Ovarian Cancer: Symptoms, Warning Signs and Risks

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September is Ovarian Cancer Awareness Month — an opportunity to increase awareness so that women reduce their risks of the disease and detect it sooner, and so that we can all encourage public education and continued research.

According to the American Cancer Society, in 2018, an estimated 22,240 women in the U.S. will be diagnosed with ovarian cancer, and approximately 14,070 women will die from it. Women most at risk for ovarian cancer are in their 50s and 60s.

Fortunately, the rate at which women are being diagnosed has been gradually decreasing over the past two decades. Unfortunately, there is still no adequate screening test for ovarian cancer that is available, and the disease is hard to detect in its early stages when it is most treatable.

Therefore, it’s important for women to be aware of the possible warning signs and symptoms of ovarian cancer as well as to assess their reproductive history and family history of the disease. Ovarian cancer symptoms are often subtle and can be easily confused with other issues.

Ovarian Cancer Symptoms

  • Bloating
  • Pelvic or abdominal discomfort
  • Frequent need to urinate

Assess Your Reproductive and Family History

Research shows a link between the number of menstrual cycles a woman has had in her lifetime and increased risk of developing ovarian cancer. A woman is at greater risk if she:

  • Began menstruating before age 12
  • Has never given birth
  • Never took birth control pills (oral contraceptives)
  • Has experienced infertility
  • First gave birth after age 30
  • Experienced menopause after 50

Also, be aware that approximately one in four women diagnosed with ovarian cancer has a strong family history of the disease, and the greatest risk factor is an inherited mutation in one of two BRCA genes. However, women who have a grandmother, mother, daughter or sister with ovarian cancer but no known genetic mutation still are at greater risk of developing the disease.

How to Reduce Ovarian Cancer Risk

Although ovarian cancer can’t be prevented, women can talk to their healthcare providers and identify the best steps to take to help reduce risk. If ovarian cancer runs in the family, a consultation with a genetic counselor may be recommended.

Here are examples of non-surgical approaches a gynecologist may recommend:

  • Take oral contraceptives: When used for five or more years, women can cut their risk of developing ovarian cancer in half in comparison to women who have never used them.
  • Breastfeed: Breastfeeding is linked to a reduced risk of ovarian cancer, likely because a woman ovulates less often when she is pregnant or breastfeeding.
  • Lose weight: Studies have discovered a link between obesity and ovarian cancer. A 2009 study in the journal Cancer found that obesity was associated with a nearly 80 percent higher risk of ovarian cancer among women between the ages of 50 to 71 who had not taken hormones after they entered menopause.
  • Reassess hormone replacement therapy: Studies show that using estrogen and progestin for five years or longer increases the risk of ovarian cancer in women who have not had a hysterectomy. If a woman has had a hysterectomy and has used estrogen for more than 10 years, her risk also increases.

A gynecologist may also recommend a surgical procedure such as:

  • Hysterectomy: Removing the uterus can decrease the risk of ovarian cancer by 33 percent.
  • Prophylactic bilateral salpingo oophorectomy: This procedure to remove the ovaries and fallopian tubes can significantly reduce the risk of ovarian cancer.
  • Tubal ligation: Having the fallopian tubes tied can reduce risk by up to 67 percent.

Hopeful News Regarding Ovarian Cancer

Finally, be aware of this good news regarding ovarian cancer: according to the American Cancer Society, familial genetic research is beginning to offer clues about how the disease develops. Eventually, this is expected to lead to new therapies that could be used to prevent or treat ovarian cancer. Learn more.

Probiotics, Fiber and Water Help Prevent Colon Cancer

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A healthy colon is essential for overall wellness, and you can nurture your gut by making a few nutritional changes.

The large intestine, or colon, is responsible for digesting food, processing waste and supporting immunity. A well-balanced diet and proper hydration will help maintain colon function and prevent digestive disease. Colon cancer is the third-leading cause of cancer death in the United States, but most cases of colon cancer are preventable through positive lifestyle changes and routine colonoscopies.

You can be an advocate for your own colon health by consuming more fiber, probiotics and water.

Benefits of a High-Fiber Include Colon Cancer Prevention

Fiber is non-digestible plant material found in skins and peels of fruits, vegetables and whole grains. Eating five to nine servings of fresh fruits and vegetables and three to four servings of whole grains provides adequate fiber to meet the daily recommended allowance. Men should consume at least 38 grams of fiber per day and women should consume 25 grams per day.

