Monday, May 31, 2010

Skin cancer: Why it’s Important to Catch this Common Disease Early

This week, we've used the blog to talk about Vitamin D and Protecting Your Skin . Today we tackle skin cancer.

It's beautiful and sunny today in Baltimore, but remember to put on your sunscreen before heading outdoors. About one million cases of skin cancer are diagnosed in the U.S. every year, and one in 5 Americans will be diagnosed with skin cancer at some point in his or her lifetime. Some of the risk factors for skin cancer include having a fair complexion (especially with red or blond hair), a blistering sunburn as a child or teenager, exposure to radiation – including light from tanning beds, and certain medical conditions that weaken the immune system.

In a Lunch and Learn session at the Alvin & Lois Lapidus Cancer Institute last week, Sean T. Gunning, M.D., talked about the three forms of skin cancer: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Basal cell, which is the most common skin cancer, typically affects the head and neck and is primarily caused by sunburn. It can look like a spot that is shiny, with a rolled border that may turn into an ulcer or a red scaly spot. If you have a sore or pimple that doesn’t heal after 4 to 6 weeks, you should see your doctor as it could be basal cell skin cancer.

Squamous cell skin cancer forms after chronic sun exposure. Patients who have received a kidney transplant are especially at risk. This type of skin cancer can metastasize and spread to other parts of the body, making it very dangerous.

Finally, malignant melanoma is the least common form of skin cancer, making up only about 5 percent of cases. However, it is the most deadly. People with light complexions, with one or more blistering sunburns before age 18 and a large number of moles are particularly susceptible. Moles should be checked against the ABCDs:
  • Asymmetrical – Is the mole an odd shape with sides that don’t match the other?
  • Border – Does the mole lack a defined border?
  • Color – Is the color the same throughout the mole, or are there patches of brown, black, white, red or blue?
  • Diameter – Is the mole larger than ¼” in diameter (about the size of a pencil eraser)?
If the answer to one or more of these questions is “yes,” go see your doctor.

If skin cancer metastasizes (spreads to other organs), it can be life-threatening. Therefore, early detection is important. Skin cancer screenings will be held at Northwest Hospital on June 14 and on June 28 at Sinai Hospital. To sign up for one of these free screenings, call 410-601-9355.

-Holly Hosler

Friday, May 28, 2010

Magic of Life Gala Fundraser Features American Idol Jordin Sparks


If you love watching American Idol, now you have the chance to see the winner of season six live at the 2010 LifeBridge Health Magic of Life Gala.

Jordin Sparks will headline this one-night only concert at the Meyerhoff Symphony Hall on Saturday, June 5. Proceeds from the evening will benefit projects at Sinai Hospital, Northwest Hospital, Levindale Hebrew Geriatric Center and Hospital and Courtland Gardens Nursing & Rehabilitation Center (formerly Jewish Convalescent & Nursing Home). The 2008 gala raised $2.5 million.

Sparks captured the nation’s heart as the winner of American Idol in 2007. Since then, she’s been touring the country with her unique blend of R&B and pop. She is a Grammy nominee and an American Music Award winner, and soon to star in "In the Heights."

In addition to Sparks’ soothing sounds, gala goers will laugh at the comic talents of SARGE. There also will be cocktails, a light supper party and a dessert reception.

The gala kicks off at 6 p.m.

For more information or to purchase tickets, you can call 410-601-9328 or send an e-mail to jpolkow (at) lifebridgehealth.org. LifeBridge Health employees are eligible for discounted tickets.

Thursday, May 27, 2010

Sinai Kicks Off Walking at Work on Wednesdays


If yesterday's weather was any indication, Mother Nature is sending a resounding "yes" to Sinai employees ready to exercise.

Under sunny skies, Sinai Hospital kicked off its annual Walking at Work on Wednesdays program at noon in the K lot. Roughly 125 employees turned out and one lucky winner received a $25 Target gift card. All Sinai employees are encouraged to wear walking or running shoes EVERY Wednesday through Labor Day. Levindale and Northwest are also promoting walking at work.

