Important facts about breast reconstruction

Many women who are facing a mastectomy may not be aware that breast reconstruction is considered part of the overall treatment plan. More awareness of breast reconstruction is needed, and that’s why October 17, 2012 has been designated Breast Reconstruction Awareness Day. BRA Day first took place in 2011.

“Breast reconstruction is not a luxury. It’s a part of treatment and an option that is readily available and can offer high quality results,” explains Dr. Tim Sproule, TSH Plastic Surgeon.

Dr. Sproule shares the following:

1. More than 10 per cent of women develop breast cancer in North America and other developed countries.
2. Treatment usually involves some type of ablation of the breast, which can be painful, unsightly and psychologically distressing for many women.
3. Sadly, the majority of women do not opt to have breast reconstruction despite effective treatment being readily available.
4. Plastic and reconstructive surgeons have a large number of options to help with reconstruction of the breast post-mastectomy, which can go a long way to restoring unacceptable appearance, confidence and self-esteem for women who have needed to undergo breast cancer treatment.
5. Options include implants of various kinds, sometimes including tissue expansion or utilizing a patient’s own tissues (autogenous reconstruction). The most popular of these involves using the lower abdominal tissue and transferring this to the breast defect.  This gives the happy result of also providing a woman with a ‘free’ tummy tuck!
6.  The latest advance is to utilize microsurgery techniques to spare more of the abdominal muscle and increase the reliability of the transferred tissues.

“The Scarborough Hospital has a large and sophisticated breast reconstruction program that can provide every type of reconstruction that is presently available anywhere in the world, with the highest level of quality and safety,” Dr. Sproule adds. “A large volume of breast reconstruction procedures is performed at TSH.  In fact, TSH has the third most active microvascular breast reconstruction unit in Ontario.”

Join us on Wednesday, October 17 from 4 p.m. to 8 p.m. at The Scarborough Hospital, General campus Auditorium where the breast reconstruction group will host a speaker series that will include intimate and personal discussions on all aspects of breast reconstruction, including implant choices, pedicled and microvascular flaps, and ancillary procedures such as nipple reconstruction and tattooing. The event will feature talks in English, Cantonese and Tamil. For more information on this TSH event, visit TSH’s BRA Day website.

The importance of prevention and screening for cervical cancer

Worldwide, cervical cancer is the second most common type of gynaecological cancer. In North America, it is the eighth most common cancer. The incidence of cervical cancer has decreased in the developed world because of regular Pap screening. Pap tests detect abnormal cells before they become cancer and further treatments can prevent them from ever becoming cancer. 

“Sadly, not all women go for regular testing and so we continue to see this lethal disease,” said Dr. Georgina Wilcock, an Obstetrician/Gynecologist at The Scarborough Hospital. “Each year in Canada, it’s estimated there are 1,300 new cases of cervical cancer diagnosed and 390 women will die of the disease. “

For these reasons, Dr. Wilcock reminds women about the importance of regular Pap test screening, which has been shown to decrease the incidence of cervical cancer by 50 per cent.

The Pap test is a quick, simple and usually painless procedure where a doctor scrapes and removes cells from the surface of the cervix with a small brush or spatula.  The cells are then examined in a laboratory. In the event that a Pap test shows  changes or abnormalities in the cervical cells, follow-up tests or procedures may be done.

Currently in Canada, it is recommended that women between the ages of 18 and 69 (or women under 18 who are sexually active) undergo cervical screening.

“Although the cause of cancer in general remains somewhat of a mystery, the cause of cervical cancer is not. The culprit is almost always the human papilloma virus (HPV) infection, one of the most common sexually transmitted infections (STIs),” points out Dr. Wilcock.

While some types of HPV cause genital warts, other strains of the virus can infect the cervix and then cause abnormal changes within the cells that may slowly progress to cancer.

There are several other important steps women can take to minimize their risk of developing cervical cancer:

• Get the HPV vaccine – The world’s first vaccination against HPV was approved in Canada and the U.S. in 2006. The vaccination provides protection from four different types of HPV – two of which cause 70 per cent of cervical cancer. In Ontario, this vaccine is given free to girls in grade eight. It is given at this young age because it has been shown that this is the best age for young women to develop a strong immunity to the virus.
• Practice safe sex – The HPV virus is most commonly transmitted via sexual contact and intercourse. Refraining from genital contact with an infected person or using a condom will reduce the risk of HPV infection.  However, condoms are not 100 per cent effective as they only protect the covered area.
• Stop smoking – Both tobacco smoking and exposure to second hand smoke have been associated with the development of cervical cancer. Quitting smoking can reduce the chance of developing the disease.

And, of course, ensure that you are receiving regular Pap testing.

Know the risk factors and symptoms of ovarian cancer

Ovarian cancer has been called ‘the cancer that whispers’ because of its vague symptoms and lack of effective screening. But more and more women and health care providers are speaking out about this ‘silent killer’.

