MD Chats

Takeaways from the Colorectal Cancer Live Chat at Winship

colorectal-chat-emailThanks to everyone who joined us Tuesday, March 8th for the live online colorectal cancer program chat at Winship Cancer Institute of Emory University hosted by Drs. Bassel El-Rayes & Seth Rosen.

Drs. El-Rayes & Rosen answered several of your questions about colorectal cancer risk factors, symptoms and therapy. The colorectal cancer program at Winship Cancer Institute of Emory University offers multidisciplinary teams including oncology surgeons, radiologists, medical oncologists, pathologists, and advanced practice nurses with expertise in colorectal cancer and other gastrointestinal cancers. There are a variety of treatment options for colorectal cancer; for some patients, a combination of treatment methods may be used.

Check out the conversation by viewing the chat transcript! Here are just a few questions from the chat:

Question: How prevalent is family history? Should I have a plan to have [colorectal cancer] testing done?

  • Answer from Dr. Rosen: Approximately 15% of colorectal cancer patients have a family history of the cancer.
  • Answer from Dr. El-Rayes: Family history is an important predictor of the risk of developing colon cancer. Patients with family history of multiple relatives with colorectal or other cancers should seek evaluation to determine if their family history puts them at added risk for developing cancer. At Winship we have a multidisciplinary team that includes geneticists, genetic counselors, colorectal surgeons, gastroenterologists, and medical oncologists who can work with families who have inherited pre-dispositions for colon cancer.

Question: If you have been diagnosed/hospitalized (8 years ago) with divraticulos how often should you have a colonoscopy? And is it related to bleeding that starts and stops when you are stressed and your bowels lock up? And is it hereditary?

  • Answer from Dr. Rosen: Diverticular disease does not have any bearing on risk of colorectal cancer, so it does not change surveillance or screening recommendations. It can cause bleeding, and there is possibly a hereditary component.
  • Answer from Dr. El-Rayes: The frequency of colonoscopy is dependent on family history, presence of chronic inflammatory conditions (like Ulcerative colitis) and presence of polyps. Diverticulosis of in of itself does not impact the risk of developing colon cancer.

Question: If a person with family history of Colon Cancer can’t afford the test who can help them?

  • Answer from Dr. Rosen: The Affordable Care Act offers free screening for colorectal cancer.

 

If you missed this chat, be sure to check out the full list of questions and answers on the web transcript. For more information go to the Colorectal Cancer at Winship Cancer Institute website or 404-778-7777 to learn more from a registered nurse.

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If you have additional questions for Drs. El-Rayes & Rosen, feel free to leave a comment in our comments area below.

 

Colorectal Cancer Live Chat: Risk Factors, Screenings, Symptoms & Therapy – March 8, 2016

colorectal-chat-emailMost 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.  According to American Cancer Society, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States and 134,490 new cases are expected to be diagnosed in 2016 nationally.

The colorectal cancer program at Winship Cancer Institute of Emory University offers multidisciplinary teams including oncology surgeons, radiologists, medical oncologists, pathologists, and advanced practice nurses with expertise in colorectal cancer and other gastrointestinal cancers.  There are a variety of treatment options for colorectal cancer; for some patients, a combination of treatment methods may be used.

Join Drs. Bassel El-Rayes & Seth Rosen, two physicians with Winship Cancer Institute of Emory University’s colorectal cancer team, on Tuesday, March 8th at 12pm EST for a live chat where they will answer your questions about colorectal cancer risk factors, screenings, symptoms and therapy. All are welcome to attend an online open-forum discussion about colorectal cancer. Sign up for this live chat here.

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Takeaways from the Prostate Cancer Live Chat at Winship

prostate-chat-cil638Thanks to everyone who joined us Tuesday, November 24th for the live online prostate cancer program chat at Winship Cancer Institute of Emory University hosted by Drs. Pattaras & Rossi.

Drs. Pattaras & Rossi answered several of your questions about prostate cancer risk factors, symptoms and therapy. Check out the conversation by viewing the chat transcript! Here are just a few follow up questions we didn’t get to from the chat:

Question: What preventive measures are most effective for improving urinary function and quality of life?

Answer: Preventative measures include exercise, weight loss and a healthy low fat diet. Unfortunately there are genetic predispositions for prostate enlargement and bladder dysfunction including spinal disorders that even prevention will not help. See a urologist if there is a noticeable change in urination.

Question: Conventional wisdom is that if you have prostate cancer you should no take testosterone. Dr. Abraham Morgantaler has written a number of articles in JAMA and NEJM challenging that conventional wisdom. Are doctors Pattaras and Rossi familiar with his research, and if so, any thoughts?

