Category Archives: Blog

Spotlight On: Flakka–The New Designer Drug

Equipment used in the preparation of illegal street drugs.In Spanish, the word flake is a term of endearment for a thin person. When I was a teenager, my friend’s Colombian father used to call me “flakita”. But the word Flakka is anything but that. It’s the street name for a new designer drug that is highly addictive and extremely dangerous. (more…)

Hormone Therapy: “Bioidenticals” Can Be Risky

iStock_000020503776_SmallThere’s nothing pleasant about sweating through your blouse during an elegant dinner party or having to get up in the middle of the night to change pajamas, but that’s precisely the sort of discomfort faced by many menopausal women. (more…)

Dr. E’s DOs and DON’Ts: School Lunches

DrelogoAs the new school year approaches and we’re bombarded with back-to-school sales and advertisements for everything from backpacks to paper clips, it’s time to focus on what your kids are going to be eating throughout their busy days. (more…)

For Breast Cancer Prevention, More Exercise is Better

It’s no secret that body fat increases postmenopausal breast cancer risk. Regular exercise is an integral part of breast cancer prevention and, further, exercise should play a key role Multi-ethnic group of mature women (50s) exercising in gym, lifting hand weights.in breast cancer recovery as well (we posted a blog on the subject last summer). But how much exercise is optimal for reducing breast cancer risk? According to a recent study, more seems to be better.

A clinical trial conducted in Alberta, Canada between 2010 and 2013 studied how different levels of exercise affected the body fat levels of 384 previously inactive postmenopausal women (aged 50 to 74 years) in both normal and obese body fat ranges. The participants were randomly assigned workout regimens of either 30 or 60 minutes per day for five days each week (with no dietary changes) and continued the regimens for 12 months. Body fat measurements taken before and after the trial showed that decreases in body fat were significantly higher in those women who participated in a higher volume, more intense exercise regimen (300 vs. 150 minutes per week).

Overall, the women exercising 300 minutes weekly lost 1% more body fat than those in the 150 minute group. An important finding, however, was that those exercising at the higher level did not lose significantly more weight. Many cancer studies focus on how weight affects cancer risk, but this study focused specifically on body fat levels.

Christine Friedenreich, PhD led the study along with her colleagues at Alberta Health Services in order to differentiate between how body fat, not just weight, could lower cancer risk. She said that general guidelines for exercise concentrate on lowering blood pressure and other heart disease-related measurements. But for cancer prevention, Friedenreich says, “We may need to exercise at higher volumes. So yes, doing 150 minutes of activity a week is good, but if you can do more, then from a cancer prevention perspective, 300 minutes is better.”

Since fatty tissue is the main source of hormones that can drive postmenopausal breast cancer, the study results are significant. Fat also plays a role in the body’s immune and inflammatory responses, both of which are involved in cancer. So when it comes to exercise and breast cancer prevention, upping your game could really improve your odds!

Spotlight on: Lara Devgan, MD, MPH

Dr. Lara DevganLara Devgan, MD, MPH is a board-certified plastic and reconstructive surgeon in New York City. Here is an interesting and provocative blog she posted on her website. (more…)

Dr. E’s DOs and DON’Ts: “Dieting”

DrelogoFor some of us, the onset of summer brings a wave of anxiety about how we’ll look in shorts, sleeveless tops and….of course…..swimsuits. It’s hard to imagine being in a women’s clothing store without overhearing self-loathing comments such as, “I could never pull this off unless I lost 10 pounds”, or “I really need to go on a diet”. (more…)

Breast Surgery and Medical Testing: Understanding What’s Going On

Doctors examining medical testsWhen you’re facing breast surgery, there’s a lot of information to process. In addition to all the physical and emotional prep, there are myriad medical imaging and other tests that you may have to undergo. Here’s a list and explanation of the tests that could be necessary (more…)

Tattoo Ink or Cancer?

A cropped shot of a tattooed young woman

Read our blog on The Huffington Post about how tattoo ink can be mistaken for cancer cells.

