“Breast cancer is the second leading cause of cancer death in women in America,” says Gail Starr, M.D., diagnostic radiologist at Hackensack University Medical Center. “An early breast cancer diagnosis is your best hope for a cure. In addition, the treatment options can be less aggressive and better tolerated when cancer is detected early, so having regular mammograms is crucial.”

While there is no concrete way to prevent breast cancer, annual mammograms have reduced the mortality rate by 40 percent. “Routine breast cancer screening is important for all women, because it is common and most women who get breast cancer have no family history of breast cancer or other risk factors” says Harriet Borofsky, M.D., breast imaging specialist at Bayshore Medical Center and Riverview Medical Center.

Source: American College of Radiology

“In addition to these general guidelines, women of color have the highest breast cancer mortality rate and are more likely to receive an advanced-stage diagnosis,” says Rebecca Gamss, M.D., diagnostic radiologist at Hackensack. “All women should have a risk assessment before age 30, so those at higher risk can be identified—especially women of color and of Ashkenazi Jewish descent.”

Next Steps & Resources:

• Meet our sources: Gail Starr, M.D. MS.Ed., Rebecca Gamss, M.D., and Harriet Borofsky, M.D. To make an appointment with a doctor near you, call 800-822-8905 or visit our website.
• Find a breast imaging location near you
• 6 questions every woman should ask about breast cancer
• Can lipstick cause breast cancer?

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post Who Should Get Screened for Breast Cancer? appeared first on Hackensack Meridian Health.

Since English surgeon Edward Jenner discovered vaccination in 1796 and Louis Pasteur invented vaccines in 1880, vaccines have been one of the most successful advances in medicine with the eradication of many infectious diseases worldwide.

The advantage of engaging the immune response—particularly the T cells—is that it generates a long-lasting immune memory that can prevent infections but can also help fight cancer. Immunotherapy—particularly T cell therapy (such as CAR T cells) or checkpoint blockade (that unleash the dormant immune system)—are now transforming cancer care.

The development of cancer vaccines has seen a resurgence over the last decade, thanks to better understanding of the immune response, the development of better platforms and technologies to deliver these vaccines. “The goal of therapeutic cancer vaccines is to prevent cancer, induce tumor regression, eradicate minimal residual disease after initial therapy and establish lasting antitumor memory,” says Andre Goy, M.D., chairman and director at the John Theurer Cancer Center at Hackensack University Medical Center.

Cancer vaccines come in two categories:

Prophylactic or Preventative Vaccines

These vaccines work by killing viruses that may lead to cancer.

“There is a vaccine against the human papillomavirus [HPV], also known as HPV, which is spread through sexual contact and has been known to cause cervical, anal, throat, vaginal, vulvar and penile cancers,” says Heather Appelbaum, M.D., pediatric and adolescent gynecologist.

Additionally, there is also a vaccine to combat hepatitis B, which can, in some cases, lead to liver cancer.

Therapeutic or Treatment Vaccines

Currently, three forms of cancers vaccines have been approved by the FDA:

• In advanced refractory prostate cancer, a vaccine called Sipuleucel-T (where the patient’s own cells have been stimulated against a prostate cancer protein found in >95% prostate cancer cells and then reinfused to the patient) can be used as treatment.
• In advanced melanoma (skin cancer), a vaccine called Talimogene laherparepvec (a modified attenuated virus is injected into skin lesions where it infects tumor cells and induces an immune response) can be used as treatment.
• In early-stage bladder cancer, the Bacillus Calmette-Guérin (BCG) given intravesically can induce long-lasting protection and prevent progression or recurrence of bladder cancer.

Improvement in vaccine design and delivery models, including mRNA vaccines (which allow expression of many tumor antigens in one “shot”), have led to many ongoing trials that will likely offer new options for cancer patients in the near future.

