Fox Chase Cancer Podcasts
Cancer Conversations LIVE at Fox Chase Cancer Center
The Philadelphia Chromosome: A Mutant Gene and the Quest to Cure Cancer at the Genetic Level
by Jessica Wapner.
Book Launch May 14, 2013.
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Fox Chase Cancer Center Experts
The region's only hospital devoted entirely to cancer prevention, research, and treatment presents a series to help you make sense of the cancer news we hear every day.
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Question 40: Interventional G.I. Procedures at Fox Chase Cancer Center.
I’m Dr. Jeffrey Tokar, Attending Gastroenterologist at Fox Chase, and I’d like to talk about interventional endoscopy.
This is a safe, effective alternative to more invasive surgical or radiologic procedures for diagnosing and treating a variety of conditions.
Endoscopists can often treat cancerous and precancerous growths, and most patients often go home the same day.
Not all medical centers offer the level of endoscopic specialization provided at Fox Chase, which involves advanced training and sophisticated equipment.
Fox Chase delivers this highly specialized care on a daily basis. We’ve also developed relationships with innovative biotechnology companies, enabling us to offer the newest endoscopic procedures before they are available at other medical centers.
And that means better outcomes for you.
Learn more about interventional endoscopy.
Question 39: Minimally invasive surgery at Fox Chase Cancer Center.
I'm Dr. Jeffrey Farma, attending surgical oncologist at Fox Chase, and I'd like to say a few words about minimally invasive cancer surgery.
There are numerous benefits to this kind of surgery: smaller incisions, faster recovery, and minimal blood loss to name a few.
But not all minimally invasive surgery is the same.
At Fox Chase, our surgeons are fellowship-trained, meaning they complete up to four years of additional training focused specifically on cancer surgery.
These techniques include robotic-assisted, laparoscopic, single-incision, and video-assisted thoracic surgery.
We’re one of only a handful of institutions nationwide using robotics to treat nearly all types of cancer.
At Fox Chase, our surgeons know how to use the technology, and they have more experience using this technology to treat cancer patients.
And that means better outcomes for you.
Learn more about Minimally Invasive Surgery at Fox Chase Cancer Center.
Question 37: Dr. Eric Horwitz, Chair of Fox Chase's Radiation Oncology department, discusses radiation therapy and patient safety.
I'm Dr. Eric Horwitz, Chair of the Department of Radiation Oncology. I’ve treated patients at Fox Chase for 14 years.
I’d like to address some of the issues that have made news recently in regard to radiation therapy and patient safety.
Treating cancer with radiation has evolved tremendously over the years. We now have sophisticated technologies such as Calypso, Rapid Arc, and Cyberknife. Where we used to talk about accuracy in terms of centimeters, we’re now down to millimeters, even point-one millimeter. This allows us to apply powerful doses of radiation with the utmost safety and precision. It also helps reduce side effects and treatment times.
All radiation treatments are not equal. For the best outcomes, you should go where the experts are – where cases like yours are handled every day. NCI-designated cancer centers like Fox Chase offer the best care, backed by the latest research and technology.
For more on this conversation, learn more about Radiation Therapy and safety.
Question 36: A friend of mine has a rare cancer that runs in her family and is about to undergo genetic testing to see if she is at risk. Is this something I should consider, too?
This week a listener asked about genetic testing and cancer risk assessment.
One of the best ways to stop cancer is to prevent it from happening in the first place. Certain patterns within families provide clues to hereditary cancers, such as multiple people in the family with the same or related cancer, or family members with more than one type of cancer.
Under the direction of Dr. Mary Daly, a national leader in cancer prevention and risk assessment, fox chase established one of the nation’s first risk assessment programs twenty years ago.
Risk assessment involves a deep dive into your personal medical history and the history of cancer in your family. If appropriate, genetic testing is performed.
Genetic testing allows you, your family, and your treatment team to know your risk so that together you can develop a tailored plan to reduce it.
For more on this conversation, learn more about Genetic Testing and Cancer Risk Assessment.
Question 35: I’ve had a persistent sore throat and swollen glands, and each time my doctor treats me with antibiotics, I get better – only to see my symptoms return. Could I have esophageal cancer?
