Cancer Care, Men's Health, Women's Health
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Skin cancer screenings: Know what to look for
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Skin cancer is the most common form of cancer in the United States, and it’s on the rise. Skin cancer can affect anyone at any age, with more than three-and-a-half million skin cancer cases diagnosed each year—that’s more than the incidence of breast, prostate, lung and colon cancers combined.
Melanoma is the deadliest form of skin cancer, and it’s rising fastest among 25- to 29-year-olds. One in 50 people will be diagnosed with melanoma in their lifetime. Exposure to UV rays from tanning beds is a major risk factor for melanoma, along with your total sun exposure as a child and teenager.
When caught early, it can almost always be cured. But left untreated, melanoma can become deadly. This cancer develops when pigment-producing cells grow and form a tumor, which can eventually spread to other parts of the body.
Spot the Problem
There would be fewer deaths from melanoma if people regularly took time to do a thorough skin exam. This means checking for moles from your scalp to the bottoms of your feet and even under your fingernails and toenails.
If you find something unusual, have it checked even if you can’t trace any recent sun exposure. It’s not the sunburn you might have received on a recent vacation, but the exposure to sun earlier in your life that can affect your risk of getting skin cancer.
Know Your ABCD and E’s
When it comes to monitoring your moles, the Skin Cancer Foundation recommends you know your ABCD and E’s:
A for Asymmetry: One half of the mole is different from the other half
B for Border Irregularity: The edges are notched, uneven or blurred
C for Color: The color is uneven. Shades of brown, tan and black are present
D for Diameter: The diameter is greater than 6 millimeters (about the size of a pencil eraser)
E for Evolving: There is change in size, color or shape over time, or additional symptoms like itching or bleeding start
If you notice any of these, seek out your doctor’s advice.
Protect Yourself
It’s important to protect yourself from the sun when you are outdoors. Seek shade from 10am to 4pm and wear a wide-brimmed hat, UV-blocking sunglasses and protective clothing. Apply UV-blocking sunscreen with an SPF of 30 to all exposed skin every two hours.
Those who develop melanoma have a three-fold risk of developing it again, so always be vigilant. If you have had melanoma, guidelines suggest you get screened every three to six months.
About 80 percent of people who develop melanoma have local, curable disease if caught early. If you’re concerned about a mole, talk to your dermatologist about getting a melanoma screening, or ask your primary care doctor for more information about seeing a dermatologist.
Check your risk of skin cancer with our free skin cancer risk assessment.
Author
By Glen Gibson, MD, surgical oncologist at Anne Arundel Medical Center.
Originally published April 21, 2015. Last updated July 9, 2018.
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Behavioral Health
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Your Mental Health Matters: 5 Ways to Safeguard Mental Health in Older Adults
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At any age, mental health challenges can arise. While significant focus has been rightly given to mental well-being in younger people, it’s crucial not to overlook our seniors. The National Council on Aging (NCOA) underscores this, revealing that up to 25% of older adults live with mental health issues, like anxiety or depression.
If left untreated, mental health conditions can negatively affect your physical well-being and quality of life. Fortunately, many factors contributing to mental health decline are avoidable. As May marks Mental Health Awareness Month and Older Americans Month, now is an ideal time to implement these five strategies aimed at preserving your mental well-being as you grow older.
1. Nurture/invest social connections
Loneliness and social isolation can significantly increase mental health issues later in life. They can also increase your risk of high blood pressure, heart disease and early death.
These tips can help nurture/invest social connections:
Stay in touch with friends and family via social media or video chat. Virtual meet-ups can help you feel less alone.
Volunteer. Giving back to others can help you meet people in your community. It can also provide a sense of purpose that older adults may lose after retirement.
Get tested and treated for hearing loss. It affects one in three adults aged 65 to 74, according to NCOA. Hearing loss can make it difficult to follow what’s happening around you. It’s a common reason older adults withdraw from social interaction.
2. Get regular physical activity
Sitting for long periods of time and lack of physical activity can increase your risk of depression. Physical activity can boost your mood.