“The power of the immune system cannot be underestimated, and restoring or augmenting our immune response will be at the core of all cancer therapies,” says Dr. Goy. “This being said, the best way to improve cancer outcomes today is through regular screenings, as catching cancer early always translates to better outcomes!”

Next Steps & Resources:

• Meet our source: Andre Goy, M.D. and Heather Appelbaum, M.D. To make an appointment with Dr. Goy, Dr. Appelbaum or a doctor near you, call 800-822-8905 or visit our website.
• Are you up to date on cancer screenings?
• Get screened for colon cancer earlier
• Can an abnormal Pap or HPV prevent pregnancy?

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post What Are Cancer Vaccines? appeared first on Hackensack Meridian Health.

“Lipstick, foundation and other beauty products can contain preservatives that have hormone-like properties and can act as hormone ‘disruptors,’ altering our hormonal environment,” says oncologist Deena Mary Atieh Graham, M.D. “Over time, these disruptors could potentially affect how estrogen and other hormones function in the body. In cases of large doses, these ingredients could theoretically promote tumors, including breast cancer.”

What Should You Do?

That doesn’t mean you have to throw out all of the contents of your makeup bag. While cosmetic products are made of a number of ingredients, a few chemicals are being studied for possible links to breast cancer:

• Parabens. Parabens are a type of preservative used to prolong the shelf life of lipstick and other makeup products. “Parabens can disrupt hormone function by mimicking estrogen,” says breast surgeon Renee Armour, M.D. “We know excess estrogen after menopause can promote the growth of tumors and breast cancer.”
• Phthalates. This hormone-disrupting ingredient is used to hold color in cosmetic products. While phthalates don’t mimic estrogen, they can change the balance of hormones that interact with estrogen.

“Some women choose to limit their exposure to these chemicals and look for products that are paraben- and phthalate-free, including mineral makeup,” says breast imaging specialist Harriet Borofsky, M.D.

Screening to Reduce Breast Cancer Risk

When it comes to breast cancer, screening is key to early detection. The American Cancer Society recommends women at average risk of breast cancer should start annual mammograms in their 40s:

• Women between 40 and 44 have the option to start screening with a mammogram every year.
• Women 45 to 54 should get mammograms every year.
• Women 55 and older can switch to a mammogram every other year or choose to continue annual mammograms.

For women with a family history of breast cancer or genetic tendency for breast cancer, earlier screening may be needed, including breast MRI. “Your doctor can talk to you about your individual risk of breast cancer and the best screening plan for you,” says Dr. Graham.

Next Steps & Resources:

• Find a breast imaging location near you
• Meet our sources: Deena Mary Atieh Graham, M.D., Harriet Borofsky, M.D. and Renee Armour, M.D. To make an appointment with a doctor near you, call 800-822-8905 or visit our website.
• Which breast cancer screening is right for you?
• Are mammograms painful?

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post Can Lipstick Cause Breast Cancer? appeared first on Hackensack Meridian Health.

There’s a low percentage of pediatric cancers that are associated with a family predisposition to cancer or with disorders that impact the immune system. “But for most children with cancer, there are no identifiable risk factors,” Dr. Appel says. “In terms of lifestyle risk factors, there’s very little we can tell parents to avoid or do differently.”

Importantly, Dr. Rifkin-Zenenberg says, children’s cancers are highly responsive to treatment, and the cure rates for childhood cancers are high. The NIH reports that childhood cancer deaths decreased by more than 50 percent between 1975 and 2010.

Signs to Watch

While there are a number of signs that could indicate cancer in kids, many of them could indicate another condition.

If your child is experiencing any of these issues, make an appointment with your child’s doctor:

• Paleness or easy bruising
• Unexplained persistent fever
• Loss of energy or fatigue
• Unusual swelling or lumps
• Persistent headaches, with or without vomiting

According to the National Institutes of Health’s National Cancer Institute, while rates of cancer in children have slowly increased since the 1970s, cancer in children is still rare with only about 15,000 cases in the United States each year.

