MD Chats

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

Chat Sign Up

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

Chat Sign Up

How We’re Working to Cure Multiple Myeloma

Over the past ten years, I have seen the treatment of multiple myeloma dramatically improve because of new drug therapies that have come out of clinical trials. I am now leading a clinical study to learn more about the genetic components of multiple myeloma and how we can use that knowledge to come up with better, more targeted drugs and individualized therapies for patients. I think this landmark study will lead to treatments that effect long-term remission, or even cure, from the cancer.

In the CoMMpass study, launched by the Multiple Myeloma Research Foundation, we will follow 1,000 newly diagnosed patients with multiple myeloma over the course of eight years. We will study the genomic changes in their disease while they receive frontline treatments, and continue studying those changes through remission stages or relapse. One of the questions we hope to answer is why some patients do well on a specific drug, while others do not and may need multiple drugs to keep their myeloma from advancing.

The first step in the study is mapping out the molecular characterization of a patient’s tumor using sequencing at the time of initial diagnosis, and then following what happens in the sequencing information during and after treatment. If the disease comes back, we want to know if there were changes in the disease or new mutations that were influenced by the therapy or by the original mutations themselves?

As we learn more about cancer and its various types, we do less lumping them together and more splitting them into individual diseases. Lymphoma is a good example. It used to be that the disease was characterized as six or seven different types, and now we know there are at least 50 different variations of lymphoma. We look at the molecular characterization of lymphoma and create subtypes that are potentially treated in different ways. We may need to do that in myeloma. In the CoMMpass study, we will be able to have individual tumor specimens molecularly sequenced, which has never been done before, and we will learn much more about the cancer and its number of subtypes.

We are also looking at the impact of side effects on quality of life issues in this trial. There may be molecular characteristics of a patient’s tumor that can tell us whether that patient will have side effects from a specific treatment, so mapping a patient’s molecular subtype might influence the type of drugs he gets.

We have seen the life expectancy of multiple myeloma patients double in the last ten years. I think that there are probably some patients we are curing now and I believe that CoMMpass will help us to identify the best drugs and the best targets to increase the cure rate in this disease. We hope this study will help push the barrier to cure even further, but do it in a way that does not compromise a patient’s quality of life.

To learn more, watch this video as Dr. Lonial further explains Multiple Myeloma and treatment options for the diease.

Multiple Myeloma Online Chat

Multiple Myeloma Chat Sign UpWant to learn more about multiple myeloma? Join expert physician, Jonathan Kaufman, MD, for a live web chat on March 11, 2014 at 12:00 PM EST. Dr. Kaufman will be there to answers all your questions about known risks, prevention, diagnosis and treatment of multiple myeloma. Bring your questions and prepare for a great discussion!

Multiple Myeloma Chat Sign Up

About Dr. Sagar Lonial

Dr. Sagar LonialDr. Lonial is Vice Chair of Clinical Affairs for the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University, and Director of the Translational Research for the B-Cell Malignancy Program. He is also a professor in the Emory University School of Medicine.

Dr. Lonial’s research focuses on combination therapy in B-cell malignancies focusing on myeloma. He is a trained bone marrow transplant physician with an interest in molecular therapy for lymphoma and myeloma. His clinical interests include evaluating the combination of new molecular targeted agents for B-cell tumors as well as target discovery and validation.

Dr. Lonial has authored or coauthored over 200 publications and recently was awarded the Celgene ‘Young Investigator’ Award, the MMRF ‘Top 15 Innovator’ Award, and the MMRC ‘Center of the Year’ award.

He earned his medical degree from the University Of Louisville School Of Medicine. He completed his internship and residency at Baylor College of Medicine in Houston, Texas, followed by a fellowship in Hematology/Oncology at Emory University School of Medicine in Atlanta, Georgia.

Related Links
Understanding Multiple Myeloma
Phase I Trials – Where All Anticancer Drugs Begin

 

Understanding Multiple Myeloma

While still a relatively uncommon cancer, multiple myeloma has recently received attention surrounding the diagnosis of popular news reporter, Tom Brokaw. This year, an estimated 24,000 people in the United States will be diagnosed with multiple myeloma, and there are about 77,600 people now living with this blood cancer.

