Indo American News

Tag: Texas Oncology

Texas Oncology Cancer Prevention Series: I Don’t Have Cancer – So Why am I Seeing an Oncologist?

Hematology is the specialty that addresses blood disorders. It is an area that does not get much publicity, but is one where many patients need the services of a specialist. This month, Dr. Muffaddal Morkas discusses the specialty of hematology and its interaction with oncology.
Vivek S. Kavadi, M.D.

By Muffaddal Morkas

If you ask my daughter what I do, her answer would be that I’m an oncologist – a cancer specialist. Even though it’s true that I devote a lot of time taking care of cancer patients, there is another important aspect of my practice that impacts millions of Americans every year. Patients with blood disorders are treated by hematologists, and many oncologists are also trained to practice hematology. I explain to my patients that these are sister specialties that are often intertwined. Some of the most common conditions treated by a hematologist are anemia (low hemoglobin) and thrombosis (blood clots).

Anemia affects more than 3 million Americans. This condition is manifested by low hemoglobin, or shortage of red blood cells. Anemia is often the manifestation of an underlying disease, such as iron or Vitamin B12 deficiencies, other deficiencies, chronic diseases, blood loss, cancers, or bone marrow disorders. Since hemoglobin is needed to carry oxygen in the blood, individuals with anemia get fatigued; therefore, this is often the main presenting symptom. Hematologists treat anemia by evaluating, diagnosing, and recommending treatment for the underlying condition.

Patients with thrombosis (blood clots) also see hematologists. Thrombosis affects about 900,000 Americans with about 100,000 deaths each year attributed to it. There are several types of thrombosis related to various parts of the body, which can be very serious and potentially life threatening in some circumstances, especially if the clot travels to the lungs.

While cancer in itself can be a risk factor for cause of these blood clots, many people develop the condition from factors completely unrelated to cancer, such as being sedentary for long periods of time (e.g., a transatlantic or transpacific flight), recent surgery (especially orthopedic surgery), certain medications such as estrogens, pregnancy, smoking, and obesity, to name a few.

Hematologists treat thrombosis with a variety of medications commonly known as “blood thinners.” In addition, they provide guidance to other medical practitioners in the management of thrombosis in the setting of any planned surgical procedures.

4Blood disorders may not have specially-colored ribbons or widely recognized awareness events, but my patients with these conditions are every bit as heroic, standing up to and fighting their disease. They deserve all the support and encouragement we can give them.

To learn more about hematology, visit www.TexasOncology.com.

Dr. Muffaddal Morkas is a hematologist and oncologist at Texas Oncology–Memorial City, 525 Gessner Road, Suite 310 in Houston, Texas.

April 21, 2016
Texas Oncology Cancer Prevention Series: Treating Cancer with Transplants

Traditionally. the term leukemia has been a very scary one for most people. Over the years, there has been a great deal of publicity around bone marrow transplants. This exciting treatment has evolved and now there are many versions of transplants. The technique has become much safer and has been critical in our ability to treat several different types of cancers in addition to leukemia.

In this month’s article, Dr. Sanjay Sethi discusses transplants and also talks about the need for people of our ethnic background to register with the national marrow database.
– Vivek S. Kavadi, M.D.

By Dr. Sanjay Sethi
Cancer is an equal opportunity offender. It can strike anyone at any time. It can also occur just about anywhere on your body, including your blood stream. According to the Leukemia and Lymphoma Society, an estimated 1,185,053 people in the U.S. are either living with, or are in remission from, leukemia, lymphoma or myeloma.

Adults have about five quarts of blood circulating in their bodies, which is made of red blood cells that help carry oxygen through the body and white blood cells that help fight off infection. Your body continually replenishes its blood supply by growing new red and white blood cells and plasma cells from stem cells in adult bone marrow.

There are three primary forms of blood cancers. Leukemia is caused when your body produces abnormal white blood cells. It starts in the bone marrow, the soft tissue inside the bone, where blood cells develop.