Next Steps & Resources:

• Meet our sources: Stacey Rifkin-Zenenberg, D.O. and Burton Appel, M.D. To make an appointment with one of them or a doctor near you, call 800-822-8905 or visit our website.
• Learn more about nationally recognized pediatric cancer care at Hackensack Meridian Children’s Health
• 5 ways to calm your child’s nerves about surgery
• What are the signs of cancer in kids?

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post Why Do Kids Get Cancer? appeared first on Hackensack Meridian Health.

Because people are wearing sunscreen more often than ever, it has prompted researchers to scrutinize the ingredients within sunscreen to ensure that what we’re putting on our skin is safe and effective. Although some ingredients are considered safer than others, doctors and researchers still strongly recommend sunscreen use, especially when you’ll be outside during peak sunlight hours, between 10 a.m. and 4 p.m.

“Sunscreen helps to protect your skin from ultraviolet radiation, which lowers your long-term risk of skin cancer, the most commonly diagnosed type of cancer,” says Margaret H Hager, M.D., a family medicine specialist, HMH Medical Group Primary Care-Forked River. “People shouldn’t avoid wearing sunscreen out of concern about certain ingredients; they should consider what ingredients are in their sunscreen and perhaps choose other products with different ingredients.”

More research is needed on certain sunscreen ingredients

In 2019, the U.S. Food and Drug Administration (FDA) ruled that it needed to get more information on 12 ingredients within sunscreen to determine whether they are safe and effective. It did not say that these ingredients are unsafe:

• avobenzone
• cinoxate
• dioxybenzone
• ensulizole
• homosalate
• meradimate
• octinoxate
• octisalate
• octocrylene
• oxybenzone
• padimate O
• sulisobenzone

Certain experts recommend avoiding the use of sunscreen containing oxybenzone. Some research has shown that the chemical is absorbed through the skin, where it may interfere with endocrine activity and hormones, particularly among children and possibly among pregnant women. The American Academy of Pediatrics recommends that parents shouldn’t use sunscreen with oxybenzone on children.

Also in 2019, the FDA named two sunscreen ingredients that are not safe. They shouldn’t be included in sunscreen formulations sold today, but if you have an old container of sunscreen lying around, look at the ingredients and toss it if it contains:

• PABA
• trolamine salicylate

Concerns about benzene in some sunscreen products

In May 2021, an online pharmacy that tests products for quality assurance released a report which found that levels of the chemical benzene were in certain batches of sunscreen products that they tested. Benzene is a component of cigarette smoke and gasoline, and it’s been shown to cause cancer, such as leukemia. It’s not added to sunscreen products purposely; rather, it’s believed that contamination during the manufacturing process led to the introduction of benzene in certain products.

Some researchers have questioned the methods that were used in the benzene-sunscreen report. Others have pointed out that the benefits of wearing sunscreen outweigh the risks of possible benzene exposure.

“Skin cancer is much more prevalent than the cancers associated with benzene, and people shouldn’t assume that the sunscreen that they have in their homes is from the specific batches that were tested and found to contain some benzene,” says Dr. Hager. “People shouldn’t avoid sunscreen because of news coverage of this report. They may not realize it, but they already come into contact with benzene in their daily lives, whenever they inhale car exhaust or second-hand smoke.”

Seek out safe sunscreen ingredients

In 2019, the FDA also recognized two sunscreen ingredients as safe and effective:

• Zinc oxide
• Titanium dioxide

Both ingredients are mineral-based. They work by creating a physical barrier between your skin and ultraviolet rays, helping to keep UV light from burning or damaging the skin.

Zinc oxide and titanium dioxide may not be as well-liked as other sunscreen ingredients, because they don’t blend in well; they sit on the surface of the skin, typically giving you a whitish sheen, no matter how well you try to rub it in.

If you prefer, you may still use sunscreens containing ingredients that the FDA wants more information about. However, if you’re pregnant or have children, you may want to avoid formulations containing oxybenzone.