Good sources of fiber include black beans, split peas, brown rice, oatmeal, wheat germ, oat bran, baked potato, flaxseed meal, chia seeds, avocados, pears and apples.

Probiotics Benefits

Probiotics are living strains of bacteria and yeast that regulate digestion, immune function and hormone production. A healthy colon contains 100 billion to 100 trillion beneficial bacteria per milliliter, but advanced age, illness, poor diet and antibiotic use can destroy healthy gut flora.

Eating foods that contain probiotics can fortify the gut microbiome with new colonies of beneficial bacteria. Good sources of probiotics include kombucha, kimchi, sauerkraut, kefir, miso, tempeh, pickles, and some yogurts. Many yogurts sold at commercial grocery stores have been pasteurized, which kills the probiotic cultures. When evaluating food labels, look for yogurts and fermented products that contain L. acidophilus and Bifidobacteria.

Water

Proper hydration is essential for colon health. Water is necessary for absorbing vitamins and minerals and removing toxins from the liver and kidneys. Water also binds with fiber to create bulk in the stool and helps move solid waste through the digestive tract.

A good general rule is to drink half of your body weight in fluid ounces. Stay away from caffeinated beverages like soda, coffee and black tea that are diuretics and cause dehydration and constipation.

Schedule a Colonoscopy

Finally, colon-healthy living includes routine colonoscopies at regular intervals, as recommended by your gastroenterologist. The American Cancer Society recommends that people who are at average risk for colon cancer begin screenings at age 45. Although there are other methods of colon cancer screening, a colonoscopy is the gold standard because it allows a gastroenterologist to examine the entire colon for precancerous polyps. Any suspicious polyps that are found during the procedure can be removed, so they do not develop into colon cancer.

Call your gastroenterologist to discuss your digestive health and schedule a colonoscopy. A healthy colon makes a healthier YOU.

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Colorful, Nutrient-Rich Fall Vegetables Help Prevent Eye Disease

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Your eyes need proper nourishment for lifelong, healthy vision, and fall vegetables are some of the best sources of essential nutrients.

The autumn season provides a bountiful harvest of squash, root vegetables, legumes and leafy greens that contain high amounts of antioxidants. These vitamins and minerals neutralize free radicals and protect eye cells from oxidative stress.

Research suggests that people who eat more vegetables and fruits are less likely to develop chronic diseases. A diet that is rich in antioxidants like zinc, lutein, zeaxanthin, and vitamins A, C and E can help prevent age-related eye diseases like cataracts, glaucoma and macular degeneration.

Buying produce from a vegetable stand, co-op or farmer’s market allows you to eat vegetables that are locally grown and harvested at the peak of ripeness. You’ll find that the produce tastes better because it has ripened on the vine, which also makes it more nutritious.

Vitamin or Mineral That Promotes Eye Health

  • Beta carotene and vitamin A: Pumpkins, carrots, sweet potatoes, yams, cantaloupe, acorn squash, curly kale
  • Vitamin C: Broccoli, bell peppers, Brussels sprouts, cabbage, cauliflower, turnip greens
  • Vitamin E: Swiss chard, mustard greens, parsley, pumpkin seeds, butternut squash
  • Zinc: Lima beans, spinach, beet greens, okra, sunflower seeds, peanuts, zucchini
  • Lutein and zeaxanthin: Collard greens, radicchio, watercress, arugula, green peas, leeks, broccoli rabe

Eat a rainbow of fall vegetables for optimum eye health. Incorporate red peppers, orange yams, yellow squash, green limas and purple beets into your autumn menu and remember that More Matters. Try to eat at least five to nine servings of fresh fruits and vegetables daily and purchase local produce if possible.

As the calendar year comes to a close, call your ophthalmologist for an annual comprehensive eye exam. Yearly eye check-ups are just as crucial for eye health as a well-balanced diet. Your eye doctor will test your visual acuity, evaluate your current prescription and screen you for degenerative eye disease. 

 

Fibroids: Signs, Symptoms and Treatments

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A fibroid is a type of non-cancerous tumor that forms in the uterus. Fibroids — also called uterine fibroids — consist of smooth muscle cells and connective tissue and can range from pea-sized to grapefruit-sized. An estimated 20 to 80 percent of women in their childbearing years have fibroids, although many women do not know it.