Walking is one of the least expensive but most beneficial way to get in exercise. According to the National Institute of Diabetes and Digestive and Kidney Diseases, walking improves stamina, tones muscles, burns calories, and relieves stress. Many health care providers may feel stress, work odd hours, or face other challenges when trying to squeeze in an exercise plan. But walking at work during a lunch hour or break can be a great way to keep your day on track. Aim for 10,000 steps a day!

The Walking at Work program is one of the reasons Sinai and Northwest hospitals were awarded the American Heart Association's Gold Start! Fit Friendly award. This honor is for hospitals that have a healthy environment and are "creating a culture of physical activity in the workplace," according to AHA Chief Executive Officer Nancy Brown.

To see more about the LifeBridge Health's Fit & Friendly goals, and the Walking at Work on Wednesdays program, watch our video below.




Tuesday, May 25, 2010

Vitamin D: Should you soak up the sun to get this vital nutrient?

Yesterday we discussed UVA sun rays and the aging effects they cause. Though UVA can also be responsible for skin cancer, UVB is the part of sunlight primarily responsible. (Think UVA, “A” for “aging”; UVB, “B” for “bad.”)

However, UVB light, which is the more dangerous of the two, is also the part of sunlight that causes the body to produce vitamin D – a necessary nutrient. Recent medical news has stressed that up to half of the U.S. population could be vitamin D deficient, and the FDA is considering increasing its daily recommendation of 400 International Units (IUs) of vitamin D to 800 IUs. Healthy levels of vitamin D have been linked to a decreased risk for osteoporosis, high blood pressure, cancer and certain autoimmune diseases.

While vitamin D occurs in foods such as fish and fortified dairy products, your body produces vitamin D naturally when you skin is exposed to sunlight. In fact, just 20 minutes of full body exposure will produce 10,000 International Units of vitamin D. (After about 20 minutes, your body creates a chemical response so you can’t produce too much vitamin D.) If you wear sunscreen (recommended to reduce your risk for skin cancer), the UVB rays will be blocked and your body will NOT produce vitamin D. So should you forego sunscreen so that you can get your vitamin D?

In a May 19th lunch and learn at the Alvin and Lois Lapidus Cancer Institute, Sean T. Gunning, M.D., said that he believes that the jury is still out on the health benefits of vitamin D. While there is a correlation of people who have higher levels of vitamin D in their systems and a lower risk for certain diseases, it doesn’t mean that their health is due to the vitamin D.

Healthy people tend to exercise outside, make better dietary choices and take vitamin supplements – all of which can lead to higher levels of vitamin D. Therefore these people may test higher for vitamin D simply because of their choices that make them healthy also give them more vitamin D; their health is a byproduct of their lifestyle, not necessarily because of their high levels of vitamin D.

As for getting the recommended daily amount of vitamin D, so far there’s no evidence that the vitamin D produced from being out in the sun is superior to the vitamin D we can get from vitamin supplements. The 400 (and even 800) IUs recommended by the FDA is an amount that can be easily obtained through a multi-vitamin, making it unnecessary to expose your skin to the sun.
-Holly Hosler

Monday, May 24, 2010

Protecting Your Skin

Dermatologist Sean T. Gunning, M.D., addressed a full house at Wednesday’s Lunch and Learn session at the Alvin & Lois Lapidus Cancer Institute. Thanks to the graphic images he shared of skin damage, either aging or skin cancer-related, it’s a safe bet that most members of the audience probably won’t be venturing outside again without first applying a hefty dose of sunscreen! Today’s blog entry will cover the aging effects of ultraviolet A (UVA) rays; tomorrow we'll address ultraviolet B (UVB) and vitamin D; and the next day we’ll talk about sunlight and skin cancer.

“Tanning is your body’s response to direct DNA damage by ultraviolet light,” says Dr. Gunning, noting that a peeling, blistering sunburn actually signifies dead cells. The sun depletes the collagen and elastin in your skin, so if you are concerned with keeping your youthful looks, your best bet is to stay out of the sun, use a sunscreen that blocks UVA as well as UVB rays, and cover your head, face and neck as much as possible.

For both anti-aging and anti-cancer measures, Dr. Gunning recommends that you apply sunscreen 2 to 3 hours before you go out, and then again every 2 to 3 hours you spend outside. If you’re swimming or participating in water sports, sunscreen should be reapplied every 40 minutes.

