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Beating Cancer: FAQ from the on-line chat

11:01 PM, Oct 8, 2011   |    comments
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 How much radiation is in a mammogram? Is prostate cancer screening necessary anymore? At what age should I be screened? My grandmother has breast cancer, what does that mean for me?


Those were some of the questions viewers nationwide had while watching Cutting Edge: Battling Breast and Prostate Cancer. Many viewers who watched the broadcast on air also took part in a live web chat with medical experts to get specific answers to their questions about breast and prostate cancer.


Dr. Robert Shenk, breast surgeon at Seidman Cancer Center at University Hospitals Case Medical Center and Dr. Robert Abouassaly, urologist and prostate cancer expert at the Urology Institute at University Hospitals Case Medical Center were on-hand answering questions and providing medical expertise.


Q.  How much radiation is in a mammogram?
A. A very small amount (70 millirems) - less than getting a chest x-ray. It's a minimal amount and it does not increase your risk for cancer.


Q. If a woman has a family history of breast cancer, does she need a mammogram every year?

A. Every woman over 40 needs a mammogram every year. If you have a family history of breast cancer, you may want to start earlier. Other types of cancers and the extent of the family history should be discussed with your doctor to outline the best course of action.


Q. Do insurance companies still cover for the prostate screening test?

A. Most insurance companies are still covering the screenings.


Q. What are the current statistics of survival for breast cancer?

A. According to the American Cancer Society, 100 percent of women who detect their breast cancer at stage one live at least five years, and many remain cancer-free for life. But as the cancer advances, survival rate declines. By Stage 4, the five-year survival rate declines to 20 percent.


Q. Is it true that screening for prostate cancer is not necessary anymore?

A. It depends on what organization you ask! The US Preventative Task Force has recently said screening is not necessary. The American Urologic Association and the American Cancer Society both say that screening is worth discussing with your physician.


Q. I am a 50-year-old being treated for invasive lobular cancer. I have two daughters, 28 and 30. When should they start screenings and/or preventative measures and what would those be?

A.  Screenings typically start 10 years before the youngest diagnosis. So in this case the daughters should start screenings at age 40 unless there is deeper family history (your mother or other relatives have had cancer, for example).


Q. My grandmother had breast cancer at age 32. When should I start to get a mammogram? I am 30 now.

 A. You should start now. Also, if your grandmother is your father's mother and there is any other cancer history on your father's side, you may want to seek genetic counseling. That is a very young diagnosis, and you should definitely have ongoing discussions with your gynecologist about your screening time line.


Q. Is there a place people can go to get screened for breast and prostate cancer if they don't have insurance?

A. You may qualify for a free or reduced-price mammogram from the National Breast and Cervical Cancer Early Detection Program. Hospitals hold free screenings for prostate cancer regularly. And there is a traveling bus that also promotes and offers free prostate exams.


Q. Having been diagnosed with Stage 4 lung cancer in April 19th do I need to be worried about breast cancer as well? I am still seeing my oncologist every 3 weeks.

A. Since it started in your lungs, it is not related to your breasts. You still could develop breast cancer down the road, but you really need to stay focused on treating your lung cancer. You should talk to your oncologist about whether you need breast screenings at this point.


Q. I was told in December 2010 that I had Stage 3 breast cancer. I have had chemotherapy and a lumpectomy. I just finished radiation. Now I live with the fear that the radiation and the Herceptin will hurt my heart due to a heart attack I had eight years ago. What other options do I have other than Herceptin?

A. You should talk to your oncologist, but it is unusual to have heart problems from Herceptin (less than 2 percent). Doctors should be checking your heart while you're taking it. In general, they protect the heart when giving radiation treatment, so that shouldn't affect your heart. They wouldn't be giving you these treatments if they didn't think your heart could handle it. But, again, you should discuss with your oncologist.


Q. I am now a 47-year-old male. Do I need a prostate exam?

 A. The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about what we know and don't know about the risks and possible benefits of testing and treatment.


Starting at age 50, talk to your doctor about the pros and cons of testing so you can decide if testing is the right choice for you. If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with your doctor starting at age 45.


If you decide to be tested, you should have the PSA blood test with or without a rectal exam. How often you are tested will depend on your PSA level.


Q. My sister found a lump on the side of her right under her arm under the skin. Would this be the start of breast cancer.?

A. She should have it checked it out. Under her arm can still be breast tissue. There is no way to know for sure without a mammogram and proper diagnostics.


Q. I am only 29 years old. I am too young to get breast cancer?

A. Twenty-nine is not too young to get breast cancer. Self breast exams and early detection are important. Women should begin self breast exams in their 20s.


Q. Can you tell me about proton beam radiation or the limitations of cyberknife radiation?

A. Proton beam treatment doesn't add any proven benefit. The cyberknife is still an experimental protocol and there isn't any data on long-term effectiveness.


Q. What are the benefits of Image Guided Radiation Therapy (IGRT)?

A. IGRT and other modifications of radiation therapy in theory are supposed to push higher doses to the affected area and have less affect on other surrounding organs.


Q. I am scheduled for surgery for the removal of my prostate using traditional open surgery. After seeing this show, I somehow want to postpone the surgery and give myself more time. My PSA was 12.5 and I'm 54 years old. Any suggestions?

A. Postponing your surgery should depend on the stage of your cancer and the reasons for postponement. If you are not comfortable with the treatment plan, you should consider all of your options and discuss them with your doctor. You should be fully aware of all of your treatment options and potential side effects before surgery.



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