Dr. Cynara Coomer

The most common surgery for breast cancer these days is a lumpectomy, which is considered breast-conserving therapy. If patients choose to undergo this surgery, it has to be combined with radiation therapy, which can be administered in the form of external radiation, where the whole breast is radiated, or partial breast radiation called brachytherapy.

Another option for surgically treating breast cancer is by mastectomy. Mastectomies remove all the breast tissue, but nowadays, most women are candidates for immediate breast reconstruction done during the same operation.

When reconstruction is used, women can have either a skin-sparing, areola-sparing, or nipple-sparing mastectomy. This is where the skin and/or the areola and nipple are preserved, which improves the cosmetic outcome dramatically. The type of breast cancer that a woman has will determine which of these procedures is appropriate.

Reconstruction can be performed by using implants or tissue transplanted from other areas of the body. Most commonly, abdominal fat is used, which results in a tummy tuck.

Some patients may need to have chemotherapy prior to surgery. Although this is not proven to improve the survival outcomes, it increases the surgical options and may potentially decrease the risk of local recurrence in the breast.

There are so many more options for women these days for surgically treating breast cancer, and they should be discussed with a breast surgeon.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

Dr. Cynara Coomer

When a woman is told that she has an abnormality on her mammogram and/or breast ultrasound, it’s often a very frightening and emotional experience. Most commonly, a woman may be told that the results are benign, and that she needs to return in 6 months for a repeat study. Generally this means that the finding on the mammogram or the ultrasound is most likely non-cancerous, and the radiologist just wants to confirm that by monitoring the lesion.

But sometimes, the recommendation from the radiologist is that the lesion be biopsied. Obviously this is even more anxiety-provoking, but women should remember that 80 percent of the lesions we biopsy are non-cancerous.

These diagnostic biopsies should almost always be performed as a minimally-invasive needle biopsy as opposed an open surgical procedure. Currently, too many women are undergoing surgery to obtain a diagnosis. Surgery should be generally reserved for therapeutic reasons. Many women undergoing a needle biopsy will not need to have surgery because the results are usually benign.

The most common reasons for undergoing surgery after a needle biopsy is if there is a finding of atypical cells, cancer, a benign lesion that has the potential of having a malignancy associated with it – meaning it may develop or have cancer cells near it. Another reason might be if there is discrepancy between the biopsy and radiology results.

Once there is a need for surgery, you should talk to a breast surgeon/specialist about the different surgical options available to you. Never be afraid to get a second opinion from a surgeon and/or a pathologist.

Next week we’ll talk about surgical options for women once they’ve been diagnosed with cancer.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

I recently read an article about a cancer patient who chose to use herbal remedies over a surgical procedure that could quite possibly have saved her life. Leslee Flasch was barely 50 years old when doctors told her she would need surgery for her rectal cancer that would leave her wearing a colostomy bag for the rest of her life. She had tried other conventional therapies, but refused surgery and turned to herbal supplements she had researched on the Internet. Her condition worsened and she eventually died.

This story is just the latest in what seems to be a growing trend of alternative treatments breaking into mainstream medicine — and in some cases, replacing it. In fact, a recent report even suggests that 60 percent of cancer patients try herbal remedies — and sometimes, the consequences are deadly.

Leslee Flasch’s story has prompted some questions about colorectal cancer and about the treatment of cancers with alternative therapies, so I sat down to answer some of them here. 

1. What is the difference between colon cancer and rectal cancer?
Colon and rectal cancers are actually very similar — but the difference lies in what part of the large intestine the cancer affects. The colon and rectum make up a long, muscular tube that most people know as the large intestine. The first part of the large intestine is the colon and at the end of it is the rectum.

Cancers in the colon and rectum usually grow slowly and may start as benign polyps. These polyps are found during a colonoscopy, and early removal of polyps may prevent it from becoming cancer. Over 95 percent of colon and rectal cancers start in the cells that line the inside of the large intestine.

Cancer of the colon and/or rectum is the third leading cause of cancer in men and the fourth leading cause of cancer in women worldwide.

 
2. Who is at risk for colorectal cancer?
There are several risk factors for developing cancer of the colon and/or rectum including:

• Age — people aged 50 and over should be screened, with frequency depending on medical history;
• Medical history — a personal history of polyps or colorectal cancer increases your risk;
• Family history — a family history of colon cancer also raises your risk of developing the disease;
• Inherited syndromes — certain syndromes such as Familial Adenosis Polyposis (FAP) also increase your chances of developing colorectal cancer;
• Ethnicity — Studies have shown higher incidence of colorectal cancer in African-Americans and Ashkenazi Jews;
• Diet & lifestyle — diets high in red meat and overcooked foods, smoking, obesity, heavy alcohol consumption are all risk factors;
• Overall health — underlying conditions like type 2 diabetes can increase your chances of developing colon and/or rectal cancer.