Answer: Though specifically not familiar with his publications there are numerous studies which suggest that men with low testosterone could be supplemented to normal levels if watched carefully. Testosterone itself does not cause prostate cancer but can feed advanced cases. Chemical castration is a therapy for advanced prostate cancer but is not done for localized treated cancer so testosterone supplementation is feasible but does have risks. We have placed men on testosterone replacement after therapy as long as they are compliant.

If you missed this chat, be sure to check out the full list of questions and answers on the web transcript. For more information go to the Prostate Cancer at Winship Cancer Institute website or 404-778-7777 to learn more from a registered nurse.

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If you have additional questions for Drs. Pattaras & Rossi, feel free to leave a comment in our comments area below.

Prostate Cancer: Risk Factors, Screenings, Symptoms & Therapy Live Chat on November 24th

prostate-chatAccording to the American Cancer Society (ACS), about 1 man in 7 will be diagnosed with prostate cancer during his lifetime. If detected early and depending on the type and stage of the disease, prostate cancer can be treated.

Join John G. Pattaras, MD and Peter Rossi, MD, two physicians with Winship Cancer Institute of Emory University’s prostate cancer team, on Tuesday, November 24th at 12pm EST for a live chat where they will answer your questions about prostate cancer risk factors, screenings, symptoms and therapy. All are welcome to attend an online open-forum discussion about prostate cancer with Dr. Pattaras and Dr. Rossi. Sign up for this live chat here.

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Takeaways from the Pancreatic Cancer Live Chat at Winship

Pancreatic Cancer Chat

Thanks to everyone who joined us Tuesday, May 12th for the live online pancreatic cancer program chat at Winship Cancer Institute of Emory University hosted by Drs. El-Rayes & Kooby.

Drs. El-Rayes & Kooby answered several of your questions about pancreatic cancer risk factors, symptoms and therapy. There are a variety of treatment options for pancreatic cancer; for some patients, a combination of treatment methods may be used. Check out the conversation by viewing the chat transcript! Here are just a few highlights from the chat:

Question: Who is at the most risk for pancreatic cancer?

David Kooby, MDDr. Kooby: Pancreatic cancer can affect anyone. People with a family history of pancreatic cancer in first degree relatives have an increased risk. Smokers are at risk, as tobacco appears to be a causative factor. Other groups who have an elevated risk of getting pancreatic cancer are those with new onset or long-standing diabetes mellitus and those with one of several uncommon genetic syndromes: BRAC2, HPSS, FMS, Peutz Jegher. Other associations include age over 60, chronic pancreatitis, and obesity. Many of the symptoms for pancreatic cancer are vague, which makes this a difficult disease to diagnose.

Question: When surgery is not an option, are there any treatments beyond chemo and radiation?

Bassel El-Rayes, MDDr. El-Rayes: A number of novel therapies are currently on clinical trials and those include drugs that stimulate the immune system or drugs that target specific molecular abnormalities in cancer (targeted therapies). In addition, in certain situations there are options to use therapies that ablate (physically destroy the tumor). These include nano knife.

 

Question: Are qualifying patients given the option to participate in these trials Dr. El-Rayes?

Bassel El-Rayes, MDDr. El-Rayes: When we evaluate patients in the clinic, we always discuss with them the different options of therapy, including, standard therapy vs. clinical trials. For patients to participate in clinical trials, they have to meet predefined criteria. If patients are interested in clinical trials, we will screen them to determine whether or not the meet these criteria.

 

Question: My sister and brother have both been diagnosed with pancreatic cancer within months of each other. There are three remaining siblings. Can you address how we can be tested?

Bassel El-Rayes, MDDr. El-Rayes: The first step would be to see a genetic counselor to look for a possible genetic link. There, they can test for specific genes that might indicate a higher risk in the family.
David Kooby, MDDr. Kooby: If the genetic testing doesn’t yield any abnormality, the second step would be to consult with a pancreatic cancer specialist. These specialists are either gastroenterologists or medical oncologists. Currently, there are no set guidelines on how frequently family members of current patients should be tested. Your specialist can outline a plan that works best for you and your family. Researchers at institutions like Winship are actively working on better methods for screening for pancreatic cancer.

If you missed this chat, be sure to check out the full list of questions and answers on the web transcript. For more information go to the Pancreatic Cancer at Winship Cancer Institute website or 404-778-7777 to learn more from a registered nurse.

If you have additional questions for Drs. El-Rayes & Kooby, feel free to leave a comment in our comments area below.

