Daily Aspirin Recommended by Doctor May Prevent Colon Cancer

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A new study finds daily aspirin can lower colon cancer risk, but some doctors warn against regular aspirin use because of possible side effects.

March is Colon Cancer Awareness Month, a time to raise awareness about colon cancer and take steps toward prevention. Colon cancer is the third-leading cause of cancer death in the United States, but most cases are preventable with regular colonoscopies and screenings. Preventing colon cancer is always less expensive than treating the disease, so researchers are continually performing studies to test new methods of prevention.

Through a recent study conducted at City of Hope Hospital in Duarte, California, Ajay Goel, Ph.D., M.S., discovered aspirin can prevent colon tumors from returning and even from forming. Goel and his research team used mice and mathematical modeling to mimic the different amounts of aspirin people in Europe and the United States take daily.

The researchers gave three different aspirin doses to mice that had four different colon cancer types. As aspirin doses increased, colon tumor cells died and fewer tumor cells divided. The team also found daily doses of aspirin prevented colon cancer from recurring.

“We are getting closer to discovering the right amount of daily aspirin needed to treat and prevent colorectal cancer without causing scary side effects,” Goel said. Goel plans to continue his research on aspirin and colon cancer, and he is optimistic about future findings. “We are now working with some of the people conducting those human clinical trials to analyze data and use mathematical modeling,” he said. “This process adds a layer of confidence to the findings and guides future human trial designs.”

Potential Dangers of Daily Aspirin

Goel’s aspirin study provides encouraging news for colon cancer research. Doctors have prescribed aspirin for decades to prevent blood clots in arteries and lower risk for stroke. It is inexpensive and readily accessible worldwide. However, cardiologists do not recommend daily aspirin for middle-aged, healthy men and women unless a doctor prescribes it. Daily aspirin can be dangerous for individuals who:

  • Are allergic to aspirin
  • Have had a brain bleed
  • Have a bleeding disorder
  • Have a stomach ulcer
  • Have asthma that is made worse by aspirin use (University of Michigan)

Get a Colonoscopy During Colon Cancer Awareness Month

Call your gastroenterologist during Colon Cancer Awareness Month to schedule a colonoscopy. It is estimated that there will be 50,000 new cases of colon cancer this year, but you can prevent colon cancer by scheduling regular colon cancer screenings.

The American Cancer Society recommends all adults who are at average risk for colon cancer begin screening at age 45, but Medicare and many insurance carriers do not cover screening colonoscopies until age 50. Talk with your doctor about colon cancer screening guidelines so you can get screened at proper intervals, and call your insurance provider to get the most updated information about your plan. Awareness is the first step in colon cancer prevention, so spread the news about the importance of colon cancer screening.

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California Governor Announces Plans to Lift Restrictions on Surgeries

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From the office of California Governor Gavin Newsom:

California Governor Gavin Newsom announced plans to allow hospitals and health systems to resume delayed medical care for Californians – such as heart valve replacements, angioplasty and tumor removals, as well as key preventive care services, such as colonoscopies – which were deferred as the state’s health care delivery systems prepared for a surge of COVID-19 patients. The decision was based on progress toward one of the six critical indicators the governor unveiled last week as part of the state’s framework for gradually modifying California’s stay-at-home order.

As part of the Western State’s Pact, California will work with Washington and Oregon to share best practices on how our states can allow hospitals and medical providers to resume delayed medical care in areas that have sufficient hospital capacity, while ensuring the safety and health of our health care workers and patients. The Western states had previously announced a shared, science-based vision for gradually reopening their economies and controlling COVID-19 into the future.

For additional information on resuming elective and preventative procedures, read the stories below:

ABC 10 News

CBS San Francisco Bay Area

Replacing Enzyme May Be a New Macular Degeneration Treatment

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A new study at the University of Virginia suggests gene therapy could offer new age-related macular degeneration (AMD) treatments for wet AMD and dry AMD.

What Causes Age-Related Macular Degeneration? (AMD)

Macular Degeneration (AMD) is a leading cause of vision loss and affects more than 10 million people in the United States. This is more than glaucoma and cataracts combined. AMD is caused by the breakdown of the center of the retina, the part of the eye that sends images to the brain through the optic nerve. The middle of the retina is called the macula, and it is responsible for central vision. It provides the ability to read, drive, decipher color, recognize faces and see details in objects.

According to the Centers for Disease Control and Prevention, AMD incidence is expected to double from 48 million to 88 million in the next 30 years.

What are the Types of AMD

AMD is divided into two basic types: wet and dry. Wet AMD comprises about 15 to 20 percent of cases, and the symptoms can often be treated with eye injections. The majority of AMD is dry, and there is no treatment for this variety of the disease.