Skin protective factor, or SPF, only measures how well the sunscreen blocks UVB rays, the part of sunlight most responsible for causing skin cancer. Some more advanced products, however, also block UVA rays, the rays that are chiefly responsible for causing age spots and wrinkles. Dr. Gunning recommends that people use a product with a SPF 45 rating that also contains mexoryl, Ti02 or helioplex to block the UVA light.

How do you know if darker blotches on your skin are freckles or age spots? According to Dr. Gunning, freckles will fade with decreased sun exposure, while age spots are permanent.

Somewhat ironically, there’s evidence that the fear of aging is a greater motivator than the fear of cancer in causing women to protect their skin. Recently, a study conducted by a dermatology professor from the Northwestern University Feinberg School of Medicine found that college-age females reduced their visits to the tanning bed by 35 percent after being shown images of wrinkles caused by tanning. These same women had been previously unmoved by the dramatic risk of melanoma caused by tanning beds.

While you can’t reverse previous skin damage, you can take steps now to slow down the aging process by protecting yourself from UVA light. Windows, including those in cars, block UVB but not UVA rays. If you’re doing a lot of driving or riding in a car, use a sunscreen that protects against UVA. And when outside, a hat and long sleeves are your friends.

In what ways does your skin show sun damage? What are you doing to protect your skin from UVA rays?

-Holly Hosler

Friday, May 21, 2010

Is Your Child Being Bullied?

by Sharon B. Richter, D.O.
Behavioral and Developmental Pediatrics, The Herman & Walter Samuelson Children's Hospital at Sinai

Bullying has received a lot of attention lately, with many school districts revising their anti-bullying policies in the wake of cases like Massachusetts teenager Phoebe Prince.

Bullying is aggressive behavior that is intentional, repeated over time, and involves an imbalance of power or strength. A child who is being bullied has a hard time defending himself or herself.

Most people think of bullying in the form of physical aggression, such as hitting or pushing or in terms of teasing and verbal insults. But bullying also includes less observable behaviors such as social exclusion or isolation, stealing or damaging property, and threatening the victim, or forcing him to do things.

Cyberbullying is a relatively new form of bullying, where the victim is harassed through e-mail, cell phone, texts, instant messaging, chat room exchanges, or a website. On the Internet, the bully is allowed to be anonymous. If the target of the bully does not know who is bullying them, there is additional stress associated. The anonymity of the bully also leads bullies to engage in behaviors that they might not do face-to-face. Social media is accessible 24 hours per day, so victims may receive test or instant messages or read things about themselves when they are anywhere in addition to school, such as in their own home. Victims of cyberbullying are also less likely to report the bullying to adults for fear of having their parents remove their cell phone or computer from them.

There is an enormous impact from bullying on not only the victim, but also the bystanders, and school or community. Victims of bullying are more likely to have emotional health difficulties such as depression, suicidal thoughts and low self-esteem. They are also likely to have lower grades than their peers. Bystanders are affected as they may believe that they are in an unsafe environment, appear fearful, and feel powerless to act and guilty for not acting. When teachers and school administrators do not take action to stop the bullying, the school environment becomes one of fear and disrespect. Students feel insecure, have difficulty learning, and do not trust that the adults care about them or have control over the students. Bullying behaviors need to be taken seriously by all adults who interact with children.

There is a common perception regarding bullies that they are also more likely to have emotional health difficulties. Many bullies themselves also have poor grades, and are more likely to engage in high-risk behaviors such as getting into frequent fights. They are more likely to steal and vandalize property, drink alcohol, smoke, and carry a weapon.

However, there are also many bullies who are very popular among their peers and their teachers. This is more common among bullying girls but can be seen with the bullying boys as well. For this reason, it is often difficult for adults to believe that these students engage in bullying behavior.

Some children who are bullied may actually start the fight with the bully, and this behavior needs to be identified and stopped. For these children, called “bully-victims”, social skills may need to be directly taught. These children are at the highest risk for later mental health and emotional problems.

Although bullying has always occurred, it is now occurring with greater prevalence and increased lethality than it has in the past. Up to 25 percent of students have reported being victims of bullies.

There are warning signs that bullying is occurring to a child. In addition to the obvious bruise, torn clothing or missing and destroyed property, there are emotional signs. A child may be experiencing bullying if he or she appears sad or anxious, avoids school, withdraws from social activities, or has declining grades. Additional signs of cyberbullying are that the child appears sad or upset after using the computer or reading a cell phone message.

If you are a parent or educator, you can be a partner in anti-bullying interventions. Effective interventions for bullies need to come from adults in charge. These interventions must be implemented in schools and communities and alter the response towards bullying of teachers and other supervising adults. Changes within the upper reaches of administration are needed in the school and community system in order for the interventions to have a lasting effect. If you are a parent, you can also use these questions to start a conversation about bullying with your child.

While bullied children are at risk for later emotional and behavioral problems, there are some factors that promote resiliency in children who are victims of bullying. Maternal warmth, sibling warmth and a positive atmosphere at home are all particularly important in bullied children for promoting emotional and behavioral adjustment. Parents can help their children find friends, inside and outside of school, with whom to spend time. Children need to be taught to avoid isolation in school, as bullies are less likely to target people when they are alone than when in a group. Parents of children who are bullied need to be in contact with school personnel, encourage their child to report the bullying to the authorities, and expect that the bully will receive a consequence.

Thursday, May 20, 2010

Parking Notice

Sinai security will be blocking off handicapped and valet parking sections on Friday and Saturday to repaint. Drivers or passengers who remove the blockades and park their vehicles in the construction zone will be towed. Patients who need handicapped parking will be assisted by the valet attendants. We regret this inconvenience.

Bike to Work Tomorrow

If you're like many of us, finding time to exercise can seem impossible.

But one way to fit in exercise is to walk or bike to work. And what better day to try that than tomorrow, Baltimore's Bike-to-Work Day?

Biking is a low-impact activity that's especially great for anyone with bad knees. It's a way to burn off those calories: a 150-lb person can expect to burn 300 calories in a half hour by biking between 12-14 mph. Biking to work also saves you money on gas and car maintenance, plus saves you money on parking. By biking to work, you are also cutting back on pollution and being environmentally responsible.

Tomorrow is a great day to start a new commitment to biking to work. Remember to wear a helmet and layer your clothes. Morning celebrations for Bike-To-Work Day will be at:
  • Anne Arundel Co/Annapolis - City Dock, Annapolis
  • Baltimore City - War Memorial Plaza at City Hall (100 N. Holliday St.)
  • Baltimore County - Courthouse Square (400 Washington Ave, Towson)
  • Carroll County - Westminster
  • Harford County - Government Center (220 S. Main St, Bel Air)
  • Howard County - The Mall in Columbia (by Sears Service Center, 10300 Little Patuxent Parkway, Columbia
And once you're getting back into biking, remember that the Save-A-Limb Ride is October 17.

Wednesday, May 19, 2010

Celebrate Cancer Survivors with LifeBridge Health


Are you or a loved one a cancer survivor?

If so, then join us for LifeBridge Health's Cancer Survivors Day, an afternoon of fun, information, companionship and education. Light refreshments will be provided. There will be a survivors celebration activity and a keynote speaker, Kathy LaTour.

LaTour is a nationally renowned humorist, inspirational speaker and cancer survivor. Diagnosed with breast cancer in 1986, LaTour went on to write The Breast Cancer Companion. She is the creator of the one-woman show “One Mutant Cell” and has served on on the board of the National Coalition for Cancer Survivorship.

Cancer Survivors Day will be from 2 to 5 p.m. on Sunday, June 6 at the Pikesville Hilton. There is no charge, and the event is open to the public. However, pre-registration is encouraged. Call today at 410-601-9355.

Tuesday, May 18, 2010

Hot Topics in Women's Health

There’s still time to sign up for a ladies tea at Northwest Hospital this Sunday, May 23 at 3 p.m.

The highlight of the event will be two vibrant speakers who are women’s health experts: Women’s Wellness Center director and gynecologist Dee-Dee Shiller, D.O., and Herman & Walter Samuelson Breast Care Center medical director and breast surgeon Dawn Leonard, M.D.