“Unfortunately, only about 19 per cent of ovarian cancer cases are diagnosed before the cancer has spread outside the ovaries,” says Dr. Orit Freedman, a Medical Oncologist at The Scarborough Hospital. “However, when ovarian cancer is found after it has spread, while it’s sometimes not curable, it is treatable.”

One of the most important parts of the treatment is the patient’s initial surgery. The Scarborough Hospital has partnered with Sunnybrook Health Sciences Centre to have their surgical oncologists participate in ovarian cancer surgeries at TSH so that patients have the best outcomes possible.

Risk factors for ovarian cancer can include:

• Having a personal or family history of breast, ovarian or colon cancer
• Being post-menopausal
• Being obese
• Infertility and using fertility drugs.

Dr. Freedman encourages women to be aware of the following common symptoms that persist almost daily for two weeks or more:

• Bloating
• Pelvic or abdominal pain
• Trouble eating or feeling full quickly
• Urinary urgency or frequency.

In addition, other symptoms of ovarian cancer may include:

• Upset stomach
• Back pain
• Pain during sex
• Constipation
• Menstrual changes
• Unexplained changes in bowel habits
• Unexplained changes weight gain or loss
• Ongoing unusual fatigue.

“Talk to your family doctor about any concerns you may have about ovarian cancer and ways you can reduce your risk,” says Dr. Freedman.  “General information about ovarian cancer can also be found on the Ovarian Cancer Canada website at http://www.ovariancanada.org/.”

Sun damage and signs of skin cancer

Before heading out into the sun this spring, summer and fall, it’s important to take a moment and consider the harmful effects summer weather can have on our largest organ—our skin.

Even when the sky is overcast, you still need sun protection. Overexposure to the sun can cause your immune system to malfunction, and cause melanoma and non-melanoma skin cancer, as well as wrinkles, freckles and telangiectasias (dilation of small blood vessels).

“I would suggest watching for melanoma characteristics, such as asymmetry (one half is unlike the other), border irregularity (irregular, scalloped or poorly defined), colour that varies from one area to another, with shades of tan, brown and black, and sometimes white, red or blue,” explains Plastic Surgeon Dr. Sarah Wong with The Scarborough Hospital. “Also look for the size – anything greater than 6mm, but it can be smaller. And if it is changing in size, shape or colour. If any of these characteristics occur, have it checked out.”

While nothing can undo sun damage to your skin, Dr. Wong says it’s never too late to start protecting yourself from the sun. She offers the following advice:

1. The sun can damage your skin in as little as 15 minutes. Wear sunscreen or cosmetics with a sun protection factor (SPF) of 15 or greater 30 minutes before sun exposure and then every few hours thereafter.
2. Avoid direct sun exposure as much as possible during peak UV times (between 10 a.m. and 3 p.m.)
3. Perform skin self-exams regularly to become familiar with existing growths and to notice any changes or new growths.
4. The average T-shirt has an SPF rating of less than 15. Wear clothes that fit loosely and long pants in darker colours. Tightly woven fabrics offer more protection to your skin. Hats with brims can also offer protection to your face and neck.
5. Listen to the news to get updates on the latest weather alerts. If a heat warning is in effect, try to stay in the shade, carry an umbrella or avoid exposure to the sun.
6. Eighty per cent of a person’s lifetime exposure is before the age of 18. Foster skin cancer prevention habits in your child.

Four signs of colon cancer

Colon cancer is one of the most lethal cancers around. In fact, in non-smokers, it is THE cancer most likely to kill. It does not discriminate between genders; males and females who have been diagnosed with colon cancer face a 50 per cent chance of dying from it.

“So this means screening is critically important in saving lives,” explains The Scarborough Hospital Gastroenterologist Dr. Eric Hurowitz. “We think we can prevent 85 to 95 per cent of colon cancer through screening, be it with fecal occult blood testing or telescopic tests like colonoscopies or sigmoidoscopies.”

There is a “weak association” between diet and colon cancer, he adds.

“Vegetarians are less likely to get colon cancer, plus colon cancer is more prevalent in societies that consume higher fat diets, more cholesterol and more red meat,” Dr. Hurowitz explains. “The main thing people can do to prevent colon cancer is exercise; it’s more important than diet or where you come from or anything else.”

The symptoms of colon cancer are:

1. Blood in stool
2. Pain in abdomen
3. Change in bowel habits
4. Weight loss

Ten reasons to quit smoking today

Although smoking rates have decreased significantly over the last two decades, lung cancer – most commonly caused by smoking – is the leading cause of cancer deaths in Canada. Each year, over 24,000 people in Canada are diagnosed with lung cancer and 20,000 Canadians die of the disease.

“For those who do smoke, quitting can have a significant and positive impact on your health,” says Dr. Henry Krieger, a medical oncologist at The Scarborough Hospital. “Lung cancer is the most preventable cancer and the deadliest. Quitting smoking can reduce your risk of developing the disease.”