The reason fibroids develop is still not fully understood. However, what is known are the types of women most at risk of developing them. Women most at risk are:

  • African-American
  • Nearing menopause
  • Obese

Symptoms of Uterine Fibroids

Some women have no symptoms at all, while others’ symptoms are severe. And although every woman experiences a unique set of symptoms, some of the more common ones include:

  • Abnormal bleeding
  • Frequent need to urinate
  • Heavy or prolonged menstrual periods
  • Lower back pain
  • Painful intercourse
  • Pelvic pain

Fibroids Are Usually Found During a Pelvic Exam

Fibroids are most often discovered during routine pelvic exams. However, only about one-third of fibroids are large enough to be detected during an exam. If a gynecologist believes a woman may have fibroids but does not detect them during a pelvic exam, the doctor may schedule an imaging test such as an x-ray, ultrasound or MRI.

Examples of other possible tests a gynecologist may recommend are:

  • Hysteroscopy: A procedure in which an instrument called a hysteroscope is inserted into the vagina so the gynecologist can see the canal of the cervix and the inside of the uterus.
  • Endometrial Biopsy: A procedure in which the doctor numbs the cervix, inserts a thin tube into the cervix and gently suctions out a tissue sample from the uterine lining.
  • Hysterosalpingography: A type of x-ray exam that uses dye and records images of the uterus and fallopian tubes.

Deciding to Treat Fibroids or Wait

Most fibroids stop growing or may even shrink as a woman approaches menopause, so a gynecologist may recommend waiting and monitoring fibroids versus treating them. However, if a woman has fibroids that are very large or are causing pain and severe symptoms, a gynecologist may recommend treatment.

When deciding whether or not to treat fibroids, it’s important for a woman to communicate closely with her doctor and discuss things such as:

  • Overall health
  • Severity of symptoms
  • Available medications, procedures or therapies
  • Plans for future pregnancies

Types of Treatment

If the gynecologist and patient decide to move forward with treatment, there are surgical, minimally invasive and non-surgical options that can include:

Surgical

  • Hysterectomy: Surgical removal of the uterus, which also removes the fibroids
  • Myomectomy: Removes the fibroids, but leaves the uterus intact so a future pregnancy is possible

Minimally Invasive

  • Uterine artery embolization: A process in which the arteries supplying blood to the fibroids are identified and then embolized (blocked). Because the blood supply to the fibroids is blocked, the fibroids shrink.
  • Endometrial ablation: The lining of the uterus is removed or destroyed.

Non-Surgical

  • Anti-hormonal agents: A gynecologist may prescribe an anti-hormonal agent, like progestin, or a gonadotropin-releasing hormone (GnRH) agonist. These medications cause estrogen and progesterone levels to fall, which stops menstruation. This in turn causes fibroids to shrink. Additionally, it can improve associated anemia. While these prescriptions can help reduce symptoms of fibroids, they are often used temporarily or prior to surgery or embolization to help with pain or symptom relief.

For More Information

Visit womenshealth.gov to read frequently asked questions and to learn more about fibroid treatment methods. If you are experiencing any symptoms, schedule an appointment with one of our physicians today.

Schedule GI Procedures Before Health Insurance Deductible Resets

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You should never delay urgent medical procedures, but you could save money by scheduling elective and screening procedures after you have met your deductible.

Preventative Appointments and Colon Cancer Screenings

Have you ever considered waiting until the last quarter of the calendar year to schedule a colon cancer screening or GI procedure?  Annual well visits and screenings are usually covered at 100 percent under most insurance plans, but labs and diagnostic testing fees are often the patient’s responsibility. Waiting until you have met your deductible means that additional tests and labs may be covered, or at least, may be more affordable.

A colonoscopy is one procedure that can be less expensive if you have met your deductible. Under most private insurance plans and Medicare, colonoscopy screenings are covered at 100 percent for adults between ages 50 and 75. Because young-onset colon cancer incidence is steadily increasing, the American Cancer Society recommends screening colonoscopies starting at age 45. If you are under 50 and choose to have a screening colonoscopy, your cost-sharing responsibility could be much lower if you have met your deductible.

Diagnostic Colonoscopies

If you have a history of polyps or colon cancer, or you receive a positive result from another colon cancer screening test, your colonoscopy likely will be considered diagnostic. It can make financial sense to schedule a diagnostic colonoscopy after meeting your deductible.

