Winship at the Y was established to provide cancer survivors with better access to specialized exercise programs. This program, which is unlike any other in the country, is open to any cancer survivor, not just patients at the Winship Cancer Institute. In addition to physical benefits, exercise may provide a psychological and emotional benefit during and after cancer treatment. Breast cancer survivor, Janel Green, who was treated at Winship Cancer Institute of Emory University, talks about how the special exercise program has helped her regain her health.
Did 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
Suephy 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.
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
John 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.
April is Cancer Control Month. That means we need to find ways to reduce our risk of cancer as well as the chances that we’ll die from the disease. We have a tough job ahead. Before the year is over, nearly 1.7 million Americans will be newly diagnosed with cancer. It’s a sobering statistic and one that we can impact in a big way by taking steps now to help prevent the second leading cause of death in the United States.
If you’re a smoker, find a way quit. According to the Centers for Disease Control and Prevention, smoking cigarettes can cause cancer in almost any part of the body and is responsible for some of the most deadly types of the disease. As an oncologist, I would recommend that you stay away from all tobacco products and byproducts, including second hand smoke.
It is estimated that one in three Americans is now obese. Obesity is proven to be a major risk factor for breast, colon, esophageal and kidney cancers. It’s more important than ever that you maintain a healthy weight by eating a diet rich in fruits, vegetables and whole grains. Pay attention to portion size and cut down on alcohol consumption. While you’re at it, get off the couch and get some regular exercise. It will not only help you watch your weight, but studies show staying physically active can lower your risk of certain cancers.
As the summer months approach, be sure to protect your skin from the harmful effects of ultraviolet radiation by wearing sunscreen with an SPF 30 or higher. Cover up or better yet, stay out of the sun during the peak hours of 10am to 2pm and stay away from tanning beds and sun lamps.
Finally, some cancers are hereditary. Know your family history of cancer and learn about the importance of early detection through screening. If you’re a woman at average risk for breast cancer, be sure to have a clinical breast exam and mammogram every year starting at age 40. Women ages 30-65 should also be screened every five years for cervical cancer. Colorectal cancer screening for women and men should begin in those 50 and older. Your health care provider can give you more information about the benefits of a colonoscopy.
For advice on locating cancer-screening opportunities, contact Emory Health Connection at 404-778-7777 to learn more from a registered nurse.
About Dr. Jillella
Anand Jillella, MD, is a national leader in bone marrow transplantation and has led the development of a strategy to decrease induction mortality for acute promyelocytic leukemia. He leads the efforts of the Winship Cancer Network and is expanding Winship’s role in bringing clinical and population-based cancer research to communities throughout Georgia and surrounding states.
Screenings Help Catch Head and Neck Cancers
“Top Secret” Cancer Facts Worth Sharing
Taking a Stand in Favor of E-Cigarette Regulation
Bite into a Healthy Lifestyle
Cancer Clinical Study Leads to Video Tool for Prostate Cancer Patients
Winship Cancer Institute of Emory University
It’s time to stop being embarrassed about the 3rd most commonly diagnosed cancer and the 3rd leading cause of cancer death for both men and women. More than 140,000 people will be diagnosed with colorectal cancer this year and nearly 50,000 will lose their battle to the disease according to The American Cancer Society.
It’s colon cancer awareness month – share the facts about how a colorectal cancer screening could save your life.
A study, published in JAMA Surgery and recently reported in the NYT, showed that incidences of colorectal cancer have been decreasing by about 1 percent a year since the mid 1980s. Simply said, more people under the recommended screening age of 50 are being diagnosed with colorectal cancer.
Colon cancer is not embarrassing. There’s simply no sense in keeping secrets from your physician. If you have a history of colorectal cancer in your family or have particular symptoms that you’re unsure about then it’s time to get the facts from your doctor. Speak openly about your risk factors, prevention, early detection, and treatment.
Prevention and early detection of colorectal cancer are possible by appropriately scheduling a colorectal cancer screening. A conversation with your doctor is always confidential; make it honest and candid.
As a Nurse Practitioner in gastrointestinal cancers, I have had many patients who have stated that they wish they had gotten a colonoscopy as recommended for colorectal cancer screening. They also say they now preach to everyone they know to get their colonoscopies.
Find a primary physician through our Emory Healthcare Network or call Health Connection at 404-778-7777 to learn more from a registered nurse. No topic is top secret or off limits.
A chemotherapy infusion specialist and adult nurse practitioner, Ms. Brutcher’s clinical specialties include gastrointestinal and aerodigestive cancers. She has 27 years experience as a Registered Nurse, and 8 years as an Adult Nurse Practitioner with Medical Oncology. She obtained her Master of Science in Nursing Adult Practitioner, specializing in oncology and immunology, at Emory University in Atlanta, Georgia.
