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Legacy Health Cancer 3.15.15

Mar 11, 2015|

AN INTERVIEW WITH DR. NATHALIE JOHNSON, MEDICAL DIRECTOR AT LEGACY CANCER INSTITUTE, ABOUT THE LATEST IN CANCER PREVENTION AND SCREENING.

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Automatically Generated Transcript (may not be 100% accurate)

This is metro scope and Entercom radio Portland public affairs program money Gary blocks and and today on microscope we're going to be focusing on cancer. It's mostly cancer prevention and cancer screening. I'd like to welcome doctor Nathalie Johnson are practicing surgical oncologist and medical director of the legacy cancer institute and the legacy breast health centers in Portland cement discover whether doctor. I. So today we wanna talk about cancer and looks like you've been practicing medicine for a long time I have what are some advancements we were are we with cancer prevention and screening these days. Well I think they're bid out whole lot has changed since I first it got out of medical school. In terms of imaging things have gotten to feel much better. From you know reading mammograms and pet CT scans his. To all sorts of a tip marker feet so bad it's gotten a lot better and then in the world best treatment. Things have really exploded with its. Personalized come here and targeted therapies. So it has been an exciting time to be in in camp third treatment. Every notice that people's attitudes about cancer has changed over the years to. Isn't it really has come at personally my mom had a breast cancer when I was isn't my idea teams and attitude then was cancer third has meant deaths. Whereas now you have there is survivable. And we have so many people that are thriving after treatments for cancers although it's still a struggle. And we don't sure everybody we've made such advancements. That people are dotted afraid of the word cancer. Throw the best place to start is his prevention. Yes it is so what are what are some things people can do to reduce their risk of cancer. Well life style and nutrition is a huge. So extreme diet they know it doesn't sound sexy but exercise is really important and you can do that is so many ways. It is gonna have to be you know it in the classic can be a good brisk walk. It could be doomed they can be you know riding a bike but anything that gets your heart rate up. For at least to thirty minutes and you need to do that about. Five days a week Philip total of three hours a week really reduces your risk of cancer and heart disease. In terms of diet. The having five. Servings of fruits and vegetables. Everyday eight. I'll which sounds like a lot that you have big bananas two servings of that both fruit so it just thinking about it and being. You know conscious about it intentional. You can do those get those unhealthy. Habits into your diet. It all sounds very simple really hit it a little bit daunting the kind of simple act upon it and making the commitment to do that. That we simply serve to considering bids cancer prevention efforts. Still he we should start even with the with our children you know teaching them what a good diet is like an instilling in them the importance of exercise. We can start the air and then modeling that's an about face showing. Eight you know in our. Like violent behavior. There's some other things that we can teach you like and some products. You know that are we used ideally can be cancer. Positive though just being aware of that. Spirit than a website called Environmental Working Group that has been really on easily accessible list step. Food that you might wanna consider buying organic and food where it really doesn't make any difference. And some household products and then beauty products that we use that. You may want to stray away from our other they're really good and safety used. So those are some things he can do smoking for instance is one thing that we know is linked to cancer. So we don't get it making a real effort to quit smoking or encourage those around those who do. And to help them quit smoking. Know what chemicals are linked to cancer we were exposed to so many things every day. We are so that he knows by those BP A free bottles because that's definitely associated with cancer risk. Some of that being very cosmetic compared something called Arab bend and those are linked to risk of cancer as well. So again you can go to that web site Environmental Working Group and you you can get in easy information about app. Totally agree website a lot of knowledge there yes there really. Know how about family history. There's nothing you can do about your family history and schools. Tell you can't and all both people really focused on that all be about 10% of cancer risk is associated with. Family history they'll most of its associated with lifestyle and each mission. But family history is and can be important and if spirit a lot of character in your family I would certainly talk to your care provider about it. Because there is currently genetic testing that can be done his feet. If spirit. Mutation it's called a big jeans. Particular family. And those that have that can be screened more closely though that if they do you develop cancer. We will be able to pick it up early and treated. Where do you see the eve of future of cancer research headed. Dare I film many other avenues so right now there's a lot of exciting work around is vaccines. I'll waste product gay with Brad and and it's. Surveyors that they do area and then it's. We have