Cancer Care, Women's Health
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Is over-the-counter genetic testing for breast cancer reliable?
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Think of your genes as an instruction manual for your body. There are two copies of every gene – one from your mother and one from your father – and each has its own job. For example, the BRCA1 and BRCA2 genes in our body act like police officers making sure tumor cells don’t grow out of control and develop into cancer. They’re the good guys.
But when a person has a genetic predisposition, that means that one of the copies of the gene is not doing its job. Or, in other words, that person was born with fewer “police officers” in their body.
Although we have around 25,000 genes, we only know what half of them do at this time. BRCA1 and BRCA2 are just two of the most common genes associated with hereditary breast cancer. There are many genes that can increase someone’s risk for cancer besides BRCA1 and BRCA2. It’s also possible that there are other genes that haven’t yet been identified that can put a person at a higher risk of developing breast cancer.
Can I rely on over-the-counter genetic tests?
Genetic testing is complex and is only one piece of the puzzle when determining your risk for developing a disease. The 23andMe test – the first direct-to-consumer test approved by the U.S. Food and Drug Administration to report on breast cancer gene mutations most common in people of Eastern European descent – detects only three out of more than 1,000 known BRCA mutations. It is also limited in that it doesn’t rule out other BRCA mutations that increase cancer risk.
People who receive positive test results for these mutations should ask their doctor or a genetic counselor about being retested in a clinical setting under the supervision of a medical professional before making any medical decisions. Those who test negative, yet have a strong family history of cancer, should consider comprehensive genetic testing and should consult with their doctor.
What is the difference between over-the-counter tests and seeing a counselor?
Because of its limitations, at-home genetic testing can give a false sense of security when you test for BRCA1 and BRCA2 genes.
The National Society of Genetic Counselors also advises people to consider the risks, limitations and psychological implications of genetic testing for themselves and their families before purchasing an at-home genetic test without the involvement of a clinically certified genetic counselor.
Unlike over-the-counter tests, when you meet with a genetic counselor you receive guidance and support when seeking more information about your genetic health. A genetic counselor can provide pre- and post-test counseling. Pre-test counseling includes a thorough look at your family’s health history. During post-test counseling, the genetic counselor interprets results with you and advises on the best next steps. Depending on test results, a genetic counselor can advise on how to discuss the information with family members.
When should I consider being tested?
When Angelina Jolie shared her personal journey with breast cancer in a New York Times opinion piece, she explained why she decided to be tested. She’s a good example of someone who understands the chances of being at risk and doing something about it. We encourage you to learn about your family’s health history and ask your doctor if genetic testing is right for you.
Genetic testing isn’t a crystal ball that predicts whether you will develop cancer. Instead, it’s looking in the ‘rearview mirror’ to figure out why cancer is occurring in a family and to help better understand cancer risk. If there is breast cancer in your family, a genetic counselor will work with you to understand if genetics could be the cause. If you are considering over-the-counter genetic testing or have received results and need further explanation, a genetic counselor can help.
Authors
Adam Riker, MD, is chair of Oncology at Anne Arundel Medical Center.
Margo Gallegos, CGC, is an oncology genetic counselor at Anne Arundel Medical Center .
Katherine Lincoln, CGC, is an oncology genetic counselor at Anne Arundel Medical Center.
Originally published Oct. 21, 2019. Last updated Sept. 29, 2020.
Cancer Care
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5 things no one told me about breast cancer
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Michelle Hutchison is a breast cancer survivor.
After finding a lump in her breast during a routine self-exam, Michelle was diagnosed with stage II breast cancer in October 2016. She was 25.
Today, at 27, Michelle is proud to say she beat breast cancer with the help of her dedicated care team at Anne Arundel Medical Center’s Rebecca Fortney Breast Center. She now gives time helping other women in their breast cancer journey.
For this Breast Cancer Awareness Month, Michelle shared some of the advice she gives her peers; things she never could have expected during her own treatment.
Below are her words.