Colon Cancer Chat Transcript
An Intro to Colorectal Cancer Part I: Risk Factors, Symptoms & Diagnosis
An Intro to Colorectal Cancer Part II: Prevention, Diagnosis & Treatment
Winship Cancer Institute – Colon Cancer Resources
The Academy of Nutrition and Dietetics recognizes March as National Nutrition Month. This year’s theme, “Bite into a Healthy Lifestyle,” encourages everyone, including individuals undergoing cancer treatment, to adopt plans focused on making informed eating choices and getting daily exercise to improve overall health.
A healthy eating plan limits foods with added fats, sugars, and salt and emphasizes nutrient-rich foods such as vegetables, fruits, whole grains, seafood, lean meats and poultry, eggs, beans and peas, nuts and seeds. Nutritional needs should be met primarily through consuming food, not supplements, because whole foods provide a variety of other components that are considered beneficial to health. A healthy lifestyle is also more than just choosing to eat more fruits and vegetables. Age, gender, family history, and current health condition play a role in determining which foods we should eat more of and foods to avoid.
Understanding the nutritional content of foods is essential to making informed choices when building an eating plan. For example, dairy is not the only food group that contains calcium. Collard greens are also a good choice. Reading the Nutrition Facts Panel and the ingredient lists can be confusing, but it is a good way to determine nutritional content of food products.
Daily physical activity should go along with eating a healthy diet. Recommendations include at least 150 minutes a week of moderate physical activity. Strength training exercises, such as lifting light weights and doing push ups, are also beneficial.
Here are some additional tips to help you “bite into a healthy lifestyle”:
- Try one new food every week, instead of a complete diet overhaul.
- Cook a new recipe or adapt an old one each week.
- Fill half your plate with a variety of fruits and vegetables at every meal.
- Try whole wheat, quinoa, brown rice, oats, barley.
- Consume healthy lean protein sources.
- Limit foods with added fats, sugars and salt.
- Limit sweetened beverages.
- Reduce foods that increase health risks.
- Stay within your calorie needs when increasing healthier foods.
- Eat a healthy balance between proteins, fruits, vegetables, fats and grains.
A registered dietitian can work with your preferences and routine to provide sound, easy-to-follow personalized nutrition advice to meet a lifestyle based eating plan.
Attend a cooking demonstration
Attend a cooking demonstration hosted by registered dietitian, Tiffany Barrett, on March 18th from 12:30pm until 1:30pm in the John H. Kauffman Auditorium at Winship Cancer Institute of Emory University (1365-C Clifton Road NE, Atlanta, GA, 30322).
About Tiffany Barrett
Tiffany Barrett, MS, RD, CSO, LD, is a Certified Specialist in Oncology Nutrition and sought after expert in her field. She is a key contributor to support programs at Winship and provides personalized nutritional advice to Winship Cancer Institute patients who are undergoing cancer treatment. She also consults with patients who have completed treatment and wish to continue to build a strong and healthy diet. She earned her Bachelor of Science at Florida State University and a Master of Science at University of North Florida. Tiffany is a Certified Specialist in Oncology Nutrition and completed a Certificate of Training in Adult Weight Management.
At Emory, research plays a key role in the mission to serve our patients and their families. Medical advances and improvements to patient care have been made possible by research and volunteer participation in clinical trials. More than 1,000 clinical trials are offered at Emory, making a difference in people’s lives, today.
Recently, a clinical study initiated by Winship Cancer Institute of Emory University, found that providing prostate cancer patients with a video-based education tool significantly improved their understanding of key terms necessary to making decisions about their treatment.
The breakthrough study was led by three Winship at Emory investigators; Viraj Master, MD, PhD, FACS; Ashesh Jani, MD; and Michael Goodman, MD, MPH; and is the feature cover story of this month’s Cancer, the peer-reviewed journal of the American Cancer Society.
In 2013, Master, Jani and Goodman released an Emory study that showed that prostate cancer patients (treated at Grady Hospital in Atlanta) experienced a severe lack of understanding of prostate key terms. The original study showed only 15 percent of the patients understood the meaning of “incontinence”; less than a third understood “urinary function” and “bowel habits”; and fewer than 50 percent understood the word “impotence.”
In response to their findings, the three principle investigators jumped to find a solution to the problem. The latest study explored using a video-based tool to educate prostate cancer patients on key terminology. The physicians predicted that with a better understanding of terms linked to disease, patients would be able to participate in shared and informed decision-making throughout the prostate cancer treatment process.
About the Prostate Cancer Video Trial:
- 56 male patients were recruited from two low-income safety net clinics and received a key term comprehension test before and after viewing the educational video.