Spotlight on: FORCE

FORCE logo Facing Our Risk of Cancer Empowered (FORCE) is the nation’s only nonprofit organization dedicated to families facing hereditary breast, ovarian and related cancers. (more…)

Combination Drug Therapy More Effective on Melanoma

melanoma skin cancer on woman arm with sun in the backgroundMy best friend Kelly and I love to go running together. It’s great for both us, since it combines exercise and what we call “free therapy”. She loves the sun, and just feeling its warm rays brightens her mood. The problem, however, is that Kelly is also very fair-skinned—and the two don’t mix. This is compounded by the fact that, as a teenager in New Jersey, she belonged to the baby-oil and iodine club (that only those in their 40’s and 50’s remember now). Many of us are now suffering consequences from the choices we made back then, and these are showing up in the form of wrinkling, sun spots and, most unfortunately, skin cancers. Last year, what Kelly thought was a “beauty mark” on her cheek turned out to be a melanoma. It was removed, and left behind a scar to remind us that protection from the sun is not only wise, it’s also crucial to maintaining good health.

Skin cancers are on the rise and, according to the American Cancer Society, are by far the most common of all cancers. While melanoma accounts for less than 2% of skin cancer cases, the number of cases has been rising for at least 30 years and it causes a large majority of skin cancer deaths.

Here are the American Cancer Society’s estimates for melanoma in the United States for 2015:

  • About 73,870 new melanomas will be diagnosed (about 42,670 in men and 31,200 in women).
  • About 9,940 people are expected to die of melanoma (about 6,640 men and 3,300 women)

I have written on this subject for years and it continues to be something I’m passionate about. With incidents of melanoma increasing, the medical community must grapple with the issues of diagnosis, treatment and, unfortunately, what to do when the cancer spreads to other parts of the body. Obviously, prevention is key, and a crucial component in warding off this potentially deadly disease. That said, there is important melanoma research on evaluating new drugs and potential treatment modalities. While the drug names are lengthy and hard to spell (much less pronounce), the important message is that these new drug therapies show promise in dealing with melanoma. Good news for Kelly and for the thousands of others facing this growing health issue.

Specifically, a recent study has concluded that drug therapy using a patient’s own immune system to fight cancer cells by combining two drugs (rather than one) has proven to be more effective in slowing cancer growth and extending a patient’s progression-free survival period. The two drugs, called nivolumab and ipilimumab, led to better results compared to the use of ipilimumab alone– when given to previously untreated patients with melanoma that had spread beyond the original site (stage III or IV metastatic melanoma).

The double-blinded study (in which neither the researchers nor participants were aware of who was getting study drugs vs. placebo) was conducted using 945 patients. After a minimum of 9 months’ follow-up, disease progression was reduced by 58% when both drugs were used. Dr. Michael Atkins, deputy director of the Georgetown-Lombardi Comprehensive Cancer Center in Washington, said the principal take-home message is that, “Ipilimumab can no longer be considered as standard first-line immunotherapy for patients with advanced melanoma. This clearly has important implications for the field and for our patients.”

Professor Roy Herbst, chief of medical oncology at Yale Cancer Center said the combination treatment, which uses the body’s immune system to attack cancerous cells, could potentially replace chemotherapy as the standard cancer treatment within five years. “I think we are seeing a paradigm shift in the way oncology is being treated,” he said. Dr. James Larkin, a consultant at the Royal Marsden Hospital in London, said, “By giving these drugs together you are effectively taking two brakes off the immune system rather than one, so it is able to recognize tumors it wasn’t previously and react and destroy them.” This results in a sort of “one-two punch” against advanced stage melanoma.

There is some downside, however. The combination drug treatment is expensive, raising concerns regarding relative value. Dr. Atkins said that judgment about whether the additional cost is justified will need to be withheld until it can be determined whether or not the combination treatment can reduce the need for other therapies. Also, there are some concerns regarding increased side effects (know as toxicity) when both drugs are administered, since treatment-related adverse side effects occurred in a greater percentage of the study group which received the combination therapy. However, the management of these side effects suggests that the combination therapy can be used safely in many cases.