all these targeted therapies so as we've gotten better at understanding genetic authority chain of tumors. We are seeing all these defects that we are now developing tribes that targets that defects. So with those drugs we hope and make Sri meant less toxic so we don't have as many side effects. But really are able to have focus that treatment the work killing the cancer cells. And not hurting normal self and that just exploding so it's it's really exciting and I think a lot of research will be around back. Well vaccine that's that's intriguing yeah. Well vaccine Doocy for for prostate cancer and Pratt and breast now. We actually at legacy have a vaccine trial open where one fight at a fourteen around the country. Where we aren't giving a vaccine to breast cancer. So. If you qualify for this study you have to have a fair blood type then that third cancer types. Then after you have your treatment that you received that vaccine. And ultimately a booster vaccine and so far the preliminary. He studies are showing that it reduces their risk. A cancer recurring though it's been exciting area. Well I've met. The good time to be in medicine yeah really exciting well let's focus a little bit on specific cancers will serve with breast cancer. Now there's a lot of misinformation about mammograms out there what does legacy cancer institute's recommendation. Well there's been a lot of misinformation technique about screening. And we continue as do most of major society to recommend that women start screening at forty. And then be screened annually. And screening does he create the risk of dying of breast cancer. Some of the concern is that you know people when he's screen you may get called back to have additional pictures and it turns out nothing's wrong. But. When you look at the population. Than the women that are being screened for breast cancer have a much higher survival rates. And if we picked that. Cancer up early often there's less treatment associated with securing hits. So. So we continue to do Mattel web it started at forty and be screened annually. How about the women that may be are concerned in their under the age of forty. So that that's when family history plays that they Grohl Phillips there's a strong family history that we DDT it's screening under the age of forty. And we may use MRI in addition to Bob Barker fee for a screening as that group. There's also been some controversy about breast density so some women who have some very dense breasts. Even with Bob Barker we we made shots he hit two of our early so now opt in or again and many other states around the country. My marker fi unit I have to let you know or let no one bit so if she has extremely dense breasts. So that she did ask that question is that bad a Graham and tough for me. And women who have dense breasts also have an increased risk for breast cancer. Her. Now moving on to coal rectal cancer what's what's the recommendation there. So the recommendation it is pull it not to be which everybody just loves but I. Release party at there's nothing like good night complete Poland of make it feels good though that for colonoscopy is even if they should feel good. And so we've recommended. Starting collapse could be at fifty and then depending on the fine being ethical enough to be. Is this schedule after that both. First somebody who has a colonoscopy at this could have Eddie Pollack that everything looks great that they won't eat it another one for ten years. But if you have Paula put depending on what type you have you made needed again in three years or five years. Headaches out and he's meeting that it's also played their role is creating for colon cancer cheap because she can to have it it inherited risk for developing. Colon cancer so is it you have that situation. That every two years maybe you're screening schedule. But he still should start at age fifty yet. This family history or not. At bay if you have a family history that it would be earlier so it. It may be as early as 354. Family history. The other prep for a colonoscopy you that's literally and fears the most I think what do what is that process like. You know it used to be did speak gallon jug of disgusting piece thinks that's. But now it's a smaller bottle and so you'd drink that L com and that it gives you you know of course you have to go to the bathroom several times. But it could mean without the coal is so that there is nothing in there those tools so that they can see if they're polyps. And it really isn't bad. Yeah but not bad at all but like I said you know you lose a couple of pounds that he felt that establish buffer. Apple based well that's good news yes dad what are some of the symptoms of colorectal cancer. So sometimes they can be just that he because it fits on boat bright side of that Colin. It tends to leak blood and Egypt get beat make without Elway or not seeing it. Really see it that they're still. Because somebody has that DBS that's the reason for us to do that coal or not if he had checked. For others you may see blood in the stool. And that's another way that we can screen I was tied as colonoscopy. Is there. Something hits that called a fit you have to Wear use smear a little bit as tool on all of a swab which. And that we checked for himself time and that it that it tested positive that we'll do the colonoscopy. That's another way to do it although that's cool enough BP is really the best way. It seems like colorectal cancer is kind of an equal opportunity cancer ms. are there specific ages and ethnic