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Personal Preference is Key when Debating Partial vs. Full Mastectomy

Lytle Brown IV, MD, FACS — Fri, 10 May 2013 20:00:59 +0000

Approximately 75 % of women diagnosed with early stage breast cancer are candidates for either mastectomy or breast-conserving surgery (also called a partial mastectomy.) Mastectomy is the removal of the entire breast, while breast-conserving surgery removes the cancerous tumor and part of the surrounding breast tissue. Breast-conserving surgery is usually followed by radiation therapy.

Data has long shown that survival outcomes to be similar whether a full or partial mastectomy is performed. But, now a new study of California breast cancer survivors suggests that those who undergo breast-conserving surgery have the same, or even better, survival rates than who chose mastectomy.

Researchers analyzed information from more than 112,000 California women with early stage breast cancer between 1990 and 2004 who underwent breast-conserving surgery plus radiation, or mastectomy alone.

The data collected showed breast-conserving surgery patients age 50 or older with tumors that were sensitive to estrogen and progesterone, were 13 percent less likely to die of breast cancer than those who opted for mastectomy.

The study, however, did not take into account whether the women with mastectomies had other conditions that could have impacted the mortality rate. And, as a group, those patients tended to have larger, more aggressive tumors.

While the results of the new study may prompt some women to consider a partial mastectomy over a full mastectomy, neither option can be heralded as the best treatment for every patient every time. Individual factors such as tumor size, location, family history, and the woman’s personal preference will continue to be key in decision making.

Women, who don’t wish to go through weeks of radiation and repeated follow-up scans, may opt for full mastectomy. Some patients, especially those with a family history of breast cancer, may even decide to proactively have both breasts removed.

Every patient should talk openly with her surgeon to determine which option will best suit her health, lifestyle, and personal preference. Because, at the end of the day, each woman has to has to be comfortable with her own surgical choice for her own body.

Dr. Lytle Brown IV, MD, FACS, is a general surgeon with the Premier Surgical Associates office located at Parkwest Medical Center. He is board certified in general surgery by the American Board of Surgery and a fellow of the American College of Surgeons.

About Premier Surgical Associates
Premier Surgical Associates is the Knoxville area’s largest surgical group, with 27 surgeons performing general, vascular, bariatric, breast and laparoscopic procedures. Premier has offices in Knoxville, Maryville, Jefferson City, Lenoir City, Sevierville, and Seymour.

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No More Diabetes: The Not-So-Secret Side Effect of Weight Loss Surgery

Mark A. Colquitt, MD, FACS, FASMBS — Fri, 12 Apr 2013 13:29:02 +0000

It’s not a new notion that bariatric surgery, especially gastric bypass, often puts patients’ diabetes into remission. It’s something that weight loss surgeons have long known by witnessing the phenomenon in their own patients.

Of the than 1,700 bariatric procedures Dr. Jonathan Ray and I have done over the past 10 years, probably 80 percent of those patients have been diabetic. Within a just a few days of surgery (or sometimes sooner), the majority of diabetic patients are off their insulin and experiencing a drastic improvement in their pancreas function.

I don’t like to use the word “cure”, because in some cases diabetes can return if the patient doesn’t follow the recommended diet and regains their weight. However, the idea that the remission of diabetes is prompted by the surgical rerouting of part of the digestive system, independent of weight loss, is gaining new ground.

Growing evidence suggests that incredibly fast metabolic changes are taking place when the small intestine is rerouted, such as in gastric bypass. This could explain why diabetes remission is somewhat less prevalent in sleeve or gastric banding patients, where the intestine stays intact.

With an estimated 25 million American children and adults living with diabetes, it’s increasing important to identify options for treating this previously “uncurable” disease.

The next step is to educate the public and physicians about the use of bariatric surgery to remedy diabetes, especially in patients for whom medication and lifestyle changes have been ineffective.

The hope is that in the near future, severely diabetic patients will have a viable and accepted treatment for stopping this deadly disease.

For further information about the bariatric procedures performed by Dr. Mark Colquitt and Dr. Jonathan Ray, please visit www.foothillsweightloss.com.

Catch It EARLY: The Best Cure for Colon/Colorectal Cancer

Gregory P. Midis, MD, FACS — Fri, 15 Mar 2013 17:58:08 +0000

You may not realize that March is National Colorectal Cancer Awareness month. It doesn’t usually garner a lot of news coverage and attention like Breast Cancer Awareness month in October. But, because colon cancer is the second deadliest cancer in the United States, it deserves attention, and its own month for awareness

The American Cancer Society expects nearly 143,000 Americans to be diagnosed with colon cancer this year. An estimated 50,000 people in the U.S. will die from colon cancer in 2013.

