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Study: Genetic Testing for Ashkenazi Jews

Posted on: September 10, 2014

Study: Ashkenazi Jewish Descent as a Criterion for Genetic Testing
by Nancy Cohen, MS, CGC

Nancy Cohen Genetic Counselor WestchesterA new study, Population-based screening for breast and ovarian cancer risk due to BRCA1 and BRCA2 (abstract available in PubMed), suggests that population screening of Ashkenazi Jews for BRCA mutations may be beneficial because the cancer risks of those without a family history suggestive of a BRCA gene mutation were shown to be very similar cancer risks to those with such a history.

Since 2.5% of Ashkenazi Jews harbor BRCA mutations, and increased cancer surveillance and cancer risk reduction have been shown to improve outcomes for mutation carriers, such screening may have a useful role in this population. It will be interesting to see whether or not the guidelines from the NCCN will be adjsted to reflect this study.

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Study Shows Exercise Lowers Risk of Breast Cancer and Recurrence

Posted on: September 4, 2014

Take a Walk and Reduce Your Risk

A recent study found that postmenopausal women, who in the past four years had undertaken regular physical activity equivalent to at least four hours of walking per week, had a lower risk for invasive breast cancer compared with women who exercised less during those four years, according to data published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

At the Breast Institute at Northern Westchester Hospital, we encourage the entire health and wellness of our patients, whether it is prior to diagnosis, all the way through survivorship of breast cancer.

As part of the care we provide, we discuss prevention with our patients, as well as prevention of recurrence of breast cancer.  A sedentary lifestyle can impact a patient’s risk for developing breast cancer, so we encourage all of our patients to add exercise such as walking or bicycling to their regular routines if they are not already doing so.

A combination of exercise and a healthy diet will also help manage weight, another risk factor tied to developing breast cancer.  The following tips could help reduce developing breast cancer, as well as work to prevent developing a recurrence in our survivor population:

•    Regular exercise (walking, bicycling);
•    Weight reduction, if applicable;
•    Stop smoking.

This is good advice for all people, and it certainly applies to lowering one’s risk of developing breast cancer or a recurrence.

It is important that you have access to a full spectrum of experts skilled in the latest advancements in breast health.  Our team of dedicated professionals includes geneticists, radiologists, oncologists, cancer and reconstructive surgeons, integrative medicine practitioners and oncology nurses, each with experience and expertise in restoring women to their best possible health.

Editor’s Note: Dr. Philip Bonanno is Director of The Breast Institute at Northern Westchester Hospital

Northern Westchester Hospital Dietitian Shares Tips to Prevent Foodborne Illnesses

Posted on: August 28, 2014

Keeping Your Food Safe

By Stephanie Perruzza, MS, RD, CDN

Stephanie Perruzza MS, RD, CDN Northern Westchester Hospital

Every year, one in six Americans (about 48 million) gets sick from foodborne illnesses and 128,000 are hospitalized, according to the Center of Disease Control. The good news is most foodborne illnesses can be prevented with simple food safety tips. September is National Food Safety Month, which focuses on the importance of increasing food safety awareness.

Children, pregnant women, and those with weakened immune systems are often more susceptible to foodborne illness. To reduce your risk, follow these simple steps:

 

Clean
• Clean your hands and all cooking surfaces (counters, utensils, cutting boards) with hot soapy water before preparing or eating meals
• Consider paper towels to clean surfaces; if you use cloth towels wash them often.
Cook
• Use a food thermometer to cook foods to proper internal temperatures, for example poultry should reach an internal temperature of 165°F and fish to 145°F.
• Bring sauces, soups and gravies to a boil when reheating. Heat other leftovers thoroughly to 165°F.
Chill
• Keep your refrigerator at 40°F or below and your freezer 0°F or below to reduce risk of foodborne illness.
• Never defrost at room temperature.  Three safe methods to thaw are: in the refrigerator, in cold water or in the microwave. If you are thawing in cold water or the microwave food must be cooked immediately.
Separate
• Separate raw items (poultry, seafood) from other food items in grocery bags and in your refrigerator. Store raw items on shelving below cooked or ready to eat items.
• Use separate cutting boards for items like fresh produce and raw meats. I find that color-coded cutting boards (green for veggies, red for meats) work best to help prevent cross-contamination.

Myth Busters:
Below are some common food safety myths:
MYTH: Glass or plastic cutting boards don’t hold harmful bacteria like wooden cutting boards do.
FACT: ALL cutting boards can be a breeding ground for bacteria regardless of type.  It’s important to wash and sanitize after each use. Solid plastic and glass are dishwasher safe; however, wooden don’t hold up very well. Once cutting boards become old with cracks and excessive knife scares it’s time to dispose.
MYTH: Rinsing my hands under running water kills germs.
FACT: Water with soap is the best way to wash your hands and remove harmful bacteria. Be sure to scrub both the front and back of your hands under running water. Sing Twinkle, Twinkle Little Star twice (about 30 seconds) to ensure your hands are clean, dry with a clean MYTH: Pre-packaged produce does not need to be washed before eating.
FACT: Just because produce is pre-packaged doesn’t mean that it’s ready to eat. Ready the label to make sure it states, “ready to eat” or “triple washed,” if it does you’re good to go!