groups that are of their biggest risk. Well a it is kind of think equal opportunity. Cancer and it is we seem to be seen get more and younger people which is interest staying. Because usually we kind of because it is being you know people that are fifty or older. But the prevalence and people in their thirties and forties this increased they. And that may relate to diet and you know we were talking about the Tricia that has been good you know fruits that. Vegetables because having a high fiber diet. Also having good level of vitamin. Sometimes vitamin. Yes it is so what you don't we do recommend supplementation and then a lot of pediatricians are recommended at this while the house. Is colorectal cancer fairly treatable. It really is as good that that's his prevention lets you get court not to teach. And we remove polyps than they ever go on to become colon cancer. So is it a population that speaks screens get it then but that incidence of colon cancer really dropped off. But earlier we find it very easier it is to treat an for a lot of people it's as simple surgical removal. For others that does require the addition of chemotherapy. Ever that colon cancer is relatively slow sec correct. Is determined that yet development from a Paula that would be true. So that's that's why it works if he'd get the pole and knocked could be it we can get fat pol about. Before it had the chance to progressed that to colon cancer. And that's why this greedy you know can beat them head gear at because it it doesn't tend to be a rapidly growing cancer. Certainly public screening is that is the perfect way to go it really anything to do it really is. How about lung cancer screening. So we are offering that as well and lung cancer screening is four people we meet at all. So anybody that smoked more than. Thirty package ears. So we had a bit explanation that packed gear would be equal to smoking one pack of cigarettes that gave birth I pour out a full year. So for instance if he's smoking half a pack of cigarettes that day then that would be after and eat calculated over a year of the half pack here. Or is somebody smoke too. Do taxes and bigger as did David it's six months they would reach one attack here. So does that is that for a current smoker or even the past smoker. It's for a pass smokers so anyone that smoked thirty pack gears of war is over at the age of fifty. And it's either currently smoky or quit smoking within the past ten years is eligible for screening. What is the screening for lung cancer like. So it won't CT scans of the lungs so I'll. They they keep coming is actually very quick so mainly we talk about you know looking to see if you eat that screening criteria. And then if you give me this meeting criteria it's that quick tap stand it takes about its teeth and at. And then we look to see if we see any early log dot Jill. Because that that tenth of a lung cancer that we really don't do it current till it's very advance. And so we know there's that group of people were at brisket we can fight it early age seen being early detection beats a higher rates of cure. What are some of the symptoms of lung cancer. So coughing up blood com short in her breast. And repeated the repetitive episodes of that well again this same area of the long. Those can all these symptoms don't want to have her. No fluid during a screening if something is found cool what are what are the next steps. So if we do find that they got that screening for those. For lung cancer. Often that next step would be going to either he pulled acknowledges targeted at CT pet scan to see whether that lesion looks. This vicious. And then from their baby biopsy. Many times with greetings we find some meat and we see who we are not sure so we may do it better follow up get an a couple months trying to sort out if it is that night or only and it's. Without Ito doing something in base. Now I've heard that skin cancer is probably the most popular type of cancer is that true yes I'm very top yet. So what are some of the warning signs of skin cancer. So. Sole lead changes color or a skin lesion that doesn't appeal or he'll. And then it a couple days his basket so those are all fine this get cancer. And there are other other various types of skin cancer. There are exposed the most common form that it has terrorists something called clean myself. And basal cell cancer within those often coveted areas that are exposed to decide. And then that most of lethal form of skin cancer village spell adult. It is and so that's the peak that it lesions that change color that you should be aware of. And they're screening I'm assuming for skin cancer as well. There is. So. People kids see their primary care doctor or dermatologists. Go to the to do they do you see your doctor wants loves to check things out tech at exactly the one of the top ways to prevent skin cancer sun screen I would imagine is up there. That's created is is as good idea. And so that also ties in to looking up because there's something called foxy. That many can screen to have Betty kitty were increase your risk for cancer. Other cancer but he did try to be aware of that. But protecting your skin protects you against. Yes Weymouth cell basal cell. And melanoma. But also. That ravages of eighteen because you know a lot of speed exposure of sun exposure eighty your skin. Or quickly as well. Other certain people that are more risk of who have skin cancer. Yeah lighter skinned people are at more at risk for around forty skin cancer. Although darker skinned