Those are certainly sobering statistics, but here’s a good number to consider: if colon cancer is found at the local stage (confined to the colon or rectum), the five year survival rate is 90%. 90%! That’s great odds, but the key is the catching it in the early stage of development. That’s when treatment is most effective.

This is why regular screening is so important. My advice to you is: get screened. And, especially if your doctor is telling you to get screened for colon cancer: do it. In most cases, screening can prevent colon cancer by finding and removing polyps in the colon before they become cancer. Lots of times I see patients who didn’t follow up and do the screening.

The most common screening test in the United States is a colonoscopy. During a colonoscopy, a physician uses a long, flexible tube called a colonoscope, to look at the lining of your colon. Changes or abnormalities can be spotted, tissue samples and be taken, and polyps can be removed.

I recently had a 25-year old patient who had a colonoscopy because of a persistent change in her bowel habits over several months. Although she is younger than the average colon cancer patient, a large cancerous polyp was discovered.

Fortunately, it was in an early stage. I was able to laparoscopically remove the diseased portion of her sigmoid colon and several lymph nodes. She did not require radiation or chemotherapy. The patient was understandably relieved that her cancer was detected at a manageable stage.

The bottom line: colorectal cancer is very common and very preventable. Get screened.

American Center Society guidelines for early colon cancer detection:

Screening test every 10 years, beginning at age 50
Screen earlier if there’s a personal or family history of polyps or colon cancer.
Talk to your doctor if you have changes in your bowel habits, such as blood, pain or a change in frequency.

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Laparoscopic Sleeve Gastrectomy Produces Results for Patients

Mark A. Colquitt, MD, FACS, FASMBS — Mon, 11 Feb 2013 20:32:18 +0000

Laparoscopic sleeve gastrectomy, also known as the gastric sleeve, was first introduced in 2005, and we’ve been performing the procedure since 2008. As of March 2011, we’ve performed 65 gastric sleeve procedures and are pleased with the results.

The procedure involves surgically removing 85 percent or more of the stomach, resulting in a new stomach roughly the size and shape of a banana. The procedure generates weight loss by restricting the amount of food (and therefore calories) that can be consumed. Also, because the procedure removes the portion of the stomach that produces ghrelin, the hormone responsible for appetite and hunger, the level of ghrelin decreases, resulting in a reduced appetite.

Sara Trombley lost 146 pounds following her gastric sleeve surgery in February 2008. About Foothills Weight Loss Specialists, she says, “They not only gave me back my life but gave me a life I didn’t think possible.”

To read more about this procedure, visit Foothills Weight Loss Specialists’ “Weighing In” blog.

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Flying High after Weight Loss

Mark A. Colquitt, MD, FACS, FASMBS — Tue, 05 Feb 2013 14:57:20 +0000

Looking at Jill Mayfield today, you see an active, healthy and happy 47-year-old mother of two. It’s hard to believe that just 18 months earllier, this fit and trim lady had a difficult time fitting into an airline seat and fastening the seatbelt.

“We fly a lot,” said Mayfield. “Before I had surgery in April, I remember barely being able to get my seatbelt fastened. We flew again in October after surgery, and I was amazed at how much weight I had lost. I didn’t have anything to measure with, but it was a big difference.”

The airline seatbelt isn’t the only difference for Mayfield since surgery. She says that before surgery she was morbidly obese, had no energy and led a very minimal lifestyle. “I couldn’t keep up with my girls, work, my husband, or life in general. I just couldn’t do it.”

At age 47, she decided there had to be more to life.

To read more of Jill’s story, visit Foothills Weight Loss Specialists’ “Weighing In” blog.

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A “Measure” for Weight Management Success

Mark A. Colquitt, MD, FACS, FASMBS — Wed, 30 Jan 2013 17:14:38 +0000

Whether you’re trying to lose weight or to maintain weight, Foothills Weight Loss Specialists now offers a customized way to gauge the number of calories you should consume in order to achieve success.

The simple fact of dieting is this: In order to lose weight, you take in fewer calories than you burn. The number of calories you burn, however, depends on your individual metabolic rate. Now, determining your individual metabolic rate through the ReeVue indirect calorimeter is easy, quick, painless, inexpensive and covered by most insurance.

