lung cancer symptoms, screening

[© Ilexx |]

According to the National Institutes of Health, “Lung cancer is the most common type of cancer in both men and women, and the majority of these cancers are directly linked to cigarette smoking.” Lung cancer is more prevalent in smokers; however, non-smokers can also get lung cancer. If you are suffering from a chronic cough, recurring pneumonia or bronchitis, shortness of breath, or have a cough that produces blood, you should see your physician.

Smokers often disregard their cough as “a smoker’s cough” and do not seek a diagnosis until the cancer is advanced. Also, some patients in their 30s and 40s falsely believe they are too young to have lung cancer and ignore their symptoms.

In addition to smoking, risk factors for lung cancer include:

  • exposure to radon
  • secondhand smoke
  • certain chemicals or asbestos
  • a family history
  • or previous radiation to the chest.

Many people think that lung cancer is a death sentence, but, when caught early, a combination of chemotherapy, radiation and surgery can significantly increase your chances of a cure. The key is to catch the cancer in its early stages through screening.

New Screening
If you are age 55 to 80, have smoked in the last 15 years, or are currently smoking and have a 30-pack-per-year smoking history, the U.S. Preventive Services Task Force recommends you receive an annual low-dose CT scan. This test allows us to see lung cancer in its earliest stages using much less radiation than a traditional CT scan. This screening has saved many lives and is available at local imaging facilities with a prescription from your doctor.

Here to Help You Quit
Cigarette smoking is the number one risk factor for lung cancer. In fact, nearly 90 percent of lung cancers in the United States are linked to cigarette smoking. Even if you have smoked for many years, quitting now can still significantly reduce your risk for developing lung cancer. If you are looking for help to quit smoking, join the Howard County Department of Health Tobacco Cessation Program or call 410-313-6265.

In recent years, many people have been turning to e-cigarettes as a substitute for tobacco cigarettes. E-cigarette users should keep in mind that the safety of electronic cigarettes has not been adequately studied (nor demonstrated). Formaldehyde, a known carcinogen, has been shown to be an inhaled vapor of e-cigarettes.

Francis Chuidian, M.D., is a pulmonologist with Johns Hopkins Community Physicians Pulmonary Medicine in Columbia.

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cervical cancer vaccine

Vaccination to protect females against the types of HPV that cause most cervical cancers is recommended for 11- and 12-year-old girls, and for females 13 through 26 years who did not get the shots when they were younger. [© Bvdc |]

January is Cervical Cancer Awareness Month

What is cervical cancer?
The cervix is the lowest part of the uterus, which opens at the top of the vagina during childbirth. Johns Hopkins Medicine notes that if the cells in the cervix begin to grow and change, they can become malignant and the cancer can spread to the uterus and surrounding organs.

What causes cervical cancer?
According to the Centers for Disease Control and Prevention (CDC), the highest risk factor for developing cervical cancer is carrying HPV, a common virus that can be passed from one person to another during sex. Worldwide studies have shown that HPV virus exists in more than 99 percent of cervical cancers and viral proteins play a role in the transformation of HPV-infected cells into tumor cells. HPV is very common and often causes no symptoms, so it can go undetected and often goes away on its own. While not all women carrying this virus will develop cervical cancer, it is important for women who know they carry the virus to have an annual Pap smear to check for changes in cervical cells.

Other things that can increase the risk of developing cervical cancer are smoking, being HIV positive, using birth control pills for more than five years, giving birth to three or more children and having multiple sexual partners.

What are the symptoms of cervical cancer?
According to Johns Hopkins Medicine, in its early stages, cervical cancer usually has no noticeable symptoms, which makes it critically important for women to have Pap smears, a test to collect cells from the cervix to check for abnormal cells or signs of malignancy. Some women do experience symptoms such as abnormal vaginal bleeding or unusual discharge, pelvic pain and pain during intercourse. These symptoms are not always signs of cancer, but it is always best to check with your gynecologist to be sure. Your doctor may recommend further screening, a pelvic exam or a biopsy.

