Dr. David Sheldon and Dr. Sydney Lillard say that universal screenings such as colonoscopies would drastically change their patient numbers.
“About 85 percent could be prevented if we saw it (cancer) when it was a polyp,” Sheldon said.
Both fellowship-trained in surgical oncology, Sheldon and Lillard are the only such specialists in Montana. Practicing as Northwest Montana Surgical Associates-Surgical Oncology, the two surgeons see too many patients who weren’t screened for colon cancer at the recommended age of 50.
“I see a fair amount of more advanced stage,” Lillard said.
Sheldon said some Montanans just don’t have easy access to these screenings. He pointed out that people living along the Hi-Line don’t have any gastroenterologists in their area.
Lillard added that the stoic character of hard-working Montanans sometimes causes them to brush off symptoms. When these include changes in bowel habits, particularly bleeding, doing nothing is the worst course of action.
“A lot of people attribute the bleeding to hemorrhoids,” Lillard said. “If you are over 50 and having bleeding, you should have it checked.”
Sheldon said if you notice that you don’t feel right, you should have it checked out to eliminate the possibility of some type of cancer. Symptoms are all too often nonspecific, Lillard added.
When Sheldon arrived in August 2009, Kalispell Regional Medical Center began attracting cancer surgery patients from a wide area. No one had anticipated just how many patients were seeking surgery for more complex cancers in centers in Spokane, Salt Lake City, Seattle or the Mayo Clinic in Minnesota.
“Typically when you have a new surgeon come with a new skill set, you have a ramp-up phenomenon,” Sheldon said. “Within a month, I was booked out several months.”
Lillard described it as more of a launching pad than a ramping up. Within a year, she joined the practice to help shoulder the demand for the new cancer treatment-at-home option.
She said many patients with gynecological cancers who were seeking treatment out of state now are choosing surgery here.
“Even some with basic skin cancer were leaving,” Lillard said.
She and Sheldon have credentials that give patients confidence that surgical techniques here equal those in larger centers for cancers including esophageal, lung, colorectal, liver, pancreas, skin and melanoma, ovarian, lymph node and endocrine gland.
After receiving his medical degree from the University of Pittsburgh School of Medicine, Sheldon completed a general surgical residency at Virginia Mason Medical Center in Seattle. He was awarded a fellowship in surgical oncology at the Roswell Park Cancer Institute in New York.
His expertise in cancer surgery includes gastrointestinal cancers, melanoma skin cancers and endocrine tumors. Sheldon also has mastered advanced laparoscopic and minimally invasive techniques.
Ryan Solum, a native of Kalispell now living in Texas, recently benefited from Sheldon’s experience and skill when he had his colon removed. (See side story.)
Lillard earned her medical degree at the University of Texas Health Science Center and spent her residency in general surgery at the University of Washington. She also completed a fellowship in surgical oncology at Roswell Park Cancer Institute and a gastric cancer fellowship at Seoul National University Hospital in Korea.
Since moving here, Lillard said she has been extremely impressed by the nurses. She said some have pursued or are pursuing additional certifications in oncology nursing.
“I find the nursing care here fantastic,” she said.
Both surgeons would like to see cancer eliminated but statistics don’t suggest that will happen any time soon. With screenings and sophisticated diagnostic techniques, patients have the opportunity to catch breast, cervical and colon varieties early.
With the two surgical oncology-trained physicians, Kalispell Regional Medical Center has added a new choice for people dealing with the one of the most dreaded diseases.
“We’re an option now for the patient to stay in Montana,” Sheldon said. “There’s a tremendous amount of stress and logistical problems for people with a sick family member finding a place to stay and navigating in the city and big hospitals.”
Retired anesthesiologist Dr. Dudley Page was so impressed with his cancer surgery that he made a video testimonial to share his experience. He was one of the rare candidates for surgery to treat pancreatic cancer.
Sheldon said about 35,000 people a year receive a diagnosis of pancreatic cancer and only about 3,500 can benefit from surgery. He said a CAT scan determines if the tumor may safely be removed.
“We’ll handle 20 to 25 a year,” he said.
Page said an anesthesiologist friend suggested that he go to Virginia Mason for the surgery. But when he learned that Sheldon trained at that facility, he chose to have the surgery closer to Finley Point where he lives with his wife, Ann, a retired RN.