Dr. Krieger shares some good reasons to quit smoking today:

1. Cigarettes contain 70 chemical compounds known to cause cancer.
2. Smoking is the leading cause of lung cancer and kills more than 20,000 Canadians annually.
3. Smoking can also lead to other cancers including oral, esophageal and larynx cancers.
4. Exposing others to second-hand smoke puts them at risk of developing health problems.
5. Quitting smoking saves money.
6. By butting out permanently, you will improve your sense of smell and taste.
7. Smoking can cause complications with other diseases like diabetes.
8. Smoking contributes to heart disease, emphysema, stroke and several other life-threatening conditions.
9. Stopping smoking can give you fresher breath and cleaner teeth as well as a fresher smelling home, car and clothes.
10. Quitting smoking can improve breathing.

Eight reasons to be tested for prostate cancer

There’s been a lot of buzz about “Movember” a light-hearted campaign involving men growing moustaches during the month of November to bring awareness about a serious disease – prostate cancer.

As the most common cancer affecting men, prostate cancer will be diagnosed in 24,600 men in Canada this year and 4,300 men will die from the disease.

“Typically, in the early stages, prostate cancer has no signs or symptoms,” says Dr. Edward Woods, a urologist at The Scarborough Hospital. “That’s why it is important for men to be tested regularly, before symptoms occur. Prostate cancer is very treatable if detected and treated early.”

Here are eight reasons why men 40 years and older should be tested for prostate cancer:

1. Early diagnosis is imperative.
2. One in six men will be diagnosed with prostate cancer in his lifetime.
3. The disease is more commonly being diagnosed in men in their 40s.
4. When found early, 90 per cent of prostate cancer cases are curable.
5. Prostate cancer often has no signs or symptoms in the early stages; proactive testing can detect the disease early.
6. Due to an aging population, the incidence of prostate cancer is on the rise.
7. If you have a family history of prostate cancer you are at higher risk.
8. Testing for prostate cancer could save your life.

Eight tips to reduce the risk of breast cancer

It is estimated that 23,000 women in Canada will be diagnosed with breast cancer this year and 5,300 women will die of the disease. But over the past 30 years, death rates have steadily decreased, in part due to increased screening and awareness.

In Ontario, women between the ages of 40 and 49 should have a clinical breast examination by a trained healthcare professional at least every two years and discuss whether screening mammograms should be started. Women between 50 and 69, should also have a mammogram every two years. Women 70 or older should talk to their doctor about how often testing is necessary.

Following these screening guidelines and conducting regular self breast exams are important for early detection, says Dr. Nadine Norman, a surgeon who specializes in breast cancer surgery at The Scarborough Hospital. In addition, there are some things you can do to decrease the risk of developing the disease.

October is Breast Cancer Awareness Month and Dr. Norman shares her tips for helping to reduce the risk of developing breast cancer:

1. Maintain a healthy weight.
2. Get regular exercise. Even moderate exercise may reduce your risk by 30 to 40 percent, according to studies.
3. Discuss with your doctor the risks associated with taking oral contraceptives.
4. Breastfeed your baby. Research shows moms who breastfeed have a reduced risk of developing breast cancer.
5. Limit your alcohol intake to not more than one drink per day.
6. Don’t smoke and avoid second-hand smoke.
7. Talk to your doctor about the risks and benefits of hormone replacement therapy (HRT). Although HRT can reduce symptoms of menopause, it increases the risk of breast cancer if taken for too long.
8. Talk to your doctor about your risk and concerns to determine the best course of proactive care.

For more information about breast health, click here.

Six tips for testicular self-exams

Toronto Public Health recently launched the “Check Your Package” ad campaign aimed at creating awareness about testicular cancer and the importance of monthly self exams. Ads for the campaign, which include a photo of a man’s midsection, were denied by Facebook and deemed distasteful and threatening.

“Testicular cancer is the most common type of cancer among men 15 to 35,” says Dr. Henry Krieger, a medical oncologist with The Scarborough Hospital for 35 years. “In most cases, the cancer is curable if detected early. It is important to bring awareness to the significance of self exams.”

When conducting a self exam, check for swelling or enlargement of a testicle; a hard lump on the front or sides of your testicles; an increase in firmness; and pain, discomfort or a heavy feeling in the scrotum or lower abdomen. If you have any of these symptoms you should consult a doctor.

Here are the steps to conducting a monthly self exam:

1. Look at your testicles in the mirror and get familiar with their size, shape and feel.
2. After a bath or shower, hold the scrotal skin in the palms of your hands.
3. Check one testicle at a time.
4. Using both hands, gently roll each testicle between your fingers.
5. Gently roll your thumb over the top of the testicle. You should be able to feel the epididymis, the tube that carries sperm. This is a normal lump at the back of each testicle.
6. Repeat monthly.