While the study results provide optimism for the treatment of advanced stage melanoma, the positive results may not justify the high cost of the treatment. The fact remains–prevention is key. As we head into July 4th weekend, don’t forget to wear sunblock, a hat and long sleeves when out in the sun, because there’s nothing mood-boosting about skin cancer!

DOs and DON’Ts: Pre-Surgery Prep

DrelogoWhen you’re about to undergo breast surgery, there are many things to think about and plan for. But it’s difficult to really consider all of the parts of one’s life that the surgery will affect. You think about the obvious things, (more…)

BFFL Co Making A Difference

DoubleBreastBfflBag_nooilWe receive many letters of thanks for the products we offer from people who have used them or bought them for a friend or loved one struggling with cancer. We received this one recently, and were touched by the heartfelt gratitude and, more importantly, by the fact that our Double Mastectomy BFFLBag® and the BFFL Co Guide to Mastectomy were so helpful. This has always been our mission: To improve the patient experience. There’s nothing better than finding out we have done just that. Here’s what she wrote:

The BFFL Company Bag was delivered right on time. I have yet to open it since both my daughter and I are down with an ugly sinus infection, but I will be delivering it to her very soon. I just want you to know what a wonderful difference products such as this and your personal and kind help provide to cancer sufferers and their relatives. I would do anything for my daughter, but so far, except for accompanying her to appointments and doctor visits, I have been able to do little. This product – the thought of it, the hope of it, the kindness with which it was put together – has been so instrumental in providing a little relief to a grim situation.

I was especially impressed with your “The BFFL Co Guide to Mastectomy.“ For 25 years, I worked as an Instructional Systems Specialist – first for the U. S. Army and then the U. S. Coast Guard. Smaller service though it was, the CG, early on, was particularly good at realizing the great advantage of job aids, etc. Your Guide to Mastectomy is one of the best I’ve ever seen, and it even includes a video that I plan to watch.

Ironically to us anyway, my daughter is an oncology nurse, having devoted 13 or more years of her working career to chemo and now radiation. She knows how to care for drains – I don’t — but I will because your video and instruction and her skill set and teaching skills will make sure I get one thing out of this experience and that is how to care for drains. My daughter also got me through a very tough year as my husband struggled with pancreatic cancer. Of course, he ultimately lost that battle, but my daughter was why I could keep his multitude of meds straight and other visiting nurses who patiently taught me were why I could ultimately administer infused antibiotics through a Smart Port twice a day. If you’re me, you think you can’t do these things. If you’re my daughter you not only know you can but you know how to help other people to experience that they can, too. I know you must get accolades and praise all the time, but just wanted to add mine. I think you’re fantastic!!!!

Sheila Shepard, proud mother of the best oncology nurse in the whole world!

Spotlight on: Breast Reconstruction Guidebook

Breast Reconstruction Guide 3coverIn 2006, when making my decision about prophylactic mastectomies, there was one book that was essential in teaching me what I needed to know and what I had no idea was even possible.

Kathy Steligo’s Breast Reconstruction Guidebook is now in its third edition and is even wiser and more comprehensive. (more…)

DOs and DON’Ts: A Strong Mother-Daughter Relationship Sets The Stage

DrelogoAs we celebrate our mothers this month, it’s hard to overstate the influence they have on the lives of their daughters. A strong and open relationship can nurture and empower a young girl and serve as a springboard to a healthy adulthood. But this can be tricky road to navigate, (more…)

Doctors Should Preach What They Practice

When it comes to the practice of medicine, the old adage “practice what you preach” should be reversed to “preach what you practice.” Physicians must serve as role models for healthy habits and lifestyle choices. An overweight doctor who smokes is hardly the example a patient should see, much less trust in the advice they give. Doctors should Smiling doctor holding an apple with focus on doctoralso embrace the other tried and true adage which says, “actions speak louder than words.”

