By Carol Bryce
It's not unusual for a patient to arrive at MD Anderson with one diagnosis and leave with a different one.
For example, when approximately 2,700 patient cases were reviewed during September 2011, 25% showed discrepancies between the original pathologists' reports and our pathologists' reports. While the changes in diagnosis were minor in 18.7%, in the other 6.2%, the diagnosis change made a major difference.
"In some of those cases, we changed the diagnosis from malignant to benign or vice versa," explains Lavinia Middleton, M.D., professor in Pathology. "That adds up to approximately 2,000 cases per year where we can say that our pathologists' reviews have impacted patients' treatment.
"Changing the diagnosis from malignant to benign is the best call to make. This makes us feel really good."
"Review of outside material is a major component of the work done by our Pathology and Hematopathology departments," adds Stanley Hamilton, M.D., division head in Pathology/Laboratory Medicine. "The correct pathologic diagnosis and stage of each tumor are key to high quality care for patients."
How we make the correct diagnosis
So why do we find things overlooked by other health care institutions?
"Our system here helps us make the right cancer diagnosis. It's based on three things: sub-specialization, volume and redundancy," Middleton explains.
Recently in Screening Category
By Carol Bryce
A monstrous art project. A groundbreaking lung cancer screening trial. Inspiring stories from our patients and caregivers. Our mission to end cancer. These are just a few of the topics that been popular on MD Anderson's YouTube channel in 2014.
To find out what you missed -- or rediscover some favorites -- check out our top five videos from 2014.
What drives MD Anderson to end cancer
What if we could end cancer? This is the bold idea that guides everything we do here at MD Anderson. Watch our patients, survivors, volunteers and employees describe the hope they feel here and share why they believe MD Anderson is the best place to treat and ultimately end cancer:
From the gardens to the skybridge to our leading doctors and kind volunteers, there are many things that set MD Anderson apart and help our patients feel at home.
Whether it's your first appointment or you've become an old pro, you're likely to appreciate these 17 unique features.
1. Our 69 aquariums. The 66 freshwater and three saltwater live coral reef aquariums in our clinics are home to 3,000 fish -- mostly cichlids, angelfish and rainbow fish. The largest freshwater aquarium, by the Pharmacy in the Main Building, holds 850 gallons.
2. The Observation Deck. Located on the 24th Floor of the Main Building, the Observation Deck offers peace and quiet, as well as a scenic view of Houston. You're also welcome to play the piano up there.
3. Our volunteers. MD Anderson is fortunate to have more than 1,200 volunteers who contributed 193,921 hours of service last year. Stop by our Hospitality Centers for a cup of coffee and to visit with these caring individuals, many of whom are survivors or caregivers themselves.
4. Our pianos. Twenty-five of our volunteers play the piano in The Park and the Mays Clinic between 10 a.m. and 5 p.m. Mondays through Fridays. They also play at the Rotary House each day. If you're lucky, you may hear our harpist or one of our two flautists as well.
5. Room service. Inpatients -- as well as their families, caregivers and friends -- can order whatever they want from room service each day from 6:30 a.m. to 9:30 p.m. Our classically trained senior executive chef comes up with the menu of fresh, cooked-to-order meals.
By Erika Archer Lewis
Twenty years ago, while a college senior, I spent weekends commuting from Austin to Houston to care for my 42-year-old mother. She was battling an aggressive form of stage 4 breast cancer and was told her odds for survival were less than 20%. After witnessing first-hand her intense, four-year battle that included chemotherapy, radiation, bone marrow extraction, a mastectomy and breast reconstruction, I wondered for years if and when breast cancer might strike me.
A family history of breast cancer
When my young, healthy, active mother was diagnosed with breast cancer, there was no pattern of women with breast cancer in her family history. But shortly after she was diagnosed, her cousin was diagnosed with the same cancer, even in the same breast. Since that time, there have been four other women on my maternal grandmother's side of the family who have struggled with or lost their lives to breast cancer.