Next Steps & Resources:

• Meet our source: Margaret H Hager, MD, Family Medicine, HMH Medical Group Primary Care-Forked River
• To make an appointment with Dr. Hager, or a doctor near you, call 800-822-8905 or visit our website.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post Are There Harmful Ingredients in Your Sunscreen? appeared first on Hackensack Meridian Health.

These numbers may seem scary, but the good news is it can often be treated successfully.

“While prostate cancer is very common, and while there are people who pass away from it, the therapies and treatments we have are phenomenal for prostate cancer,” says Mark Perlmutter, M.D., FACS, medical director of urologic oncology, Jersey Shore University Medical Center and Ocean Medical Center.

If you or someone you love has been diagnosed with prostate cancer, you might wonder why or what caused it. Unfortunately, this is something researchers and doctors are still trying to understand.

Genetic Factors for Prostate Cancer

“We don’t know for sure how prostate cancer starts. But there are a variety of genetic components that we’re learning about more and more every year,” says Dr. Perlmutter. “We now know there’s a very large association between the BRCA genes and prostate cancer. We’ve known that in regards to breast cancer for a long time, but we now more fully appreciate and understand its link with prostate cancer.”

Everyone has two copies of these BRCA genes: BRCA1 and BRCA2. But you have an increased risk of developing some cancers—such as prostate—if you have a mutation in these genes.

What Puts You at Increased Risk?

Other factors that may increase your risk of developing prostate cancer include:

Age. Your risk of prostate cancer increases as you age. It’s most common after age 50, with about six in 10 cases found in men older than age 65.

Race. African-American men are ata greater risk of prostate cancer than men of other races. As well, it affects African-American men at a younger age and is often more aggressive.

Family history. If you have a blood relative with prostate cancer, your risk increases. There are also other cancers that may be genetically related, and you may have an increased risk if you have a family history of breast or pancreatic cancer.

Screening for Prostate Cancer

While there is no known way to prevent prostate cancer, you should discuss the pros and cons of prostate-specific antigen (PSA) screening with your doctor. PSA, a protein produced by cells in the prostate gland, may be elevated in men with prostate cancer. Men with a higher risk for prostate cancer should consider PSA testing at age 40, while all men should consider it once they reach 45.

Next Steps & Resources:

• Learn more about how we treat a full range of urologic disorders and diseases.
• Meet our source: Mark Perlmutter, M.D., FACS. To make an appointment with Dr. Perlmutter or another doctor near you, call 800-822-8905 or visit our website.
• What you should know about prostate cancer
• 7 conditions that affect men more than women

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post How Does Prostate Cancer Start? appeared first on Hackensack Meridian Health.

Goiters affect about 16 percent of people worldwide, ranging from just under 5 percent in the United States to 28.3 percent in Africa, according to the National Institutes of Health. But the most common cause of goiters globally—a lack of the nutrient iodine—isn’t a significant issue in the U.S., where iodized salt is routinely used.

“In our country, many goiters are idiopathic, meaning we don’t know the reason why they occur,” says Alexander Shifrin, M.D., an endocrine surgeon at Jersey Shore University Medical Center.

Still, various risk factors can make it more likely that you’ll develop a goiter. These include:

• Gender: Women experience more goiters than men, as well as more thyroid problems overall.
• Age: Goiters happen more often in those over age 40.
• Family history: If you or a family member have dealt with an autoimmune disease, this ups your risk for a goiter.
• Pregnancy and menopause: Thyroid problems happen more often during these hormone-fluctuating times in women’s lives.
• Radiation exposure: Those who’ve undergone radiation treatments to the head, neck or chest, or have been exposed to radiation from a nuclear facility or accident, are more prone.

Symptoms of Enlarged Thyroids

Located at the base of the neck, the thyroid produces hormones that regulate a variety of crucial bodily functions, ranging from helping us keep warm and use energy to fueling proper function of organs and muscles. The development of a goiter doesn’t mean the gland isn’t working. But this enlargement, which can happen slowly or quickly, may also signal the thyroid is making too much or too little hormone.

