Pisgah Family Health News

April 2014

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Fight to make yourself and the world cancer free


Office News

Alison Rittenberg

Alison Rittenberg

Please welcome Alison Rittenberg to Pisgah Family Health. Alison is a third year medical student at UNC, and a graduate of Davidson College. She will be completing her Family Medicine rotation with Dr. Curran in the months of April and May.

Babies!

Sewell Twins

Congratulations to the Sewells, who are new parents of twins Isabel and Nico. Both babies are healthy and thriving.

We've had several babies born to our practice in the last few months. Babies bring a special joy to Pisgah Family Health. Dr. Curran sees newborns at Mission Hospital, including performing circumcision if necessary. In the office we offer the full range of childhood vaccinations and child health care. If you or your friends are expecting a baby, please inquire about our pediatric services.

DOT Physicals

Do you have a Commercial Drivers' License? Dr. Curran and Melissa Martinez have been certified for CDL physicals under the new DOT changes effective June 2014.

If you are due to renew your CDL license, please call us to make an appointment. Be sure to get your DOT papers, and complete your portion prior to the visit. If you wear glasses or contacts to drive, be sure to bring them for your visit.

Office Reminders

Thank you for referring your family and friends to Pisgah Family Health. We are always eager for new business.

Remember to bring your insurance card to each visit and present it to the receptionist when you check in. This ensures we have the most current insurance information for you.

Please notify our office if you have a new mailing address or phone number.

Bring your medications to each visit. Dr Curran likes to see your medication bottles.

HIPAA states that we can not release any of your information without your written consent. Please let us know if you would like to authorize us to release information to your spouse or a family member.

Office Hours

Our office hours are now 8:30-5pm Monday through Thursday, and 8:30 to 12 on Friday. Our answering service can be reached after hours at 251-4873. When the office is closed, emergency care is available at the Urgent Care Centers and Mission Hospital ER. On nights and weekends, Dr. Curran shares call with five other physicians. These doctors are all Board Certified in Family Medicine. We do not handle prescription refills after hours.

  • Pisgah Family Health will be closed Monday, May 26th for Memorial Day
  • Pisgah Family Health will be closed Friday, July 4th for Independence Day.

Medical News

cigarette-lungs (70K)

E-Cigarettes and Nicotine Replacements

Are you a smoker or tobacco user? Have you thought of quitting? Then you've probably considered using a nicotine replacement, such as the nicotine gum, losenges, patch, or e-cigarette. These devices may help you quit smoking, and are certainly safer than tobacco use. However, the safety of these devices is currently in question by the FDA.

If you want help quitting tobacco, please call our office. We can help you make an effecive plan to improve your health. Also consider these free resources:

What are electronic cigarettes?

Electronic cigarettes, also known as e-cigarettes, are battery-operated products designed to deliver nicotine, flavor and other chemicals. They turn chemicals, including highly addictive nicotine, into an aerosol that is inhaled by the user. Most e-cigarettes are manufactured to look like conventional cigarettes, cigars, or pipes. Some resemble everyday items such as pens and USB memory sticks.

E-cigarettes have not been fully studied, so consumers currently don’t know:

  • the potential risks of e-cigarettes when used as intended,
  • how much nicotine or other potentially harmful chemicals are being inhaled during use, or
  • whether there are any benefits associated with using these products.

Additionally, it is not known whether e-cigarettes may lead young people to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death.

Source: www.fda.gov

FDA Regulation of e-Cigarettes

Only e-cigarettes that are marketed for therapeutic purposes are currently regulated by the FDA Center for Drug Evaluation and Research (CDER). Currently, the FDA Center for Tobacco Products (CTP) regulates

  • cigarettes,
  • cigarette tobacco,
  • roll-your-own tobacco, and
  • smokeless tobacco.

FDA has issued a proposed rule that would extend the agency’s tobacco authority to cover additional products that meet the legal definition of a tobacco product, such as e-cigarettes. Visit FDA’s Extending Authorities to Additional Tobacco Products webpage for more information on the proposed rule, including how to submit comments.

New FDA Regulation

The U.S. Food and Drug Administration is proposing long-awaited regulations governing the fast-growing electronic cigarette industry.

The new rules, made public April 24, 2014, would give the FDA the authority to regulate e-cigarettes as tobacco products, placing them under the same requirements as cigarettes. That would include a ban on the sale to minors.

The new proposed regulations would also give the FDA oversight of numerous tobacco products that up to now have had no federal oversight. Those products include cigars, pipe tobacco, nicotine gels and waterpipe (or hookah) tobacco.