The amount that you will pay for the colonoscopy will depend on whether you have met your deductible or not. If you schedule the procedure at the end of the year when you have already met your deductible, you may not be responsible for any out-of-pocket costs. However, if you wait until January, when your deductible resets to zero, you could be subject to a physician fee, facility fee and laboratory diagnostic fee.

Elective GI Procedures

You could also save money by scheduling other GI procedures at the end of the calendar year. Diagnostic testing and treatments for certain digestive conditions are not considered urgent and can be scheduled at a time that is most convenient for the patient. If your GI doctor has suggested a test, lab or procedure to improve your digestive health, it is most cost-efficient to schedule the appointment when you are close to meeting your deductible. Do not delay too long, though. With the approaching holidays, appointment availability will rapidly diminish, so look over your calendar and call soon.  

Elective GI Procedures to Schedule Before September Include:

Before you schedule your GI procedure, call your insurance provider. Request a cost estimate for the procedure and ask how close you are to meeting your deductible. Having all the facts can help you plan effectively and can stretch your healthcare spending dollars. 

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Prevent Eye Disease by Exercising with Family Regularly

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Exercising is a great way to spend time together as a family and to maintain healthy vision.

When is the last time you played basketball, frisbee or flashlight tag with your family? How about the last time you went on a family hike or bike ride? Physical activity is essential for men, women and children of all ages. It helps with weight management, mental alertness and disease prevention. According to the American Academy of Ophthalmology, many eye diseases can be delayed or even prevented by exercising regularly.

Protect Your Vision with Regular Exercise

Physical activity benefits the entire body – and especially the eyes. Studies show that being active for only 30 minutes a day reduces the risk for chronic conditions like hypertension, high blood sugar, obesity and high cholesterol. These diseases are known as metabolic syndrome, and they can be precursors to heart disease, stroke and diabetes. As for visual health, many eye diseases like glaucoma, diabetic retinopathy and age-related macular degeneration are linked with metabolic syndrome, and fortunately, exercise can help limit their effects.

Model Healthy Habits for Kids

Cardiovascular fitness, like healthy eating, is a life skill that must be learned. It’s not enough to simply tell children to be healthy. Parents need to form their own positive, diet and exercise habits and then model those behaviors for their children.

Len Saunders, acclaimed author on family fitness, says, “…children are watching their parents’ every move, mirroring their every action; if a parent is sedentary, there is a good chance their children will be too. However, parents who eat healthily and exercise with their children on a regular basis are teaching them many valuable lessons” (PBS).

Make Exercise FUN for the Family

If you’re just getting started with family exercise, keep it simple! Walking, swimming, hiking, playing tennis and doing yard work are just some of the activities the whole family can enjoy. Exercising together can be much more fun and can make “working out” go by faster. Try putting the kids in charge of accountability for your family’s commitment to fitness. That way, they won’t let you skip out on a workout!

Here are some ways to blend fitness and fun:

1. Take a family walk each night after dinner.

2. Swim at your local pool or community center on the weekends.

3. Participate in a couch-to-5k race and train together. Invite extended family and friends to join you and create a team t-shirt.

4. Locate a yoga studio in your area and take a weekly class together.

5. Create a backyard boot camp. Use a free app like Sworkit to set up a cardio circuit.

Keep Safe During Exercise

Before you implement your exercise plan, contact your family physician or eye doctor to make sure that your workout plan is appropriate for your family’s level of fitness. You can always increase the duration and intensity of your workout, so begin slowly and be patient. So, get out there, get moving and have FUN!

If You’re Pregnant, Decide on Newborn Circumcision Now

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When boys are born, they have a covering on the end of their penis, called the glans or foreskin. Circumcision is an elective (optional) procedure to remove this foreskin. It can be performed by an obstetrician-gynecologist (ob-gyn), is ideally done within the first two days after the baby is born and is brief, usually taking just a few minutes.

Deciding whether or not to circumcise an infant is very important and parents should ask questions or discuss concerns with their doctor while a woman is still pregnant—not after the baby is born. It’s important to discuss both the potential benefits of circumcision as well as the possible problems that could develop as a result of the procedure, even though it is considered low risk.