- The video software (viewed by participants on iPads) featured narrated animations depicting 26 terms that doctors and medical staff frequently use in talking with prostate cancer patients.
- Learn more by watching this video:
Results of the Prostate Cancer Video Trial:
Participants who viewed the educational video demonstrated statistically significant improvements in comprehension of prostate terminology. For instance, before viewing the application, 14 percent of the men understood “incontinence”; afterward, 50 percent of them demonstrated understanding of the term.
“This shows that video tools can help patients understand these critical prostate health terms in a meaningful way. The ultimate goal is to give patients a vocabulary toolkit to further enable them to make shared and informed decisions about their treatment options,” says Viraj Master. “Our next goal is to improve the tool further, and study this tool at different centers.”
Additional Information about the Prostate Cancer Trial:
The research for this study was made possible by a Winship Cancer Institute multi-investigator pilot grant and the contributions of faculty and students from Winship, the Rollins School of Public Health and the Emory School of Medicine.
This study was led by three Winship at Emory investigators: Viraj Master, MD, PhD, FACS, Winship urologist and director of clinical research in the Department of Urology at Emory University; Ashesh Jani, MD, professor of radiation oncology in the Emory School of Medicine; and Michael Goodman, MD, MPH, associate professor of epidemiology with the Rollins School of Public Health.
Along with the worries, sadness and frustrations of dealing with cancer, many patients experience the heartbreak of their loved one failing to support them. How could a life partner or spouse fail you during cancer? There are many ways, some more obvious than others.
Jan’s husband never came to any appointments, ever. He never learned about her diagnosis, her treatment plan, the side effects of the medicines or the recommendations for how she might improve her energy and strength. He blamed the lymphedema in her arm after her surgery on her “lazy lifestyle.” He told her that support groups were for “wimps” and even took some of her pain medicine for himself.
Sally’s partner came to every appointment – he would never let anyone else bring her. He kept a medical notebook with her test results and argued with every doctor about each treatment plan. He would not let her eat any ice cream or cookies because he thought the sugar would make her tumor grow, even though Sally was at a very healthy weight and ate a very balanced diet.
Gary’s girlfriend would never stop talking about herself. At appointments with the oncologist she would ask questions about breast cancer even though Gary had lymphoma. She repeatedly complained about Gary being at home instead of work, “having him around the house all day is making me crazy, I need my space!” She had no understanding of cancer fatigue: “he looks fine, no vomiting or fever – he should be able to do more!” In the past Gary had been able to participate in his girlfriend’s extremely busy social schedule, but after lymphoma, he asked his girlfriend about limiting their social time to just close friends. His girlfriend insisted on accepting every invitation, and started leaving Gary at home, alone.
Some spouses and partners don’t get it, but they want to, which is huge. If a loved one wants to do better, there is hope for the relationship. If you’re the partner — not the patient — in this scenario, and you’re wondering how to recover from your initial missteps, here’s what I would suggest: Start by setting aside time when there are not any children yelling or bills to be paid or dishes to be done. Begin with a question, “so how are things going for you?“ Wait for an answer. Listen. Then ask “Anything I can do to help?” Breathe, pause, listen. Maybe put your hand on your partner’s shoulder, gently, in order to emphasize you are listening. If you start getting yelled at for being late once 6 months ago, breathe deeply, and respond simply, “I am sorry I was late, but now I really want to help, and do better. Let’s keep talking, but no yelling please.” Make eye contact and smile.
Sally’s partner took the advice above, he set aside the time, took several deep breaths, and listened. He listened closely because he really did love her, and wanted to know how she was doing. He admitted that he had hoped to stop the cancer by controlling everything about her medical care and diet. Sally was able to explain she did appreciate the help with scheduling and tracking her medicines, but she did not want to be treated as an invalid or a small child. Sally’s partner was eventually able to become the partner she needed – a partner interested in caring for her but also respectful of her autonomy.
Gary spent a lot of time after cancer treatment thinking about what kind of life partner he wanted. Reflecting back over the years, he was able to see that his girlfriend had always been self-absorbed. Friday nights, she chose the restaurant; Sunday morning she picked the breakfast; and during the week she rarely asked how Gary was doing at work. Gary realized that he would rather be alone than in a relationship with someone who only cared about herself. “After everything I have been through, I deserve real love.”
Jan always knew that her husband drank too much, but she had hoped he would stop on his own. Through her cancer treatment Jan was terribly embarrassed that her husband was not at appointments. On the day Jan came home to tell her husband that the oncologist told her she was cancer free, he was passed out on the couch. Not being able to share the journey, or the joy in the recovery, pushed Jan to tell her husband that she wanted a divorce. When he realized Jan was actually planning to leave him, he knew he had to get sober. The addiction to alcohol had robbed Jan’s husband of the chance to be a support when his wife really needed him. The only hope for the marriage was for him to get completely sober, and with medical care, Jan’s husband finally stopped drinking. Once sober, he returned to being the kind of husband Jan remembered from when they were first married. He cooked pasta dinners, rubbed her feet in the evening, and actively listened when she talked about her health concerns and hope for the future.
We all hope that our partner will step up and be there for us if we need them, but sometimes they don’t support us as we’d hoped. There are a variety of reasons why a loved one may fail during cancer treatment, and the psychological work is to realize the failure is about their issues, not about you or your self worth. If there is genuine caring, and a real desire for a loving relationship, a couple may get through the challenge of cancer. And if not, there may be grieving process if the relationship fails, but there is great beauty in a cancer survivor taking steps to be in the healthiest, most loving relationship possible. After cancer, you deserve it.
About Dr. Baer
Wendy Baer, MD, is medical director of psychiatric oncology at the Winship Cancer Institute of Emory University, with appointments in the Department of Psychiatry & Behavioral Sciences in the Emory School of Medicine, and the Department of Hematology and Medical Oncology at Winship.
In her work at the Winship Cancer Institute, Dr. Baer helps patients and their families deal with the stress of receiving a cancer diagnosis and subsequent treatment. As a psychiatrist, she has expertise in treating clinical depression and anxiety both with medications and with psychotherapy to help people manage emotions, behaviors, and relationships. The fundamental goal of Dr. Baer’s practice is to promote wellness and maximize patients’ quality of life as much as possible. She believes strongly in the team approach to patient care and collaborates regularly with the doctors, nurses, and social workers that make up a patient’s care team.
Dr. Baer attended medical school at the University of North Carolina at Chapel Hill, where she graduated with honors. From UNC she went to the University of Pennsylvania, where she completed her residency in psychiatry and served as the chief resident in her senior year. Prior to moving to Atlanta, Dr. Baer worked with patients dealing with cancer at the Swedish Cancer Institute in Seattle, WA.
I have been a dedicated palliative and supportive care specialist for the last seven years. When people ask me about palliative care, they often wonder if it is reserved for those patients who are dying. Nothing could be further from the truth. The Center for Palliative Care Excellence explains it this way: “palliative care provides relief from the symptoms and stress of a serious illness—whatever the diagnosis.” Simply put, I help people do and keep doing the things they love best for as long as they can.
People with cancer are more than their illness. They have lives with responsibilities, hopes, fears, and dreams beyond their diagnosis. As supportive care specialists, we are trained to recognize and partner with individuals to help them cope with and manage the physical, emotional and spiritual distress that can arise during and after cancer treatment. Our team-based approach focuses on the person as a whole.
An important concern we address is symptom management. Whether the goal is to cure or slow the progression of a disease, a cancer journey often can be fraught with distressing symptoms of pain, shortness of breath, nausea, anxiety and fatigue. Supportive care specialists work with the healthcare team to aggressively manage these symptoms. Our goal is to help a patient maintain quality of life while managing the disease, so we work closely with a person’s oncologist to develop an individualized symptom management plan that complements the patient’s treatment plan. The supportive care team can provide access to expert symptom management resources in the hospital, through clinics, and in some programs in the home. Most insurance companies typically cover referrals to supportive care specialists.
Supportive care can also provide symptom management after cancer treatment is completed or discontinued. Supportive care is available no matter where patients are in their illness, whether at diagnosis or late in the disease process. We also recognize the role of caregivers and families in providing support and try to add to this support by filling in the gaps.
Supportive care teams bring together doctors, nurses, social workers and a chaplain, to help a patient define and clarify his or her goals for care and treatment. The care team does this by helping a patient figure out what is most important and how that fits with a treatment plan. Supportive care can help individuals continue to have comprehensive care when disease targeted cancer treatment is no longer beneficial or what the individual wants.
If you are having symptoms from your illness or treatment that are difficult to control, or if you feel you are needing more support, talk to your doctor about getting a referral to a supportive care specialist. You deserve the best care that the medical system has to offer. Improving your quality of life by having an extra layer of support during your cancer journey can be an invaluable addition to your treatment plan.
About Dr. Kimberly A. Curseen
Board certified in Internal Medicine, Geriatrics, and Palliative Care, Kimberly A. Curseen, MD, is the Director of Supportive and Palliative Care Outpatient Services for Emory Healthcare. She is the director and the primary provider for the Supportive Oncology Clinic. The clinic provides physical, emotional, and spiritual care for patients with cancer at any point in their disease process. The clinic also assists patients with complex decision making.