This week a listener asked about cancer of the esophagus.
Esophageal cancer can be difficult to diagnose. A sore throat associated with severe acid reflux – or even flu-like symptoms, such as a lingering sore throat and swollen glands – may mask the development of esophageal cancer.
Treatment usually involves surgery – or a combination of surgery, chemotherapy, and radiation therapy. Fox Chase offers minimally invasive surgical options, including treatments for very early esophageal cancer that allow patients to retain their esophagus and avoid surgery.
This is not a common cancer, but acid reflux, smoking, drinking, and being overweight do increase your risk. Women who take osteoporosis drugs like Fosamex double their risk. See a cancer expert for a comprehensive and accurate diagnosis, which is critical for best outcomes.
For more on this conversation, learn more about Esophageal Cancer.
Question 34: The other day, after my most-recent colonoscopy, my doctor told me he “thinks we’re looking at cancer.” Should I let this play out with my current provider, or should I seek a second opinion?
This week a listener with colon cancer asked how to improve his chances for cure.
Curing cancer is complicated. Unfortunately, people spend more time getting a second opinion on what car to buy than seeking a second opinion on their cancer care.
A second opinion confirms the primary diagnosis, and allows you to explore other treatment options. In short, it provides peace of mind.
Early and comprehensive treatment provides your best chance for cure, and where you seek that treatment from the very start is critically important.
So, what questions should you ask your doctor? Is this a comprehensive cancer center? How many cases like mine do you see each week? Do you conduct clinical research? And do you consider yourself a national leader?
Second opinions sometimes lead to better first treatments.
For more on this conversation, learn more about the Fox Chase difference.
Question 33: My mother was recently diagnosed with endometrial cancer. What can you tell me about this disease and the recommended course of treatment?
This week a listener asked about endometrial cancer.
Endometrial cancer, or cancer of the uterus, is the most common gynecologic cancer in the U.S.
While postmenopausal women have the highest risk, other factors include obesity, family history of uterine or even colon cancer, and the use of hormone therapies.
Common symptoms include unusual bleeding or discharge, and pelvic pain.
Treatment can include surgery, radiation, and chemotherapy, so faced with this decision, what should you do?
Fox Chase has made a multi-million dollar investment in developing the region’s first women’s cancer center. Our internationally known experts will guide you through your cancer journey. From robotic surgery to the latest systemic therapies, we create a tailored treatment plan that’s best for you.
For more on this week's conversation, learn more about Endometrial Cancer Treatment.
Question 32: Do cancer patients require specialized nursing care?
This week a listener asked whether cancer patients need specialized nursing care.
Cancer patients have unique nursing needs. Like our doctors, the nurses at Fox Chase receive specialized cancer training.
One measure of excellence is magnet status, awarded by the american nurses credentialing center. Only about six percent of hospitals in the nation achieve this distinction.
Ten years ago, fox chase became the first comprehensive cancer center in the U.S. and the first Pennsylvania hospital to gain magnet status. Since then, Fox Chase has become the first hospital in Pennsylvania to earn three consecutive magnet nursing designations.
In the end, compassionate nursing care leads to better outcomes. That’s an award we can all live with.
For more on this conversation, learn more about Fox Chase Cancer Center Nursing.
Question 31: My community hospital has a well-regarded cancer center but I repeatedly hear about comprehensive cancer centers, too. What’s the difference?
This week a listener asked about the difference between care at a community hospital cancer center and a comprehensive cancer center.
The national cancer institute recognizes 40 comprehensive cancer centers, including Fox Chase. These are the elite cancer centers recognized for expertise in research, education, cancer screening and prevention, and patient care.
This year , Fox Chase celebrated the 50th anniversary of its discovery of the Philadelphia Chromosome – the first genetic abnormality linked to cancer, and the first to lead to a targeted cancer therapy.
From nobel laureates to cutting-edge cancer care, comprehensive cancer centers like Fox Chase are home to nationally recognized physicians and researchers who develop new treatments that others use.
For more on this conversation, learn more about Fox Chase Cancer Center.