people African Americans can get ballot L but in odd places like on their total war. And those can be a little bit more aggressive so it's also being aware of you know if you get a bowl under your tailored dark spot that does. Seem typical wage. You should pay attention and that is well. It may have would be kind of surprising to find something that it in an area that wasn't. Exposed to the sun. But that I'm assuming that he can still get skin cancer anywhere right you can't. So that wouldn't do it certainly is like under on your back or something like that that you can't seem to have those things to tell. Yeah so yeah to have a friend one of our big focuses now on. Cancer treatment it's not just. Prevention and you know screening treatment for cancer. But also what we called survivorship. So helping people to get back to its. Their hair bested you in normal after cancer treatment. So freaked some people on cancer treatment effect sexuality. It can affect appearance. So healthy people could get baskets to mom's feeling good about themselves feeling healthy and live feed forward. So we have a program can't get ear cruised back. Like that let me ask antidote for bad everywhere meant to that you don't get help that term that's. You know looking at walls where you are in it embassy your relationship. That whether they're from physical changes that have happened. Offer treatment that we can help get you back to it in place where you enjoy that part of your life. For some people at the emotional as can almost be like posttraumatic stress disorder where. You know going through treatment has really changed the way you the core of the way the world appears. And helping them to learn how to to the old happy and secure in as they go forward in life. There are still ready seeing that happen and we can't help but now weigh in now. We focused on app or at its twenty years ago we just treated people at whatever the outcome was see you we're just happy to be alive. But now we want people to really enjoy it and I'll cherish the life that they have after treatment. Cancer can be very devastating and after herb treatment at the you have kind of a new normal. Exactly. Exactly so we're helping people it's. Feel fulfilled and that is adorable and teammate that they're adorable. Hedo at great he did to fulfill their their best physical. Possibilities. Spiritual possibilities and emotional possibility. Your disposal be a day when cancer is no more after. I hope so I pray for that. There's this film many different types of cancer but it is found. To hear cases we've really won that battle for instance testicular cancer which used to be devastating now you know 99% of people. Survived that. So we're looking and it's just they those winds hit it each hit every type of cancer and for breast we've come a long blonde played. Feel pancreatic cancer slowly we're not there yet it's but we're we continue to make headway. Cancer seems like a relatively new thing to do. There and by that I mean it back in the old days maybe people die than they can really as they had cancer. That's very shrewd so. That you don't want and that being that we hear alive is if you have surgery. Either you're gonna die of that cancer if you open it to the air but what that came from was that. He Ito before we had big image seen it and test states. When people presented with to have to it was a very expands so. We would. Oh that and that realized that there was anything we can do it and that closes site gets to everywhere else it appeared that this surgery was heard speak that. That's I'll put the final event when in reality Al weekend in an agent we know where we are so weak team do you treat them before. And they beat the better so that we can't surgically were both that they know. So I think you're right this the approach to cancer and the survivor ability now. From most cancers is so good that be added to do about it and the willingness to talk about it this is different. Yes survivor surviving is that is a reality now yes it really is. Well doctor you've given us some really great information today thank you doctor Nathalie Johnson a practicing surgical oncologist and medical director of the legacy cancer institute. And the lacy breast health centers in Portland thanks reveal a microscope today. You microscopes and Entercom communications public affairs program. My name's Gary and if you have a nonprofit or public affairs organization that you'd like let others know about you can email me at microscope @entercom.com. Remember inter com starts of any. Four you can go directly to the station's website click on the community link and submit your information there. Also we like to hear this program again you can visit our podcast page at microscope PDX dot com thanks for listening to mr. scope and enjoy your weekend. Right now in conflict zones refugee camps and remote villages around the world. Doctors Without Borders is delivering emergency medical care. Which you or support our medical teams respond quickly when conflicts. Deadly outbreaks. Are natural disasters strike. Doctors Without Borders is funded by individual donors around the world. So our independence and impartiality. Allow us access to patients in need. In places others often won't go. Doctors Without Borders is dedicated to delivering high quality medical care. In the worst circumstances. Doctors Without Borders is saving a life somewhere right now. Please support us today by visiting Doctors Without Borders ought to work. You make our work possible.