Lymphoma is a blood cancer of the immune system and can be found in the blood or lymph nodes. Multiple myeloma is a cancer that begins in the plasma cells of the body.

When we treat cancer, we most commonly use surgery, radiation therapy, and chemotherapy. Our goal is to shrink or eliminate the cancer, and we often use these tools in combination to give patients the best outcomes.

Unfortunately, when a blood cancer develops, it cannot be surgically removed. Oncologists must focus on the source of the cancerous blood cells—cells that could be anywhere in a patient’s blood stream, lymph nodes, or bone marrow.

Blood and marrow transplants give patients another option for treating these cancers. Healthy blood stem cells are collected from either the patient or a donor, whose genetic makeup closely matches the patient.

The patient then receives high dosages of chemotherapy, which kills the cancer-producing cells throughout the body. The healthy blood stem cells are then injected into the patient, where they begin to grow and reproduce to replenish healthy cells.

This treatment was first developed in 1968, but advances have made it far easier for donors to donate marrow to patients and for patients to supply their own healthy adult stem cells. There have also been advances to make it easier for patients to recover from the transplant, and, most importantly, increase the patient’s chances of living cancer-free.

Several decades ago, “blood and marrow transplants” conjured up thoughts of pain for the donor and a month or more of recovery in isolation in a specialized hospital unit for the patient. However, techniques have substantially improved.
While the transplants are still completed in specialized hospital units, the recovery period is often outpatient. “Mini transplants” have reduced recovery time and made the experience less taxing for many patients. The donor experience has become far more convenient with less discomfort.

There is a nationwide shortage of blood and marrow donors, and ethnic minorities are significantly underrepresented in donor registries. Registering to be a donor is easy—visit www.BeTheMatch.org to get a mail-in packet to register or attend a donor drive in your area. With a simple cheek swab, you can enter a national registry of potential donors.

You may never be called to be a donor, but by registering, you give patients another opportunity for hope. If you’re interested in learning more, visit www.TexasOncology.com.

Dr. Sanjay Sethi is a medical oncologist at Texas Oncology–Sugar Land, 1350 First Colony Blvd. in Sugar Land, Texas.

March 24, 2016
Texas Oncology Cancer Prevention Series Adding Life to Your Years

By Dr. Meghana Bhandari

A concept in the field of oncology that is getting more attention recently is survivorship. A diagnosis of cancer is often an overwhelming and life-changing circumstance. The entire focus of the patient and their loved ones is on the treatment. However, once the treatment is finished, what happens next? As oncologists, we not only want to treat and hopefully cure our patients, we also want them to get back to their lives even if that is a “new normal.” In this month’s article, Dr. Meghana Bhandari talks about many of the issues in survivorship.
– Vivek S. Kavadi, M.D.

I see a number of patients each week in my oncology practice. Many are in various stages of cancer treatment, but others are returning for a regular check-up after completing what was often an intense course of therapy designed to maximize the chances for cure or at least disease control. Some are cured, some are not, but for all the experience of having cancer has consequences that may last a lifetime.

Many patients talk about how their lives have changed as a result of their disease. These changes create a “new normal” patients adjust to when they complete treatment. I enjoy the opportunity to see all of my patients, but I always am inspired by the “thrivers” – the people who embraced their new normal and kicked it up a notch or two.

Patients thrive on varied tracks. Some may go from a couch potato to an ultra-marathoner; others may volunteer at their community cancer center and become a part of other patients’ support networks.

Thriving can mean finding new hobbies and interests, or it can be as simple as living in the moment. Cancer treatments can change a person in any number of ways. Some are outward and easily noticed.

Treatments may result in changes to their physical appearance or cause side effects like lymphedema or hormonal changes. Some patients are motivated to make lifestyle changes that help reduce their risk of cancer returning, such as quitting tobacco, starting a regular exercise program, or eating a healthier diet.