Question 30: We closed on a home this summer and have been living in it since August. Last month it tested for elevated radon levels. While we consider radon reduction measures and who should pay for them, we have no choice but to live in the house. Should we be concerned about developing lung cancer?
This week a listener asked about radon gas and lung cancer.
Radon is in the air we breathe – however, exposure to high levels over the long term poses a serious risk for developing lung cancer.
Fox Chase is one of a few comprehensive cancer centers using a less-invasive technology called light-induced fluorescent endoscopy, or life. This provides safer, more accurate early detection.
According to Dr. Michael Unger, an internationally renowned pulmonologist at Fox Chase, this new tool examines areas beyond the reach of traditional technology. It also allows for more precise therapies, preventing damage to healthy lung tissue.
Early detection is critical for better outcomes. People who are at risk for lung cancer – including those exposed to radon and asbestos, should see a lung cancer expert.
For more on this conversation, learn more about Lung Cancer.
Question 29: I went to my OB-GYN for my regularly scheduled pap smear and it came back abnormal. What now? I have to wait for several days before my appointment to discuss this with my doctor.
This week a listener asked about what to expect after an abnormal pap smear.
Abnormal Pap smears are not always dangerous but do require some additional evaluation. This is usually done by a simple office procedure called a colposcopy, where the cervix is evaluated with a microscope.
Sometimes small biopsies are also done to help clarify the severity of the abnormality. Mild changes can be managed conservatively. Precancerous growths, however, could require additional procedures.
Fox Chase’s Colposcopy Clinic, located in our new Women's Cancer Center, is led by Dr. Cynthia Bergman. This clinic delivers the expertise you expect from an NCI-designated comprehensive cancer center. It also provides access to a care and treatment plan developed just for you.
For more on this conversation, learn more about Cervical Cancer.
Question 28: My neighbor has been diagnosed with a cancer I’ve never heard of, peripheral T-cell lymphoma. And his diagnosis started with what seemed to be a routine visit to his dermatologist. What can you tell me about it?
This week a listener asked about Peripheral T-Cell Lymphoma.
Lymphoma is cancer of the white blood cells, an important part of our immune system. T-cell lymphoma is a very rare type of this disease.
According to a specialist in t-cell lymphoma at Fox Chase, symptoms can be vague – it can often start as a simple rash.
There are many types and subtypes of lymphoma and proper treatment depends on recognizing these differences. It’s therefore critical to seek out a lymphoma expert to get an accurate diagnosis and to develop a personalized treatment plan.
Several new drugs being studied in clinical trials show promise with t-cell lymphoma. Nationally recognized cancer centers like Fox Chase offer the latest research and the best treatment options.
For more on this conversation, learn more about Lymphoma treatment.
Question 27: I am moving to the Philadelphia area for work in a few weeks and will need to seek out a new primary-care physician, among other things. In the Chicago suburbs, I go to my community hospital for mammograms. I’m wondering if I should do the same in Philadelphia.
This week a listener relocating to Philadelphia asked where she should go for her annual mammogram.
There are many methods to detect breast cancer, and the key is to find a facility with expertise in all of them. For example, not all mammograms are created equal. Digital mammography has become the gold standard, especially with the high-density breast tissue often found in younger women.
At Fox Chase, our new women’s cancer center offers a comprehensive range of diagnostic tools, including digital mammography, ultrasound, and MRIs. You should look for centers like Fox Chase that have been recognized for excellence by the American College of Radiology.
In the event of a diagnosis, state-of-the-art breast imaging is only the first step in a personalized treatment program. Comprehensive cancer centers deliver the best in both screening and treatment.
For more on this conversation, learn more about the Women's Cancer Center.
Question 26: I’m a 62-year-old nonsmoking male and I’ve developed a chronic case of heartburn over the past few years. My doctor has found nothing wrong with me in particular but wants me to be tested for Barrett’s esophagus. Does this mean I’m developing cancer?
This week a listener with chronic heartburn asked about Barrett’s Esophagus.
Barrett’s Esophagus is a precancerous condition where the lining of the esophagus has been repeatedly exposed to acid reflux. It is named for Dr. Norman Barrett, the thoracic surgeon who first described the condition.