“No one told me…
…the importance of fertility treatments and freezing eggs.
…how remaining positive truly can make the difference in treatments. It’s hard to not be in a dark place going through cancer treatments, but it’s important to remember to laugh and smile.
…that not every breast cancer is the same and not all treatments are the same.
…that social media and movies do not portray a cancer journey as what it is.
…IT IS OKAY TO NOT BE OKAY AND IT IS FINE TO NOT BE FINE.
Photo courtesy of Michelle Hutchison
With a growing number of cancer survivors still in their reproductive years, advances in cancer treatment make it possible to restore the reproductive future of cancer patients. Learn more about fertility preservation.
Originally published Oct. 8, 2018. Last updated Sept. 29, 2020.
Men's Health, Senior Care, Women's Health, Pediatrics
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Flu vaccine myths: What’s true, what’s not
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There’s an easy fix for the muscle aches, high fevers, sore throats, stuffy noses and headaches the flu causes: it’s the flu shot. While the shot has been around for many years, some people still don’t take advantage of it and suffer nasty flu symptoms.
Now because of the coronavirus (COVID-19) pandemic, it’s especially important to make sure you get your flu shot because underlying conditions can increase your risk for infection. Vaccines are an effective way to protect you from other serious diseases, including the flu.
READ MORE: Don’t neglect your immunizations during the pandemic
There’s no question the flu shot is the best defense against the flu, but there’s a lot of confusing information out there. Here are five common myths about the flu vaccine explained.
Looking for a primary care doctor? Our services focus on prevention and screening as well as treating illness. Find a primary care doctor today.
Myth #1: The flu shot gives you the flu.
You can’t get the flu from the flu shot. But it takes about two weeks for the shot to start working in your body, so you may still catch the flu after you have the shot.
While most people feel fine after the shot, some may develop a mild fever or feel tired for a day or two. After you receive the shot, your body works to protect you against the virus, which can make you feel tired.
Myth #2: The flu shot doesn’t work.
Is it still possible to get the flu after you get the flu shot? Yes. Is it much less likely to happen? Yes.
The flu shot is not 100 percent effective, but it does greatly lower your risk of getting the flu.
There are many different types of the flu virus. The shot doesn’t protect you against all of them. Each year, the World Health Organization identifies three or four types to include in the flu shot. These are the types most likely to be spread for that year’s flu season.
Myth #3: You don’t need the flu shot if you had it last year.
Because the flu virus changes, your body needs the vaccine each year to protect you against each year’s most common flu type.
Myth #4: If you’re a healthy, young adult, you don’t need the flu shot.
The flu is most life-threatening for people age 50 and older, pregnant women, children under age 5 and people with a chronic medical condition.
However, healthy adults can still become very sick, hospitalized or even die. Each year in the U.S., more than 200,000 people are hospitalized and about 36,000 people die from the flu.
Myth #5: If you wash your hands, eat healthy and get lots of sleep, you can prevent the flu.
These are all important and improve your overall health, but they can’t stop the flu. Germs in the air cause the flu, which means when a sick person coughs or sneezes, those germs in the air can make you sick.
Each year, five to 20 percent of people in the U.S. get the flu. If you want to increase your chance of staying healthy this winter, the flu shot is an easy step to take. Minor discomfort from the shot is much better than a serious illness and the effects that can follow. Getting vaccinated will not only help keep you healthy, but prevent you from getting others sick as well.
Author
By Lauren Parmer, DO, a primary care physician at AAMG Pasadena Primary Care. She can be reached at 443-270-8600.
Originally published Dec. 16, 2015. Last updated Sept. 25, 2020.
News & Press Releases
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September is National Preparedness Month: Get Ready, Set, Plan
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National Preparedness Month is an annual government campaign that encourages everyone to plan for emergencies and disasters. Led by the Federal Emergency Management Agency (FEMA) and sponsored by the Ready Campaign, this year’s theme is “Disasters Don’t Wait, Make Your Plan Today.”