 
3. What is the treatment and survival rate for rectal cancer?
Surgery is usually the most common treatment for stages I, II and III rectal cancer — although radiation and chemotherapy will often be given before surgery to try and shrink the tumor and kill off cancerous cells in affected tissue.

There are several types of surgery for rectal cancer. Stage IV rectal cancer is treated primarily with chemotherapy and palliative surgery, if necessary. Palliative surgery provides a treatment that will relieve a problem (such as a bowel obstruction) but does not lead to a cure.  In the case of obstruction, a colostomy surgery would be performed.

4. What does it mean to have a permanent colostomy bag?
Colostomy is a surgical procedure that brings a portion of the large intestine (colon) through the abdominal wall. Waste (stools) moving through the colon drain into a bag that is attached to the abdomen. It is done when the cancer is removed from the rectum or to bypass an obstruction caused by colon cancer. 
 
Contrary to people’s perception, having a colostomy bag is hygienic and can be very discreet because the bag can be well-hidden under clothing.
 
For some patients suffering from rectal cancer, colostomy surgery may be part of a curative treatment, while for others, it may be relief for an incurable situation. But either way — patients who are candidates for this procedure often see significant improvements in their quality of life.

5. What would Leslee Flasch’s quality of life have been like if she had sought conventional treatment?
There’s still a lot we don’t know about this particular case. But I can say that If her cancer was caught in the in the early stages, the chances of her being cured would have been very good.  Colorectal cancer is almost always treatable if caught early.  She may not have required a colostomy if the cancer was treated in the very early stages when it was still small in size. 

Even in stage II and III, she could have been treated with surgery and chemotherapy and had an excellent prognosis. If she had agreed to a colostomy, she would have been able to return to her normal activities and lifestyle — and nobody would even be aware of the bag. 

In general, when treated at an early stage, most colorectal cancer patients survive at least 5 years. If the disease does not come back during this time, they are considered cured. Stages I, II, III are considered potentially curable.  Once the cancer spreads to other areas of the body (stage IV), the 5-year survival rate drops, and most cases are not curable.

6. What do you think about this trend of patients trying to treat themselves with herbal remedies?
I think that including alternative treatments with conventional medicine can be very beneficial to patients as long as it’s under the guidance of a medical doctor who supports this course of treatment and monitors a patient’s progress and overall health. I certainly don’t think that alternative treatments should replace conventional therapy and patients need to be careful because there are a lot of scams out there that may or may not be harmful, and can take a financial toll.

7. What are some of the reasons a person might seek alternative treatment?
One of the most effective uses of alternative medicine in cancer patients is to alleviate pain associated medical treatment. For example, acupuncture has been proven to help with pain and other negative side effects like nausea brought on by chemotherapy or surgery. Certain types of relaxation therapy can relieve anxiety associated with a course of conventional treatment. And there are some natural herbs that aid in calming nausea or vomiting — which are often side effects of chemotherapy.

So for patients who want to use alternative medicine to alleviate negative side effects of medical treatment or to enhance the healing effects of conventional therapy — physician-monitored alternative treatments can help. But again, there is no evidence to support alternative therapies being used in place of conventional medicine — whereas we have a wealth of evidence supporting the effects of chemotherapy, radiation and surgery in the treatment of cancer.

8. What advice do you have for people thinking of skipping out on medical treatment and trying alternative therapies for cancer?
Often when people are initially diagnosed with cancer, they often don’t feel sick (especially if the cancer is caught early) so a lot of times, the thought of going through medical treatment seems beyond the realm of comprehension.

There are no regulations for alternative treatments, and in most cases, no proof they work. If doctors give a medication and patients have severe negative side effects — that medication is studied and pulled from the market. But with a lot of these herbal remedies, there is no proof that these treatments work. Each patient is different and each situation is different. So what a patient really needs to consider when they talk to their doctor about their diagnosis, is how much they really want to risk.

It comes down to what your current treatment options are, and their effect on your quality — and ultimately quantity — of life.

Leslee Flasch is a perfect example of someone whose quality and quantity of life could have been extended by conventional therapy.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

Millions of Americans watch the hit reality TV series “Jon & Kate Plus 8” on TLC. 

