our classrooms. Within their minds are new treatments for cancer, novel screening approaches for neurodegenerative diseases, ideas for space exploration, and new robotic technologies. It is up to teachers, scientists, families, and communities to engage these students, make science more accessible, and let them know what is out there. I believe that if they can know the names and abilities of every single super-hero, princess, and cartoon character by age 7, they can surely know the parts of a cell. Let’s challenge them and see what we get!

About Dr. Marcus


Adam Marcus, PhDAdam Marcus received his PhD in cell biology from Penn State University in 2002 and went on to do a post-doctoral fellowship in cancer pharmacology at Emory University. Dr. Marcus is an Associate Professor at Emory University School of Medicine and has developed his own laboratory which focuses on cell biology and pharmacology in lung and breast cancer. Dr. Marcus’ laboratory studies how cancer cells invade and metastasize using a combination of molecular and imaging-based approaches. For more information about Dr. Marcus and his outreach and research efforts, please use the related resources links below. You can also follow Dr. Marcus on Twitter @NotMadScientist.

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It’s Melanoma Awareness Monday: Reduce Your Risk

melanoma awarenessDid you know that melanoma cases in the United States are growing faster than any other cancer? Malignant melanoma is a type of skin cancer that can be deadly if it spreads throughout the body. It usually grows near the surface of the skin and then begins to grow deeper, increasing the risk of spread to other organs. Detecting and removing a malignant melanoma early can result in a complete cure. Removal after the tumor has spread may not be effective.

Melanoma can occur anywhere on the skin, including areas that are difficult for self-examination. Many melanomas are first noticed by other family members.

Most patients with early melanoma have no skin discomfort whatsoever. See a doctor when a mole suddenly appears or changes. Itching, burning or pain in a pigmented lesion should cause suspicion, Visual examination remains the most reliable method for identifying a malignant melanoma.

Avoiding exposure to ultraviolet radiation is the best way to prevent melanoma and other skin cancers. Melanoma Monday is May 4th so here are a few tips for reducing your risk:

  • Avoid direct exposure between 10am and 4pm, opt for shade
  • Cover up with clothing (broad brimmed hat, sunglasses, long sleeves, etc.)
  • Use a sunscreen of SPF 30 or higher every day (including lip balm with SPF 30)
  • Apply 1 ounce (2 tablespoons) of sunscreen to the entire body, 30 minutes prior to going outdoors; reapply every 2 hours or after excessive sweating or swimming
  • Keep newborns out of the sun; if it cannot be avoided use a sunscreen with physical blockers to exposed areas (see below)
  • Avoid tanning beds
  • Remember water, sand, and snow reflect the sun; and clouds allow 70-80% UV penetration

Have fun this summer, but remember these tips for sun safety.

About Dr. Chen

chen, suephySuephy Chen, MD, MS, began practicing at Emory Healthcare in 2000 and has been board certified in dermatology since 1997. In addition to melanoma, Dr. Chen has clinical interests in pruritus, psoriasis, and atopic dermatitis.
Dr. Chen is a member of the Cancer Prevention and Control Research Program at Winship Cancer Institute of Emory University. She is also a member of the American Academy of Dermatology, the Society for Investigative Dermatology, and the Women’s Dermatology Society. In addition, she is a founding member of the Pigmented Lesion Group of the Melanoma Prevention Working Group.

Dr. Chen earned her Doctor of Medicine from Johns Hopkins University School of Medicine. She completed her internship at the Beth Israel Hospital, a Harvard University teaching hospital, before continuing on to a dermatology residency at Emory University Hospital. She obtained her Master of Science in Health Services Research at Stanford University and completed her fellowship at Stanford Hospital.

Dr. Chen is interested in quantifying the burden of skin disease, particularly the quality of life and economic burden on both patients and society as a whole. She is also interested in testing new technologies in the delivery of dermatologic care. She has contributed to numerous phase I-IV clinical studies of novel therapeutic regimens for the treatment of both inflammatory skin disorders and skin cancers.

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Kidney-Saving Robotics & Education

Saving kidneys from cancerous tumors and stones using minimally invasive techniques is my specialty. I’ve performed nearly 200 kidney operations in the last year alone and I recently launched a robotic kidney tumor program for Winship Cancer Institute at Emory Saint Joseph’s Hospital. Kidneys are essential to life but most people aren’t aware of their extraordinary function until there’s a problem. As a vital organ, kidneys are a filter for the body and they make urine to rid the body of waste toxins.

How would you know if you have a possible kidney concern? Check for a change when going to the bathroom. Kidney cancers in the early stages usually do not cause any signs or symptoms, but patients will sometimes experience signs that should be brought to a doctor’s attention, such as:

  • Noticing blood or very dark urine
  • Flank/back pain on one side (not caused by injury)
  • A mass (lump) on the side or lower back
  • Fatigue (tiredness)
  • Loss of appetite
  • Weight loss not caused by dieting
  • Fever that is not caused by an infection and doesn’t go away

Contact your doctor if you see changes like these. Recognizing your body’s warning signals can reduce your risk of serious disease, but the best option of all is prevention.

Kidney cancer prevention starts with smoking cessation and being aware of any history of kidney cancer in your family. The National Cancer Institute also identifies obesity as a known risk factor for kidney cancer, so take steps to manage your weight, exercise as a doctor prescribes for your individual condition, and eat whole foods that are rich in nutrients. Everyone should get regular check-ups.

When tumors or stones do develop, my job is to preserve this vital organ by using a minimally invasive procedure such as laparoscopic or robotic surgery (see video below). Not every tumor in the kidney is cancerous so options other than removing the entire kidney should be evaluated. Emory surgeons have been pioneers in using technologies like these to do organ-sparing cancer surgeries and complex stone surgeries.

As a specialist, I typically see patients after they are found to have a tumor or mass in the kidney or start experiencing symptoms. Let’s make prevention a part of your routine.

See Dr. Pattaras discuss this special type of organ-sparing robotic surgery:

About Dr. Pattaras

pattarasJohn G. Pattaras, MD, FACS, is an Associate Professor of Urology at the Emory University School of Medicine, Chief of Emory Urology services at Saint Joseph’s Hospital and Director of Minimally Invasive Surgery.

As the Director of Minimally Invasive Surgery, Dr. Pattaras started laparoscopic and robotic urologic surgery program at Emory University. Over the past 14 years, the program has expanded to become the premier laparoscopic and robotics program in Atlanta serving patients from Georgia, neighboring states as well as international patients. The program offers highly specialized minimally invasive surgery that includes organ-sparing cancer surgery and complex stone surgery. Patients attending Emory Urology for cancer treatment have the unique opportunity to be cured of their disease while at the same time preserve their vital organs, their functionality and quality of life.

Dr. Pattaras is a diplomate of the American Board of Urology (2002) a Fellow of the American College of Surgery.

In addition to his dedication to Emory patients, Dr. Pattaras is also involved in humanitarianism outside Emory. On an annual basis, he volunteers his time to organize and head a team of Emory medical students to Haiti. The team provides free urologic care including surgical treatment to indigent Haitian patients with urologic conditions.

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