Sheldon described the procedure he needed in detail.
“He explained it was a very difficult piece of surgery that took some five to six hours, called the Whipple procedure,” Page said.
Called “the surgery of a thousand steps,” the procedure involves partial removal of organs and complex blood vessel rerouting. As an anesthesiologist, Page points out he was closely associated with the medical field, particularly surgery.
“I was dumbfounded by the quality of care at this hospital,” he said.
Ann said she was, as a nurse, prepared to strongly advocate for the care of her husband but found she didn’t have to because the staff gave him such good care. She said staying in the Flathead Valley was a great choice because friends were able to come and support her as well as her husband.
Page agreed, adding that they also saved a considerable amount of money by having all of his treatment here.
“I’m sure it was done just as well here as it would have been done in Seattle or any other major center in the United States.”
2011年6月26日星期日
2011年3月28日星期一
10 Symptoms Women Shouldn't Ignore
You work hard taking care of your family, friends and work. But are you taking care of yourself? Too often we ignore symptoms because we're just too busy to bother getting checked out. That can be a big – possibly fatal – mistake. Find out the 10 symptoms you shouldn't ignore…
More often than not, it's the smart, educated women who put off going to the doctor, even when it should be a top priority, says Judy Kinzy, M.D., an internal medicine specialist in Knoxville, Tenn. It's not unusual for a woman to come in long after a symptom has persisted.
"They read about it and try to figure it out on their own," Kinzy says. "They don't think about possible consequences. Bottom line, they don't really want to have to deal with it."
But not addressing a mysterious problem can be dangerous – and can even lead to a chronic or fatal disease. Check out these symptoms you shouldn't ignore:
1. Acute Fatigue
Let's face it: Women are used to being tired. Who doesn't have a book-length "to-do" list? Take car to mechanic, go to bank, pick up cat food, take children to soccer game, finish project at work, get mechanic, check on Mom and Dad… and on and on.
Overload leads to fatigue, but when low energy and exhaustion are chronic and continue for more than two weeks, see a doctor.
Acute fatigue can be a difficult symptom to diagnose, Kinzy says, but that doesn't mean you should ignore it. It can indicate hypothyroidism, which can be treated with a hormone, or anemia, which is treatable with iron or vitamin B12 shots.
More seriously, it can be a sign of depression, sleep apnea, heart disease or even lung cancer.
2. Rectal Bleeding
Pregnant women who've had hemorrhoids while pregnant might dismiss rectal bleeding as a sign of a new hemorrhoid and not take it seriously, says Ruth Stewart, M.D., assistant professor at Meharry Medical College and Vanderbilt University.
Rectal bleeding can indeed indicate a hemorrhoid, but it can also be a sign of colon or rectal cancer, which is curable if caught early, she says.
If you experience rectal bleeding, see a doctor right away. And even if it's just a hemorrhoid, it still needs to be treated.
3. Abdominal Bloating and Pain, Change in Bowel Habits
Like rectal bleeding, abdominal bloating and pain or a change in bowel habits can indicate something serious like colon cancer.
These symptoms also can signal ovarian cancer, inflammatory bowel syndrome or diverticulitis.
Diverticulitis occurs when you have small pouches that bulge outward in your colon (diverticulosis) that get infected. It can be treated with antibiotics but sometimes requires surgery.
If you experience abdominal bloating or a persistent change in bowel habits, such as constipation, make an appointment with your doctor.
4. Pain or Discomfort in Chest
Heart disease may be the No.1 killer of American women, but "most women still don't think about it happening to them," Kinzy says. "Then it ends up being about their heart."
The signs of coronary artery disease, which can lead to a heart attack, are typically much more subtle in women than in men.
"Angina isn't always obvious in women. It's not the classic ‘elephant sitting on my chest' feeling," Stewart says. "Sometimes it's just discomfort or a ‘not well' feeling."
Women might misdiagnose the discomfort as acid reflux or a "burpy" sensation.
One of Stewart's former patients said the feeling was akin to having a balloon inside her chest. She assumed it was acid reflux, took a Maalox and went to work; a few hours later, she came into the hospital having a heart attack.