Only a small percentage of those with chronic acid reflux will develop Barrett’s. Screening for Barrett’s is still important because it does increase your risk of developing esophageal cancer. See your doctor about other key risk factors such as smoking and increased consumption of alcohol and red meat.
Personalizing your care and managing risk factors are critical for better outcomes. At Fox Chase, we’ve opened a Barrett’s Esophagus clinic to provide individualized screening and treatment options.
For more on this conversation, learn more about Barrett's Esophagus.
Question 25: I've read and heard a lot of conflicting information about PSA tests and screening for prostate cancer. Are they useful or not?
This week a listener asked about the PSA test for prostate cancer.
The concern about this test is whether it leads to overtreatment in men. Prostate cancer is the second-most prevalent cancer in american men, however, so the risks and benefits of the psa test warrant a discussion with your doctor.
High-risk populations such as African-Americans or those with a family history of prostate cancer are excellent candidates for the psa test.
Fox Chase's Prostate Cancer Risk Assessment service personalizes the screening process for high-risk men. Under the direction of Dr. Veda Giri, this program evaluates expanded family histories and screens for relevant genetic mutations. We then make appropriate recommendations ranging from genetic testing and preventive measures to early detection and treatment.
Question 24: I've been reading about "virtual colonoscopy" procedures to screen for colon cancer. What is the rationale for having this done instead of a traditional colonoscopy?
This week a listener asked about virtual colonoscopy.
Virtual colonoscopy uses Cat Scan and computer imaging to produce two- and three-dimensional images of the colon. Although the preparation is the same as traditional colonoscopy, the benefit is that no sedation is necessary, and the exam only takes about 10 minutes.
According to Fox Chase radiologist Dr. Kristin Edwards, studies show that virtual colonoscopies are just as effective as traditional ones in detecting large polyps and colon cancers.
Since colon cancer is a leading cause of death, and early detection is essential, colonoscopy is vitally important. At Fox Chase, our expertise in virtual colonoscopies provides an option for patients when traditional colonoscopies are incomplete.
For more on this conversation, learn more about Colonoscopy.
Question 23: My friend's 15-year-old son has been diagnosed with Ewing's sarcoma. What can you tell me about this cancer? I'm trying to be as helpful and supportive as I can with this family.
This week a listener asked about Ewing's Sarcoma.
Sarcomas are tumors arising from the bone or soft tissues such as muscle or fat.
Ewing's is a rare form of bone cancer which most often strikes children and adolescents between the ages of 10 and 20 but can be seen in adults, as well. It does not appear to be hereditary.
Although Ewing's can occur in any bone, the most common sites are the limbs, pelvis, and ribs. Treatment may include a combination of surgery, radiation, and targeted therapy.
Fox Chase's nationally ranked sarcoma program leads and participates in studies looking at these targeted therapies. Our team of sarcoma experts, led by oncologist Dr. Margaret von Mehren, provides personalized care for these uncommon tumors.
For more on this conversation, learn more about Sarcoma Treatment.
Question 22: My father is 80 years old and has a cancerous tumor next to his jawbone. His primary physician is doubtful that he can safely undergo the lengthy, complicated surgery required to remove the tumor and rebuild the jaw. What are our options?
A: This week a listener asked whether an elderly patient should undergo complicated surgery to remove a tumor next to his jawbone.
This procedure can take up to 20 hours and involves both removing the tumor and reconstructing the jaw using a bone from the lower leg.
However, Fox Chase is using a game-changing technology that makes better outcomes possible for more patients.
Working from a CAT scan, a virtual computer model is developed to reconstruct the jaw. This pioneering work by Fox Chase reconstructive surgeons Drs. Neal Topham and Sameer Patel, in collaboration with our head and neck cancer surgeons, customizes the bone for reconstruction, cutting surgical time in half.
Fox Chase is the sole provider of this patient-specific technology in the region and one of only four nationally.
For more on this conversation, learn more about Head and Neck Cancer.
Question 21: Are all breast cancers the same? A colleague of mine has suspicious swelling in one breast and is having it checked out. She's worried that it could be a rare form of breast cancer.
A: This week a listener asked whether all breast cancers are the same.
The fact is, they're not. Inflammatory breast cancer accounts for about one percent of all cases.