Gene Therapy Reverses AMD in Mice

Researchers are hopeful that new macular degeneration treatments for wet and dry AMD could be available in the near future. Brad Gelfand of the University of Virginia’s Center for Advanced Vision Science successfully treated age-related macular degeneration in mice. Gelfand discovered the absence of an enzyme called Dicer could initiate both forms of macular degeneration. Dicer levels reduce with age, and the loss of Dicer causes an overgrowth of blood vessels in the retina. Using gene therapy, Gelfand restored Dicer in the mice and found it reversed AMD.

“We weren’t really satisfied with just one system,” Gelfand explained. “We actually got a different model that had originated from a totally different lab, in Japan, and found the same exact thing. Then we went back to some of our old models where we had gotten rid of Dicer and found the same exact thing.”

Further testing will determine the effectiveness and safety of this new macular degeneration treatment.

“It’s not as if this is the final answer to the problem, but it’s certainly a big step along the way,
hopefully… It certainly solidifies the idea that wet and dry AMD share a lot of mechanisms” said Gelfand.

It will take years to develop a new macular degeneration treatment based on Dicer. However, Dicer has the potential to be the premier treatment for dry AMD.

Know Your Risk for AMD

Risk for AMD increases with age, especially in individuals 55 years of age and older. Genetics also play an important role, as well as race. Caucasians are at a higher risk for AMD compared to Latinos and African Americans. Certain lifestyle choices like smoking also increase likelihood of AMD.

Call Your Ophthalmologist

Although currently, there is not a cure for AMD, you can reduce your risk or slow the progression of the disease by visiting your ophthalmologist once a year for a comprehensive eye exam. Healthy lifestyle changes like exercising, eating a balanced diet, avoiding smoking and wearing sunglasses that offer 100 percent UVA and UVB protection can help prevent degenerative eye diseases. Make an appointment today with your eye doctor to talk about ways you can support your vision health.

Colonoscopy Aids Patient’s Health Outcome as COVID-19 Crisis Ensues

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On Friday, the Florida governor ordered all hospitals and ambulatory surgery centers to cease all elective surgeries due to COVID-19, leaving surgery centers like ours to decide which procedures are considered an emergency. Making these decisions are not easy for our physicians.  Each decision is painstaking, having to determine the medical necessity of each procedure on a case-by-case basis.

COVID-19, the new invisible disease, arises in addition to another daily invisible disease – Colon Cancer. March is colon cancer awareness month and although this fight is understandably taking a back seat in its importance, it is still a very real killer.

Earlier this week, a 37-year-old woman began showing somewhat benign symptoms of possible rectal cancer.  Feeling that overlooking her symptoms and delaying a colonoscopy could mean dire consequences, our physician performed the procedure.  Upon completion, our physician diagnosed her with rectal cancer.  If our center were not open to proceed with her procedure, it may have been months before she had her colonoscopy, drastically changing her life story.

Colon Cancer Kills Too

Colorectal cancer is the second-leading cause of cancer death among men and women combined in the U.S. There will be an estimated 147,950 new cases of colorectal cancer in 2020. 1 in 20 people will be diagnosed with colorectal cancer. 1 in 3 people are not up-to-date with colorectal cancer screening.

Symptoms of colorectal cancer may include:

  • A persistent change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool
  • Rectal bleeding or blood in your stool
  • Persistent abdominal discomfort, such as cramps, gas or pain
  • A feeling that your bowel doesn’t empty completely
  • Weakness or fatigue
  • Unexplained weight loss

If you believe you are experiencing any of the following symptoms, it’s important for you to schedule an appointment with a gastroenterologist immediately.

How Our Center is Protecting Patients from COVID-19

Our staff continues to be diligent in keeping patients safe during this pandemic.  Our center has implemented the following standards:

  • Prescreening Patients via the phone and text message
  • Screening our staff
  • Asking all patient caregivers to wait outside
  • Reassessing our patients and taking their temperatures upon entering our facility
  • Social distancing our patients in our pre/post procedure area
  • Wiping down our facility twice a day or more per the recommended CDC guidelines
  • Wearing N-95 masks per recommended NETEC and CDC guidelines

Yes, procedure numbers are approximately a quarter of our usual caseload, yet we continue to play a vital role in our community as we abide by local/state health department guidelines while readying ourselves to assist however we can. We remain connected with the local police and fire marshal, assuring them of our support as they are truly on the frontlines of this pandemic. We have also reached out to a local nursing home, where one of our staff members works aside from our center, providing an encouraging note and a prepackaged goodie for their patients if their diet permits. In continuing to give, we all feel truly blessed.

