Month: October 2018

How strong are your bones?

We frequently hear talk of osteoporosis, but do you know what it is—or if you have it? Osteoporosis literally means “porous bones.” It is a disease in which bone tissue and mass deteriorate, leading to frailty and a susceptibility to fractures.

“The kicker,” says Dr. Mary Wemple, a rheumatologist at Pacific Medical Centers, “is that this bone-loss condition occurs without symptoms. That’s why screening is so critical.” Because bones weaken gradually, people may not know that they have osteoporosis until a sudden strain, bump, or fall causes a fracture. In some serious cases, even a sneeze can cause a rib to break. Hip and spinal fractures can be significant, possibly leading to a hospitalization or surgery, a reduced ability to walk unassisted, or further injuries and decline. “Though osteoporosis cannot be cured, it can be effectively treated,” Dr. Wemple stresses. “And it’s important to note that it can be prevented.”

Who Gets Osteoporosis?

Of the 10 million people who have osteoporosis, 80 percent are women. Older women are particularly susceptible. Women can lose as much as 20 percent of their bone mass in the five to seven years following menopause. If you are a woman over age 65, screening is highly recommended. If you are younger than 65, but have risk factors for osteoporosis, you may benefit from screening.

While osteoporosis is more common in women, it certainly can affect men as well. Men who are over 70 years old should discuss bone density screening with their primary care doctor. Men younger than 70 may benefit from screening if they have risk factors for osteoporosis.

Bone Density Screening

One method of screening that your primary care physician might suggest is a bone density test or scan. A bone density scan is a quick, painless procedure using an enhanced, low-radiation form of X-ray technology called DXA (pronounced “dexa”). DXA, which stands for dual-energy X-ray absorptiometry, is the most-often used method to diagnose bone loss. The DXA test can also assess your risk for developing fractures.

If your bone density is found to be low, you and your physician can work together on a treatment plan, which might include medication, to help prevent fractures before they occur. Future DXA scans can track the effects of your treatment.

Pacific Medical Centers, where Dr. Wemple works, has three locations where you can receive a DXA scan: Canyon Park, First Hill and Beacon Hill. Prior to scheduling your DXA scan, please contact your insurance company to determine if you need a referral from your primary care provider. Many insurance companies do allow patients to get a DXA scan without a referral.

Preventive Measures

The National Osteoporosis Foundation recommends the following five steps to optimize bone health and help prevent osteoporosis:

  • Get the daily recommended amounts of calcium and vitamin D
  • Engage in regular weight-bearing and muscle-strengthening exercise
  • Avoid smoking and excessive alcohol
  • Talk to your healthcare provider about bone health
  • Have a bone density test and take medication when appropriate
  • Consult your physician for advice regarding appropriate dose of calcium and vitamin D and the right exercise program for you.

Combating cancer

PacMed provider answers questions related to breast health and cancer prevention

Breast cancer is an ever-present and unfortunate reality in America. One in eight women are diagnosed with the disease in their lifetime, and it is the second leading cancer-causing death among women in the United States, according to the National Breast Cancer Foundation. With staggering statistics across the board and so many people impacted by its very existence, the reasons to be vigilant about breast health are numerous. In honor of Breast Cancer Awareness Month, Pacific Medical Centers’ Hematologist and Medical Oncologist Atis Barzdins, MD, explains how this sickness affects not only the women diagnosed, but their loved ones, survivors, and men as well.

What biological and environmental factors play a role in developing breast cancer?

The most significant predictors of breast cancer risk are genetic factors, reflected by personal and family cancer history. The risk is significantly higher if breast cancer was previously diagnosed in a person’s first or second-degree relatives before the age of 45, and/or if more than one relative has been affected. Also, the presence of other cancers, especially ovarian cancer, can be associated with hereditary cancer syndromes that also may carry significant breast cancer risk.

While breast cancer is common all around the world, the incidence rates are the highest in the developed Western countries (North America, Europe, Australia and New Zealand) and lowest in Asia and sub-Saharan Africa.

The factors known to be associated with higher risk, which are more prevalent in the industrialized world, include: increased fat intake and weight gain after menopause, earlier start of menstruation, working night shifts, using alcohol, hormone replacement therapy during menopause, having fewer pregnancies, less breastfeeding or a later age at first birth. (In other words, having a baby before the age of 30 is protective).

What routines and exams should women receive on a regular basis to monitor breast health? What day-to-day habits should people adopt to do the same?