Inflammatory breast cancer rarely produces breast lumps and may not show up on a mammogram. Symptoms tend to progress rapidly and can include pronounced swelling or skin changes like irritation or redness. This rare form of breast cancer can often be confused with mastitis.
Early diagnosis can save lives. At Fox Chase, we've opened an inflammatory breast cancer clinic in our Women's Cancer Center, led by internationally renowned expert Dr. Massimo Cristofanilli.
Personalizing your cancer care is essential. See a breast cancer specialist who can tailor a program that's best for you.
For more on this conversation, learn more about Inflammatory Breast Cancer.
Question 20: I've been reading about vitamin D and how it may reduce the risk for some cancers. I know we produce vitamin D naturally when our skin is exposed to the sun - but I have a very fair complexion. Won't this increase my risk of getting skin cancer even if I use sunscreen?
A: This week's question is about vitamin D, sun exposure, and skin cancer.
One of the many benefits of a bright, sunny day is that our skin produces vitamin d naturally when exposed to sunlight. Some studies have shown that vitamin D may reduce the risk for certain cancers. However, increasing your sun exposure to get more vitamin D also greatly increases your risk of developing skin cancers – including melanoma, the deadliest form of skin cancer.
Melanoma is one of the most common cancers in Americans under 30 – and its incidence is on the rise.
So protect yourself from the sun and examine your skin regularly. Ask your dermatologist to assess any irregularities you find.
Fox chase has a nationally recognized skin cancer program, including Mohs microsurgery and risk assessment for melanoma.
For more on this week's conversation, learn more about Skin Cancer.
Question 19: The federal guidelines that came out last fall call for mammograms starting at age 50, not 40 – and every two years instead of annually. I'll turn 40 next year and I'm wondering what I should do.
A: This week a listener asked about the new federal guidelines for breast cancer screening.
Previous guidelines called for annual mammograms beginning at age 40. These new guidelines recommend mammograms every two years, starting at age 50.
Catching cancer early is essential for the best outcomes. That's why cancer centers like Fox Chase still recommend annual screening beginning at 40 — and earlier if breast cancer runs in your family.
Tennis great Martina Navratilova is a case in point. An extremely fit and healthy person, she skipped mammograms for four years and recently was diagnosed with breast cancer at age 53.
Personalizing your cancer screening and treatment is essential. The new women's cancer center at Fox Chase specializes in digital mammography and can tailor the right approach for you and your family.
For more on this week's conversation, learn more about Making Sense of the Mammography Debate.
Question 18: My brother was just diagnosed with prostate cancer and his doctor is suggesting radiation. How long is the process? Can he still work while undergoing radiation treatments?
A: This week a listener asked if radiation therapy for prostate cancer will disrupt a patient's work schedule.
Like most cancer therapies, radiation sounds ominous. But there have been significant technological advances. The most sophisticated technique uses multiple small beams and is called intensity modulated radiation therapy, or imrt. A typical treatment takes about 10 minutes and is painless.
Fox Chase clinicians use the latest radiation technologies, such as the Calypso system, which acts like a GPS as it tracks tumors during treatment. This technique also helps minimize potential side effects.
During radiation we encourage patients to remain active and not limit themselves in any way, including diet or exercise. Most men drive themselves to treatments and are able to maintain their full-time work schedules.
For more on this week's conversation, learn more about Prostate Cancer.
Question 17: Should I take aspirin once a day to prevent breast cancer from returning? I am a five-year survivor. My cancer was estrogen-positive.
A: This week a listener asked if aspirin helps to prevent breast cancer recurrence.
Recent data from a large, ongoing national study show that in more than 4,000 breast cancer survivors, aspirin reduced the risk of dying from breast cancer by nearly 50 percent.
In this study, most women who took aspirin did so for heart disease prevention, joint and muscle pain, or headaches.
These results are promising, according to Dr. Lori Goldstein, a nationally known breast cancer expert at Fox Chase Cancer Center. However, the study relied on self-reported aspirin use – and it did not evaluate aspirin dose or frequency.
That said, an aspirin a day may not only be good for your heart, but also reduce risk of breast cancer recurrence and death. As in most cases, we encourage you to seek the advice of a cancer expert.