How can you reduce your risk of getting cervical cancer?
CDC recommends the following ways to reduce your risk of getting cervical cancer:

  1. Have an annual Pap test (or Pap smear) starting at age 21.
  2. Have an (HPV) test to see if you have the virus that can cause cell changes.
  3. Get an HPV vaccination.
  4. Two HPV vaccines are available to protect females against the types of HPV that cause most cervical cancers. Both are recommended for 11- and 12-year-old girls, and for females 13 through 26 years of age who did not get any or all of the shots when they were younger. Females should get the same vaccine brand for all three doses if possible. Remember that women who are vaccinated against HPV still need to have regular Pap tests because these vaccines do not protect against HPV types found in approximately 30 percent of cervical cancers.
  5. Don’t smoke.
  6. Use condoms during sex and limit your number of sexual partners.

Cervical cancer is very curable when detected early through screening with a Pap smear. Because precancerous lesions found by Pap smears can be treated and cured before they develop into cancer, and because cervical cancer is often detected before it becomes advanced, the incidence and death rates for this disease are relatively low in developed countries like the U.S. In places where there is limited access to health care and health screenings, however, the death rates are much higher.




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calendar_2014smMonday, Oct. 20, 3:30 p.m. – 5:30 p.m. Blood Pressure Screening at Glenwood Branch. Free, walk-in blood pressure screening and monitoring offered by Howard County General Hospital: a Member of Johns Hopkins Medicine. No registration required.

Monday, Oct. 20, 3:30 p.m. Superfoods at Miller. Some foods promote health and longevity better than others. Licensed nutritionist Karen Basinger names these powerhouses and how to best use them. Register online or by calling 410.313.1950.

Tuesday, Oct. 21, 9 to 11:30 a.m. Diabetes Screening & BMI. Free. Held in Howard County General Hospital’s Wellness Center. Meet with an RN for a glucose blood test, BMI measurement and weight management information. Immediate resu­lts. Fasting eight hours prior recommended.

Tuesday, Oct. 21, 7 to 8:30 p.m. Choose Your Pediatrician and Promote Your Newborn’s Health. Free. Held in Howard County General Hospital’s Wellness Center. Learn factors to consider and questions to ask when choosing your pediatrician and ways you can promote your newborn’s health. Presented by Dana Wollney, M.D.

Thursday, Oct. 23, 7 to 9 p.m. Get Moving Again: Total Joint Replacement. Held in Howard County General Hospital’s Wellness Center. Free. Learn about total hip and knee surgery from health care professionals, past patients of our Joint Academy and Richard Kinnard, M.D.

Monday, Oct. 27, 5:30 p.m. to 9 p.m. Adult, Child and Infant CPR/AED in Howard County General Hospital’s Wellness Center. Cost is $55. This course will teach the skills needed to clear an airway obstruction, perform cardio-pulmonary resuscitation (CPR), and how to use an automated external defibrillator (AED).

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Even though all women are at risk for gynecologic cancers, the risk can be lowered, and treatments work best when these cancers are found early.
Margot Watson, M.D.

Margot Watson, M.D., chair of the Department of Obstetrics and Gynecology at HCGH.

Uterine Cancer
Uterine cancer is the most common cancer of the female genital tract, and 2.6 percent of U.S. women will develop uterine cancer in their lifetime. “It often is caught early and usually has a high cure rate because most women have an early warning sign of abnormal bleeding or bleeding after menopause,” says Margot Watson, M.D., chair of the Department of Obstetrics and Gynecology at HCGH. “Women are encouraged to see their gynecologist promptly if they experience heavy or irregular bleeding or, most especially, any bleeding – even spotting – after one year of not having periods.” Long-term use of birth control pills and the levonorgestrel-releasing intrauterine system (IUD) can greatly lessen the risk of uterine cancer.

The strongest risk factors for uterine cancer include being over 50, obesity, never having had children, previous use of Tamoxifen or a long history of irregular menstrual cycles.