About Multiple Myeloma

Multiple myeloma is a type of cancer that forms because of a disorder in the plasma cells, which live in the bone marrow and are the producers of antibodies. These antibodies are what provide protection from infections after vaccination, but in myeloma, the plasma cells become malignant and grow out of control, crowding out the normal bone marrow.

When plasma cells grow uncontrolled by the normal immune system, the consequences can include:

  • Anemia, a condition caused by low red blood cell counts due to crowding in the bone marrow.
  • Bone lesions, as myeloma cells like to create “holes” in the bones.
  • Kidney problems, because the antibodies produced by the plasma cells can clog up the kidneys.
  • Elevated blood calcium level, typically as a consequence of the bone issues.

Multiple Myeloma Symptoms

The most common symptoms for patients are typically fatigue, weakness, bone pain, anemia, or frequent unexplained infections. Multiple myeloma affects both men and women but is more common in men and there is a higher occurrence of multiple myeloma among African Americans than among Caucasians.  It is a disease typically seen in patients who are older than age 65, although it occurs in African-American patients about ten years earlier, and it affects a fair number of younger patients.

Multiple Myeloma Treatment

Treatment for patients with multiple myeloma has changed dramatically over the past decade. As we have developed more effective drugs to target the plasma cells, we also have significantly improved overall survival. Fifteen years ago, the average survival was 3 to 4 years, whereas the average survival is now over 7 years, and for many patients, expected survival is more than 10 years.

The keys to this improvement in overall survival are related to several factors. First, we have better tools to combat myeloma. There have been 6 new drugs approved for treating myeloma over the past decade, and these agents are more effective at treating the disease than the standard mixtures of chemotherapy we had before. The second factor that has improved survival for certain patients is the use of high-dose chemotherapy and autologous stem cell transplantation, in which the patient’s own stem cells are given back to the patient’s body after receiving high-dose chemotherapy. Finally, we now have a better understanding of the biological changes that occur in a myeloma cell and this is helping us to better target treatment needed among these patients.

As we discover new tools and expand the options available for treating multiple myeloma, we see encouraging advancements in both survival and quality of life for these patients. The multidisciplinary treatment team at Winship at Emory has been recognized as a national and international leader in both transplant and non-transplant based approaches to treatment therapies, patient outcomes and clinical trials.

Multiple Myeloma Online Chat

Multiple Myeloma Chat Sign UpWant to learn more about multiple myeloma? Join expert physician, Jonathan Kaufman, MD, for a live web chat on March 11, 2014 at 12:00 PM EST. Dr. Kaufman will be there to answers all your questions about known risks, prevention, diagnosis and treatment of multiple myeloma. Bring your questions and prepare for a great discussion!

Multiple Myeloma Chat Sign Up

About Dr. Sagar Lonial

Dr. Sagar LonialDr. Lonial is Vice Chair of Clinical Affairs for the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University, and Director of the Translational Research for the B-Cell Malignancy Program. He is also a professor in the Emory University School of Medicine.

Dr. Lonial’s research focuses on combination therapy in B-cell malignancies focusing on myeloma. He is a trained bone marrow transplant physician with an interest in molecular therapy for lymphoma and myeloma. His clinical interests include evaluating the combination of new molecular targeted agents for B-cell tumors as well as target discovery and validation.

Dr. Lonial has authored or coauthored over 200 publications and recently was awarded the Celgene ‘Young Investigator’ Award, the MMRF ‘Top 15 Innovator’ Award, and the MMRC ‘Center of the Year’ award.

He earned his medical degree from the University Of Louisville School Of Medicine. He completed his internship and residency at Baylor College of Medicine in Houston, Texas, followed by a fellowship in Hematology/Oncology at Emory University School of Medicine in Atlanta, Georgia.