They are now following Katie Irene Gosselin and Jonathan Keith Gosselin into a fifth season of parenting their eight children — fraternal twin girls and a set of fraternal sextuplets.

The show is taped in the Gosselin home — the “set” includes permanent light fixtures.

Lately, the drama has focused on whether Jon did or did not cheat on Kate with either of two women spotted with him over Memorial Day weekend and, more recently, at a mall.  He insists the women are the wife and daughter of plastic surgeon Dr. Larry Glassman who performed Kate’s tummy tuck surgery.

I don’t really care whether Jon has been faithful to Kate or not.  My question about him and his wife is about how they can justify turning  their kids’ lives into entertainment, with unknown, possibly severe, psychological fallout.

No one knows the precise psychological impact of having parents who are “acting” like parents for the cameras or having producers around who are hoping for high drama, but the impact could be significant and negative.  Life has to stay interesting to keep viewers around, after all. Decisions about how to handle family crises, including the question of whether to stay a couple at all, might well be colored by  worries about how it all will play out on TV.

Kate Gosselin recently went on a vacation with her eight kids to North Carolina. They were accompanied by body guards and camera crews.

This is like having a stage mother (and father) on steroids.  Because in this case, she’s on stage, too.  How does one of the children decide to drop out of the series?  If he or she did, would that child risk losing parental attention and love?  Who has the moral right to decide that another human being’s life story will be played for television audiences?

Movie stars and politicians often have enough good sense to understand — as good parents — that they need to protect their children from the glare of bright lights and media exposure.  They understand that their own notoriety shouldn’t be a ball-and-chain for their kids.  They don’t want their sons and daughters defined by them.  They want them to have their own lives — for real.

I hope that each and every one of the Gosselin children grows up to be happy and healthy. But if they should end up depressed or on drugs, I hope they find therapists who will explore whether part of their pain is a feeling that their lives were stolen from them, whether they were put on display like zoo animals under glass, all for fame and profit.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s Web site at livingthetruth.com.

The topic of anal cancer has gotten a lot of media attention lately because of Farrah Fawcett’s very public battle with the disease. And it’s raised a lot of important questions about advances in cancer treatment and the future for patients fighting the battle of their lives.

What is anal cancer and who is at risk for it?

Anal cancer is characterized by the growth of a tumor around the anus ― which is opening at the end of the intestinal tract — and it’s completely different from colon cancer. A large proportion of anal cancers have tested positive for human papillomavirus (HPV), which is a sexually transmitted disease, but this isn’t the only cause.

Other patient populations at a greater risk for developing anal cancer include patients with multiple sexual partners, those who participate in anal intercourse, smokers, people with immunosuppressive diseases, such as HIV, and people with chronic inflammatory bowel diseases.

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What is the treatment for anal or intestinal cancer?

If it’s caught early, the most common treatment for anal cancer is surgery. But in patients whose cancer affects the anal sphincter, having surgery to remove the tumor and cancerous cells can lead to fecal incontinence causing the need for a permanent colostomy. So often for these patients, radiation and chemotherapy may be the preferred course of treatment. For later stage anal cancers, doctors treat patients with a combination of radiation and chemotherapy.

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What is the cure rate for anal cancer?

Well ― like any cancer, early detection greatly increases the chance of survival. If it’s caught in the early stage, there is an 86 percent five year survival rate. If the cancer has spread to the lymph nodes, the survival rate decreases to 54 percent. Up to 10 percent of patients treated for anal cancer will develop cancer elsewhere in the body.

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What kind of advances are we making in cancer research?

We have made advances with regard to the surgical treatment of cancers by offering minimally invasive surgeries. In some cases, we’re able to provide surgical treatments with less negative side effects and shorter recovery time. Clinical studies have shown that other treatments like radiation and chemotherapy may be just as effective as surgery without many of the negative side effects.

With regard to medical treatments, there have certainly been advances in the kinds of treatments we’re using. New medical technologies are making it possible for doctors to individualize a patient’s treatment by studying the genetic makeup of their particular cancer — ultimately decreasing the chances of recurrence or spread of the cancer, and increasing a patient’s survival outcome.

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What are the major milestones/accomplishments we’ve seen in cancer research recently?

Well again, one of the major milestones is being able to identify the genetic makeup of cancers individual to each patient.

The other advancement is the research that’s been done in molecular-targeted therapies. These therapies target the development of cancers by inhibiting the growth of the disease at the cellular level — which we hope will be able to limit or potentially even stop the cancer from spreading.