FightBac!® is a campaign created by a non-profit organization called Partnership for Food Safety Education. It aims at improving public health and food safety by bringing together health educators and other partnered organizations to increase awareness and reduce the risk of foodborne illness. For more information on food safety please check out the following credible websites:
www.FightBac.org
www.FoodSafety.gov
www.HomeFoodSafety.org

Dr. Forcade on a Promising Treatment to Help Patients Battling Metastatic Liver Cancer

Posted on: August 25, 2014

When There is No Cancer Cure, There Can be ‘Cancer Control’

Carlos Forcade, MD

Chief, Interventional Radiology, Northern Westchester Hospital

Some radical cancer therapies are being replaced in favor of treatments that honor a person’s wish for quality of life over prolongation of poor life.

One example is an interventional radiology treatment at Northern Westchester Hospital using trans arterial radioembolization, or TARE.  TARE shows promise in prolonging quality of life for many patients battling liver cancer and metastatic colorectal cancer in the liver.

This unique interventional treatment delivers Yttrium-90, a radioactive isotope, directly to a tumor through the vascular system. It is a scientifically sophisticated technique for giving NWH patients a cancer treatment that doesn’t harm the healthy cells.

First, What is Interventional Radiology?

A subspecialty of Diagnostic Radiology, Interventional Radiology uses image guidance to perform minimally invasive procedures to treat a wide range of diseases.

Better Outcome for Our Patients

More than three-fourths of liver cancer patients can’t have surgery; TARE with Yttrium-90 gives patients more time.  And as an interventional radiology procedure, it offers the benefits of a minimally invasive treatment:

  •    Reduced infection rates, risk, pain and recovery time
  •    Shorter hospital stays
  •    Uses under local anesthesia instead of general anesthesia

TARE with Yttrium-90 is an advanced treatment that is invaluable for patients with primary and secondary malignancies of the liver who have previously exhausted or who do not have other options in combating their liver cancer.

How TARE with Yttrium-90 Works

Tumors need a blood supply, which they actively generate, to feed themselves and grow. Interventional radiologists are uniquely skilled in using the vascular system to deliver targeted treatments via catheter throughout the body. In treating cancer patients, Interventional Radiologists can attack the tumor from inside the body without medicating or affecting other parts of the body.

Combining the radioactive isotope Yttrium-90 (also known as Y-90) into microspheres to deliver radiation directly to a tumor allows for a higher, local dose of radiation to be used-without subjecting healthy tissue in the body to the radiation.

 trans arterial radioembolization Northern Westchester HospitalEach microsphere is about the size of five red blood cells in width. These beads are injected through a catheter from the groin into the liver artery supplying the tumor. The beads become lodged within the tumor vessels where they exert their local radiation that kills the cancer cells. Y-90 radiates from within and is administered via the hepatic artery. Y-90 treatment is approved by the Food and Drug Administration for the treatment of inoperable liver cancer and metastatic colorectal cancer in the liver.

While this advanced treatment doesn’t cure liver cancer, the lives of patients at NWH are being extended and their quality of life is improved with Yttrium-90 microsphere treatment.

The Team Approach at NWH

Paramount to the application of this leading-edge treatment is the multidisciplinary collaboration at Northern Westchester Hospital between the Interventional Radiology Department and the Radiation Oncology Department, led by Dr. Alfred Tinger, Chief of Radiation Oncology in The Cancer Treatment and Wellness Center.

There are other interventional radiology treatments available at Northern Westchester Hospital that are used to treat primary liver cancer, as well as other cancers that have metastasized in the liver, such as colorectal cancer, breast cancer, gynecologic cancers, melanoma, and others. These nonsurgical interventional radiology treatments are:

  • Trans arterial embolization (TAE)
  • Trans arterial chemoembolization (TACE), which delivers chemotherapy directly to the liver
  • Radiofrequency ablation (RFA), which kills the tumor with heat to treat the cancer locally.

Editor’s Note:  Carlos Forcade, MD, is Director of Interventional Radiology at Northern Westchester Hospital in Mt. Kisco, NY.  For more information or for a referral please call the Interventional Radiology Department at 914.242.8154

NWH is one of only 5 Hospitals in New York State to offer Yttrium-90 therapy for the treatment of liver cancer. (The other hospitals are: Memorial Sloane-Kettering, NYU, Mt. Sinai and NY Presbyterian.)

Northern Westchester Hospital Chief of Dermatology Talks Skin Cancer and Melanoma

Posted on: July 31, 2014

Melanoma: The black sheep of the family

By Dr. Ross Levy

Of the three common types of skin cancer, melanoma is the most worrisome. This aggressive cancer is deadly when caught late. Skin cancer in general is on the rise: Fifty years ago, one in 2000 people developed a melanoma. Now it’s one in 35. By gaining a better understanding of melanoma and its causes, you remove some of the scare and can protect yourself. Continue reading