Category Archives: Cancer Treatment & Wellness Center

Preventing Cervical Cancer Screening

Posted on: January 23, 2015

Women – This Regular Screening Can Save Your Life

by Dr. Navid Mootabar

There’s important news for every woman in a recent report from the Centers for Disease Control and Prevention (CDC): Despite evidence that cervical cancer screening saves lives, iStock_27565368_Women_Coffee_HiRezabout eight million women, ages 21 to 65 years, have not been screened for cervical cancer in the past five years. In addition, more than half of new cervical cancer cases occur among women who have never or rarely been screened.  Here, I explain which tests you need, when to get screened, and demystify the protective HPV vaccine. I also offer women a silver lining: You rarely have to worry about advanced cervical cancer if you are regularly screened.

Did you know that cervical cancer was the leading cause of death among women 40 years ago?

The introduction of screening through the Pap smear has caused the disease to drop to the fourth cause of female mortality. But that incidence could be lowered even further if more women had the recommended Pap test. To understand this screening’s exceptional value, you need to know more about the primary cause of cervical cancer: Human Papillomavirus (HPV).

HPV causes approximately 90 percent of all cervical cancer cases.

This sexually transmitted virus is so common, most people will contract it at some point in their lives. There are many strains (types) of HPV. Certain HPV strains are responsible for changes on a woman’s cervix that can result in cervical cancer. Other strains may cause genital or skin warts.  Additional factors that contribute to an increased risk for cervical cancer include smoking, extended use of birth control, and having multiple sexual partners.

Most women who have cervical cancer will have no symptoms. However, infrequent symptoms may include unexplained vaginal bleeding, bleeding after intercourse and abnormal vaginal discharge. What’s more, the strains of HPV that may lead to cervical cancer are also asymptomatic.

Regular screening for cervical cancer has extraordinary life-saving potential.

The screening test — the Pap smear– involves brushing cells off the cervix, which are then examined for abnormalities. Our goal is to identify cervical cancer in a precancerous state, when it is highly curable. The impact of identifying the disease early through a Pap smear is evidenced by the fact that, from 2001 to 2010, the incidence of the disease decreased by almost two percent per year.

So when should you get screened? New guidelines recommend that women start at age 21. A Pap smear is recommended every three years, combined with an examination of the same cervical cells for HPV, until the age of 65, provided you have no risk factors or abnormal Pap smears. At 65, screenings can be discontinued if there have been no abnormal results in the previous 10 years, or no history prior to the past ten years of moderately pre-cancerous growth.

“Seeing your gynecologist annually is a vital
part of a woman’s comprehensive health care.”

The three-year guideline takes into account that for most women, cervical cancer doesn’t progress quickly. Very rarely does it advance from normal to cancer in one year. Therefore, if a woman is screened every three years, there is every likelihood the disease will be caught while still in the highly curable pre-cancerous stage.

Keep in mind that the guideline represents the minimum number of screenings you need to be safe. However, some women require more frequent screenings. At each visit, your gynecologist will determine if it is appropriate to do a Pap smear, by assessing all risk factors.

There are two other forms of prevention for cervical cancer.

One is the condom. The other is the HPV vaccination, which protects women from several of the most common and aggressive strains of HPV that can lead to cervical cancer. However, it does not protect against all strains that can lead to the disease. The vaccine – a series of three injections over six months – is recommended any time from age 9 to 26. Because HPV is transmitted through intercourse, I often recommend to my patients that they wait until they are considering becoming sexually active. Many parents question if their daughter needs the vaccine at such an early age.  The decision as to when to receive the vaccine is very individual, and I believe it should be made in consultation with the patient’s gynecologist or pediatrician.  I want to stress that the vaccine does not replace regular Pap smears.

Treatment for cervical cancer in the pre-cancerous stage can be as simple as an office procedure called a LEEP (loop electrosurgical excision procedure) which involves a local anesthetic and removal of all pre-cancerous cells from the cervix. There is a low incidence of recurrence. If the disease advances to cancer, treatment depends on the stage and the woman’s wish to remain fertile.  It can involve a cone biopsy, in which the outer portion of the cervix is removed; a hysterectomy, involving removal of the uterus and cervix; or radiation therapy.

It is essential to understand that, although the recommendations call for a Pap smear every three years, seeing your gynecologist annually is a vital part of a woman’s comprehensive health care. Pelvic exams, Pap tests and cancer screenings can help prevent illness and detect problems at an early and potentially more treatable stage. All women need to be diligent about visiting their gynecologist each year.

Editor’s Note:
Dr. Navid Mootabar is a member of Westchester Health Associates in Mount Kisco, NY. He is the Chief of Obstetrics and Gynecology and a Director of the Institute for Robotic & Minimally Invasive Surgery at Northern Westchester Hospital. He received his medical degree from the Mount Sinai Medical School, where he also completed his residency in Obstetrics, Gynecology, and Reproductive Medicine. Dr. Mootabar completed his undergraduate courses at Columbia University and was named among “America’s Top Obstetricians and Gynecologists” from the Consumer Research Council of America. Dr. Mootabar has received advanced training in robot-assisted Single Incision Laparoscopic Surgery (SILS) and utilizes this approach for select gynecologic surgery procedures.

 

 

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Health Benefits of Yogurt

Posted on: October 24, 2014

Deciphering the Yogurt Aisle: Get cultured!

By Elisa Bremner & Amy Rosenfeld

Yogurt ParfaitIt’s official!  Governor Andrew Cuomo named yogurt New York’s official state snack on October 15.  The Governor expects to raise public awareness of the health benefits of yogurt and economic benefits of supporting local yogurt industry. New York has become the nation’s top yogurt producer (making 741 million pounds of the dairy product last year), and health-conscious New Yorkers are literally eating it up.  Here are some of the great health benefits of consuming (the right kind of) yogurt. Continue reading

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

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?

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