Takeaways from Dr. Sanda’s Chat on Prostate Cancer

Thank you for attending the live chat with Dr. Martin Sanda on prostate cancer. (Link to: ) Your questions and participation were terrific. Below are additional Q&As that we didn’t have time to get to during the live chat portion.

As you know, prostate cancer is the second most common cancer in men, second only to skin cancers. Emory Healthcare is privileged to partner with you in your health and is ready and able to assist if needed. Please use the resources on this page and this website to contact us if we can help in any way.

Question: What are today’s best prostate cancer diagnosis methodologies?
Answer: Despite a lot of advances in imaging tests such as MRI or higher-resolution ultrasound, there is still a need to biopsy the prostate in order to determine whether or not prostate cancer is present. The biopsy provides important information, not only as to whether there are cancer cells, but if so, how aggressive or how fast-growing those cancer cells appear to be. Bone scans and CT scans are useful to look for spread of prostate cancer elsewhere. Also, new PET (positron emission tomography) scans or other diagnostic studies that image molecules which are taken up by cancerous tissue and not by normal tissue are emerging. But, their role in standard care is not yet sorted out. MRI can provide valuable information about the size and configuration of tumors in the prostate itself and the immediate vicinity, as part of a watchful waiting monitoring plan, or as a guide for treatment planning.

Question: What are the dangers of conventional biopsy?
Answer: The main risk of prostate cancer biopsy is infection, which can be seen in approximately one out of 50 to one out of 100 cases and can require hospitalization for treatment. More commonly, some men may feel faint after a biopsy and should plan on taking the day off or taking it easy if they undergo a prostate biopsy procedure. Rarely, men might experience bleeding from where the needle is inserted into the prostate and this, too, can require hospitalization. Common after prostate biopsy is having blood in the semen or ejaculate; however, this does not pose any danger or risks and will typically resolve in a matter of a few weeks.

Question: Are there new drugs and and prostate cancer treatments on the near horizon?
Answer: Major scientific discoveries have taken place over the past five to 10 years and many more are underway. This has led to a half-dozen new treatments for advanced prostate cancer that have become available in the past several years. A broad range of new treatments are being developed, including more refined types of hormonal therapy, including immune therapies or therapeutic vaccines and also targeted therapies that are aimed at molecular differences between the cancer cell and normal tissue.

Related Resources:

About Dr. Martin Sanda

Dr. Martin SandaMartin G. Sanda, MD, an internationally recognized prostate cancer surgeon and scientist, was appointed chair of the Department of Urology at Emory University School of Medicine and service chief for Emory Healthcare. He also serves as director of the Prostate Cancer Center, which will be established within Emory’s Winship Cancer Institute.

Sanda joins Emory from Harvard Medical School, where he was professor of surgery in urology, and from Beth Israel Deaconess Medical Center, where he served as director of the Prostate Cancer Center. He was also the co-leader of the Prostate Cancer Program at the Dana Farber Cancer Center.

 

Though Common, Prostate Cancer is Often Very Treatable – Join Our Q&A Chat for Details

Prostate Cancer Q&A ChatDid you know that prostate cancer is the second most common cancer experienced by men, after skin cancer? The good news is that, when caught early, it can often be treated with great success.

Millions of men are living today as survivors of prostate cancer. Being armed with good information in advance is a key ingredient in protecting yourself or your loved ones from this disease.

Join Emory Chairman of the Department of Urology, Dr. Martin Sanda, on Tuesday, September 24, for an online web chat to discuss “Prostate Cancer.”

Prostate Cancer Chat Sign Up

A New Interactive Tool to Answer Your Cancer Questions: Introducing the Whiteboard

Cancer Facts & FAQs whiteboardWe’re excited to introduce a new interactive initiative that was launched in partnership between Emory Healthcare and Winship Cancer Institute of Emory University. This platform, called “Whiteboard,” opens up a new way for people to do their own kind of research about cancer. Readers can scroll through a variety of questions on different cancer topics, read and like these questions, or submit their own. Newly submitted questions will be reviewed by our Winship team, including our physicians, investigators, nurses and other support and care team members. Depending on the type of question, we are able to respond quickly (within a business day or two). More complex or specific questions may require further research and collaboration on our part and therefore may take us longer to answer.