Cervical Cancer
Cervical cancer is the only gynecologic cancer for which there is an effective screening test: the Pap smear. It also is highly curable when found and treated early. The human papillomavirus (HPV), which is a sexually transmitted infection, causes cervical cancer. Eighty percent of sexually active adults will acquire HPV by age 50. HPV also causes cancer of the anus, vagina, vulva, penis and many oral cancers; however, there are two vaccines available (Gardasil and Cervarix) which lessen the risk of developing cervical cancer.

“All young people, both boys and girls, should be vaccinated against HPV at age 11 or 12, the ages at which they get the best immune response,” says Dr. Watson. “It is a great advance in medicine that we have a vaccine that lessens the risk of several types of cancer.”

Regardless of sexual activity, women should have their first gynecologist visit at age 15, and Pap smears should begin at age 21. From ages 21-30, women should have yearly gynecological exams and Pap smears every three years if normal. From ages 30-65, women should have yearly exams and Pap smears with HPV testing every five years if their Pap smears are normal.

Ovarian Cancer
About 90 percent of women who get ovarian cancer are older than 40, and the greatest incidence occurs in women over 60. Risk factors are obesity, never having had children and a strong family history of breast or ovarian cancer.

Unfortunately, there is no effective screening test for ovarian cancer, and it is difficult to detect in the early stages. Some women do present with symptoms such as abdominal swelling or bloating (due to a mass or a buildup of fluid), pelvic pressure or abdominal pain, difficulty eating or feeling full quickly and/or urinary symptoms (having to go urgently or often). Birth control pills and tubal ligation greatly lessen the risk of ovarian cancer.

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Patricia Silvia’s story

When I learned I had Stage III colon cancer in July of 2012, my first reaction was that I wanted no further treatment beyond surgery—no radiation and no chemotherapy. I had just gone through several hip surgeries and another one to remove a section of my colon, which resulted in a month-long hospital stay. I had been through it all with a dear friend some years ago and, after all my friend suffered, she didn’t survive her cancer. So I opted to go to my brother’s house to be cared for with the help of visiting nurses to change my dressings and help with physical therapy.

When I was well enough to go home and live on my own, I was ready to accept my fate and my family was ready to accept my choice to not have treatment, but my sister finally convinced me to see my oncologist, Dr. Edward Lee, one more time. I waited until November to make the appointment.

The very first appointment with Dr. Lee was great. He really got it and understood that the choices had to be mine. He offered me an alternative drug that had fewer side effects, and said that if at any time I didn’t like the way it was affecting me, I could stop taking it. A PET scan showed that my cancer had not spread and Dr. Lee had me take eight cycles of the drug and one week off. After seven weeks I had painful, burning feet and Dr. Lee stopped the pills for nine days and then reduced the dose. I finished my eight cycles in April 2013.

All through the whole thing, I had this attitude that whatever is, is, and whatever isn’t, isn’t. That’s my favorite saying, because we really don’t have control over it.

Surviving cancer on my own terms has changed my life and taught me how to cope with change. I am very thankful and now I’m working on changing some eating habits to improve my nutrition, gain some weight and fully get my health back.

I attended the first annual Surviving Survivorship: Living with Cancer conference last fall and was so excited to be there. It was a wonderful adventure and a gift. The speakers were great, the classes were exciting and even the food was excellent. The seminar I enjoyed the most was the one in which I made my first mandala and I have kept it on my desk ever since. (In various spiritual traditions, especially Buddhism, mandalas are circular drawings used to focus attention and as a spiritual guidance tool for creating a sacred space and as an aid to meditation.) I am very much looking forward to the second annual Surviving Survivorship: Living with Cancer seminar on Saturday Oct. 11, 2014.

I learned that I was in remission in May 2013 and I am so happy that I decided to take a chance on being a survivor and that I’m still here to tell my story. My advice to anyone going through something like this is to give it a try. And if the first thing doesn’t work, see if something else will. I believe in miracles and I believe I have received several. I also think that through my blessed visits to the Claudia Mayer/Tina Broccolino Cancer Resource Center, the miracles have kept on coming. I love all of my friends there! A good attitude helps, too, and of course all of the prayers from friends and family and from people I didn’t even know. I am truly blessed!!


