April is Cancer Awareness Month, and we fight the disease every day at the UAB Medicine-Russell Medical Cancer Center, located on U.S. route 280 in Alexander City. Thanks to our innovative relationship with the O’Neal Comprehensive Cancer Center at UAB, we’re able to provide world class cancer care right here in our corner of the world.
Approximately 2,500 members of our community will be diagnosed with cancer in 2021. To put that number in perspective, in every group of 10 people, three will be diagnosed with this disease.
The most prevalent cancers in our community are skin, breast, prostate, lung and colorectal cancer. The good news is that we have made so much progress in the last two decades in detecting and treating cancer that nearly two-thirds of cancer patients survive more than five years.
Perhaps the most progress we’ve made recently is in lung cancer, where five-year survival rates have climbed from about 12 percent to 18 percent in recent years. Thanks in part to lung cancer screening with computed tomography, approved in 2015, which has increased the number of lung cancer cases diagnosed at earlier stages. The five-year survival rate is now 56 percent. New molecular-based treatments for advanced lung cancer have also extended survival – sometimes by several years – for patients who have incurable cancer.
While we still have a way to go, we’ve made significant progress in turning cancer from a fatal disease to a chronic illness, like diabetes or heart disease.
The good news is that no one has to drive to Birmingham or Montgomery to get high-quality cancer care. Nationally recognized physicians, like breast surgeon Dr. Helen Krontiras and colorectal surgeon Dr. Gregory Kennedy, commute to Russell Medical every week to take care of our neighbors.
Radiation oncologists on the forefront of research – including proton therapy specialists Drs. Michael Soike and Adam Kole – staff our radiation therapy center every day. Dr. Hunter Boggs utilizes innovative treatment methods (SBRT, proton therapy) to reduce the amount of radiation that breast cancer patients are exposed to while still receiving curative doses. Dr. Rojymon Jacob, an expert in treating gastrointestinal cancers, sits on editorial boards deciding which research studies to publish.
Our medical oncologists, Dr. Mary Emily Sheffield and Dr. Alex Minter, could have worked at any cancer center in the country but chose to come to the Lake Martin community because they grew up in small towns and know how important, and yet how rare, it is for rural communities to have access to excellent cancer care.
We screen people for cancer to detect the disease early while it’s still curable. I inform patients about recommended cancer screenings for the five most prevalent cancers, beginning with skin cancer.
Next month, we celebrate “Melanoma Monday,” where we will be providing skin cancer screening at our rural health centers in Dadeville, New Site and at the Cancer Center in Alexander City. Follow our Russell Medical Facebook page or local newspapers for screening information.
September is Prostate Cancer Awareness Month. There is a difference of opinions among the professional societies regarding prostate screening, but the American Urological Association recommends screening beginning from age 55 until 70. The patient and doctor should decide upon a schedule together. This recommendation is for men with an average risk for prostate cancer.
But we know that African American men are at a greater risk for the disease than Caucasian men, as are men with a family history of prostate cancer. In these cases, talk with a physician about when to start screening, typically earlier than 55.
Historically, physicians have screened for prostate cancer with a blood test called prostate-specific antigen and a digital rectal examination; however, the U.S. Preventive Services Task Force no longer recommends DRE due to lack of data proving a benefit. On the other hand, there is no data against DRE.
October, as everyone knows, is Breast Cancer Awareness month, but women should not wait until then to have their screening mammogram. The baseline mammogram should be performed at 40 for women at average risk for breast cancer and every year after that. Women who have a mother, sister or daughter diagnosed with breast cancer, or who have other risk factors, like fibrocystic breast disease should perhaps begin screening at an earlier age and/or screening twice a year – once with mammogram and once with magnetic resonance imaging or an MRI. Talk to a doctor about risk factors to make an informed decision about breast cancer screening.
The Women’s Center at Russell Medical is equipped with state-of-the-art 3-D mammography, which provides higher sensitivity than traditional mammography in detecting breast lesions. If a lesion is detected, we can perform an ultrasound-guided biopsy or a biopsy under MRI, if appropriate. We are in the process of adding stereotactic biopsy equipment in our breast center, which more accurately locates a breast lesion for biopsy.
The gold standard for colorectal cancer prevention and detection is colonoscopy. Russell Medical has an excellent endoscopy lab manned by Dr. Derek Holcombe. In fact, I’m having my colonoscopy there this month. While preparing for the procedure is admittedly not the most memorable evening you’ll ever spend, the procedure itself is painless and quick.
Patients at average risk should have their first colonoscopy at 50 years of age. Once again, African Americans are at higher risk for colon cancer, and therefore, should begin surveillance at 45 years of age; however, the insurance company might balk at covering the procedure at that age. Those who have family history of colon cancer or personal histories of colon polyps or benign intestinal diseases like Crohn’s or diverticulitis are also at higher risk. Once again, in these cases, have a conversation with a physician about an appropriate screening protocol. The good news is that those at average risk and who have had clean colonoscopies would not have to repeat the procedure for another 10 years.
Just last month, the USPSTF expanded eligibility for lung cancer screening with low-dose CT, dropping the minimum age and reducing the length of smoking history, which will nearly double the number of people who qualify for lung screening. Those who are eligible for low dose CT screening are between the ages of 50 and 80 and have smoked at least 20 pack-years or anyone who is a current smoker or has quit within the last 15 years.
A pack-year is calculated as the number of packs of cigarettes you smoked per day, times the number of years you smoked. If someone smoked a pack a day for 20 years, they have a 20 pack-year smoking history. Similarly, someone who smoked two packs a day for 10 years would have a 20 pack-year smoking history, as well.
Lung cancer screening with low-dose CT is available at Russell Medical. The doctor will prescribe the screening once a shared decision-making consultation with the physician has taken place. In the consultation, the following would be discussed: the risks and benefits of screening; the importance of following through with screening every year; and (if you’re still smoking) the importance of quitting.
Cancer treatment, at Russell Medical, is managed by a team of physicians that regularly consult on the best treatment plans for their patients. This team typically consists of a surgeon, a radiation oncologist and a medical oncologist. Because these doctors are up-to-date with the best medical evidence, they can offer the best cancer care available. In addition, we have a cancer rehab program that is available from start to finish, including a post-treatment exercise program designed to return the patient to wholeness.
Patients with nutritional concerns can meet with the dietician, who offers nutrition plans designed to help patients be their best selves while under treatment. And our patient navigator assists with the financial challenges that often come with cancer treatment.
Our relationship with the University of Alabama in Birmingham O’Neal Cancer Center brings many of the benefits of a world-class NCI-designated cancer hospital to the forefront. Consultations with highly specialized experts in cancer care are available via our new telemedicine program, as is access to a plethora of clinical trials open at UAB.
Those who are candidates for proton therapy, a relatively new and highly accurate form of radiation treatment, could meet with one of two proton therapy specialists who regularly see patients at our Alexander City campus.
Our goal is to provide the highest quality cancer care available right here at home and refer patients to Birmingham for only the most specialized treatment unavailable here or at any other community hospital.
~George Miranda is the Director of the UAB Medicine – Russell Medical Cancer Center.