For overall health and well-being, older adults should get at least 150 minutes of moderate-intensity exercise, like brisk walking, each week, or 75 minutes of high-intensity exercise, like running. Talk to your primary care provider and decide what’s best for you. They also need at least two days of strength-building and balance activities, which can be done from the comfort of your home.
The Centers for Disease Control and Prevention recommends multicomponent physical activities to meet these triple goals. Try these:
Sign up for a dancing class at a local community center for older adults.
Take up yoga or Tai-chi. There are many online offerings at no cost.
Explore outdoor activities like gardening or hiking. But remember to stay hydrated.
3. Try music therapy
Listening to or making music seems to activate brain areas that can improve mental and physical health. Research finds that music-based interventions may be helpful for anxiety, depression and chronic pain. Go ahead and play that oldie but goodie!
4. Reduce caregiver stress
Some older adults face the added emotional challenges of caregiving. According to a 2023 AARP Survey, 50% of caregivers said caregiving increased their emotional stress, while 37% said it caused physical stress.
If you’re a caregiver, the Luminis Health Caring for Caregivers page provides self-care tips and local caregiver resources. These can help you care for your loved one while taking care of yourself.
5. Recognize mental health issues
Depression is common in older adults, but it’s not a normal part of aging. Less than half of older adults who struggle with mental health and substance use issues get the treatment they need.
Getting help starts with scheduling regular checkups with your primary care doctor. They can help you manage physical limitations or medical conditions, such as post-stroke or cancer recovery, which may increase your risk of depression. Should you or your loved one experience any of the following symptoms persistently for more than two weeks, it’s crucial to inform your doctor, as they could point to mental health issues:
Anger or irritability.
Anxious or sad mood.
Changes in appetite, mood and energy level.
Difficulty concentrating, remembering or making decisions.
Difficulty sleeping or sleeping too much.
Drug or alcohol misuse.
Feeling guilty or hopeless.
Hearing, feeling or seeing things other people don’t.
Loss of interest in things they once enjoyed, including sex.
Next steps
After ruling out medical causes, your doctor may start treatment for a mental health condition, or refer you to a mental health professional for evaluation and treatment. Mental health problems are often treated with a combination of medication and talk therapy.
You can receive high-quality mental and behavioral health services at The Luminis Health Doctors Community Medical Center Behavioral Health Pavilion on our Lanham campus. You can also call 301-623-4350.
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Cancer Care
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Which Cancer Screenings Should You Be Getting?
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During the height of the COVID-19 pandemic, millions of people in the United States delayed getting routine cancer screenings. Fortunately, data shows cancer screening rates are returning to pre-COVID levels but, even in the best of times, the number of people who are screened is lower than it should be. But what screenings should you get and when? The Centers for Disease Control and Prevention (CDC) encourages screening for breast, cervical, colorectal (colon), and lung cancers because early detection leads to better outcomes.
April is Cancer Control Month, which raises awareness for cancer prevention, detection, and treatment. Many people don’t realize that they are due for a cancer screening. Read the guidelines below to make sure you are up to date.
Breast Cancer Screening
Individuals should undergo breast cancer risk assessment by age 25 years and be counseled regarding potential benefits, risks, and limitations of breast screening in the context of their risk stratification. You and your doctor can work together to decide what’s best for you and we strongly encourage you to ask questions and share your concerns. Our providers recommend that women who are at least 40 years old and are at average risk for breast cancer get a mammogram annually.
Cervical Cancer Screening
The HPV test and the Pap test can help prevent cervical cancer or find it early.
The HPV test looks for the virus (human papillomavirus) that can cause cell changes on the cervix.
The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.
You should start getting Pap tests at age 21. If your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test.If you are 30 to 65 years old, talk to your doctor about which testing option is right for you:
An HPV test only. This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
An HPV test along with the Pap test. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test.
A Pap test only. If your result is normal, your doctor may tell you that you can wait three years until your next Pap test.