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Preparing for Bariatric Surgery

Mark A. Colquitt, MD, FACS, FASMBS — Wed, 19 Dec 2012 20:36:10 +0000

You’ve weighed your options and decided that weight loss surgery is best for you. So, what now?

If you’re a Foothills Weight Loss Specialists patient, you’ll get a pre-operative behavioral plan designed to help ensure your weight loss success. The plan includes elements that will prepare your body and your mind for surgery. Here are some highlights:

Take the long view of this process. Remember that you are not perfect. Getting it right 80 percent of the time is good enough.
Chew food slowly. Try to chew each bite 30-40 times.

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The Steps to Surgery

Mark A. Colquitt, MD, FACS, FASMBS — Wed, 12 Dec 2012 16:37:42 +0000

This is the time of year when many people resolve to lose weight. If you’ve spent many years making – and failing to fulfill – that resolution, you may be considering bariatric surgery. You may also be wondering what steps are required to get you there.

The following gives you a quick snapshot of what to expect:

Step One: Educational seminar. Your first step begins with attending a free educational seminar, where you’ll learn about surgical weight loss options and meet other patients and our staff.

To read more about the path to better health through bariatric surgery, visit Foothills Weight Loss Specialists’ “Weighing In” blog.

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Dieting: As Effective as Bariatric Surgery?

Mark A. Colquitt, MD, FACS, FASMBS — Wed, 28 Nov 2012 21:58:49 +0000

“I lost 50 pounds, but gained back 60” is a lament that I’ve heard more times than I can count.

If you fall into the category of morbidly obese (more than 100 pounds over your ideal body weight), chances are you have suffered through nearly every diet craze out there, hoping that each one will be your ticket to success. Rather than putting yourself through the emotional and physical turmoil of yo-yo dieting, consider having weight loss surgery.

Research shows that diet and exercise – even when combined with weight loss medications – simply do not work for the severely obese. For individuals who have repeatedly tried and failed to lose significant weight, bariatric surgery offers the best chance for success.

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A Quick, Painless Procedure Can Put Hemorrhoids Behind You

C. Stone Mitchell, MD, FACS — Mon, 05 Nov 2012 19:50:40 +0000

Hemorrhoids are very common. They affect both men and women, young and old, from age 20 to 90. About half of the population has hemorrhoids by the age of 50.

You probably wouldn’t know it though: People often suffer in silence.

Even worse, people don’t like to seek treatment for hemorrhoids, in part because they feel embarrassed and in part because they have heard negative stories about hemorrhoid surgery.

Both were factors for one of my recent patients.

“I had struggled with hemorrhoids since giving birth to my first child 17 years ago,” said Kimberley Thomas. “They were uncomfortable, painful and embarrassing. But I had heard how painful hemorrhoid surgery could be, so I just continued to struggle with them.”

It was Kimberley’s OB-GYN that convinced her to have them checked. Kimberley was thrilled to discover that for her and so many of the patients we see, there is a quick, easy, non-surgical solution to hemorrhoids. Infrared coagulation (IRC) is a treatment that uses laser therapy to help the varicose vein (hemorrhoid) to shrink and recede.

The procedure is quick, painless and requires no anesthesia. It usually requires a series of 2 to 4 treatments about one month apart to shrink the vein and eliminate the problem completely.

“When I had my first procedure,” said Kimberley, “It took just a few minutes in the office, and then I headed straight for my daughter’s 17^th birthday celebration. I couldn’t believe how painless it was.”

We are able to use this non-surgical procedure in about 90 to 95 percent of the cases we see here at Premier Hemorrhoid Treatment Center. In some cases, we may also have to excise, or remove, what we call an external tag or a piece of the hemorrhoid that is projecting from the body. But that is a minor, in-office procedure.

Sometimes patients are referred to us by their physicians, like in Kimberley’s case. But often our patients come in because they are bothered by uncomfortable symptoms. Hemorrhoid symptoms include:

pain or a burning sensation,
bleeding during bowel movements,
protrusion of tissue from the anus, and
itching around the anus.

Sometimes hemorrhoid symptoms can be treated by changes in diet or with over-the-counter creams and ointments. But if symptoms persist, or get worse, see your doctor. Bleeding during bowel movements, the most common symptom of hemorrhoids, can also be a sign of other conditions or diseases in your digestive tract.

Now Kimberley says, “There is just no reason to live with hemorrhoids. You can have the treatment and immediately get back to your normal life, just more comfortably.”

For more information and to request an appointment at Premier Hemorrhoid Treatment Center, click here.

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