Breast cancer screening needs to be tailored in discussion with a doctor, according to a person’s risk factors, specifically family history. Genetic testing for hereditary cancer syndromes may be warranted if there is a strong family cancer history. High-risk patients, such as those with BRCA gene mutations, may need to start screening as early as age 25, and the screening strategy may entail breast MRI and breast exams by a healthcare specialist.

For average-risk women, the American Cancer Society (ACS) recommends the following:

  • Women between ages 40-44 have the option to start screening with a mammogram every year
  • Women ages 45-54 should get mammograms every year
  • Women 55 and older can switch to a mammogram every two years, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and expected to live 10 more years or longer.

Research has not shown a clear benefit to regular breast self-exams. Most often when breast cancer is detected because of symptoms (such as a lump), a woman discovers the symptom during usual activities such as bathing or dressing. ACS recommends women be familiar with how their breasts normally look and feel and report any changes to a healthcare provider right away.

Do you have any suggestions for individuals who are in remission? What can they do to decrease their odds of recurrence?

Many breast cancer patients are recommended further treatments after breast cancer surgery, even when all the known cancer has been successfully removed. These “adjuvant treatments” help to decrease the risk of cancer recurrence and are prescribed by oncologists based on individualized risk assessment and features of the cancer. Because we cannot often be certain that some cancer cells haven’t escaped the surgical treatment, adjuvant treatments are very important for many patients, as they are geared towards reducing the risk of developing metastatic disease, which is cancer that has spread to distant organs.

Today, there is generally no cure for metastatic breast cancer, although the treatments for patients who cannot be completely cured have significantly improved, and many women live for many years, even decades.

Healthy lifestyle choices, especially physical activity, diet and weight control, and minimization of alcohol intake have been linked to improved cancer outcomes, particularly in survivors of breast cancer. Lifestyle modification can be an empowering and effective way to boost physical and mental health in breast cancer survivors.

Although breast cancer primarily affects women, it is also possible for men to be diagnosed. What advice or precautions do you have for men in this regard?

In the United States, between 0.5-1 percent of breast cancer cases are diagnosed in men. As with women, the risk of breast cancer in men increases with age. Men tend to be five to 10 years older than women at the time of diagnosis.

The typical first symptom of breast cancer in men is a firm, painless mass, usually next to or underneath one of the nipples. This always requires immediate attention and evaluation.

Is there anything else you would like to share regarding breast health?

About one in eight U.S. women will develop invasive breast cancer. However, due to great medical advances, around 80 percent of the women diagnosed with breast cancer in the United States will survive it. When breast cancer is found in the early stages and treatment is initiated promptly, the chances for a positive outcome are improved. Over time, treatments have become less invasive and are tailored more accurately to the individual risk. This allows most women today to avoid mastectomy and chemotherapy. Because early detection is so critical, I encourage all women to address their breast cancer risk with a sense of importance and without fear.

Dr. Atis Barzdens is an oncologist at PacMed.

Better with Age

PacMed expert gives insight on healthy aging

It’s no secret that getting older isn’t quite what younger versions of ourselves hoped it to be. As years pass, bedtimes are traded for backaches; summer vacations are forfeited for overtime; and the youthful, spritely mentality we once took for granted wanes as our age makes the steady numerical climb. Fortunately, there is a silver (pun intended) lining to aging — it’s entirely possible to live a fruitful life by being steadfast in the pursuit of health. Like a fine wine, it is possible for people to get better with age. Pacific Medical Centers’ Family Practice Physician Dr. Priyanka Naik, DO, is here to explain how this is possible.

Aging is inevitable, naturally. Although changes to the mind and body are par for the course, what steps can people take to ensure longevity and long-term health?

It’s important to lead an all-around healthy lifestyle, both physically and mentally. This can be done by making permanent, positive lifestyle changes that are sustainable in the long term. For example, the American Cardiology Association recommends moderate-intensity exercise for 150 minutes each week, or high-intensity exercise for 75 minutes each week. When it comes to eating, the Mediterranean diet is incredibly heart healthy and supports long-term health. Lastly, I recommend exploring meditation as a way to reduce stress and live a mentally healthy life.

What exams should men and women receive on a regular basis to keep tabs on their health?

Age-related preventive screening is the key. For females, regular Pap smears, breast cancer screenings and colon cancer screenings are incredibly important. Males should also be getting colon cancer screenings, along with regular prostate checks. In general, it’s vital for all to receive their routine recommended vaccines, and annual preventive visits are the perfect time to discuss this with your primary care provider.

The life of military personnel can be demanding and stressful. What suggestions do you have for aging individuals with busy lifestyles?