For more on this week's conversation, learn more about Breast Cancer.
Question 16: I'm exploring surgical options for my father, who is suffering from lung cancer. He's not in the best physical shape and probably is not a good candidate for major surgery. What would you recommend?
A: This week's question is about lung cancer surgery.
Open lung cancer surgery is highly invasive. Chest muscles are cut and the ribs are spread.
However, there is a much less-invasive approach, one that is less painful, with faster recovery and a shorter hospital stay.
VATS, or Video-Assisted Thoracic Surgery, is much like a laparoscopic gall bladder removal where surgeons insert a camera and small instruments into the chest to perform complex lung cancer procedures. The surgeons at Fox Chase are the most experienced in the region using this technique.
VATS patients tend to have fewer complications – and many older patients who do not qualify for conventional surgery are candidates for VATS.
Personalizing your cancer care is essential, so look for a surgeon experienced in VATS.
For more on this week's conversation, learn more about Video-Assisted Thoracic Surgery (VATS).
Question 15: Is it possible for chemotherapy to be teamed with another treatment to fight colon cancer that has spread to the liver? What's the best course of action here?
A: This week a listener asked about treatment options for colon cancer that has spread to the liver.
Because liver surgery is highly complex and difficult, the first consideration is whether surgical removal is possible. Fox Chase is one of a handful of centers nationally where surgeons perform minimally invasive liver surgeries.
When surgery is not possible, the tumor can be destroyed by other means. Fox Chase is evaluating the injection of radiation micro-spheres and chemotherapy-coated beads directly into the tumor.
These and other innovations may be used with new targeted therapies to achieve better results for patients.
Personalizing your cancer care is essential, so consult a GI cancer expert.
For more on this week's conversation, learn more about Gastrointestinal Cancer.
Question 14: My husband suffers from non-Hodgkin's lymphoma and, as a result of his chemotherapy treatments, has neuropathy in his legs and feet. Is there a treatment to correct this condition?
A: Chemotherapy is an effective way to kill cancer cells. Unfortunately, normal cells may also be killed, causing side effects.
When it comes to chemotherapy, most people fear the worst. However, modern cancer care has developed strategies to treat even the most severe side effects.
This week a listener asked about chemotherapy-related neuropathy. Neuropathy is numbness and pain in the legs, hands, and feet, affecting 10 to 20 percent of patients.
There are ways to mitigate neuropathy symptoms. At Fox Chase we use anticonvulsants and pain medications to provide maximum relief.
Fortunately, once chemotherapy is over, most patients find their neuropathy dissipates. Fox Chase is experienced in managing all types of chemotherapy-related side effects with the newest therapies and compassionate care.
For more on this week's conversation, learn more about Chemotherapy.
Question 13: I've been diagnosed with lung cancer and my doctor is advising me to seek treatment somewhere that has clinical trials. What are clinical trials and how would they help me?
A: This week a listener with lung cancer asked about clinical trials.
First, it's important to know that clinical trials are performed at all stages of cancer, from prevention to advanced care. Secondly, today's most effective therapies have gone through extensive clinical trials.
One of the primary benefits for patients is early access to the newest treatments. These trials are closely monitored and when the data show a clear benefit, all patients receive the treatment.
One of the reasons Fox Chase has been designated a comprehensive cancer center by the NCI is its extensive experience in clinical trials. Fox Chase's lung cancer program is one of only a very few in the country to offer clinical trials on personalized treatments.
For more on this week's conversation, learn more about Clinical Trials.
Question 12: I've been told I am at high risk for prostate cancer. What can I do to help myself?
A: This week a listener who is at high risk for prostate cancer asked what he could do to improve his odds.
Prostate cancer remains one of our most common cancers, with more than 192 thousand new cases this year — and an estimated 27 thousand deaths.
Men with a family history of the disease and african american men are considered to be at highest risk.
Two recent national studies show prostate cancer is preventable. According to Dr. Veda Giri, Director of the Prostate Cancer Risk Assessment program at Fox Chase, there is no one-size-fits-all strategy.
However, the data show that diet, lifestyle modifications, certain medications, and early detection can all reduce your risk.