Schedule Your Appointment with our Physicians via Telemedicine

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Our center’s physicians know the strain COVID-19 will place on our healthcare system. Even though our endoscopy center has temporarily postponed elective surgeries until May 26, our doctors and nurse practitioner are still seeing patients daily in-office or via telemedicine. If patients choose to visit the office, we are taking extra precautions to ensure their safety. Click Here to Read What Steps We’re Taking to Keep Patients Safe During COVID-19.

If a patient is seeking care without leaving their home, then we are happy to meet that need with our telemedicine visits. To schedule a telemedicine appointment, please call (979) 429-2000 or (978) 429-2010.

Evidence for Brain-Eye Connection Could Spark New Glaucoma Treatment

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A recent study reveals a new feedback pathway from the brain to the eye which regulates eye pressure, and this could promote new glaucoma treatments.

Glaucoma is associated with elevated eye pressure due to a reduced ability of the eye to regulate fluid drainage. Excess fluid in the eye causes increased pressure, which can damage the optic nerve over time. This is known as open-angle glaucoma, the most common form of glaucoma in the United States.

Brain Pressure Affects Eye Pressure

A team of neuroscientists from the University of South Florida conducted a study that proves there is a physiological connection between eye pressure and intracranial pressure (brain pressure). The researchers proved this by “altering intracranial pressure in animal models and noting changes in the fluid drainage properties of the eye that could be blocked by chemicals that eliminate feedback signals from the brain” (Science Daily).

The team found the eye was able to adapt to intracranial pressure changes to restore a healthy pressure differentiation across the optic nerve.

Chris Passaglia, PhD, professor of Medical Engineering at the University of Florida, said, “The drainage control system may service to protect the optic nerve from swings in eye or brain pressure. Its discovery offers a new target for glaucoma treatment. . .” Dr. Passaglia hopes the study can be instrumental in developing new treatments for lowering eye pressure in glaucoma patients and halting glaucoma progression.

Now, the researchers are attempting to verify the exact location of the brain cells that are transmitting messages to the eye, as well as pinpoint the nerve fibers in the eye that the brain mediates.

What Factors Influence Glaucoma Risk?

Glaucoma affects more than three million Americans, but only half are aware they have the disease. Do you know your glaucoma risk? Glaucoma usually does not have symptoms in the early stages, but it can cause permanent vision loss before any warning signs appear.

These are a few risk factors for glaucoma:

  • Age 45 or older
  • Family history of glaucoma
  • History of injury to the eye
  • African American
  • History of steroid use, either in the eye (drops) or systemically (orally or injected)
  • Diabetes
  • Nearsighted (myopic)
  • Farsighted (hyperopic)
  • History of elevated intraocular pressure

What is a Comprehensive Eye Exam?

The best protection against glaucoma is routine comprehensive eye exams. Your ophthalmologist will perform a glaucoma test as well as evaluate your vision for focusing problems, refractive errors and common eye diseases.

Call your ophthalmologist today schedule a comprehensive eye exam for the whole family. Your vision is a precious gift that requires regular care.

Ask Your Doctor About Correct Timing for Knee Replacement

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A new study found most patients who need a knee replacement are waiting too long and are missing out on the benefits of total joint replacement.

Knee replacement is one of the most successful procedures performed today, and it is effective to relieve pain and improve mobility. Doctors perform almost one million knee replacements every year. The average age of a patient scheduling total knee replacement is 70 years of age, and about 60 percent are women. Even though knee replacement is safe and produces good results, a new study from Northwestern Medicine claims patients are not scheduling their knee replacement at the optimum time.

Hassan Ghomrawi, associate professor of surgery at Northwestern University Feinberg School of Medicine, led the study which analyzed more than 8,000 participants who had knee osteoarthritis or were at risk for the condition. Ghomrawi found 90 percent of patients with knee arthritis waited too long to have knee replacement and were not reaping the benefits of surgery. Also, 25 percent of patients who did not even need knee replacement were scheduling surgery too early. Ghomrawi asserted correct timing is essential to maximize effectiveness of total knee replacement.

Problems With Delaying or Rushing Knee Replacement

“People are waiting and waiting to have the procedure and losing the most benefit,” Ghomrawi stated. “When people wait too long, two things happen. The osteoarthritis causes deterioration of their function. Some of them wouldn’t be able to straighten out their legs, affecting their walking and mobility. When you can’t get exercise, you can start to develop other health problems such as cardiovascular problems. You may also become depressed. The overall impact can be huge.”

The study also found race affected patients’ decisions regarding timing of knee replacement. African-American patients were more likely to delay total knee replacement than Caucasian patients.

Scheduling knee surgery too early could mean patients may need to have a second surgery later in life, which could increase risk for less favorable outcomes and longer recovery time. The best timing for total knee replacement is based on a combination of factors such as age, joint function, pain and radiographic assessment.