I always recommend establishing a go-to exercise routine and making it part of your lifestyle, rather than a chore. Busy lifestyles can also make it difficult to focus on nutrition, but I believe a balanced diet should always remain a priority. Lastly, carve out time in your week to focus on yourself with an activity such as meditating, reading or taking a walk outside. Personal time is a great way to relax and ease the stresses of everyday life.

What daily habits can be adopted as we age to combat the negative aspects of aging?

Adequate sleep, balanced nutrition and regular exercise are three key habits of a healthy lifestyle. Everyone has the power to take control of their own health. Establishing routine care with a primary care provider to discuss your goals at least once a year is a great way to do this. It’s also important to simply acknowledge changes that may be going on with your physical and mental health, embrace it and take action accordingly.

Is there anything else you would like readers to know about healthy aging?

Aging is inevitable, but everyone should certainly feel empowered to be in charge of their own health. I also encourage everyone to seek a primary care provider’s help, as it can be incredibly beneficial in understanding your personal risk factors for certain diseases based on family history. Prevention is always the key, and that is why annual checkups are so critical.

From the Living Well Alliance—Don’t Let Autumn Stall You! Keep Moving at Work

Autumn exercise can seem like such a challenge because of the cooler weather and darkness outside. Children are heading back to school. Our schedules feel busier. And yet, physical activity helps not only the body, but also the mind. When we are active, we are better able to focus and be productive at work. We also feel happier and less stressed, and we tend to get more quality sleep at night.

So how can you stay active this fall? Try these tips for moving more at work.

Minimize the time you spend sitting. The average time sitting at work is 6.2 hours. Researchers say these long hours of sitting correlate to greater risk for heart disease and diabetes. And unfortunately you can’t undo these periods of sitting with one longer workout after work. So, it’s important to interrupt long periods of sitting with consistent movement.

Get up and move. To keep your muscles, joints and mind’s productivity at their best, sit for no more than 30 minutes at a time. Take a two-minute moving break at least twice an hour to stretch or walk around. Stand up, move about, try some stretches. Try these resources on Stretches and Walking Your Way to Health.

Find exercise you like to do! Whatever you choose, you have to enjoy it to keep up a routine. For example, if you hate squats, use the same muscles by taking a walk up a slight hill instead. Don’t want to get out your biking gear? Maybe a jump rope would be quicker and easier workout for you.

Get a friend or colleague to join you. Peer pressure isn’t always bad, especially around exercise. Have a friend join you on a morning walk for a chance to catch up on each other’s lives.

Work different muscles throughout the day. We often forget about our upper body (think T-Rex arms), so try some of these exercises using a resistance band. These bands are easy to store at work and are affordable.

Recipe: Pomegranate Salsa with Salmon

Salmon PomegranateThis cancer-fighting recipe includes healthy fats, antioxidants and lots of flavor. Never had pomegranate molasses before? It’s a unique combination of sweet, sour and salty that can be used in other Mediterranean-style dishes like dips, salad dressings, cocktails and sauces.

Note: Prepare quick pickled onions and salsa 1 hour to 1 day in advance. This allows these condiments to get good flavor, and it makes dinner preparation go very quickly! If you’re short on time, use raw red onion in place of the quick pickled onions described below.

Nutrition for Cancer Prevention

By a PacMed Dietitian

Western countries have diets statistically high in fat, sugar and animal products—and also have high rates of colorectal, breast and prostate cancers, according to the National Institutes of Health. Being overweight also can increase the risk for several common cancers.

Fortunately, what you eat is one of the cancer risk factors you have the power to alter. Here are four dietary factors to prompt you to eat more healthily.

  1. Fiber and other cancer-fighting nutrients. Studies show that fiber may protect against cancer. Fiber is found in vegetables, fruits, whole grains and legumes. But the average US citizen consumes only half of the recommended 25-30 grams of fiber per day. To get more, aim to fill half your plate with fruits and vegetables, and make at least half your grains whole grains.
  2. Fat intake. Recent studies show that consuming too much fat affects cancer risks. The average US diet contains about 37 percent fat. The National Cancer Institute suggests lowering your intake to 30 percent—and other studies find that going well below 30 percent may have an anti-cancer effect. To make a change in fat intake, cut back on saturated fat sources like meats, processed snack foods and desserts. These foods have lots of calories from added sugars and solid fats, but few nutrients.
  3. Meat. Smoking, salting, adding nitrates and cooking at high temperatures can convert meats into cancer-causing compounds within the colon. Your best bet is to limit processed meats and instead eat a variety of fish, skinless poultry and lean cuts of pork and beef. Also consider eating plant-based sources of protein such as beans, nuts and soybeans more often.
  4. Alcohol. Excessive intake of alcohol raises one’s risks for cancers of the breast, mouth, pharynx and esophagus, as well as potential stomach, liver and colon cancers. Alcohol is considered more harmful when combined with smoking. The Academy of Nutrition and Dietetics recommends limiting alcoholic drinks—if consumed at all—to one serving daily for women and two for men. (A serving of alcohol is 1½ fluid ounces of hard liquor, 5 fluid ounces of wine or 12 fluid ounces of beer.)