"Today, we're taking another very important step toward the goal of a tobacco-free generation," U.S. Health and Human Services Secretary Kathleen Sebelius said during a Thursday afternoon news conference.

By Dennis Thompson, HealthDay News. For the full article, visit www.WebMD.com

Cancer Screening Guidelines

Cancer DNA

Cervical cancer

Women should begin cervical cancer screening at age 21, and 3 years after the first sexual intercourse. If a woman has never had intercourse, she does not need cervical cancer screening. If a woman has had her uterus removed, she does not need cervical cancer screening. Women who have had abnormal pap spears, or positive HPV tests, will require more frequent testing.

Women between ages 21 and 29 should have a Pap test every 2-3 years.

Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) every 3-5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.

Women over age 65 who have had regular cervical cancer testing with normal results should stop being tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65.

A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.

Some women – because of their health history – may need to have a different screening schedule for cervical cancer.

Breast Cancer

Breast Cancer is the second leading cause of cancer death in women, after lung cancer. The goal of screening is to detect breast cancer at its earliest stage, before it can spread or cause more harm.

Breast self-exam: Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.

Clinical breast exam: about every 3 years for women in their 20s and 30s and every year for women 40 and over.

Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.

Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.

Colorectal cancer

Beginning at age 50, both men and women should follow one of these testing schedules:

  • Colonoscopy every 10 years, or
  • Flexible sigmoidoscopy every 5 years, or
  • Double-contrast barium enema every 5 years, or
  • CT colonography every 5 years (often not covered by insurance), or
  • Fecal occult blood testing annually.

If you have certain risk factors, your doctor may recommend earlier or more frequent screening. Risk factors include:

  • A family history of colon cancer or colon polyps
  • A personal history of colon polyps

For more information on colorectal cancer screening, please call the American Cancer Society and ask for our document called Colorectal Cancer: Early Detection.

Lung cancer

Lung cancer is now the top cause of cancer death in America. While lung cancer is not the most common, it is the most deadly. Unfortunately, even early detection of lung cancer may not improve one's chances of survival. The best way to avoid lung cancer is to never smoke.

The American Cancer Society does not recommend screening for lung cancer in people who are at average risk of this disease. However, the ACS does have screening guidelines for individuals who are at high risk of lung cancer due to cigarette smoking. If you meet all of the following criteria then you should consider a chest Xray or chest CT scan:

  • 55 to 74 years of age
  • In fairly good health
  • Have at least a 30 pack-year smoking history AND are either still smoking or have quit smoking within the last 15 years

Prostate cancer

The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer. Research has not yet proven that the benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about what we know and don’t know about the risks and possible benefits of testing and treatment.

Starting at age 50, men should consider a digital rectal exam, and a PSA blood test. Frequency of testing will depend on their PSA level. Risk Factors for prostate cancer include

  • African American heritage
  • First degree relatives with prostate cancer before age 65.

Skin Cancer

Skin cancer is the most common and most easily treatable of all cancers. Skin cancer can be detected by a simple skin exam, and by a skin biopsy. All adults should have a skin-cancer screening as part of their routine physical.

Skin cancer risk is directly related to ultraviolet light exposure, and includes:

  • Caucasian (white) skin type
  • Sunburns and prolonged sun exposure
  • Use of tanning beds
  • A personal history of skin cancer.

Endometrial (uterine) cancer

The American Cancer Society recommends that at the time of menopause, all women should be told about the risks and symptoms of endometrial cancer. Women should report any unexpected bleeding or spotting to their doctors.

Some women – because of their history – may need to consider having a yearly endometrial biopsy. Please talk with your doctor about your history.

Cancer-related check-ups

For people aged 20 or older having periodic health exams, a cancer-related check-up should include health counseling and, depending on a person’s age and gender, exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some non-malignant (non-cancerous) diseases.

Take control of your health, and reduce your cancer risk.

  • Do not use tobacco.
  • Stay at a healthy weight.
  • Get moving with regular physical activity.
  • Eat plenty of fruits, vegetables, and whole grains.
  • Limit how much alcohol you drink.
  • Protect your skin from the sun.
  • Know yourself, your family history, and your risks.
  • Have regular check-ups and cancer screening tests.

For information on how to reduce your cancer risk and other questions about cancer, please call The American Cancer Society at 1-800-227-2345.

For additional information, visit www.cancer.gov/

Source: American Cancer Society

About our Newsletter

Dr. Curran and the staff at Pisgah Family Health are proud to publish the Pisgah Family Health News to our patients.  Our goal is to provide regularly updated information about the office and current medical topics.  We plan to publish a new issue each quarter with breaking news.  The newsletters will also be archived on our website, www.PisgahFamilyHealth.com/

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