These two doctors will be talking about some of the most pressing issues in women’s health today, answering questions such as when you should start getting mammograms and how often; should you have a genetic test to find out your risk for breast and ovarian cancers; and whether your daughter should receive the new vaccine for cervical cancer. Topics relating to menopause will also be discussed, including the pros and cons of hormone replacement therapy, as well as alternatives to HRT.

The event will help introduce the Women’s Wellness Center to the community. The center opened earlier this spring at Northwest Hospital, and is now accepting new patients for physicals and gynecologic care. Patients of the center will be able to take advantage of special amenities and services such as guidance from a health coach who helps patients develop a personalized comprehensive wellness plan. The health coach can also assist patients in scheduling appointments for tests or with specialists. Soon, the center will also be offering massage therapy, yoga and Pilates classes, and a free, community lecture series on women’s health topics.

At the event on Sunday, tea and light refreshments will be served, and all attendees will receive a free canvas tote bag - a great fit for use at the beach or gym.

To sign up for “Hot Topics in Women’s Health: A Ladies Tea,” call 410-601-WELL (9355).

Monday, May 17, 2010

Osteoporosis Drugs Offer New Hope

Osteoporosis or ‘porous bone,’ is characterized by low bone mass and structural deterioration of bone tissue. It leads to bone fragility and an increased risk of fractures of the hip, spine and wrist.

According to endocrinologist Esther Krug, M.D., the director of the Sinai Hospital Center for Bone Health, there are risk factors you can control - make sure that you are getting the recommended dose of calcium, stop smoking and avoid excessive alcohol use. However, factors like age, gender and body frame size - small thin-boned women are at higher risk for osteoporosis - are beyond your control. Luckily, new treatment options make it easier to find some relief.

“The treatment of osteoporosis is developing really fast,” Krug says.

The goal of physicians like Krug is to keep patients from fracturing their bones and ending up in the hospital. Caregivers of an elderly parent should consider adding a rubber bath mat in the shower or tub, make sure the house is free of clutter, and use plastic or carpet runners on slick floors to prevent slipping.

Why does grandma's body react so much worse to a fall than yours?

Krug explains that your body stops adding new bone after age 30, with rapid bone loss beginning around age 50. Women lose bone mass faster after menopause. Fractures are a key cause of disability in post-menopausal women, and it is estimated that there are 1.5 million fractures from osteoporosis each year costing America $18 billion annually.

Plus, a 2004 report by the U.S. Department of Health and Human Services Surgeon General estimates there are 800,000 trips to the emergency room and 500,000 hospitalizations stemming from osteoporosis.

While fall prevention is important, endocrinologists may recommend daily or monthly bone-building medications for severe cases of bone loss.

“If taken as prescribed, the medication lowers the rate of bone loss dramatically,” Krug says.

In 2007, the New England Journal of Medicine published an article detailing results of a three-year trial involving a once-yearly injection of zoledronic acid for treatment of postmenopausal osteoporosis. Those patients receiving the medication were nearly 8 percent less likely to develop a break in the lower back than those who were not receiving it. The FDA approved zoledronic acid for treatment of osteoporosis in 2007.

The injections of zoledronic acid, known as Reclast, allow some patients to bypass oral medication, which for some patients causes stomach upset. Nursing home residents who exhibit a low rate of compliance may benefit more from a yearly injection rather than taking another pill.

Krug, who tends to see the most extreme cases of osteoporosis, estimates roughly 25 percent of her patients are taking Reclast.

“It does liberate the patient,” she says. ‘So far, it’s performing well, and it is well tolerated by patients.”

Other injectable treatment options include Boniva, which is given four times a year. And another new drug on the market – Forteo - builds bones, cutting the risk of fracture in half.

At Northwest Hospital’s Outpatient Infusion and Cancer Therapy Center, nurses see an average of one to two patients a week for Reclast treatment, says Northwest's Mary DeClue, R.N.

“With Reclast, it’s one appointment and you are done for the year," DeClue says. "There is a lot of work done on our end to make sure all the lab work is in order, and then we call the patient to set up an appointment."

She says the nurses have not received any negative feedback about side effects, other than fatigue. But experts warn that these medications should not be prescribed unless proper indications are met – patients should talk with their doctor about the best treatment for them.

(Adapted from MdMD for Life, 2010)