Related Resources

 

 

 

5 Early-Distress Warnings of Digestive Cancer

pancreatic cancer live chatWhen you think of digestion you probably don’t think about the pancreas, but it sits right behind the stomach and works to provide essential digestive functions. The pancreas, only about 4- 6 inches long, is widely known for producing insulin, an important hormone that regulates blood sugar levels, but it also assists the body in the absorption of nutrients into the small intestine.

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, however there are five early warning signs that we can all be aware of to better advocate for our health.

  1. Yellow eyes or skin.  The pancreas uses a greenish-brown fluid made in the gallbladder, called bile, to help the small intestine in digestion. If a tumor starts in the head of the pancreas, it can block or press on the bile duct and cause bile to build up. This back-up causes yellow discoloration, called jaundice.
  2. Belly pain.  Pain has been described as distressing, as compared to a sharp cramp or ache. Pain may go away when you lean forward because it and spreads toward the back.
  3. Change in stool.  Pale, floating, smelly stools. Or dark stools. Let your stool be a guide. If a pancreatic tumor prevents digestive fluids from reaching the intestine, the result is an inability to digest fatty foods. Anytime there is a change with digestion then check in with your doctor. It may not be a sign of digestive cancer, but you do need to be aware of your own body function to determine what is or is not “normal.”
  4. Lack of appetite.  Or sudden, unexplained weight loss. A drop in appetite and a tendency to feel full after eating very little is something to be aware of. Again, it may not be alarming but you do need to be aware of your own body function to determine what is or is not “normal.”
  5. Diabetes, especially if unexpected from regular check-ups.  Most diabetes diagnoses are not due to pancreatic cancer; however, research studies show that pancreatic cancer patients have a higher rate of diabetes diagnosis than the general populace. Knowing your family history of pancreatic cancer and having a baseline of regular screening will help your doctor evaluate if additional tests should be done.

Being an advocate for your health starts with healthy behaviors; tobacco use, particularly cigarette smoking, accounts for 20-30% of pancreatic cancer. Knowing risk factors you should avoid (such as smoking) and being aware of what your body is signaling will help you in early detection as well as potential outcome.

Management of cancer requires a multidisciplinary team of healthcare specialists. Winship’s pancreas cancer team includes surgeons, medical oncologists, radiation oncologists, gastroenterologists, pathologists as well as pain specialists, nutritionists and social workers. For patients with early stage pancreatic cancer, the Whipple surgical procedure is the best option for long-term survival. Winship Cancer Institute of Emory University surgeons perform a large number of Whipple procedures every year; a high volume of these procedures directly translates into the expertise needed to perform the procedure safely. According to published data, mortality rates from Whipple surgery are four times lower at hospitals performing a high volume of the procedure, such as Emory. Some patients may be candidates for laparoscopic or robotic surgery, which may improve both recovery and cosmetic appearance after surgery. Winship at Emory surgeons are leading the world in this area as well. If diagnosed with cancer it’s important to get to Winship, first.

Continue learning about pancreatic with a conversation; all are welcome to attend an online open-forum discussion about pancreatic cancer. We will answer your questions about pancreatic cancer risk factors, symptoms and therapy on Tuesday, May 12th, 2015 at noon.

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About Dr. El-Rayes

Dr. El-Rayes, Colon Cancer SpecialistBassel El-Raye, MD, is the Director of the GI Oncology Clinical and Translational Research Program, Associate Cancer Research Director for Clinical Research at Winship Cancer Institute of Emory University and Professor of Hematology and Oncology at Emory University School of Medicine. Dr. El-Rayes earned his bachelor’s degree in biology and doctoral degree from the American University of Beirut. He then completed his residency in internal medicine and fellowship in hematology and medical oncology at Wayne State University, Detroit. He was on faculty at Wayne State University Karmanos Cancer Institute from 2003-2009. Dr. El-Rayes clinical interests include gastrointestinal malignancies specifically pancreatobiliary and neuroendocrine cancers. He is principle investigator on multiple investigator initiated trials. He has served on the gastrointestinal committee for Southwest Oncology Group (SWOG) and Radiation Oncology Cooperative Group (RTOG). He currently serves on the National Cancer Institute Neuroendocrine Tumor (NET) Task Force. He also serves as Co-chair of Hoosier Oncology Group (HOG) Cancer Research Network – Gastrointestinal Clinical Trials Working Group. Dr. El-Rayes is a Georgia Cancer Coalition Distinguished Clinical Scholar. He has published over 90 peer reviewed articles in elite journals including Journal of Clinical Oncology and Cancer Research.