For more on this week's conversation, learn more about Prostate Cancer.
Question 11: Can skin-care preparations containing parabens trigger breast cancer?
A: This week a listener asked if skin care products containing parabens are triggers for breast cancer.
Parabens are preservatives found in literally tens of thousands of cosmetic products including lotions, shampoos, sunless tanners, and gels. They are used to inhibit the growth of bacteria and to prolong shelf life.
In 2004 a small study showed traces of parabens in breast cancer tissue. However, this did not prove that parabens caused breast cancer — and the study did not look for parabens in normal tissue.
Parabens do exhibit weak, estrogen-like activity, but they are far less active than the female body's naturally occurring estrogens.
The FDA believes there is no connection between breast cancer and cosmetics containing parabens.
For more on this week's conversation, learn more about Breast Cancer.
Question 10: Chances of Recovery Post Bone Marrow Transplant for Multiple Myeloma
A: This week a listener asked about chances of full recovery after bone marrow transplant for multiple myeloma.
Multiple myeloma is cancer of the bone marrow. Typical treatment is a large dose of chemotherapy designed to wipe out the myeloma cells. But this treatment comes with collateral damage – some normal blood cells and bone marrow cells get killed. Healthy stem cells are then transplanted back into the patient – like a special blood transfusion. The stem cells travel to the marrow and regrow the normal blood cells.
At premier cancer centers like Fox Chase, close to 90% of patients will see substantial improvement, while about 40% will have a near-complete remission.
Using innovative drugs around the time of transplant is a promising option we're researching at Fox Chase.
For more on this week's conversation, learn more about Myeloma Treatment.
Question 9: Can Irritable Bowel Syndrome Lead to Cancer or Crohn's Disease?
A: This week a listener asked about Irritable Bowel Syndrome and whether it can lead to cancer or Chrohn's Disease.
Irritable Bowel Syndrome and Crohn's Disease are frequently confused. Both disorders cause abdominal pain and altered bowel function. However, it is important to distinguish Crohn's Disease from Irritable Bowel Syndrome. Specifically, there is no known association between IBS and the development of cancer. However, Crohn's Disease is a known risk factor for colon and bowel cancers.
Keep in mind that colon cancer is one of the most common cancers. The average American carries a 6% lifetime risk of contracting this disease.
Screening for colon cancer should begin between the ages of 40 and 50, depending on risk factors such as race and genetics.
For more on this week's conversation, learn more about Colon Cancer Screening.
Question 8: How Many Baseline Screenings? How to Keep Track of the Data?
A: This week a listener asked about recommendations for cancer screenings.
Successful cancer treatment begins early — before symptoms occur. This is backed by data.
Most screening recommendations are based on a person's age, genetics, or family history of cancer, according to Dr. Mary Daly, founder of the Margaret Dyson Family Risk Assessment Program at Fox Chase Cancer Center.
Annual screening for cervical cancer by pap smear starts at 21. For breast, colon, and prostate cancer, screening usually begin between 40 and 50 — depending on risk factors such as race and genetics.
Comprehensive cancer centers like Fox Chase are experts at cancer screening and continue to develop new early detection techniques to increase your chances for best outcomes.
For more on this week's conversation, learn more about Risk Assessment.
Question 7: Breast Reconstruction: What is the Most Advanced/Effective Method?
A: This week a listener asked about options for breast reconstruction after cancer surgery.
The cosmetics of breast reconstruction following mastectomy are a major concern to most women.
While many options are available, the most advanced and aesthetically appealing method of breast reconstruction is called the Micro-Surgical Free Flap Technique.
In this procedure, surgeons take skin and fatty tissue -- usually from the abdominal wall -- to reconstruct the breast using an operating microscope.
This technique, pioneered at cancer centers like fox chase, provides the most natural result and is offered at select institutions in the region. Dr. Neal Topham, chief of plastic and reconstructive micro-surgery at Fox Chase, suggests women should ask specifically for Free Flap Reconstruction.
For more on this week's conversation, learn more about Free Flap Reconstruction.
Question 6: How many robotic procedures are required for a surgeon to be considered an expert?