What signs of a goiter should you watch for? Dr. Shifrin says size matters. “Watch for an enlargement of the thyroid,” he says, including swelling at the base of your neck. “Every enlarged gland should be checked for cancer.”

According to the American Thyroid Association, you should also watch for these signs:

• Trouble swallowing, breathing or speaking normally
• Coughing
• Tightness in the throat

Most goiters aren’t cancerous, Dr. Shifrin says, but you should still have it checked by your primary physician or an endocrine specialist. Blood tests alone can’t usually determine if thyroid cancer is present. “Ninety percent of thyroid cancers are detected by palpating the gland and a thyroid ultrasound,” Dr. Shifrin says.

Next Steps & Resources:

• Learn about the endocrine surgery program at Jersey Shore University Medical Center
• Meet our source: Alexander Shifrin, M.D. To make an appointment with Dr. Shifrin or another doctor near you, call 800-822-8905 or visit our website.
• All about thyroid cancer
• What happens when you are diagnosed with cancer?

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post Causes and Signs of an Enlarged Thyroid appeared first on Hackensack Meridian Health.

Who Should Be Screened?

The task force says all adults ages 45 to 75 should be screen screened for colorectal cancer.

This recommendation is intended for:

• Asymptomatic people
• People with average risk of colorectal cancer
• People with no previous diagnosis of colorectal cancer
• People with no history of colon or rectal polyps
• People without a personal or family history of genetic disorders that put them at higher risk

For adult ages 76 to 85 years, the task force recommends screening at the discretion of a doctor based on a person’s health and previous screening history.

Why Screen Sooner?

According to research from the American Cancer Society, the rate at which people 65 and older are diagnosed with colorectal cancer in the U.S. is dropping. But in younger age groups, that rate is rising. In 2020, 12 percent of colorectal cancer cases were diagnosed in people under age 50. Since the 90s, rates have been increasing in adults ages 40 to 54.

“We don’t know exactly why we’re seeing a trend of colorectal cancer in younger patients. But by proper screening, we can effectively reduce the number of colorectal cancer cases and deaths in a younger population of patients,” says Rosario Ligresti, MD, FASGE, chief of the Division of Gastroenterology at Hackensack University Medical Center. “If polyps are found through early screening, they can be removed before they develop into cancer.”

Types of Colorectal Cancer Screening

Several tests may be used to screen for colorectal cancer. The tests are generally divided into two categories:

1. Tests that look for signs of cancer in your stool
2. Visual exams of your colon and rectum using a viewing scope (colonoscopy) or CT scan (virtual colonoscopy)

Stool testing is typically done annually to every three years and visual exams every five to 10 years.

“Each type of screening has different benefits and cons,” says Dr. Ligresti. “Your doctor can help you choose the right one for you—and tell you how often it should be repeated. Overall, the best screening test is the one that actually gets done!”

 Next Steps & Resources:

• Meet our source: Rosario Ligresti, M.D.
• Make an appointment with Dr. Ligresti, or find a doctor near you.
• Learn more about cancer screenings, including colorectal cancer screening, at Hackensack Meridian Health
• Health screenings you should never skip
• Is a colonoscopy really that bad?

 The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post Get Screened for Colon Cancer Earlier (Age 45) appeared first on Hackensack Meridian Health.

Here are three things you can expect after your prostate is removed.

1. Gradual Recovery

Prostate removal is major surgery, so expect some soreness and pain. You’ll receive IV pain medications at first, and your doctor may prescribe you pain medication to use at home. You will also have a urinary catheter in place for about the first week, which you might find uncomfortable.