Other changes are more psychological in nature. A common worry is that the cancer may return, a fear which lingers in the back of many patients’ minds.

Many patients deal with a sense of loss or loneliness when their active treatment ends. Even though our community cancer centers allow patients to stay close to the critical support of family and friends, patients have created schedules around doctors’ appointments and treatment sessions.

They have also bonded with their fellow patients, their caregivers, nurses, and physicians, but won’t be seeing them as regularly. I value close relationships with my patients, but one of the greatest joys in cancer treatment is seeing a patient transition back into their life outside of the practice.

Our oncologists and healthcare teams can help maintain the good changes and work to minimize the more unpleasant ones. Support groups, as well as consistent encouragement and companionship from loved ones, can help make the transition to survivorship easier.

Our community-based treatment setting gives our patients a big advantage because they are already near their support networks. Starting to make lifestyle changes while they complete treatment makes those positive changes easier to stick with in the “new normal.” Many survivors feel a great – and well-earned – sense of accomplishment and are well on their way to thriving.

As a community-based practice, my colleagues and I are deeply invested in Houston, in our friends and neighbors, and in our community’s well-being. Our patients don’t just disappear once they leave our clinic; they remain fellow members of our community. I hope that when our paths cross, I find them thriving.

Dr. Meghana Bhandari is a medical oncologist at Texas Oncology–Sugar Land, 1350 First Colony Blvd. in Sugar Land, Texas.

January 28, 2016
Texas Oncology Cancer Prevention Series: Colonoscopy: It’s Worth It!

By Dr. Dhatri Kodali

We often hear that American medicine is more focused on treatment rather than prevention. That may be a fair criticism at times but one important factor in prevention is patient participation. This month’s article discusses very effective cancer prevention and screening tool that, unfortunately, is one of the least utilized: colonoscopy. Starting at age 50, both men and women need to be screened for colorectal cancer. Dr. Dhatri Kodali describes the importance of this in this cancer education series.
– Vivek S. Kavadi, M.D.

There are several things on my “to do” list that I’m really good at putting off. They need to be done, but I don’t like disrupting my routine or taking time away from other activities to make them happen.

However, when it comes to cancer screenings, it’s worth a little disruption. It can give you peace of mind. Or if cancer is detected, the earlier we find it, the more treatment options we have.

A colonoscopy is a great example of something many would prefer not to do and often delay.

Colonoscopies get the worst rap of all the cancer screenings, and it’s not hard to see why. We generally don’t discuss it at the dinner table, and it might be a bit embarrassing. Between the prep and the procedure, you have to invest a bit of time. But at the end of the day, it is worth it.

Detecting cancer early through colonoscopy can be a lifesaver, which is the best reason to get one.

Typically, colorectal cancer doesn’t have symptoms in its earliest stages – when treatment is more likely to produce the best outcomes. Colorectal cancer is the third most commonly occurring type, accounting for about 8% of all cancer cases nationally. The American Cancer Society estimates 10,050 Texans will be diagnosed, and 3,470 people will die from the disease this year.

Colonoscopies are a great investment of your time. We spend a lot of time protecting our health by staying active and eating right, and it only makes sense to protect our health in this way, too. Unlike monthly self-exams, most people only need a colonoscopy once a decade, unless your doctor advises you otherwise. As an added bonus, a colonoscopy can be both a screening and prevention exam, since precancerous polyps can be removed during the procedure.

A colonoscopy simply isn’t as bad as its reputation. Yes, you have to prep, which is probably the worst part. Yes, you’ll definitely want to be home the afternoon before your procedure. However, I’ am confident that if you asked my patients, most would tell you even the prep wasn’t as bad as they had heard; the procedure itself was a piece of cake – after all, you are asleep; and the peace of mind they have now made it all worthwhile.