I recently attended the TedxManhattan conference, which offered a wealth of information about changing the way we eat and encouraging healthy eating habits both at home and among patients. I have always believed that eating healthy, maintaining a normal body weight, and exercising more are three critical tenets when it comes to preventing cancer and/or its recurrence. In our DOs and DON’Ts blogs over the last two months, we discussed strategies for making healthy choices at the grocery store as well as while eating out. With a little planning and care, good nutrition and healthier living are possible for everyone.

At the conference, the speaker that left me with the most to think about was Dr. Robert Graham, an alternative medicine guru. Dr. Graham is the Director of Resident Research and the Director of Integrative Health in the Department of Internal Medicine at Lenox Hill Hospital, and has been a leader and innovator in the field of alternative medicine for the past ten years. His presentation focused on the crucial relationship between food and health. Dr. Graham explained that 80% of the chronic diseases in this country are preventable through lifestyle changes, and that “a pill for an ill” is not an effective approach to medicine. He believes that healthcare providers have a responsibility not only to treat illness, but to educate their patients about nutrition and healthy habits.

How Are Our Doctors Doing?

According to a 2012 Gallup poll , doctors are doing better than nurses and other healthcare workers in terms of smoking, eating healthy and exercising. The report states that less than 5% of physicians smoke as compared to 15% of nurses and 20% of other healthcare staff members. Physicians exercise more, but when it comes to eating and health issues related to food, it’s a mixed bag. Physicians are more likely to have high cholesterol and suffer a heart attack compared to other staff, but they are less likely to be overweight, have diabetes or suffer from high blood pressure.

The results of a second Gallup poll conducted in July of 2013 showed that things are moving in the right direction . Specifically, the report states that 71% of Americans say their doctor does commonly discuss the benefits of engaging in regular physical exercise and 66% share the benefits of eating a healthy diet.

What Should We Expect from our Doctors?

Physicians should routinely convey the importance of healthy behaviors to their patients. Further, physicians who practice healthy habits themselves play a key role in helping their patients adopt lifestyles which will aid in the prevention of chronic disease. Erika Frank, Professor and Canada Research Chair at the University of British Columbia in Vancouver, said in a 2009 study that, “health promotion counseling by providers is more effective than outsourcing counseling to a specialist or health coach, in part because patients view general practitioners as the most trusted source of health information.”

Physicians have to do more than “talk the talk” by handing out brochures about disease and treatment options. It’s time to “walk the walk” as well, by modeling for patients how to take charge of their health through smart lifestyle choices.

Medical Test Results: When is a Positive a Negative?

LearDepositphotos_45110613_xsn how to decode medical test results in our blog on the Huffington Post! (more…)

Spotlight On: Bright Pink

My routine visit with a gynecologist in the spring of 2013 turned out to be anything but routine.

I had just moved back to New York from North Carolina (where my husband Johnny was stationed on active duty with the US Marine Corps) and was meeting with my new gynecologist, Dr. Nabil Khoury. After reviewing my personal and family history, (more…)

DOs and DON’Ts—Feed Your Brain by Using Your Head

While yDrelogoou should focus on your diet as a means to keep your body healthy and well-functioning, it’s equally important to feed your brain–because what you eat can definitely affect cognitive function. The human brain accounts for 2% of your body weight and consumes about 20% of your daily calorie intake. While scientists haven’t yet figured out (more…)

When Dealing With Illness, Don’t Go It Alone

We can all agree that going through tough times in life can be made easier when you have the moral support of a significant other, friend, or family member. Not surprisinIn the Waiting Roomgly, this is especially true when facing illness. This applies not only to visiting a friend with the flu—it also comes into play when the stakes are much higher. (more…)

Spotlight On: The Silver Lining

The Silver Lining coverHow many times have we heard the old adage: “In every cloud, there is a silver lining”? It’s hardly the thing to say when someone has just been diagnosed with breast cancer. But after Hollye Jacobs received this news at age thirty-nine, she decided to use her knowledge of the “practical” matters associated with the disease to help others. (more…)

DOs and DON’Ts: Healthy Eating Out

Drelogo

For some of us, eating out is a luxury that we indulge in only occasionally. For others, it’s a way of life born of busy days and conflicting family schedules. Wherever you fall on that continuum, (more…)