The Winship Cancer Institute of Emory University is Georgia’s only National Cancer Institute-designated cancer center, meaning that Winship meets the highest standards of cancer research. Members of the Winship team are constantly working to find new cancer treatments as well as to discover ways to prevent cancer and detect it early. By creating the Whiteboard, our online community has a way to conduct its own cancer research and get trustworthy answers directly from Winship’s experts.

Getting cancer questions answered via the Winship Whiteboard is easy. Simply go to the Whiteboard, click on the notepad on the top right, ask your question, and click submit; the team at Winship will get back to you with an answer. Questions can be submitted related to any cancer topic or type, ranging from general prevention tips and survivorship resources, to questions related to specific types of cancer, such as prostate cancer, breast cancer and lung cancer.

We’ve received some fantastic cancer questions on the Whiteboard so far. Kevin, for example, asked, “My PSA was elevated at my check-up. Do I have prostate cancer?” Justin asked, “What can former smokers do to possibly offset the damage of past smoking and reduce cancer risk?” While Travis asked, “Are there any foods I can eat to help prevent cancer?” All of these cancer questions have been answered by the doctors and researchers from the Winship Cancer Institute on our Whiteboard. Whether you have just one cancer question, or many, you can submit them all on the Whiteboard and get answers from the cancer experts at Winship. Even if you don’t have a question, please take the time to browse and like your favorites!

We welcome your feedback on our new cancer FAQ site in the comments below.

Related Resources:

When do your Moles Require a Trip to the Dermatologist?

Skin Cancer MolesHave you performed your monthly mole check? If not, take time today to do it and put it on your calendar for this day every month! Checking your moles monthly can help you from developing malignant melanoma. The earlier you find suspicious moles or lesions, the better your chances of being cured.

Some helpful tips to examine your moles:

  • Examine your skin after a shower, in good light, in front of a mirror without your clothes on.
  • Make sure to do a thorough, full body inspection. Start with your toes or your face and work your way over every surface of your body. Be sure to also check your scalp, underarms and genitals, parts that could be covered with hair.
  • Look for moles or skin markings that you haven’t noticed before, or areas that have changed in appearance since your last exam. Pay special attention to lesions that bleed or don’t heal.
  • Photos taken over a period of time can be helpful in determining whether a skin marking has changed.
  • Follow the ABC method for examining suspicious markings:
    • A = Asymmetry – do both sides of the mole match? If one side does not match the other, it could indicate melanoma.
    • B= Border – If the border has jagged or irregular edges, see your physician right away.
    • C = Color – Black, red, white and multi-colored moles should be seen by a professional right away. Tan and brown moles are usually ok, but make sure to watch for changes to these moles as well.
  • Diameter – Usually moles should be smaller than the end of a pen.
  • Elevation – moles should be flush with the skin around the mole. If you notice a mole is raised, visit your physician right away.
  • Do what you can to prevent skin cancer. Some ideas:
  • Wear sunscreen in the sun, in all seasons!
  • Wear a hat and sunglasses
  • Avoid tanning salons
  • Try to stay out of the sun between 10am and 3pm

Take action today to protect yourself and your family members!

About Margi  McKellar, MS, PA  Emory Winship Cancer Institute’s Melanoma Coordinator

Margi plays a unique role for the team as our Melanoma Coordinator. In this position, she serves as the point of contact for referring physicians and the patients and guides  them from the point of  their initial referral through long-term follow up. She helps our patients use their time efficiently, analyzing patient flow, appointment availability, clinical trial eligibility and ensures that patients see the correct complement of specialist to receive optimal care – medical oncology, surgical oncology, radiation oncology, lymphedema specialists. Margi actively interfaces with our clinical trial nurses to ensure patients have the opportunity to be considered for clinical trials while facilitating prompt screening for these programs. In addition to coordinating the care of patients, she also sees patients in our long-term follow up clinics.

Related Resources: