October 2015 - Five Star Family Care

Advancements in Breast Cancer

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October is National Breast Cancer Awareness Month and a great time of year to get screened and learn about new treatment options. Breast cancer research has advanced considerably over the past 30 years, but there is still a lot to learn about this increasingly common disease. Thankfully, there is an active community of scientists, healthcare professionals and support groups engaged in educating the public and promoting better disease management. And their advice is simple: prevent, screen and treat.

What is Breast Cancer?

Breasts are composed of subcutaneous fat, but the lumpy feeling we associate with breast cancer only rarely occurs in fat tissue. Cancerous cells are more likely to develop in the lobes, lobules and ducts that join around the nipple. Ductal carcinoma is the most common type of breast cancer and can spread through the blood and lymph; lobular carcinoma is typically found in both breasts, but rarely spreads; inflammatory cancer, which swells the entire breast, is the least common breast cancer.

Breast Cancer Prevention

There is only so much we can do to prevent breast cancer, and certain risk factors, such as genetic predisposition, are completely out of our control. We can, however, pay attention to our lifestyles, eat healthy, avoid carcinogens and take preventative medicines when appropriate. Lifestyle changes to consider include exercising, quitting smoking, drinking less alcohol and keeping a healthy weight. Studies have shown that obesity increases the risk for breast cancer, especially after menopause, so maintaining a healthy diet is critical. But lifestyle changes are never a sure bet; the truth is that we’re all cancer–susceptible to some degree, so the best way to beat breast cancer early is to screen for it.

Screening

This year’s Breast Cancer Awareness Month includes a National Mammography Day on October 16th. Of all the screening methods, mammography is by far the most common, though the medical community is split regarding its efficacy. Recent studies suggest that mammography screenings do not lead to a reduction in mortality among cancer patients generally. There is also the risk of over diagnosis—when pathology is detected, but the cancer never progresses to symptoms or death—which has been shown to occur to at least one in five women who receive mammograms. However, a more successful “work–up” process has been standardized in recent years that combines mammography, diagnostics and optional biopsy. Otherwise, there are also MRI screenings and clinical breast examinations, both of which have been shown to be efficacious.

Treatment

Breast cancer treatment varies widely based on the stage at which the cancer is found. Surgical procedures, such as mastectomy and lumpectomy, are standard measures taken to resect a tumor once found. If the cancer has spread beyond the original tumor, medication and radiation (chemotherapy) are used in tandem to halt metastasis and kill circulating tumor cells in the bloodstream. Estrogen blockers are the most common drugs used in breast cancer treatment, but current research is focusing on target–specific drugs that bind directly with cancerous cells, leaving a patient’s normal cells intact.

What Can You Do?

National Breast Cancer Awareness Month is an opportunity to stay informed and spread the word about developments in breast cancer management. Think about scheduling an appointment with your doctor for a preventative screening, practice self–breast exams regularly at home and get the facts straight about what you need to stay healthy. The more you know, the more prepared you will be.

Peanut Allergies in Children

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Peanuts—which are actually not nuts at all, but legumes, like lentils and peas—are the most common cause of severe food allergies in children. And the distinction is important: tree nuts, such as almonds, cashews and pecans can cause their own allergic reactions, but these nut allergies are typically less severe. An allergic reaction to peanuts, however, can lead to severe anaphylaxis (swelling), uncontrolled vomitting, cardiac arrest and even death. And it doesn’t take much, especially in young children: even trace amounts of peanut can lead to severe reactions in some cases. As a parent, this can be very scary. Fortunately, there are steps you can take with your family doctor to ensure that your child is properly diagnosed, treated and prepared in case of emergency.

Diagnosis

The incidence of peanut allergy is on the rise, particularly among young children, so it’s a good idea to take your child to the doctor if you notice any strange reactions to food. Even mild symptoms, such as itchiness or rash, can worsen over the years, sometimes developing into full-blown anaphalyxis. When you see your family doctor for diagnosis, she will likely recommend one of the following:

  • Blood test. This is a measure of allergen-specific antibodies, known as Immunoglobulin E (IgE), in the bloodstream.
  • Skin Test. The skin is exposed to peanuts (usually an extract), followed by a needle prick. The doctor will then check for bumps and rashes.
  • Elimination diet. Also known as an “oral challenge,” this test involves an elimination of peanuts for at least two weeks, followed by a steady increase in peanut exposure over time. If your child has experienced severe reactions in the past, this test is not recommended; the risk may be too high.

Management

Once a peanut allergy has been identified, your child’s best bet is simply to avoid peanuts altogether. Provide examples of food items that contain peanuts, and teach them not to accept any food before asking. It’s also a good idea to inform teachers, coaches and friends about the allergy. Peanuts are common ingredients in baked goods, candies, energy bars, cereals and granolas, so diet management is very important. Otherwise, be ready with treatment options in case of a reaction.

Treatment

If an allergic reaction does occur, epinephrine is the primary treatment for anaphylaxis. Be prepared by always carrying an autoinjector, such as an EpiPen or Twinject, and learn how to use the device just in case. The syringe should contain a complete dose, which can be injected with a needle in the upper thigh.

In case of severe reactions, such as abdominal pain and heavy asthma, it’s best to take your child to the ER or Urgent Care as well. Unfortunately, there are no approved therapies on the market to prevent or mitigate peanut allergy as such, but there have been recent advances that do show some promise. As a rule, strict avoidance is the best option to prevent allergic episodes; and, as always, hope for the best and prepare for the worst!