Colorectal Cancer Awareness with Dr. Larissa Lim

Colorectal cancer is a disease that develops in the colon or rectum. Colorectal cancer is the third most common cancer in both men and women worldwide, but is one of the most preventable types of cancer, and often treatable when diagnosed early. Family practice physician, Dr. Larissa Lim, discusses the symptoms and preventive screenings for colorectal cancer.

To schedule an appointment with Dr. Lim, click here. 

If you're unable to view the video, click here.

Preventing Cancer with Dr. Floegel

February is American Heart Month; a great time to focus on your cardiovascular health!

If you're unable to watch the video, click here.

Dr. Gupta's tips to achieve and maintain a healthy weight.

Family care physician, Dr. Anubha Gupta, discusses the benefits of a healthy weight, and body mass index (BMI). A healthy weight depends on factors such as sex, genetics, body frame, medical history, and lifestyle habits. Hear Dr. Gupta's tips to achieve and maintain a healthy weight through diet, physical exercise, and mental health! To schedule an appointment, click here. 

If you're unable to view this video, click here.

November is American Diabetes Month and we heard from Primary Care Provider Rachel Francis, PA-C. about diabetes prevention and risks.

If you're at risk for diabetes, talk to your SIMEDHealth primary care provider, or make an appointment here.

1.) What is the difference between type 1 and type 2 diabetes? 

The most common types of diabetes you hear about are Type 1 and Type 2.  In Type 1 diabetes a person's body becomes unable to produce enough of its own insulin. Since insulin is required to process the body's blood sugar (glucose), this leads to high levels of sugar circulating in the bloodstream.  In type 2 diabetes, the body is able to produce some or all of the insulin it needs; however the cells within the body are resistant to the insulin and therefore are unable to use it effectively. 

2.) Who is most at risk for type 2 diabetes? 

Although diabetes is present across all patient populations, the risk is higher in some more so than others. There is higher risk amongst those who are obese, live sedentary lifestyles, with strong family histories of diabetes, and who had elevated blood sugar problems during pregnancy (gestational diabetes).  Also, those who have chronic mildly elevated blood sugars otherwise known as "pre-diabetes," are at higher risk of progressing to Type 2 diabetes, as well as certain ethnicities. 

3.) What are some things a person can do to prevent development of diabetes? 

Although one cannot change certain risk factors like family history, age or ethnicity; there are things you can do to help reduce the likelihood of developing diabetes or possibly prevent it all together! Take action by improving your lifestyle habits such as eating a healthy diet, getting regular physical exercise, and getting regular preventative checks with your health care provider. 

4.) Why is it important to treat diabetes early? 

You might be wondering, "Why should I be concerned about my blood sugar? I feel fine!" In the early stages of type 2 diabetes, there may be few or no symptoms. However, over time high levels of blood sugar, either from Type1 or 2, can cause damage to small blood vessels in the eyes, kidneys, brain, and heart; eventually leading to complications like stroke, heart attack, neuropathy, kidney failure, loss of vision, and loss of arterial circulation leading to higher risk of wounds and amputations.  Early control of elevated blood sugar slows the progression and even prevents some of these complications. Talk to your healthcare provider about what is best for you. 

Family Medicine Physician, ​Dr. Jenny Chen discusses the risk factors, diagnosis, and treatment for breast cancer.

1.) What are the risk factors for developing breast cancer? Does age, gender, or race affect risks?

Globally, breast cancer is the most frequently diagnosed malignancy and the leading cause of cancer death in women, and in the US, it is the second leading cause of cancer death in women, trailing only lung cancer. While men can also get breast cancer, women are approximately 100 times more likely to get breast cancer than men. The highest breast cancer risk occurs among white women, although breast cancer remains the most common cancer among women of every major ethnicity and racial group. There are many other risk factors for breast cancer, including postmenopausal obesity, aging, family history, alcohol use, smoking, and menopausal hormone replacement therapy. In addition, earlier age at starting periods, and later age of menopause are also associated with an increased risk. Conversely, breastfeeding, increased physical activity and a diet rich in fruits, vegetables, fish and olive oil (Mediterranean diet) are associated with a decreased risk of breast cancer. Lastly, a meta-analysis showed dietary fiber intake was associated with a 12 percent relative risk reduction in breast cancer incidence.

2.) What are early signs of breast cancer?

A breast lump or mass is a common early sign of breast cancer. In countries with established breast cancer screening programs, most patients present due to an abnormal mammogram. However, up to 15 percent of women are diagnosed with breast cancer due to the presence of a breast mass that is not detected on mammogram. Other signs include breast skin changes such as dimpling and red discoloration, nipple retraction or inversion, localized pain or swelling, or enlarged axillary lymph nodes.

3.) Do self-breast exams make a difference in early diagnosis of breast cancer? What about breast exams by physicians?

Trials evaluating clinical breast examination (CBE) and breast self-examination (BSE), with or without mammography have not demonstrated efficacy in early cancer detection or improved outcomes. Therefore we no longer suggest using clinical breast examination (CBE) or breast self-examination (BSE) as part of screening of average-risk women. Screening CBE may be helpful, however, in resource-limited settings where there is limited mammogram imaging availability. Mammography is the recommended modality of breast cancer screening for the vast majority of women. The starting age and frequency of screening mammography depends on the individual’s risk, including genetic risk. No screening guideline recommends routine

screening for average-risk women (defined as less than 15 percent lifetime risk) who are under 40 years of age. Most United States expert groups encourage shared decision-making for women in their 40s for average-risk women, although European screening guidelines recommend starting screening at age 45. Regular mammograms are recommended for all women ages 50-75.

4.) 1 out of 8 women will develop breast cancer, and most of them survive the disease. What treatments are contributing to breast cancer survival?

Breast cancer mortality has dropped dramatically since the 1980s, and both earlier detection through screening and improvements in breast cancer treatment are responsible for this reduction in mortality. Medical treatment of breast cancer using endocrine therapy, and chemotherapy have increased the survival rates of breast cancer patients in the past few decades. For example, estrogen receptor-positive breast cancer patients benefit from the use of endocrine therapy with anti-estrogen drugs. More recently, advancement in genetic testing and immunotherapy are also transforming the way we treat breast cancer. Immunotherapy is a type of cancer treatment that helps our immune system fight cancer. These modern medical treatments, along with advances in surgical technique and radiation oncology equipment have helped more, and more women become breast cancer survivors.

Classes resume for fall semester, and the flu season is right behind it. August is Immunization Awareness Month and we heard from Dr. Kamal Singh about vaccines. 

Vaccines train the body to fight an invasion without developing significant illness. When the body is exposed to foreign pathogens, such as viruses or bacteria, the immune system produces antibodies allowing it to defend itself. “These antibodies attack the invading pathogens, also known as an antigens, and protect against further infection”, says Dr. Kamal Singh, a SIMEDHealth Primary Care Internal Medicine physician.

When facing the invader for the first time, there is a delay of sometimes days between the body’s exposure to the invader (antigen) and developing the antibody attack response. “For severe antigens like the measles virus or the Pertussis whopping cough bacteria, a few days delay is too long”, emphasizes Dr. Singh. “The infection can rapidly spread throughout the body, before the immune system can fight back. Unfortunately, this delay can sometimes result in death.”

Every year millions of healthy adults and children are given vaccines to prevent serious diseases. In the United States available vaccines go through many years of rigorous testing prior to being made available to the public, including:

• Multiple levels of clinical trials determining the vaccine’s effectiveness, tolerability and safety.
• Food and Drug Administration (FDA) evaluation and review of the data, and upon the FDA’s approval, the Centers for Disease Control and Prevention (CDC) must go through its own evaluation, review and approval process.
• Infants, children, adults, and senior citizens are evaluated and reviewed separately, as are males, females, and more recently ethnicity, race, and social determinants of health to best determine the vaccine’s effect, tolerance, and safety in these subgroups.
• Even after FDA and CDC approval, the vaccine production facility continues to submit reports to the FDA on the quality and safety of the vaccine, to ensure the vaccine continues to meets the required standards.

“The U.S. has one of the most advanced systems in the world for tracking vaccine safety”, says Dr. Singh.

Many people, especially new parents can be overwhelmed with keeping up with immunizations. Dr. Singh reports, "Vaccine schedules have been developed by the CDC, the American Academy of Pediatrics, and the American Academy of Family Physicians covering all current vaccine guidelines." Vaccinations keep you, your family, and others safe from potentially deadly diseases by significantly decreasing or eliminating the severity and spread of disease.

Some vaccines have precautions associated with them. “ Dr. Singh explains, “these are things which may happen in some subgroups of people, however the benefit of receiving the vaccine may still outweigh the precaution consequences, and the vaccine can be received. A contraindication, however is a very specific situation in which the vaccine will likely result in more harm to the person, than the benefit expected to be received.” He continues, “while all vaccines have precautions and contraindications, they are usually only applicable to a very small number of people, and vaccines overall are generally very well tolerated. Some precautions and contraindications are only for very brief periods of time, and the vaccination can safely be received once the period has lapsed”

If you have questions about vaccines and the appropriate vaccine schedule for you or your loved one, contact your Primary Care physician or advanced care provider who can discuss the details with you.

With hundreds of thousands of vaccines being administered per day, the end of COVID-19 feels near. But it is further away than we think, and it’s never been more critical to prevent unnecessary illness. We talked to Primary Care Physician Jenny Chen, MD, about what we can all do to stay physically and mentally healthy during this winter season.

What are the main things Dr. Chen recommends for staying physically healthy? “Wash your hands. Though the main mode of transmission for COVID-19 is respiratory droplets, washing your hands especially after being in public is vital.” If you do need to go out in public, stay away from large crowds and stay six feet away from others. Dr. Chen says, “Wear a mask when you go outside. And stay up to date on your vaccinations, including your flu shot. And when it is available to you, get the COVID-19 vaccine.” Following these tips will keep you healthy and protect the health of your loved ones and society as a whole.

Why are wearing masks so important, in any case? Dr. Chen responds, “Masks may be cumbersome for some of us to wear, but they give us protection from getting COVID-19 by blocking some of the spread of respiratory droplets. More importantly, if a sick person who has a cough is wearing a mask, then the mask decreases the chance the sick person will spread the virus to you.”

As vaccinations start to be circulated, it may feel unnecessary to get one for yourself when everyone around you has one. Dr. Chen disagrees, “The vaccines currently available are over 90% effective, but not 100% effective. Although less likely, it is still possible for a person who is vaccinated to catch the virus and spread it to you. Also, it is not possible to know in public that everyone around you is vaccinated. If you go to the grocery store, there might be other people there who are not vaccinated. You can help stop the spread by greatly reducing the chances you will be a carrier yourself if you get vaccinated.”

Not being able to do all the things people want to do has been tough on many people. Any tips for how to mentally stay fit during this period? Dr. Chen advises, “Exercise gives you a boost of endorphins and can help you stay mentally healthy. Also, any form of social contact can help. Make a point to talk to your loved ones regularly, even if it’s only through the phone or Zoom.” She adds, “Consider starting a gratitude journal. Every day making a list of things you are thankful for. Doing this simple task has been shown to lessen symptoms of depression for some people. If you are feeling overwhelmed by your depression or anxiety, if it is interfering with your daily life, it is important to seek professional help.”

Lastly, Dr. Chen adds, “This is hard to predict, but some experts believe that if we all do our part and enough people get vaccinated, we can get back to some normalcy by the end of 2021. Pandemics have happened throughout human history, and they did not stay forever. The virus may be around for a while beyond 2021, but daily new cases may drop to a very low level by that time. There is a light at the end of the tunnel once we get through this winter.”

Click here to schedule an appointment with Dr. Chen.