We know emergencies can happen at any moment. They can catch anyone off guard. But if we stay prepared with basic needs, we can minimize their impact.
Here are some safety suggestions for you and your family:
Learn about the different types of emergencies that could happen in your area, and how to respond.
Make a household plan. Practice it, and update it regularly.
Create an emergency kit. It should include flashlights, batteries, water, toilet paper, sanitary napkins, non-perishable foods for you and your pets, medication, cash, battery-powered radio and clothing.
Keep copies of important documents in a safe place. Those include birth certificates, deeds and insurance forms.
Sign up for alerts in your community.
Now is also a good time to test and check the batteries in your home’s smoke and carbon monoxide detectors.
Visit ready.gov to learn more about how you and your loved ones can stay prepared.
Physical Therapy
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Preventing Falls at Home
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Falls Prevention Awareness Week is Sept. 21-25. According to the U.S. Centers for Disease Control and Prevention:
One in four Americans ages 65 and older falls each year.
Every 11 seconds, an older adult receives treatment in the emergency room for a fall.
Every 19 minutes, an older adult dies from a fall.
Falls are the leading cause of fatal injury. They most common cause of nonfatal trauma-related hospital admissions among older adults.
As we age, our homes provide new challenges and obstacles. These challenges and obstacles remain unseen until a problem arises. Our bodies also undergo subtle (or not so subtle) changes that create a fall risk. Even in our own home.
Our homes are our castles and should be places that are safe and comfortable regardless of any physical limitations. Most people prefer to stay in their homes as they age, but are unsure of how to make changes if/when needed. When faced with mobility or cognitive changes or decline, the preference to stay at home may not remain realistic without adapting the current living environment.
Here are some tips and tools to reduce the risk of falling at home and improve your ease of mobility.
Clear walking pathways: Remove cords, papers, shoes, pet toys and laundry from your walking paths. Also, be aware of slippery surfaces and spills on the floor. Clean up or cover up a spill immediately.
Beware of uneven surfaces in your home: Changes in flooring surfaces and sunken living areas that are not highly contrasted are easy to miss. You may fall and trip on these surfaces. Highlight steps with lighting or color striping. Work with a contractor to eliminate transition strips from carpet to tile. Even throw rugs, if not secured, are enough of an uneven surface to trip you.
Add good lighting inside and outside your home: Dark hallways, poorly lit closets, stairs without lighting, doors to enter/exit the home and outside walkways without lighting increase your risk for falling. Home improvement stores have many lighting options to resolve this problem.
Add supports in the bathroom: Consider adding grab bars next to your toilets as you enter or exit your shower. There are many fashionable options available at home improvement stores and various online vendors.
Make your stairs safe: If you must navigate stairs to enter/exit your home or within your home, please use a well-installed railing for the full length of the stairs. It is best to install two railings if possible and have stairs carpeted. Stairs that are chipped, crumbling or with loose railings are risky. Please get these repaired.
Organize frequently used items at home within your reach: Remember what your “strike zone” looked like playing baseball or softball? This is the zone you should store your most frequently used items. Getting up and down from the floor or using ladders in the home can prove difficult so, if you are unsteady, make these changes ASAP.
Read the AARP HomeFit Guide: AARP has an online and printed edition guiding you on a room-by-room, area-by-area home inspection to identify fall risks and provide solutions for these risks. Visit the AARP website for details.
At Anne Arundel Medical Center, we have a specialized fall prevention program. We send specially trained clinicians to your home to provide feedback on how to optimize the safety of your home while preserving the components that you love. Next, we recommend a follow-up appointment in our outpatient clinics. At our outpatient clinics, we provide intervention to minimize the risk of falls. All steps are designed so you return home with a program tailored to your specific needs to continue to maintain a lifestyle to lower your risk of falls. Our goal is to help our loved ones age in place. This allows them to live their life in the home they love.
Author
Marilyn Pfeiffer and Jennifer Buchanan are physical therapists at Anne Arundel Medical Group (AAMG) Physical Therapy.