About Dr. Kooby

David Kooby, MDDavid A. Kooby, MD, FACS, specializes in laparoscopic/robotic and open surgical treatment of liver, bile duct, pancreas, stomach, and colon tumors/cancers. He also has expertise with tumors and diseases of the spleen, adrenal glands, and retroperitoneum. He has taught many national courses on laparoscopic resection of the liver, pancreas, and colon, and is frequently invited to speak at national conferences. He received his MD at the State University of New York, Downstate Medical College, Brooklyn, NY, in 1994; completed his surgical residency at Vanderbilt University, where he won medical student and resident teaching awards. He completed both bench research and clinical fellowships at Memorial Sloan-Kettering Cancer Center, New York, NY. He was recruited by Emory in 2003, and is currently an Associate Professor of Surgery in the Division of Surgical Oncology, Director of Surgical Oncology at Emory/Saint Joseph’s Hospital, and Director of Minimally Invasive GI Surgical Oncology. He serves on several national committees including the task force charged with updating the staging of hepatobiliary malignancies for the American Joint Committee on Cancer’s Cancer Staging Manual, the research and education committee for the American Hepato-Pancreato-Biliary Association, and the Hepatobiliary Working Group for the Society of Surgical Oncology. He is leader in multicenter clinical research and is a national leader in minimally invasive pancreatic surgery.

Related Resources

Bite into a Healthy Lifestyle
An Intro to Pancreatic Cancer Part I: Stats, Types, & Risk Factors
Steve Jobs, Pancreatic Cancer & the Whipple Procedure

Takeaways from Dr. Cohen’s “Advancements in Breast Imaging” Live Chat

Thank you to everyone who joined us for last week’s live web chat on “Advancements in Imaging for Early Breast Cancer Detection.” Dr. Michael Cohen, director, Division of Breast Imaging for Emory’s Department of Radiology, discussed the latest in breast imaging screening and technology.

Questions varied from ,“What are the current breast screening guidelines?” to “What is tomosynthesis and when is it the right choice for screening?” Below are just a few of the questions and answers from the chat. Make sure to view the chat transcript for the whole discussion.

Question: What are the current breast cancer screening guidelines?

Michael Cohen, MDAnswer:
Women aged 40 and younger should have a clinical breast exam at least every 3 years. All women aged 40 and over should get a yearly screening mammogram, clinical breast exam and perform a monthly breast self-examination.

 

Question:
When is breast tomosynthesis the right choice for screening? And how does tomosynthesis compare to an MRI in diagnosing cancer?

Michael Cohen, MDAnswer:
Digital Tomosynthesis (3D mammography) is an improvement on traditional 2D mammography. Rather than the traditional single view of a breast in 2D mammography, 3D mammography obtains a series of very thin 1 mm sections of the breast. This allows us to look at the breast as if we were viewing pages of a book and gives a much more accurate look inside. If tomosynthesis is available at your breast imaging facility, it is an excellent way to screen.

Studies have shown that 3D mammography permits detections of more cancers, while at the same time reducing the number of unnecessary call-backs to evaluate lesions that are not cancer. This is a win-win for the patient. MRI screening is reserved for a limited number of patients at high risk.

Question:
What about the radiation exposure for these types of test [tomosynthesis]; is it different from traditional mammograms?

Michael Cohen, MDAnswer:
With current technology, a patient receives both a 2D and a 3D mammogram at the same time. The addition of 3D about doubles the radiation exposure compared to 2D alone, but is still within FDA guidelines for mammography.

Also, some very exciting technology is on the horizon that will permit us to create a 2D mammogram from a 3D mammogram using sophisticated computers. When that becomes available, we will only need to do a 3D mammogram, thereby reducing the radiation exposure to the original level.

If you missed this informative chat with Dr. Cohen, be sure to check out the full list of questions and answers on the web transcript.

If you have any questions for Dr. Cohen, don’t hesitate to leave a comment in our comments area below!

Advancements in Imaging for Early Breast Cancer Detection

Advancements in Breast Imaging ChatBreast cancer is the most common cancer among American women, according to the Centers for Disease Control and Prevention (CDC). October is Breast Cancer Awareness month and the breast care specialists across Emory Healthcare want you to know the importance of screening and early detection.

The American Cancer Society recommends that women (without breast cancer symptoms), age 40 and older should have a mammogram every year as long as they are in good health. Getting yearly screening mammograms increases the chance of detecting cancers in the early stages, before they start to cause symptoms. By detecting cancer early, screening exams also help increase the chance of survival and lower the risk of mortality.