If you are older than 65, your doctor may tell you that you don’t need to be screened for cervical cancer anymore if:
You have had normal screening test results for several years, and
You have not had a cervical precancer in the past, or
You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.
Colon Cancer Screening
It is now recommended that regular screening, beginning at age 45, is the key to preventing colorectal cancer and finding it early. Colorectal cancer is the second most common cause of cancer death in the United States, and it is the leading cause of cancer-related deaths in men younger than 50. Most people should get a colonoscopy at least once every 10 years. You may need to get one every 5 years after you turn 60 if your risk of cancer increases.
Stool-based tests are becoming more popular because they are done at home, so many people find them easier than a colonoscopy. But, although these tests are easier to implement, they need to be done more often. If the result from a stool test is abnormal, a timely colonoscopy is required to check for cancer.
Lung Cancer Screening
We recommend annual lung cancer screening for people who:
Have a 20 pack-year or more smoking history, and
Smoke now or have quit within the past 15 years, and
Are between 50 and 80 years old.
A 20 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. Talk to your doctor about lung cancer screenings if you have regular exposure to second hand smoke.
Lung cancer screenings can stop when the person being screened:
Turns 81 years old, or
Has not smoked in 15 or more years, or
Develops a health problem that makes him or her unwilling or unable to have surgery if lung cancer is found.
Ask your doctor which cancer screenings are right for you and if you have concerns about cancer, you should talk to your healthcare provider as soon as possible.
Author
Robert Rice, MD, PhD is the executive medical director of oncology at Luminis Health, with more than 20 years of oncology experience.
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Pediatrics
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Are Immunizations on Your Back-to-School Checklist?
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Another school year is here, and parents may ask, “Does my child need immunizations this year?”
Immunizations are important because they keep our children safe, protecting them from certain infections and their complications by limiting the spread of illness. Kids usually receive immunizations when they see their pediatrician for an annual back-to-school wellness check-up. It’s a great time for your doctor to check your child’s progress and development and detect any potential problems.
A child receives their very first vaccination at birth, an initial dose to protect against hepatitis B. For a complete guide on what ages children should receive vaccines, the CDC’s 2022 update of the “Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger,” is an excellent resource. Keep in mind that teenagers need immunizations, too.
Each state decides which vaccines are required for your child’s enrollment and attendance at a childcare facility or school in that state.
Polio Returns to the United States
In July, the CDC reported a case of polio in an unvaccinated person in Rockland County, New York—the first case in nearly a decade in the United States—and the virus has been detected in that county’s wastewater. Polio is very contagious and can cause paralysis and even death.
The CDC recommends children get four doses of polio vaccine, starting at two months.
Keep track of your children’s vaccine record since the school where your child enrolls may require proof of vaccination. You can do this through your pediatrician’s office. Most electronic health records (EHRs) feature a patient portal to easily access or download this information. At Luminis Health, that portal is called MyChart.
COVID-19 Is Here to Stay
The recent appearance of polio in the U.S. has not reduced the importance of the COVID-19 vaccination for children.
More than 1 million Americans have died from the virus, and almost 93 million cases have been reported. “We know that COVID-19 is here to stay,” a CDC epidemiologist said at a mid-August news briefing.
The CDC recommends the COVID-19 vaccine for everyone six months or older, and boosters for everyone years and older, if eligible.
COVID-19 vaccinations for children are safe. The known risks of COVID-19 and possible severe complications outweigh the potential risks of having a rare, harmful reaction to the vaccination.
“The vaccines meet the Food and Drug Administration’s rigorous scientific standards for safety, effectiveness, and manufacturing quality,” says the CDC. They also undergo the most intense safety monitoring efforts in our country’s history.
Children 6 months to 4 years need a three-dose primary series—initial doses—of Pfizer-BioNTech, or two doses of Moderna. For kids 5 – 17 years, it’s two doses of both Pfizer-BioNTech and Moderna.
The CDC says moderately or severely immunocompromised children ages five through 17 years will need a third dose to complete their primary series, then boosters if they’re eligible. Children and teens with a weakened immune system should get one booster for ages five through 11 years and two boosters for ages 12 years and older.