In late 2013, after a series of suspicious mammograms, ultrasounds, an MRI, and three biopsies, I wondered if I was doomed by the pattern within my family that had reared its ugly head decades before. With recent advances in technology and medicine, I learned there was a simple blood test for identifying genetic mutations for breast and ovarian cancer, BRCA 1 and 2. I felt an overwhelming need to know if I had what felt like a ticking time bomb inside my chest.
By Robert Bresalier, M.D.
Colorectal cancer develops in the colon or rectum, and grows slowly. In 2014, there will be an estimated 141,000 new colorectal cancer cases in the United States and 49,000 related deaths. But colorectal cancer is preventable and curable when detected early.
Here are my top four tips to help lower your risks for colorectal cancer:Tip 1: Get screened for colorectal cancer
Screening remains the most important method to prevent colorectal cancer. People at average risk, age 50 and older, should get a colonoscopy every 10 years. A colonoscopy enables your doctor to detect potentially cancer-causing lesions or polyps early, and remove them.
By Katrina Burton
MD Anderson is standing by a recommendation that women 40 years old and older receive annual mammograms, despite a recent study that raised controversy regarding breast cancer screening.
"We are not recommending that women change their screening practices," says Therese Bevers, M.D., medical director of MD Anderson's Cancer Prevention Center. "We stand by our guidelines that recommend women have annual mammograms beginning at age 40 and continue to be screened as long as they are in good health."
But a study by the Canadian National Breast Screening says annual mammography in women ages 40-59 does not reduce mortality from breast cancer and mammography screening should be revisited.
The results of the study, published in the BMJ Journal on Feb. 11, are in direct contrast to the U.S. Preventive Services Task Force recommendation that women should begin annual mammograms starting at age 50, and of guidelines by MD Anderson, the American Cancer Society and others that call for annual breast cancer screening to begin at age 40.
"By having this testing I'm protecting my family," Terry says. "Now, we have the smoke alarm."
Terry is a mother of five -- three girls and two boys -- ranging in ages from 19 to 31, and a grandmother of five. Genetic testing for the BRCA gene could let those future generations know if they are at risk for breast and ovarian cancers.
She received the results in November 2013.
"Mutated gene 5385insc-BRCA 1," the report said. That meant her children could have the gene as well.
Facing new questions after genetic testing
Terry's daughters plan to undergo genetic testing soon. Her sons are considering testing to see if they carry the gene.
Living in southern Louisiana, my family learned to endure the heat, humidity and sun. But we struggled when it came to protection from its effects, especially sunburns.
My mom was a redheaded, blue-eyed, extremely fair-skinned woman. She had her fair share of sun exposure as a child. As an adult, after several basal and squamous skin cancer scares, she realized the value of sunscreen and, really, just avoidance of the sun. She passed those values on to me since I have reddish hair, blue/green eyes and extremely fair skin.
My mother's malignant melanoma diagnosis
Mom had a growth on her face that had been examined by a local dermatologist many times, but my mom had been advised not to worry about it.
When a massive clinical trial about lung cancer screening shows a benefit to current and former smokers, why can it take so long to become accessible for most people?
A draft recommendation by a federal task force in favor of using low-dose CT scans to screen past and current heavy smokers for lung cancer provides insight about the time lag.
The recommendation says that low-dose spiral CT lung cancer screening is only appropriate for those who:
• Are 55 to 80 years old
• Have a 30-pack-year history of smoking (which translates to 1 pack of cigarettes a day for 30 years, 2 packs a day for 15 years, etc.)
• Smoke or have quit smoking within the past 15 years
companies expected to cover CT lung cancer screening for smokers
The task force carefully sorts the pros and cons of a preventive procedure before recommending for or against. Its rulings are highly influential, so both governmental and private health insurers tend to wait for its recommendations before deciding whether to pay for a procedure, Munden says.