A: First of all, the robot is simply a tool, so it is important to find a physician who understands the biology of cancer. For surgeons, this means having completed a fellowship in cancer surgery.
The robot merely extends the surgeon's expertise and when used appropriately can achieve the best patient outcomes.
Studies show that in prostate cancer, dedicated cancer surgeons consistently perform the best. According to Dr. Rosalia Viterbo, a Fox Chase urologist who has done nearly 1,000 cases, surgeons using the robot for prostate cancer need to perform 200 procedures or more for optimal outcomes.
Remember the robot is a tool for many types of tumors that, when in the hands of dedicated cancer surgeons, offers patients the best results.
For more on this week's conversation, learn more about robotic surgery.
Question 5: Angioimmunoblastic T-Cell Lymphoma: New Treatments and Research
A: This week a listener asked about a rare cancer called angioimmunoblastic t-cell lymphoma.
Lymphomas are cancers of the lymph nodes. Lymph nodes act like a good defensive line in football. They trap bacteria, viruses, and cancer cells so that white blood cells can make the kill. The treatment of choice is usually combination chemotherapy. But that doesn't work for everyone.
Research being done at National Cancer Centers like Fox Chase holds great promise. Immunosuppressive drugs are effective in some patients . We're also using genetically engineered therapies to target unique proteins in cancerous lymph nodes.
See a lymphoma specialist to help you find new, targeted therapies aimed at better outcomes.
For more on this week's conversation, learn more about lymphoma.
Question 4: Breast Cancer and Soy Intake
A: One of you posted a question about eating soy if you are at risk for breast cancer.
According to Dr. Robert Burger, Director of Fox Chase's new Women's Cancer Center, soy protein contains isoflavones, organic compounds similar to estrogen. Estrogen has been linked to increased breast cancer risk.
But here's where it gets murky.
Some studies show that isoflavones may stimulate the growth of existing breast tumors. Other studies have found that these same compounds may actually protect against breast cancer by blocking the effects of estrogen on breast tissue.
There is little clinical evidence to suggest dietary soy will increase breast cancer risk in healthy women – or worsen the prognosis for women with breast cancer.
The data are confusing. Consult a cancer expert to find out what's best for you.
For more on this week's conversation, learn more about breast cancer.
Question 3: What steps can I take to stay safe in the sun this summer?
A: Did you know that the average person burns after only 15 minutes in the sun? Sunburns can increase the risk of melanoma, the most dangerous form of skin cancer. People most at risk are men over 50 and women between 25 and 35 with fair complexions, multiple moles or freckles, or a history of sunburns. People with a family history are at increased risk. At Fox Chase, experts are studying the genetics of cancer while providing exceptional care. Be safe this summer. Avoid exposure between 10AM and 2PM. Use lotion with an SPF of 30 or higher, with both UVA and UBB protection. And, most importantly, be vigilant. Have a dermatologist evaluate anything that concerns you.
Question 2: I've heard that doctors are using some new radiation techniques. How safe are they?
Remember what driving directions were like ten years ago? Paper maps got us to the general area. Today, GPS makes getting to an exact location a snap.
Radiation techniques we utilize to treat cancers have evolved much the same way. We used to deliver higher doses of radiation to a general cancer site, but now we target tumors with great precision.
At Fox Chase, this means using the most advanced radiation technologies, including our new CyberKnife system, now available at our new facility in central Bucks County.
Fox Chase doctors pinpoint tumors with sub-millimeter accuracy. Image-guidance technology corrects for any natural movement during treatment. This means the most effective dose can be used to destroy the tumor with minimal effect on normal tissues...reducing potential side effects.
Learn more about radiation oncology at Fox Chase Cancer Center, or learn more about our radiologists.
Question 1: What can I expect from Cancer Conversations?
In this first installment, Dr. Robert Uzzo introduces Fox Chase Cancer Center's Cancer Conversations, and gives a glimpse into what listeners can expect. For more on this week's conversation, see our Patient Risk Assessment Programs to help you understand the benefits of genetic testing; our labs to tell you what you can expect in personalized medicine, and our minimally-invasive surgery and radiation oncology teams to describe how patients are finding options they never knew existed.