Nutrition guidelines for cancer prevention are similar to those for preventing other diseases such as heart disease and diabetes. Work with your primary care provider or a dietitian to gage your overall dietary health or take this quick survey.

For more information about PacMed and our dietitian services, please visit our PacMed Dietitian page or call 206.505.1300

Flu Prevention with Handwashing

Hand WashingWe have all watched someone quickly rinse their hands in a restroom and rush out the door—or skip the sink altogether. Body fluids and viruses are invisible to the naked eye, but these germs are everywhere. They contaminate commonly touched surfaces like handles, doors, walls, counters and paper dispensers.

To help your family avoid the flu, there is no substitute for handwashing. Disposable hand wipes or gel sanitizers also work well, although they don’t remove dirt and grime.

Handwashing is one of the most effective ways to stop disease.

Wash your hands often: always before eating or preparing food, and always after using the bathroom or changing a diaper.

  1. Soap and water work well to kill germs. Rub your hands briskly.
  2. How long? At least 20 seconds—try humming “Happy Birthday” through twice.
  3. Most people miss the backs of the fingers and thumbs … fingertips … the creases in the palms.
  4. Use a paper towel to turn off faucets and to open the door.

With flu season here, give your hands the soapy wash they deserve. Take two minutes to safeguard your health—and wash your hands

Breast Cancer in Men

Yes, it’s much rarer for a man to get breast cancer. For US men, there’s a lifetime risk of about 1 in 1,000. Breast cancer in men is often diagnosed at a later stage. One reason for this may be that men are less likely than women to recognize or report symptoms to their doctor.

The Susan G. Komen Foundation offers these warning signs for men:

  • Lump, hard knot or thickening in the breast, chest or underarm area
  • Change in the size or shape of the breast
  • Puckering, dimpling or redness
  • Itchy, scaly sore or rash on the nipple
  • Inverted nipple or pulling in of other parts of the breast

If you have any concerns, contact your health care provider for a consultation.

Breast Cancer: What’s the Risk?

Breast Cancer RibbonBreast cancer remains the second-deadliest cancer in women (after lung cancer). It is important to know your personal risk factors, so you can reduce your risk through lifestyle changes and receive a breast-cancer screening that is tailored to you.

Learn Your Risk Factors

How often should you have a screening? What should your prevention strategy be? It all depends on your personal risk factors. Talk with your primary care provider about your situation.

Being female and getting older are your biggest risk factors. You are at higher risk if there’s a history of breast cancer in your family or if you have a BRCA1 or BRCA2 genetic mutation. But keep in mind: approximately 85 percent of breast cancers occur in women who have no family history of breast cancer. Other risk factors include starting periods at a young age, having your first baby after the age of 30 or never having children, being obese, and having dense breasts.

Make Lifestyle Changes

You can take positive steps to reduce your risk for many cancers. Some areas to explore: Are you getting enough exercise? Are you at a good weight? Do you smoke? Finally, how healthy is your diet? Are you eating more vegetables, fruits, beans and whole grains? How much your red meat, sugar and alcohol do you consume?

Your health care team can help you with all these lifestyle factors. For dietary inspiration, explore the recipes and ideas offered by the American Institute for Cancer Research.

Get Screened

Despite the value of knowing your risks, many breast-cancer cases develop without obvious risk factors. This is why age-appropriate breast-cancer screenings are essential for all women. The best approach to breast cancer detection is regular mammograms.

  • Mammograms should be performed every 1-2 years beginning at age 40, based upon discussion with your health care provider.
  • If you’re over age 75, the benefits of mammograms are less certain.
  • Knowing how your breasts normally look and feel can help you be aware of changes, which you can share with your provider.

Not Sure Where to Start? Ask the Right Questions

Here are some questions to ask your primary care provider at your next visit:

  • What testing should I get at my age?
  • What do I need to know about my family history that could put me at higher risk for breast cancer?
  • What can I do to prevent breast cancer or decrease my risk?

PacMed offers several options for primary care providers, an excellent place to begin a conversation about breast cancer prevention. Learn about our Primary Care team. We also invite you to explore our Women’s Health offerings and our Oncology department.