If you're having trouble exerting yourself, have some discomfort or pain in your chest, or you're just not feeling normal, see a doctor immediately.
And check out our guide to acid reflux.
5. Heart Palpitations
Heart palpitations are often related to stress. But if persistent, they can also be a sign of atrial fibrillation, or an irregular heartbeat.
Without treatment for atrial fibrillation, you increase your risk of having a stroke, especially if you have these other heart disease risk factors: abdominal girth of more than 35 inches in women, high cholesterol, high blood pressure or being a smoker.
6. Shortness of Breath
Shortness of breath is yet another symptom of heart disease. But it can also be a sign of other serious health problems, such as pneumonia, asthma, emphysema, chronic bronchitis, lung cancer or even a blood clot.
If you're having continual or increased problems breathing, make an appointment to be evaluated.
Learn more about heart health here.
7. Pelvic Pain During Intercourse
It's not normal to have pelvic pain during sex, so pay attention if this symptom occurs.
If pelvic pain happens during deep penetration, it could indicate pelvic inflammatory disease (PID), endometriosis, an ovarian cyst or cervicitis, an infection of the cervix.
Pelvic pain upon entry can mean a vaginal infection or a hormone deficiency. If sex is painful, don't shrug it off – go to the doctor. An untreated infection can lead to infertility.
8. Change in the Appearance of a Mole
Melanoma (skin cancer) is often linked to a change in moles, so check them, along with freckles, regularly for any difference in their appearance.
Follow the ABCD method recommended by the Skin Cancer Foundation and the American Academy of Dermatology to help detect possible problems:
If the mole is A, asymmetrical; B, has uneven borders; C, has changed in color; or D, changed in diameter, see a dermatologist immediately.
Any changes in your skin, such as a growth or a sore that won't heal, are also potential indicators of melanoma.
Learn more about the ABCDs of skin cancer.
9. Breast Lumps
Know your breasts intimately. Examine them monthly to detect any new masses or lumps.
Confused about last year's change in mammogram guidelines? Talk to your doctor to determine how often you should be getting mammograms.
Also, check out Which Breast Test Is Best for You?
Potentially cancerous lumps usually feel like small stones or rocks in your breast, Kinzy says. Non-cancerous lumps are typically more tender and change with your menstrual cycle. But this is not always the case, so check with your doctor if a new lump appears.
10. Swelling in Legs or Persistent Pain in Joints
If you notice swelling in one or both legs, particularly after you've been traveling in a car or airplane, see a doctor. Swelling in one leg can mean a blood clot. If it's in both legs, it could be a sign of kidney or liver disease.
Chronic or constant pain in joints could mean something more serious than arthritis, such as lupus or rheumatoid arthritis, which may require steroid treatment.
More often than not, it's the smart, educated women who put off going to the doctor, even when it should be a top priority, says Judy Kinzy, M.D., an internal medicine specialist in Knoxville, Tenn. It's not unusual for a woman to come in long after a symptom has persisted.
"They read about it and try to figure it out on their own," Kinzy says. "They don't think about possible consequences. Bottom line, they don't really want to have to deal with it."
But not addressing a mysterious problem can be dangerous – and can even lead to a chronic or fatal disease. Check out these symptoms you shouldn't ignore:
1. Acute Fatigue
Let's face it: Women are used to being tired. Who doesn't have a book-length "to-do" list? Take car to mechanic, go to bank, pick up cat food, take children to soccer game, finish project at work, get mechanic, check on Mom and Dad… and on and on.
Overload leads to fatigue, but when low energy and exhaustion are chronic and continue for more than two weeks, see a doctor.
Acute fatigue can be a difficult symptom to diagnose, Kinzy says, but that doesn't mean you should ignore it. It can indicate hypothyroidism, which can be treated with a hormone, or anemia, which is treatable with iron or vitamin B12 shots.
More seriously, it can be a sign of depression, sleep apnea, heart disease or even lung cancer.
2. Rectal Bleeding
Pregnant women who've had hemorrhoids while pregnant might dismiss rectal bleeding as a sign of a new hemorrhoid and not take it seriously, says Ruth Stewart, M.D., assistant professor at Meharry Medical College and Vanderbilt University.