Remember that the COVID-19 vaccine can cause short-term side effects such as headache, low fever, or flu-like symptoms.
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Behavioral Health
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Prejudice and Mental Health
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Over the past few months, many people are talking about race relations in America. Those conversations are hard at times, awkward and even uncomfortable. For those who experience prejudice and discrimination based on religion, race or gender identity, the effect on your mental health can be devastating and long lasting.
The day after the assassination of Dr. Martin Luther King Jr., Jane Elliott conducted her now famous “blue eyes, brown eyes” exercise with her third grade class. She separated the class into two groups based on eye color. She told one group that they were superior and had special privileges. Meanwhile, she told the other group they were inferior and didn’t give the same praise and privileges as the superior group. Eventually, the kids who were ‘superior’ soared in confidence and felt they were smarter. The kids in the ‘inferior’ group, on the other hand, started making mistakes that they would not normally make, became timid and were angry.
This experiment only lasted for a couple of days.
Now, imagine if every day of your life felt like Mrs. Elliott’s third grade classroom. And, imagine you are always in the inferior group. Even if no one ever overtly says you are inferior. When people experience prejudice, they may feel that they are not wanted or don’t belong. This causes feelings of mal adjustment that takes a dangerous toll on mental health.
Ways Experiences of Prejudice can Affect Your Mental Health
Depression
If you are constantly in an environment where you are experiencing prejudice, it’s normal to experience feelings of depression. You may start feeling emotionally drained, isolated or lonely. You may also start feeling physical exhaustion, leading to fatigue or insomnia or feelings of low motivation and feelings of wanting to quit.
Anxiety
If you are feeling judged, whether at work, school or in the community, this can lead to feelings of generalized or social anxiety. For example, you may feel nervous about starting projects or taking risks around others in their daily environment. You may also experience worry about what other people think. This can then lead to negative self-talk and low sense of self.
Low self-worth
You may question your own worth. For example, you might wonder, “Am I good enough?” or, “Do I even belong here?” Questions like this lead you to start questioning your own value. You will wonder what will you have to do to be treated differently because nothing will ever appear to be good enough. You may feel the effects of imposter syndrome and start to question your own intelligence, your value and your skill level as a result.
Feelings of hopelessness
You may start to wonder, “Will things ever get better?” or you may start to feel like all hope is lost for change. At this point, you may begin to internalize feelings of being in an inferior group. Then, you may stop demanding for things to change, stop using your voice and accept negative treatment because of a lack of equality.
How You can Overcome the Effects of Prejudice
We have to pay attention to our internal selves and listen to our mind and bodies. Then, we can start to take care of ourselves.
Self-care
You can’t pour from an empty cup. Before you can take care of anyone else, you have to take care of yourself first. Take a step back from the TV and social media. Engage in a hobby that you enjoy or spend time with your loved ones.
Breathe
Take time during the day to just breathe. Set breathing interval times throughout the day so you can remember to clear your mind. Relax your body and decrease stimulation that can feel overwhelming.
Positive self-talk
Use daily positive self-talk to help increase your self-esteem and self-worth. Tell yourself that you are good enough and you deserve the best from any position that you are in. By reminding yourself that you are worth it, you will believe that you belong when others may want you to believe otherwise.
Increase self-awareness
Know that you are not the problem. Understand that prejudice exists on many levels in society. When people are able to acknowledge that a greater issue exists, then they can increase self-confidence and be a voice for positive change.
The impact of prejudice can be devastating to a person’s mental health. The repercussions can last a lifetime and those feelings can be passed through generations. It is important for all people to continue to have those uncomfortable, difficult conversations about prejudice in society. When we take the time to listen to each other, we will feel like we are making a change. And when there is change, we will notice a positive effect in mental health based on inclusion and equality.
Author
Jennifer Williams, MA, LPC, LCPC, is a mental health professional at Anne Arundel Medical Group (AAMG) Mental Health Specialists, located in Annapolis. To reach her, call 410-573-9000.
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