Pros and Cons of Circumcision

Although circumcision is not necessary, the medical reasons why a parent might decide on circumcision is because it helps reduce risks for:

  • Infection
  • Penile cancer
  • Phimosis (a condition where the foreskin cannot contract)
  • Sexually transmitted infections or diseases
  • Urinary tract infections

In contrast, some parents choose not to circumcise their infant boy. Some of the medical reasons include possible bleeding or infection, the possibility of cutting the foreskin incorrectly or concerns about improper healing or urinary issues developing.

Concerns About Baby Circumcision Pain

Another concern many parents have is about the pain a baby experiences during the procedure. In past decades, pain medication was not typically used during circumcision. However, today it is used more often and recommended by many experts, including the American Academy of Pediatrics (AAP).

Local anesthesia can be used by a doctor or an ob-gyn to reduce the baby’s discomfort, usually administered by an injection or as a cream. Parents choosing to circumcise their baby should make sure to discuss pain relief with their doctor prior to the procedure, and if they would like to be with their baby during the procedure, they should also discuss that with the doctor.

About the Circumcision Procedure

To perform circumcision, a doctor will follow the steps below:

  • Administer anesthesia, if it is being used. Creams can take up to an hour to be effective, and if the baby urinates, it can come off. Injections take about 5 minutes to become effective and are considered better at relieving pain.
  • The ob-gyn will clean the area.
  • A tool called a probe is used, separating the foreskin from the penis.
  • A clamp is attached to the penis, and the foreskin is removed using a scalpel. (Note that sometimes devices other than a clamp may be used.) There is little bleeding and stitches are not needed.
  • A dressing or plastic ring is placed on the cut to prevent it from rubbing against the baby’s diaper and irritating it, and gauze is wrapped around the penis.
  • It usually takes 7-10 days for the penis to heal. Parents should follow all care instructions provided by the doctor.

When to Perform Circumcisions

Finally, keep this in mind: when a boy is older, it may be possible to circumcise him, but the older he gets the greater the risk. A 2014 study in the Journal of the American Medical Association reported the follow results:

  • Boys Under 12 Months: 0.4 percent experienced circumcision complications
  • Boys 12 Months to Nine Years: Risks increased 20-fold for boys in this age group who were circumcised, compared to infants
  • Boys 10 and Older: Experienced a 10-fold higher risk after circumcision, compared with infants

The lesson? If parents decide to circumcise their son, the best decision is always to do it as early as possible.

To learn more about what the American Academy of Pediatrics has to say about infant circumcision, click here.

GERD and Sleep Apnea: Which Causes the Other?

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Sleep apnea and gastroesophageal reflux disease (GERD) are two conditions that appear unrelated. However, research shows a correlation between the two.

What Are Sleep Apnea and GERD?

Sleep apnea is a disorder that causes people to stop breathing during sleep. Obstructive sleep apnea (OSA), the most common type of apnea, occurs when the airway is blocked by soft tissue at the back of the throat. Many people who experience sleep apnea are unaware that their sleep cycle is interrupted throughout the night because they do not awaken completely. They usually complain of daytime sleepiness, headaches, forgetfulness and dry mouth.

About 60 percent of people with sleep apnea have chronic acid reflux, also known as gastroesophageal reflux disease (GERD). Acid reflux occurs when the lower esophageal sphincter remains open and gastric acid backflows into the esophagus. Common symptoms of GERD include heartburn, chest pain, a sour taste in the mouth and bad breath. However, it is possible to have GERD and not experience symptoms at all.

GERD Treatment Helps Remedy Sleep Apnea

Although researchers do not fully understand the relationship between sleep apnea and GERD, studies show that sleep disturbances may induce GERD and that untreated acid reflux impairs sleep. One study followed 48 adults who experienced GERD over three times per week. The men and women who had the most severe GERD symptoms also reported the worst sleep problems.  

The good news is that treating either sleep apnea or acid reflux appears to improve both conditions. Because sleep apnea and GERD are challenging to diagnose, they can go undetected for years. It is essential to be aware of the symptoms of each condition so you can receive prompt diagnosis and treatment.

Schedule an Appointment with a GI Specialist

If you have acid reflux on a regular basis and do not sleep well, make an appointment with a gastroenterologist to be evaluated for GERD. An upper endoscopy can detect inflammation or tissue damage to your esophagus, and you can begin treatment immediately. Talk to your gastroenterologist about your sleep problems as well. You may need to be referred to a sleep specialist or pulmonologist. 

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