Rectal bleeding can indeed indicate a hemorrhoid, but it can also be a sign of colon or rectal cancer, which is curable if caught early, she says.
If you experience rectal bleeding, see a doctor right away. And even if it's just a hemorrhoid, it still needs to be treated.
3. Abdominal Bloating and Pain, Change in Bowel Habits
Like rectal bleeding, abdominal bloating and pain or a change in bowel habits can indicate something serious like colon cancer.
These symptoms also can signal ovarian cancer, inflammatory bowel syndrome or diverticulitis.
Diverticulitis occurs when you have small pouches that bulge outward in your colon (diverticulosis) that get infected. It can be treated with antibiotics but sometimes requires surgery.
If you experience abdominal bloating or a persistent change in bowel habits, such as constipation, make an appointment with your doctor.
4. Pain or Discomfort in Chest
Heart disease may be the No.1 killer of American women, but "most women still don't think about it happening to them," Kinzy says. "Then it ends up being about their heart."
The signs of coronary artery disease, which can lead to a heart attack, are typically much more subtle in women than in men.
"Angina isn't always obvious in women. It's not the classic ‘elephant sitting on my chest' feeling," Stewart says. "Sometimes it's just discomfort or a ‘not well' feeling."
Women might misdiagnose the discomfort as acid reflux or a "burpy" sensation.
One of Stewart's former patients said the feeling was akin to having a balloon inside her chest. She assumed it was acid reflux, took a Maalox and went to work; a few hours later, she came into the hospital having a heart attack.
If you're having trouble exerting yourself, have some discomfort or pain in your chest, or you're just not feeling normal, see a doctor immediately.
And check out our guide to acid reflux.
5. Heart Palpitations
Heart palpitations are often related to stress. But if persistent, they can also be a sign of atrial fibrillation, or an irregular heartbeat.
Without treatment for atrial fibrillation, you increase your risk of having a stroke, especially if you have these other heart disease risk factors: abdominal girth of more than 35 inches in women, high cholesterol, high blood pressure or being a smoker.
6. Shortness of Breath
Shortness of breath is yet another symptom of heart disease. But it can also be a sign of other serious health problems, such as pneumonia, asthma, emphysema, chronic bronchitis, lung cancer or even a blood clot.
If you're having continual or increased problems breathing, make an appointment to be evaluated.
Learn more about heart health here.
7. Pelvic Pain During Intercourse
It's not normal to have pelvic pain during sex, so pay attention if this symptom occurs.
If pelvic pain happens during deep penetration, it could indicate pelvic inflammatory disease (PID), endometriosis, an ovarian cyst or cervicitis, an infection of the cervix.
Pelvic pain upon entry can mean a vaginal infection or a hormone deficiency. If sex is painful, don't shrug it off – go to the doctor. An untreated infection can lead to infertility.
8. Change in the Appearance of a Mole
Melanoma (skin cancer) is often linked to a change in moles, so check them, along with freckles, regularly for any difference in their appearance.
Follow the ABCD method recommended by the Skin Cancer Foundation and the American Academy of Dermatology to help detect possible problems:
If the mole is A, asymmetrical; B, has uneven borders; C, has changed in color; or D, changed in diameter, see a dermatologist immediately.
Any changes in your skin, such as a growth or a sore that won't heal, are also potential indicators of melanoma.
Learn more about the ABCDs of skin cancer.
9. Breast Lumps
Know your breasts intimately. Examine them monthly to detect any new masses or lumps.
Confused about last year's change in mammogram guidelines? Talk to your doctor to determine how often you should be getting mammograms.
Also, check out Which Breast Test Is Best for You?
Potentially cancerous lumps usually feel like small stones or rocks in your breast, Kinzy says. Non-cancerous lumps are typically more tender and change with your menstrual cycle. But this is not always the case, so check with your doctor if a new lump appears.
10. Swelling in Legs or Persistent Pain in Joints
If you notice swelling in one or both legs, particularly after you've been traveling in a car or airplane, see a doctor. Swelling in one leg can mean a blood clot. If it's in both legs, it could be a sign of kidney or liver disease.
Chronic or constant pain in joints could mean something more serious than arthritis, such as lupus or rheumatoid arthritis, which may require steroid treatment.
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