Patricia Silvia is a cancer survivor and very happy to be one. She credits Dr. Edward Lee, the Claudia Mayer/Tina Broccolina Cancer Resource Center, her family and friends, and her belief in miracles for her survival.

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creative salad mix

© Dmitriy Shironosov |

“Food is a powerful arsenal against disease,” says Lynda McIntyre, R.D., L.D., an oncology nutrition specialist with Johns Hopkins Medicine. “Consuming plant-based foods, which are rich in antioxidants, helps to protect the body’s cells from damage and decrease your risk of cancer.”

HCGH Oncologist Nicholas Koutrelakos, M.D., agrees, also noting that “eating fruits, vegetables and grains that contain beta carotene and vitamin C can help prevent cancer-causing carcinogens from forming and help to reduce obesity and heart disease.”

“I encourage patients to ‘eat the rainbow;’ in other words, eat brightly colored fruits and vegetables that are high in antioxidants,” says McIntyre. “Try to consume seven to eight servings of fruits and vegetables each day (three servings of fruit/four servings of vegetables). A serving size is a half cup, and you should try to eat at least one cup at every meal.”


Add Color and Spice To Your Diet
  • Foods that are orange and dark green (high in beta carotene): spinach, mangoes, carrots.
  • Oranges! One orange contains every anti-cancer phytochemical that has been discovered. Part of the power of the orange is in the zest – adding it to salads increases the nutrition density of that food.
  • Cruciferous vegetables: broccoli and kale (four to five times per week).
  • Vitamin C-rich foods daily: strawberries, citrus, mango, bell peppers, kiwi.
  • A variety of fruits and vegetables – not just one color – but three to four colors.
  • Plenty of fiber: 30 grams per day from whole grains, whole wheat, beans (kidney, red, lentils, garbanzo, legumes) and peas.
  • A combination of foods. Certain foods can maximize nutritional impact when combined. Foods containing beta-carotene, combined with certain fats, bolster nutrition. For example, carrots dipped in hummus and sautéing spinach in olive oil increases the absorption of the beta-carotene. When we combine foods that contain iron with those containing vitamin C, the absorption of iron is increased. For example, a spinach and strawberry salad.
  • Foods containing Omega 3 fatty acids. “Our bodies do not make these,” says Dr. Koutrelakos. “They have great nutritional benefit and are only found in foods that we eat, such as fish and beans.
  • Herbs and spices (dried is acceptable and has more concentrated antioxidant benefit):
    • Turmeric and curry are healthy additions.
    • Cinnamon: Just a half teaspoon has as much antioxidant properties as a half cup of raspberries. Add cinnamon to everything you can think of – cereal, apples, coffee – and it will increase the nutrition density of your food.
    • Thyme and oregano are powerful antioxidants – just a half teaspoon provides a lot of health benefits.


    Beyond Fruits and Vegetables
    • Eat lean protein: turkey breast and chicken breast. You can include lean red meat once a week.
    • Your cooking method is important. Keep it “slow and low” temperature whenever possible. Be careful when grilling not to char.
    • Marinades with lemon and rosemary or wine and beer help to decrease cancer-causing agents in grilling.
    • Limit alcohol intake to three to four times per week.
    • Exercise/activity is as important as diet. Studies have shown that people who are sedentary and obese are at a higher risk of getting colorectal cancer. Obesity also can increase your risk of developing breast cancer.
    • “Maintain a normal body weight. Seventy percent of my patients are overweight,” says Dr. Koutrelakos. “That is directly related to cancer. I am seeing cancer in younger patients, too, who are eating the wrong foods and foods that are too high in fructose (sugar) resulting in an increased body mass index (BMI).”
    • Keep fat intake low. High fat intake can increase your risk of developing some types of cancers.

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