How does lumpectomy plus radiation compare to mastectomy for treating breast cancer?

Posted April 02, 2013

DEAR DOCTOR K: I was recently diagnosed with early-stage breast cancer. My doctor wants me to consider a lumpectomy plus radiation. But wouldn't a mastectomy be more effective?

DEAR READER: In a lumpectomy, just the cancer and tissue immediately around it are removed, and radiation therapy is used to kill any nearby cancer cells that might not have been removed. In a mastectomy, the whole breast is removed. Since sometimes breast cancer cells (invisible to the eye of the surgeon) can spread into the surrounding breast, it's plausible to think that a mastectomy might have a better cure rate than just a lumpectomy.

Should I take tamoxifen longer than five years?

Posted March 20, 2013

DEAR DOCTOR K: I was diagnosed with ER-positive breast cancer a few years ago. My doctor told me to take tamoxifen for five years to prevent my cancer from coming back. I recently read that taking tamoxifen longer further decreases the risk of a cancer recurrence. What should I do?

DEAR READER: The simple answer is: Ask your primary care doctor if you should talk to a breast cancer specialist, because it may well be a good idea to continue on the tamoxifen. But I know you won't be satisfied with a simple answer, so here's a more elaborate one.

What does colonoscopy preparation involve?

Posted March 06, 2013

DEAR DOCTOR K: I'm scheduled to have my first colonoscopy. My friends tell me the preparation is worse than the procedure. What am I in for?

DEAR READER: From my long experience as a doctor -- and as a patient -- I think your friends have it right. The large intestine (colon) is a long tube through which digested material passes. In a colonoscopy, a flexible tube with a light and camera at the end is placed inside the colon. What the doctor is looking for are abnormalities in the circular inner wall of the colon, including tumors, bleeding and inflammation.

What is leukemia and what treatments are available?

Posted February 07, 2013

DEAR DOCTOR K: My uncle was recently diagnosed with leukemia. I'd like to learn more about it.

DEAR READER: Leukemia is a form of cancer that affects the body's blood cells. Almost every type of cell in our body can turn cancerous, and blood cells are no exception. Every day, each of us makes millions of new blood cells -- red blood cells, white blood cells, and the cells that make platelets (little cell fragments that help blood to clot). Blood cells are made in the marrow (the inside) of bones.

What should I know about being treated for breast cancer?

Posted December 12, 2012

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DEAR DOCTOR K: I was just diagnosed with breast cancer. I've found an oncologist, and she's great. Now what can I do?

DEAR READER: I'm glad you've found a great doctor. The choice of treatments depends both on the details of your cancer and your own values. For example, how important is it to preserve your breast if the doctor says removal of the whole breast has a slightly better prognosis than just removing the cancer from the breast? So I hope your doctor will take the time to get to know you and your priorities. You should feel comfortable asking your doctor questions and making decisions with her.

Should I be worried about moles on my skin?

Posted August 04, 2012

DEAR DOCTOR K: I have many moles, some flat, some raised. Should I be worried about them?

DEAR READER: Yes, you should. I worry about mine. Everyone has moles. They usually appear during childhood or adolescence. Most moles never become a problem, but sometimes they can become cancerous, causing a potentially deadly skin cancer called malignant melanoma.

Can soy foods increase the risk of breast cancer?

Posted June 09, 2012

DEAR DOCTOR K: I'm a breast cancer survivor. Can soy foods such as tofu or soy milk increase my risk of a cancer recurrence?

DEAR READER: I wish I had a simple and reassuring answer. Soy has a complicated relationship with breast cancer. Many breast cancer cells have receptors for estrogens. Receptors are like a lock, and estrogen is like a key. When the key enters the lock, and fits it, breast cancer cells start to multiply.

How does emotional stress affect physical recovery?

Posted March 23, 2012

DEAR DOCTOR K: I am recovering from breast cancer surgery. Unfortunately, my healing process is coinciding with several unexpected stressful events in my life. Can stress actually slow my healing?

DEAR READER: Stress does have far-reaching physical effects. There is plenty of research showing that stress -- especially long-term stress, and the feeling that you cannot get control of your life -- can harm your body.

What can I expect during a mammogram?

Posted February 17, 2012

DEAR DOCTOR K: I just scheduled my first mammogram. What can I expect during the procedure?

DEAR READER: Unfortunately, I can't tell you from personal experience. I know what every doctor knows, but only a person who has undergone a medical procedure firsthand really knows what it's like.

What can I expect during a colonoscopy?

Posted December 15, 2011

DEAR DOCTOR K: My brother was recently diagnosed with colon cancer. Now my doctor wants me to have a colonoscopy. Can you tell me what will happen during this procedure?

DEAR READER: Your brother's diagnosis puts you at higher risk for colon cancer, so I'm glad to hear your doctor has recommended that you get checked.

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