GPPC Blog
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There’s a lot of discussion about certain cancer screenings, like mammograms, colonoscopies and skin checks (as there should be). But what about screening for lung cancer, which is the leading cause of cancer death in the U.S.?  

To find out more about lung cancer screening, we sat down with Dr. Yaron Perry, a thoracic surgeon with Great Lakes Cancer Care Collaborative, Division Chief of Thoracic Surgery at the University at Buffalo, and Medical Director of Comprehensive Center for Thoracic Malignancies and the Co-Director of Robotic Surgery.

 

Q: Who should be screened for lung cancer?

A: First and foremost, long-time smokers. If You are between the ages of 50-80 years old and you’ve smoked for 20 or more pack years, most insurance companies will cover lung cancer screening because it’s so important to have done. A pack-year is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 20 pack-year history by smoking one pack a day for 20 years or two packs a day for 10 years.

Next would be kids and spouses of smokers who have lived in the home with second-hand smoke for 20 or more years. Their risk of developing cancer is almost as high as if they were smoking themselves. We’ll get into more on that in a minute. 

The third group of people for whom lung cancer screening is important would be those who have been exposed to cancer-causing materials in the workplace, like asbestos, silica dust, and diesel engine exhaust. 

Currently there is no Insurance coverage for lung cancer screening for those exposed to second-hand smoke and workplace risk factors varies, but many plans consider both groups high-risk and may offer coverage. Check with your insurance provider before scheduling a screening appointment. 

 

Q: I’m a smoker, but I feel fine. Can’t I just wait and see my doctor if I start to feel sick?

A: No. The best way to cure lung cancer is to find it early. But the time symptoms appear, it’s really too late. People who fall into the high-risk categories I mentioned really need to be pro-active about lung screening to give themselves the best chance at a long, healthy life. 

 

Q: What are the risks to people who live with smokers?

A: Second-hand smoke is almost as dangerous as smoking yourself. In fact, in parts of China, most women don’t smoke but their husbands do—and the rates of lung cancer are relatively high in Asian women mainly because of the second-hand exposure inside the home. Spouses, children, and even pets of smokers are at risk of developing infections and cancers of the airways and lungs from the cigarette smoke they inhale inside of the house. 

 

Q: What about e-cigarettes and marijuana—are they risk factors for lung cancer?

A: The short answer is we’re not sure yet, but probably. The American Cancer Society considers both to be uncertain or unproven risks for lung cancer. But if you think about what’s happening when people use e-cigarettes or smoke pot, they’re still putting things into their lungs that aren’t supposed to be there. 

The THC itself in marijuana may not be harmful, but it’s still plant matter that’s being burned and inhaled like a cigarette. The technology behind vaping creates a vapor that carries a finer particulate than smoke, which allows the substances to be inhaled deeper into parts of the lungs that are even more delicate and susceptible to harm. 

We’ll know more in 10 to 20 years when researchers can look at the data and determine the long-term effects of these habits. I don’t consider either of them safe, especially because both are marketed toward young people. Starting unhealthy habits earlier just increases the risk of long-term damage and disease. 

 

Q: How do doctors screen for lung cancer?

A: We use a technology called low-dose computed tomography, or a low-dose CT scan. It’s a non-invasive imaging procedure with less radiation than a routine chest x-ray 20 years ago. During the scan, the patient lies on a table while a machine captures images of the lung tissue, which we’ll examine for areas of concern. The procedure only takes a few minutes and is totally painless. 

 

Q: Where can I schedule an appointment for a lung cancer screening?

A: Patients can call the Great Lakes Cancer Care Collaborative Call Center at (716) 884-3000. My colleagues and I represent a lot of different cancer care specialties from screening to treatment, and we all work together to provide patients with the most collaborative and effective cancer care in Western New York. 

 

Woman with abdominal pain

Urinary Tract Infections (UTIs) account for roughly 8.1 million annual doctor visits, and about 60 percent of women will experience a UTI in their lifetime. To understand why UTIs occur, it is helpful to understand the urinary tract, which makes and stores urine in the kidneys, and travels down the ureters to the bladder where it is stored until emptied. Urine is emptied through the urethra, a tube that connects the bladder to the skin. The opening of the urethra is at the end of the vaginal opening in females. Normal urine doesn’t have bacteria in it, but bacteria can get into urine through the urethra.

UTI symptoms include a need to urinate more often, and burning or pain when urinating. It can also cause a strong urge to urinate even when you don't have much urine in your bladder. The urine may also smell bad and appear cloudy or even bloody. It is important to call your health provider if you experience any of these symptoms. Noticing any blood in the urine may indicate a sign of something more serious, making the need to call your health provider more urgent.

One of the primary causes of UTIs in women is that they have shorter urethra than men. However, some women are more prone to UTIs compared to others. Women who are going through menopause typically have a higher chance of getting a UTI due to a reduction in their estrogen levels. Some women are genetically predisposed to UTIs. Sexual intercourse can trigger and also increase the frequency of UTIs, as can the use of diaphragms and condoms with spermicidal foam.

Sometimes the cause of UTIs is an abnormality in the urinary tract. Such abnormalities include diverticula that harbor bacteria in the bladder or urethra or blockages, such as an enlarged bladder, that prevents the body from completely draining urine from the bladder. Individuals with diabetes are also at a higher risk, as their bodies don’t fight germs off as well.

To decrease the risk of UTI, it is helpful to drink plenty of fluids, refrain from putting off urinating, or not fully emptying the bladder due to being in a rush to urinate. Drinking cranberry juice or taking over-the-counter cranberry supplements can also help prevent UTIs.

Fortunately, most women have simple UTIs that can be successfully treated with a short course of antibiotics, after which symptoms are alleviated. Postmenopausal women who experience UTIs can often be helped with topical hormone replacement with estrogen. When a UTI is complicated, a longer course of antibiotics is required, sometimes intravenously at a hospital. Women who get UTIs often should see their health provider for testing and treatment.

Armen Kirakosyan, MD, FACOG, FMPRS, FRCSC, FACS is a board-certified urogynecologist at General Physician, PC. He is experienced in treating a wide range of issues, from the most basic to complex surgeries. Learn more. To make an appointment with Dr. Kirakosyan, click here or call 716-656-4077.

Desk job

According to Dr. Emily N. Ussery et al., a quarter of adults sit for 8 hours a day in the US. Therefore, any job that requires prolonged sitting, be it taxi drivers or office clerks, are susceptible to chronic pain and joint problems in the neck, shoulders, back, hips, knees, and arms. The medical professionals at General Physician understand the issues associated with prolonged sitting and can help you take preventative measures to maintain healthy joints. 

Lower Back

Prolonged sitting’s primary victim is the disks between the vertebrae in your lumbar spine. Dr. Loubert Suddaby, MD, says your disks are like a jelly donut, with the inner part, or nucleus pulposus, consisting of high water content and layers of cartilage forming the outer part, or annulus. The disks act as shock absorbers for your vertebrae and give you the mobility to bend and twist.

Too much pressure on these disks causes problems. Dr. Suddaby states, “The intradiscal pressure is highest when you sit. It is lower when you stand and, of course, it’s lowest when you lay down.” This pressure is exacerbated when you slouch. “When people get tired, they tend to lean forward and put pressure on their spine, front-loading the discs and causing more damage.” The damage leads to degenerative disk disorder, which causes chronic pain and loss of flexibility.

Dr. Suddaby recommends keeping an upright posture to distribute pressure more evenly along your spine to lower the risk of damage. Maintaining a slight arch in your lumbar spine is especially important when driving, as bumps in the road can cause additional trauma to the disks. Dr. Suddaby suggests using a pillow or rolled-up towel as support or a specially designed Obusforme for your desk chair or car seat.

Dr. Suddaby also suggests taking breaks from sitting every 30 minutes and performing preventative isometric exercises. He states, “The best exercises are not Isokinetic exercises like you would get from sports, jogging, or running. They’re isometric exercises. They involve toning the core muscles that support the spine, neck, and lumbar by tensioning the muscles without moving the spine.” Isometric exercises need to be performed habitually to get the full effect, like brushing your teeth.

Hamstrings & Knees

Prolonged sitting also has an orthopedic impact on your hamstrings, knees, back, and core. Todd Sweeney, OTR/L, CHT, explains what happens when seated: “Your hamstrings and hip flexors shorten, impacting your back. In addition, core muscles get weak due to slouching and poor posture.” Mr. Sweeney uses the term “kinetic chain” to describe how deficiencies in one area can create a chain reaction. When one link in the chain is weakened, like your hamstrings, it can lead to back problems, knee and calf problems, and then onwards in both directions.

Another critical factor is synovial fluid. Dr. Sweeney states, “Our bodies produce synovial fluid, which occupies our joints. Regular movement, weight-bearing, and exercise help the body to produce extra synovial fluid which encourages strong muscles, flexible tendons, and healthy cartilage.” 

Mr. Sweeney says that isotonic exercises are beneficial for your joints, similar to isometric exercises. Think of lifting weights like dumbbells, resistance bands, or your bodyweight. Any controlled resistance movement will strengthen the muscles around the joint and add dynamic movement to the joint.

Mr. Sweeney, like Dr. Suddaby, also stresses the importance of good posture and taking regular breaks to get up and move around. He states, "The optimal position is to have your knees, hips, and ankles sitting at 90 degrees each." This position will maintain the integrity of the kinetic chain in your lower body and prevent pressure from building in your joints during the day. 

Wrists & Shoulders

Prolonged sitting causes problems in your upper body, too. Slouching forward causes your shoulders to slope, leading to increased pressure and grinding on your rotator cuff. Dr. Paterson, MD, an upper extremity surgeon, often sees wrist and elbow injuries. “Typing with your arms tucked in close to your body all day can cause a pinched ulnar nerve in your elbow. I work on carpal tunnels daily, which are caused by overuse and poor wrist positioning during work.” These injuries will cause shooting pains through your forearm and into your fingertips. The pain can get severe enough to disturb sleep at night, too.

Dr. Paterson states that movement is as essential for healthy joints as correct posture. He states, “While it’s always important to maintain good posture at work, whether sitting or standing, regularly getting up and moving is just as important. Movement provides blood flow to all of your soft tissues, which keeps them soft and compliant. But, unfortunately, it’s something people can neglect when trying to avoid overuse injuries associated with their occupation.” 

Dr. Paterson recommends taking breaks every 30 minutes to do mobility exercises like shoulder and neck rolls. You may also purchase a lightweight dumbbell to do wrist flexor/extensor exercises. Ergonomic keyboards can also help prevent carpal tunnel and pinched ulnar nerves. 

Take Care

No matter the work, prolonged sitting can lead to deficiencies and injuries throughout your body. So be sure to monitor how long you sit and take appropriate breaks to stand and move around. And remember, if you are experiencing symptoms or injuries related to prolonged sitting, contact General Physicians PC to schedule an appointment with one of our medical experts.

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