Molecular-targeted therapy is a more specific treatment than chemotherapy, because chemo treatment kills off not only the bad cells — but also the healthy cells in the body. So with a therapy that is very specific in its attack of cancerous cells, the hope is that it should more be effective in stopping the development of the cancer.

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What are some tips for preventing cancer?

We’ve all heard it time and time again — good health comes from making healthy choices. So my first tip would be stop smoking! I’m sure I don’t have to tell you, cigarettes are full of cancer-causing agents and have been linked to the development of many cancers in the body.

Second, everything in moderation including alcohol! If you’re the kind of person who enjoys a nice cocktail, make sure you do it in moderation, which means 1 or 2 glasses — preferrably of red wine — or else,  just avoid alcohol all together.

Make healthy dietary choices. Try to maintain a diet rich in omega-3 fatty acids and fruits and vegetables. Both provide essential nutrients and antioxidants which help ward off disease. Limit the amount of read meat you consume, since high levels of it have been linked to certain cancers.

Recent studies have shown that vitamin D may play an important role protecting against the development of certain diseases. Because exposure to small amounts of sunlight causes the body to produce healthy amounts of vitamin D, people who live in cold environments or places with extended seasons of darkness may want to consider getting their vitamin D levels checked and taking supplements.

And finally — know your family history so you can better determine your risk for other cancers, because your screenings for certain cancers may start earlier than what is recommended to the general population, and preventive therapies may be an option for you.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

By Melanie Schuman Rattigan

On my first trip to Guatemala with Hearts in Motion, I worked with a team focusing on orthopedic surgery. We hit the ground running. 

The day after our arrival we started pre-screening surgical candidates in a tiny room of the clinic adjacent to Zacapa Hospital. Green walls, little natural light, little artificial light. The surgeons carefully evaluated patients and a surgery schedule for the next four days was taking shape.

A prosthetist came down to make artificial limbs — a new project spurred by a desperate need. I first saw him making casts for a little girl — she couldn’t have been much more than 18 months old — who burned both hands in a pot of masa. 

(This is a food staple made of corn and often cooked at home to make a paste for tortillas). She was missing several fingers and soon the tears would be gone and she’d learn how to use her prosthetics.

Click here to see more photos from Guatemala

It was on this trip that I met two very special siblings — Carla and Marlin Lopez.  They both had severely bowed legs yet their five other siblings did not.  They were generally happy children and mom Sonia was thrilled about the prospect of surgical correction, which is something the state health care system would not provide.

It was a long and complicated surgery and both could not be done in the same trip. Two doctors, a nurse anesthetist and an OR surgical tech operated on Carla, the older of the two. From a lay perspective, it was hammers, drills and chisels. I wasn’t sure how I’d react having never witnessed surgery, let alone something so noisy to the untrained ear.  It was fascinating. The surgeons knew there was a possibility that future corrective surgery might be necessary, but the following year she was thriving. She came to thank us that next October when her brother underwent the same procedure.

Clubfoot is another common ailment often correctible with surgery. But I met one special family that trip that we couldn’t help. A mother and child both have dwarfism and the child’s surgery was too complicated for our team to perform in Guatemala as it involved her knee and leg. In cases like this, the director Karen Scheeringa-Parra and the in-country H.I.M. volunteers work with doctors in Guatemala and the states to try and find a solution.

In just four days, over 40 orthopedic surgeries are usually performed.  An additional day is needed for post-op rounds. Now there is a full rehabilitation clinic built by H.I.M. donations that operates year-round as well as a prosthetic clinic operated by the Range of Motion Project. The clinic has a full-service lab and uses recycled materials including gently used limbs and braces. Guatemalans would not otherwise have access to artificial limbs if not for organizations like this. Work continues even when the group returns home.

Melanie Schuman Rattigan is a coordinating producer for the FOX News Channel. Hearts in Motion is a non-profit 501 (c) 3, non-denominational organization that focuses on the needs of impoverished children and families.  It’s predominant focus is in Central and Latin America, but it also has several programs in operation in the United States. You can find out more information at www.heartsinmotion.org.

After reading the story about the couple in Arkansas that is suing the doctor and hospital because the wife became pregnant and miscarried after her husband had undergone a vasectomy, I understand how a patient could get upset and disappointed about having had that outcome happen to them.

But I’m also disappointed by the fact they’re rushing to sue the healthcare establishment for negligence and defamation and are seeking unspecified monetary damages.