At Emory Healthcare, we are proud to offer patients with leading breast screening techniques, including the latest in breast imaging technology, called tomosynthesis, or 3D mammography.

Learn more about breast screening guidelines and advancements in breast imaging by joining us on Tuesday, October 21 at 12:00 pm EST for a live web chat on “Advancements in Imaging for Early Breast Cancer Detection.” Dr. Michael Cohen, Director, Division of Breast Imaging for Emory’s Department of Radiology, will be available to answer questions such as: what is the latest in breast imaging technology? When should I start getting screened? To register for the chat, click here.

Also, during October, the Emory Breast Imaging Centers are offering extended and weekend hours for women needing a screening mammogram. Dates and details are below:

Extended Hours: Thursday, October 9, Tuesday, October 21, Thrusday October 23; 7:30 a.m – 7:00 p.m. at the Emory Breast Imaging Center on Clifton Road.

Saturday Hours: October 18, 8 a.m. – 2 p.m. at Emory University Hospital Midtown.

Registration: To schedule an appointment, call 404-778-PINK (7465). Standard rates apply.

Chat Details:

Date: Tuesday, October 21, 2014
Time: 12:00- 1:00 pm EST
Chat Leader: Dr. Michael Cohen
Chat Topic: Advancements in Imaging for Early Breast Cancer Detection

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Takeaways from Dr. Saba’s Head and Neck Cancer Chat

Thanks to everyone who joined us on Tuesday, June 24, for our live online chat on “Risk factors, symptoms and treatment options for head and neck cancer” led by Nabil Saba, MD, Chief of Head and Neck Oncology at Winship Cancer Institute of Emory University.

According to the National Cancer Institute (NCI), head and neck cancers account for approximately three percent of all cancers in the U.S. During the chat, Dr. Saba addressed some of your questions relating to risk factors, symptoms and the latest research for head and neck cancer. See all of Dr. Saba’s answers by checking out the chat transcript! Here are just a few highlights from the chat:

Question: What are the symptoms of head and neck cancer? How do I know if I need to go get checked out?

Nabil Saba, MDDr. Saba: Symptoms include having a lump in the neck, persistent changes in your voice over time, difficulty swallowing, and unusual pain in the neck/throat area (pain that doesn’t seem to get better with time). These are some common symptoms, so if you’re experiencing any of these, it would probably be a good idea to talk to your physician.

 

Question: Are there particular factors or traits that may pre-dispose a person to head or neck cancers?

Nabil Saba, MDDr. Saba: There are certain well-defined risk factors for head and neck cancer, including a history of smoking or alcohol consumption. It has also been observed that HPV-related oropharynx cancer is increasing in Caucasian males, whereas oral tongue cancer seems to be increasing in Caucasian females. While there is an increased risk of head and neck cancer in these groups of people, it doesn’t necessarily mean you are at high risk if you fall into one of these groups.
 
If you missed out on this live chat, be sure to check out the full list of questions and answers on the web transcript. You can also visit www.emoryhealthcare.org/cancer for more information on cancer treatment at Winship at Emory.

Risk Factors and Symptoms of Head and Neck Cancer

Head and Neck Cancer ChatHead and neck cancer includes a collective group of cancers occurring in the head or neck region, ranging from the nasal cavity and sinuses, to the back of the throat, including the oral cavity, tonsils, base of the tongue, nasopharynx, hypopharynx and larynx.

According to the National Cancer Institute (NCI), head and neck cancers account for approximately three percent of all cancers in the U.S. Studies show that these cancers are more common in people over the age of 50 and three times more common in men than in women; however, if diagnosed early, head and neck cancer is often curable.

Recently, a growing number of cancers occurring in the base of the tongue and tonsils have been linked to human papillomavirus (HPV), which is already a well known risk factor for cervical cancer in women. HPV-related head and neck cancer is a distinct type of cancer and so far has been diagnosed more in men than women.

Join Nabil Saba, MD, Chief of Head and Neck Oncology at Winship Cancer Institute of Emory University, as he hosts a live chat on “Risk Factors, Symptoms and Treatment Options for Head and Neck Cancer.” Dr. Saba will be available to answer all of your questions such as:

  • What are the known risk factors linked to head and neck cancer?
  • What are the symptoms of head and neck cancer?
  • How is head and neck cancer diagnosed?
  • Can head and neck cancer be prevented?

Chat Details:

Date: Tuesday, June 24, 2014
Time: 12:30- 1:30 pm EST
Chat Leader: Dr. Nabil Saba
Chat Topic: Risk Factors, Symptoms and Treatment Options for Head and Neck Cancer

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