Most patients are up and moving the day of surgery and go home the following day. Although you will need to rest and gradually resume physical activity, urologist Mina Fam, M.D., emphasizes the importance of movement. “I want patients up and walking the same day of surgery because any kind of cancer surgery has a risk for blood clotting,” Dr. Fam says. “I encourage patients to keep walking during their recovery.”

Expect it to take about four weeks to start feeling back to your “normal” self if your surgery was done robotically and up to six weeks with a traditional open approach.

2. Changes in Your Sex Life

Most men experience some decline in erectile function after their prostate is removed, but this can be managed. “It can take six months or even up to a year for the affected nerves to recover from surgery. But with proper therapy and treatment, most patients can have good erectile function again,” says Dr. Fam.

Treatment options include:

• Medication
• Pelvic floor muscle exercises
• Penile implants
• Counseling

Work with your doctor to find a treatment that is right for you.

Another change to expect in your sex life is that, because the seminal vesicles are removed during surgery, you won’t ejaculate semen during orgasm.

3. Bladder Problems

Urinary incontinence is another common side effect of prostate removal. You might dribble or leak urine when sneezing or laughing, or feel an urgent need to go to the bathroom.

If you had normal urinary control before your surgery, you will likely regain this control over time. For most men, urinary incontinence will go away within a year, often within months.

Whether your surgery is robotic or the traditional open approach can impact how severe your symptoms are and how long they last. “With the robot, we’re able to really preserve the length of the urethra and preserve all the muscles that control continence,” says Dr. Fam. Though minor incontinence still occurs with robotic surgery, most men will have full control of their bladder after about six to eight weeks.

If you are suffering from incontinence, there are treatment options that can help, including:

• Medication
• Pelvic floor exercises
• Artificial urinary sphincters (an implanted device to treat moderate to severe stress urinary incontinence)

Talk to your doctor to find the right treatment option.

Next Steps & Resources:

• Meet our source: Mina Fam, M.D. To make an appointment with Dr. Fam or another doctor near you, call 800-822-8905 or visit our website.
• Learn more about prostate cancer care
• 5 male infertility myths demystified
• Health screenings everyone should get

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post What to Expect After Prostate Removal appeared first on Hackensack Meridian Health.

There are typically no symptoms of HPV, but genital warts can be a sign of a type of HPV that may be present in the body. “HPV has more than 100 different strains and can show up in different ways depending on the individual,” says Merieme Klobocista, M.D., gynecologic oncology surgeon at John Theurer Cancer Center, part of Hackensack University Medical Center. “Usually, having HPV has no major impact to health, but if left untreated, it can turn into something more serious.”

Treatment Considerations

About 10% of women with HPV infection on their cervix will develop long-lasting HPV infections that put them at risk for cervical cancer.

If precancerous cells are found and need to be treated, certain treatment options may present challenges when it comes to safely giving birth to a healthy baby.

“Cryotherapy, laser therapy or LEEP [loop electrosurgical excision procedure], while all safe methods, can ultimately impact the strength of the cervix and increase the risk of preterm birth or even miscarriage,” says Stephanie Scianni, D.O., Obstetrics and Gynecology, Jersey Shore University Medical Center.

Even after precancerous cells have been removed, it is still possible for women who have undergone any of these procedures to conceive and deliver a healthy baby; they just may be under a careful watch.

“Ultrasounds are the best method for monitoring the health of the cervix during pregnancy,” Dr. Scianni says. “If necessary, the mother may be placed on bed rest until it is time for delivery.”

Next Steps & Resources:

• Learn more about women’s health services at Hackensack Meridian Health
• Meet our sources: Merieme Klobocista, M.D. and Stephanie Scianni, D.O. To make an appointment with Dr. Klobocista, Dr. Scianni or another doctor near you, call 800-822-8905 or visit our website.
• Are pregnant women more at risk of COVID-19?
• What cancers can be caused by HPV?
• CDC – Basic Information about HPV and Cancer

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

The post Can an Abnormal Pap or HPV Prevent Pregnancy? appeared first on Hackensack Meridian Health.