Ghomrawi said doctors must make sure the timing of total knee replacement is optimal to offer patients the greatest benefit and keep healthcare costs manageable. “Because knee replacement is an elective procedure, the timing of surgery is susceptible to not just clinical factors but also demographic, socioeconomic and sociocultural ones,” Ghomrawi explained. “We need to develop a better understanding of these factors to improve timing of surgery.”

Schedule a Visit to Your Doctor

Are you interested in total knee replacement? Correct timing is essential. Make an appointment with your doctor so you can discuss the best timing for your surgery. Knee replacement surgery can help you regain your independence by alleviating pain and increasing your mobility, but talk to your doctor to make sure you are scheduling it at the optimum time.

Weston Outpatient Surgical Center Brings Total Joint Replacements to the Center

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Each year, more physicians and patients are choosing the ambulatory surgery center setting for total joint replacements. At-home recovery, lower costs and reduced risk of hospital-acquired infections are some of the drivers for this change in setting. In line with the trend, more of our centers are bringing total joint procedures to the facilities. Weston Outpatient Surgical Center in Weston, Florida, is one of the latest to begin performing total joint procedures.

“We made total joints a priority at the center, and with preparation, we were able to perform four procedures in the fourth quarter of 2019,” explained Estella “Stella” Castoreno, Center Leader at Weston. “I am a recent hire at Weston and bring several years of experience in total joints. I made a stretch goal for myself to bring joints to Weston Outpatient Surgical Center as my first quarter initiative.”

Pairing Stella’s own experience with a highly motivated staff, Weston established a special total joints committee to begin the preparations for the new procedures. “We had many comprehensive meetings with the staff, equipment representatives and surgeon. We also created a dictionary with a list of questions and responses so that every person involved in the procedures would be aligned with the overall goals and objectives in joint procedures. The staff, physicians and vendors aligned with one vision.”

Another factor in preparing to bring total joints to the center is ensuring the patients are right for the setting. A pre-telephonic assessment of the patient history and living accommodations were a top concern for the committee. The patients must meet the criteria for an outpatient joint. While there is a significant focus on patient selection, having a high-caliber orthopedic surgeon is even more important. Stella, said, “A successful joint program requires the right patient and right surgeon.”

Preparing for total joints at the center also required the commitment of every member of the 80+ person team. In addition to the special committee that focused on the new procedures, the staff not directly involved in total joints significantly helped by maintaining operations for the center’s regular volume, 600 cases annually.

As a new leader at the center, the preparation for the total joint procedures was also Stella’s time to get better acquainted with her staff and surgeons. “I approached it as taking it back-to-basics. We went through mock procedures with every bit of equipment and supplies needed for the case.  I even included the vendor representative in our mock case,” Stella said. “One of our techs played the role of patient. We had a lot of fun preparing for the procedures.”

“I encouraged the staff to see themselves as travel agents. Our patients expect to get through the joint replacement journey and back home refreshed with even more pep in their step,” explained Stella.

Weston’s first total joint patient had an opportunity to tour the center and meet every person who would interact with the case, from the billing office, registration clerk, nursing staff (pre-admission testing, pre-op, PACU and O.R.), scrub technicians, anesthesia team, physical therapist and administrator. This helped ensure the patient was comfortable when returning on the day of surgery.

Stella encourages centers considering adding total joints to make it relatable to the staff and to consider the three pillars — patient, staff and physician.

  • Patient – Personalize the goal with the patient. A great question is “What did you like to do prior to your knee weakness (walk the mall, plant flowers, etc.)?” Keep in mind, patient(s) don’t measure their quality of life by “ambulating 20 feet.”
  • Staff – To be successful, you must have complete buy-in from everyone at the center. Procedures can become transactional, so we must always take on the opportunity with the goal of creating exceptional experiences for the patients.
  • Physician – A highly skilled, reputable surgeon is just as important. Encourage surgeons to transition to outpatient by using the patient criteria screen tool in an acute care setting.

With four successful total joint replacements completed, Weston plans to continue to expand its total joint procedures. “We thank Dr. Mario Berkowitz, Dr. Alexander Bertot and Dr. Thomas Riley for trusting us to care for your patients. It is a great honor,” Stella concluded.

Touching Hands Project Surgery Day

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OAA’s Hand Surgeons came together to volunteer with the Surgical Center of Allentown, Anesthesiologists from Northeastern Anesthesia Physicians, PC., and Hand Therapists from the Institute for Hand & Upper Extremity Rehabilitation to serve Veterans and uninsured residents of the Lehigh Valley and surrounding community.

Click here to read more.