A colonoscopy every 10 years, starting at age 50, is the gold standard of colon cancer screenings. If you’re still reluctant to have a colonoscopy, please don’t give up on screenings altogether. There are other, less-invasive methods, but they need to be conducted more often, and may not be the best option for you. Talk to your doctor about which screening is most appropriate for you.

If you’re due for a colonoscopy, stop putting it on your “to-do” list and move it to your “done” list. You won’t regret the decision.

Dr. Dhatri Kodali is a medical oncologist at Texas Oncology–Deke Slayton Cancer Center, 501 Medical Center Blvd., Webster, Texas; and Texas Oncology–Texas City, 1125 North Highway 3, Suite 150, Texas City, Texas.

January 7, 2016
Fighting Cancer from Within

Over the last several months, we have covered the principles of the three main branches of oncology: surgical, radiation, and medical oncology. We have discussed how these treatments are used alone and in combination to treat patients. Another area that is getting much research attention lately is that of immunotherapy for cancer. In this article, I will discuss the concepts behind using the patient’s own immune system in the treatment of their cancer.
– Vivek S. Kavadi, M.D.

Sometimes, a great idea comes around, but is overshadowed. In the fight against cancer, chemotherapy and radiation treatments have been our primary “go-to” treatment options for decades and most of our research has been focused on making these more effective.

Immunotherapy is a not-so-new treatment that is coming into its golden age, thanks to developments in medical technology and research. We’re just starting to scratch the surface of what may be the biggest revolution in cancer treatment in our lifetimes – harnessing the immune system to help fight cancer.

When the immune system encounters foreign cells from ordinary diseases—such as a virus or bacteria—it recognizes certain traits and starts fighting them. Within a few days, the body is healthy again. However, the immune system has a harder time recognizing threatening cancer cells.

In the late 1800’s, Dr. William Coley found that some cancer patients benefited when their immune systems were “enhanced” with certain bacteria. Coley’s treatment concept faded when advances in chemotherapy, radiation therapy, and surgery were developed. In the last few decades, researchers have returned to Coley’s intriguing idea. What if we could give the body’s immune system the boost it needs to fight cancer the way it would fight another disease?

Thanks to a more advanced understanding of the human immune system, we’re able to do just that. Immunotherapy is not currently available for all forms of cancer, but the treatments that have been fully approved or are in clinical trials are radically changing cancer treatment.

Vaccines, which are patient and cancer specific, have been developed for some forms of cancer. They may boost an immune system response or help prevent a future recurrence. Much like chicken pox, your body has a “memory” of how it fought the disease the first time.

Some immunotherapy is not specific to a cancer type. Interlukins and interferons help the immune system resist cancer and viral infections. Patients receive these medications which help the immune system cells grow and divide more rapidly to resist infection. This has proven effective for some forms of cancer.

Another type of immunotherapy is more specific. Your body already makes antibodies to fight infections like the flu. Scientists are now designing antibodies to target specific antigens in cancer cells. After they are injected into a patient, they seek to bind to the cancer cells and destroy them. Since healthy cells don’t contain the antigen, they are not affected.

Using the body’s own tools to fight cancer is opening up a new and exciting horizon in oncology. For example, immunotherapy led to the first new treatments for melanoma to be approved by the FDA in more than a decade. In some cases, immunotherapies can mean fewer unpleasant side effects for patients. For me as a physician, they mean hope for patients whose current treatment options are not enough.

Immunotherapy may be the most exciting part of the cancer research field today, and our patients are helping to move it forward. At Texas Oncology, our patients can participate in promising clinical trials, including those for immunotherapy, in their local communities. Visit www.TexasOncology.com for more information.

Dr. Vivek Kavadi is a radiation oncologist at Texas Oncology–Sugar Land, 1350 First Colony Blvd., Sugar Land, Texas; and Texas Oncology–Radiation Oncology Center at Memorial Hermann Memorial City, 925 Gessner Road, Suite 100, Houston, Texas.

October 29, 2015