The task force's recommended B rating for the procedure, subject to a comment period that ends Aug. 26, is significant. Right now, 95% of the people who want screening have to pay for it out-of-pocket, because only two health insurance companies cover it. Medicare and Medicaid don't reimburse for it, but the task force's recommendation is expected to change that.
"The implications are huge," says Therese Bevers, M.D., medical director of MD Anderson's Cancer Prevention Center. "Health plans, under the Affordable Care Act, are required to cover any screening or service given an A or B rating by the U.S. Preventive Services Task Force. They're not only required to cover it, but to cover it without any co-payment or deductible so the patient is able to get this at no out-of-pocket cost."
One in two men will be diagnosed with cancer during their lifetime. And, one in six men will be diagnosed with prostate cancer, the second leading cause of cancer-related deaths in American men, just behind lung cancer.
So, what can men do to protect themselves from cancer? We recently spoke with John Papadopoulos, M.D., assistant professor of Urology. He works at the MD Anderson Regional Care Center in Katy.
Here's what Dr. Papadopoulos had to say.
What are some easy tips for men to help men prevent cancer?
There are a lot of things men can do to protect themselves from cancer:
- Avoid tobacco - even celebratory cigars - and limit alcohol to no more than two drinks per day.
- Maintain a healthy weight and stay physically active each day.
- Maintain a healthy diet. Make fruits and vegetables the biggest part of every meal and go easy on the meat. Limit the amount of red meat you eat to 18 oz. week and avoid processed meats like hot dogs and pepperoni.
- Wear sunscreen and practice sun safety.
- See a doctor regularly and get the screening exams you need. Many men avoid seeing a doctor because they're afraid, but if you do have a chronic disease like cancer, diabetes or heart disease, the earlier we catch it, the easier it will be to treat.
Keep in mind that doing these things doesn't guarantee you won't get cancer. But living a healthy lifestyle can put you in fighting shape if you do develop cancer.
What cancer screening exams do men need? And, when should most men start screening?
Most men need both a prostate exam (digital rectal exam and PSA test) and a colonoscopy starting at age 50. This is the appropriate age for screening if you don't have a family history (father, son, brother) of prostate or colon cancer and you're not African American, which can make you more likely to develop these cancers.
By Megan Silianoff
As a blogger and cancer survivor, I'm knowledgeable about various topics. My favorite television shows, for example, are an area of my expertise. I'm also very good at shopping and can navigate my favorite mall with poise and purpose.
And, when I got my latest mammogram earlier this month, I was reminded that I'm also an expert at getting this important screening exam.
So, first, I'll tell you this: While mammograms can be life-saving, they aren't fun. But learning about them "David Letterman" style could be. (Which is telling of my expertise in watching talk shows.)
10. Plan to wait in a separate waiting room.
I've had mammograms in a number of different hospitals, and they all have separate waiting rooms for people getting mammograms.
Immediately upon checking in for your appointment, they'll call you back, and you'll think, "I'm going to be in and out of here," but that's not necessarily the case. You're actually just getting called to sit in a different waiting room. This is important to know if someone plans to go with you because you won't see them throughout the entire process.
March is National Colorectal Cancer Awareness Month. That means it's a great time to think about scheduling a colonoscopy if needed.
Colorectal cancer, cancer of the colon and rectum, is the third most common type of cancer in the United States, not counting skin cancers. But many early stage colon cancers can be prevented through a colonoscopy.
According to Gottumukkala S. Raju, M.D., professor in the Department of Gastroenterology, cancer begins as benign polyps within the colon and develops into cancer over years when left untreated, mainly because they are undetected without a colonoscopy.
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- How our pathologists help our patients
- 5 of our most-watched videos from 2014
- 17 things that make MD Anderson unique
- BRCA genetic testing for breast and ovarian cancers: It's easier than you think
- 4 tips to protect your colon
- When should women get mammograms?
- Triple-negative inflammatory breast cancer survivor: Facing new questions with genetic testing
- My mother's melanoma diagnosis: What a caregiver learned
- Lung cancer screening for smokers moves toward standard of care
- Cancer in men: What you should know
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