Now, I don’t know of any procedure that is risk-free. If you go up and down the medical literature, you will always find that there is certain percentage of patients that will experience complications and/or contribute to failure rates. Therefore it seems that we must always sue any doctor who has a complication or a failure in the procedure.

My friends, if this trend continues, we will further weaken our healthcare system.

If you read medical articles written on failure rates of vasectomies, you will find that each and every one of them quotes a small but real risk of a subsequent pregnancy. I think that many folks hear “small risk” and somehow translate it into “no risk.” Failure to communicate this type of information to patients does represent a negligent act on the part of the physician, but if the information is given, then there is a mutual responsibility among doctor and patient of understanding the reality of medicine. A vasectomy can fail within the first 3 months after surgery, and even though the chances are much less, it can also fail one year after surgery.

Yes, I know I don’t have all the facts in this case, but let’s be fair about what medical science is: not always perfect.

Brain aneurysms have been in the news this past week. First there was the unfortunate sudden death of Congresswoman Stephanie Tubbs Jones (D-Ohio) from a ruptured brain aneurysm at age 58. And now with the nomination for vice president of Senator Joseph Biden (D-Delaware), the public has been reminded of his fortunate survival following the surgical clipping of two brain aneurysms back in 1988.

Aneurysms in the news present an opportunity for educating the public about these scary blood vessel bulgings in the brain.

Biden reportedly had two aneurysms, one on each side of his brain, and they were discovered when he suffered pain in his neck.

A neurological work-up revealed the aneurysms, one of which had leaked slightly. The tiniest amount of blood mixing with the brain’s cerebrospinal fluid (the fluid which surrounds and cushions the brain) can be painful. Pain was an alert to Biden, and in 1988, he had the aneurysms surgically clipped before they could rupture.

Tubbs Jones wasn’t nearly as fortunate, and she was found slumped over the wheel of her car, already in a coma, and was soon dead.

 Biden’s neckache was due to a “sentinel leak,” which can be compared to a slow leak of air from a tire in an area where the wall is thinning. Whereas Jones’ aneurysm reportedly burst, like a tire blowing out.

High blood pressure, smoking, and drug use, particularly cocaine can all contribute to the formation (and rupture) of aneurysms. Family history of aneurysms, congenital abnormalities in the wall of the artery, or other related medical conditions such as polycystic ovaries can all play a role in causing aneurysms.

 About 6 million people in the United States have a brain aneurysm. The yearly rate of rupture is about 1 in 10,000 people. Almost half will die as a result of the rupture, and more than half who recover will have significant disability (symptoms of a stroke).

 Aneurysms are most common in middle age, and women are affected more often than men. Aneurysms tend to occur at branch points of the arteries, and are much more common at the front of the brain.

Below are some frequently asked questions regarding brain aneursyms:

Q:   Should I be checked for a brain aneurysm?

A: The incidence in the general population is not sufficient to recommend routine screening, but a MRI of the brain might be considered for a family history or multiple risk factors.

Q: What symptoms should I look for?

A: New onset Headache, neckache, nausea, and blurry vision can all be signs of impending bleed from an aneurysm. These symptoms are reasons to see your physician quickly.

Q: What is the treatment for a brain aneurysm?

A: Since the 1980s, many aneurysms are treated with the insertion through a micro-catheter of tiny platinum coils. These coils are useful to block the flow of blood to the aneurysm, which causes it to shrink.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News Medical Contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: the Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic”. Read more at www.doctorsiegel.com

A 6-year-old Texas girl is recovering after she had surgery Wednesday to remove the right side of her brain, WFAA-TV reported.

Jessie Hall, who lives in Aledo, Texas, has Rasmussen’s encephalitis, a rare illness that eats away at the brain and causes seizures and reduced mobility. In Jessie’s case, she lost the use of her left arm.

Doctors hope that removing the diseased part of Jessie’s brain will stop the uncontrollable seizures.

Australian surgeons are being credited for saving the leg of an unborn baby by operating on her while her mother was just 22 weeks pregnant, French news agency AFP is reporting.

The hospital told AFP Monday that this may be the earliest in utero surgery of its kind.

Baby Leah was diagnosed with a condition called amniotic band syndrome in which bands of tissue wrap themselves around a developing fetus’ limbs, hands or feet and cut off blood flow. Doctors say the tissue had wrapped around both Leah’s legs.

A hospital spokeswoman told AFP that doctors usually hold off on operating until 28 weeks of pregnancy to better the baby’s chances for survival. However, Leah risked losing both legs if doctors had waited in this case.