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  • Finding a second chance at life through surgical treatment for trigeminal neuralgia: Carol’s story

    One morning in February 2012, Carol Lang awoke as usual at her home in Trenton, Florida, about 30 miles west of Gainesville. Except, something was off.

  • Reducing breast cancer risk with early diet changes

    The American Institute for Cancer Research (AICR) estimates that 38 percent of all breast cancer cases in the U.S. could be prevented with simple changes to diet and exercise. We are also learning that adult breast health is largely determined during the adolescent years, when the breast tissue is developing and is most susceptible to nutritional and environmental influences. Research shows that the consumption of certain foods during the breast development process may actually change its physiology, thereby making it more or less inclined to developing cancer in the future. Although the mechanisms of action are not yet completely understood, clinical evidence has shown that there are a few basic dietary practices that appear to be protective in the development of breast cancer.

  • Personal Prescriptions: Clinical trial explores new targets for treating advanced breast cancer

    Breast cancer is the most common cancer affecting women in the United States and worldwide. When diagnosed early, it has more than a 90% cure rate. Yet, even when breast cancer spreads outside the breast and becomes metastatic, women may survive many years on effective therapy. When deciding how to treat breast cancer, the breast profile, or “phenotype,” guides oncologists to select the treatment options most likely to control the cancer and maybe even get rid of it altogether.

    So how do we do that?

    Currently, we determine the phenotype by measurement of the presence or absence of Estrogen Receptor, Progesterone Receptor, and the Her2neu growth factor receptor on cancer cells.  Scientists are also studying other biologic features of cancer cells to look for new “targets” to improve therapy. For patients suffering from metastatic breast cancer that is Estrogen Receptor or Progesterone Receptor positive, our standard of care is to initiate estrogen-blocking or estrogen-lowering treatment called “endocrine therapy.” If the cancer is life threatening, or vital organ function is being compromised, then chemotherapy is often initiated first to get control of the cancer, followed by endocrine therapy.  Examples of endocrine therapy include tamoxifen, aromatase inhibitors, ovarian suppression, fulvestrant and a new drug on the market, everolimus.  In 2012, the FDA approved everolimus (a drug that blocks a critical pathway in cancer cells) after research and clinical trials showed a significant improvement in the response to the combination of exemestane plus everolimus, versus using exemestane alone. This drug is now used for women with advanced estrogen receptor positive breast cancer.

    A new clinical trial at UF Health Cancer Center at Orlando Health

    We have just started a new clinical trial (research study) at UF Health Cancer Center at Orlando Health that explores another target, the PI3K pathway. PI3K stands for phosphatidylinositol-3-kinase. This is an important enzyme in normal cells that regulates multiple functions of cells. It appears to play a critical role in the crossroads of the intricate molecular messaging that occurs in cancer cells. In this clinical trial, we are testing BKM120, an oral medication that targets the PI3K pathway. This trial will look at whether or not this oral medication, combined with fulvestrant (another cancer fighting medication), may help to combat a patient's cancer.

    Women are eligible for the trial if they:

    Are 18 years or older with a biopsy proven diagnosis of breast cancer and tumor tissue available for special studies. Have inoperable locally advanced or metastatic breast cancer Have Estrogen Receptor or Progesterone Receptor positive phenotype and are Her2neu receptor negative Are postmenopausal Have been treated with aromatase inhibitors (anastrazole, letrozole, or exemustane) and their disease has progressed or recurred Have adequate liver function, good control of blood sugar, and adequate heart function without irregular heart rhythm Have not received more than one type of chemotherapy for metastatic disease and do not have symptoms from central nervous system metastases Do not have significant psychiatric disorder, major depression, major anxiety, or thoughts of suicidePatients who choose to enter clinical trials are given complete information regarding the details of the trial, the safety issues, and the opportunity to withdraw from the trial at any time without consequences. The process of educating patients so that they can decide whether to participate is called the “informed consent process.” Federal guidelines spell out the process for entering patients on clinical trials, the FDA approves and receives reports about the trial, a Safety Committee monitors trial safety, and Institutional Review Boards oversee the protection of the rights and welfare of research patients.

    My Personal Prescription:

    If you or a loved one has been diagnosed with cancer, ask your consultant about available clinical trials and your eligibility.

  • As we age, our diets need to change! Dawn Napoli provides dietary recommendations for women by age group

    In your 20s

    It’s important to remember that what you are eating in your 20s can set you up for eating habits throughout your whole adult life.

  • Travel Vaccinations 101: Things to Know Before you Go

    Vaccinations are a highly debated topic among parents and travelers alike. Getting immunized against potential diseases when you are traveling the world is an individual decision that you need to make with the help of a travel medicine professional.

  • Can being overweight cause cancer?

    It is common knowledge that being overweight or obese is associated with diabetes, high blood pressure and heart disease. However, too much body fat appears to increase the risk of cancer as well. In fact, the American Cancer Society Cancer Prevention Study II showed significant increases in cancer occurrence in people who are the most overweight. According to the National Cancer Institute, several different types of cancers are linked to obesity. These include cancer of the uterus, breast, kidney, thyroid, gallbladder, colon/rectum, pancreas, and esophagus.

    Being obese appears to be a problem for cancer survivors as well

    Studies have shown worse survival rates for obese women with breast cancer. Similarly, obese men with prostate cancer are more likely to have an aggressive form of cancer, and it is more likely to come back after surgery.

  • Common questions about melanoma

    Melanoma is the fastest growing cancer in the United States and the most common cancer among men and women age 20-29. In its early stages, melanoma is a very treatable cancer with a very successful (nearly 100 percent) survival rate. However, left undetected, melanoma can spread quickly, affecting other organs in the body and the lymph nodes, significantly decreasing chances for successful treatment.

  • Make Mother's Day special and healthy! Check out these unique and nutritious ideas

    Shower the mom(s) in your life with love and health this Mother's Day with one or more of these healthy and unique ideas. Their minds and bodies will appreciate it!

    Make breakfast in bed

    Shop the day before and get up early! Make an omelet with spinach, lean turkey and cherry tomatoes with fortified orange juice and whole wheat toast on the side.

  • Dr. Gupta answers: Can you discuss thyroid issues and the relationship to Type 2 diabetes?

    I am a 56-year-old woman who has been diagnosed with Hashimoto's Thyroiditis. I have a vitamin D deficiency and I also have a genetic risk for type 2 diabetes. All of this is being monitored by blood work every three weeks, but I feel sometimes as if I correct one thing, it throws something else off (cholesterol, etc.).  I feel like I have to have a specialist for each aspect of this disease!

    Can you discuss thyroid issues and the relationship to Type 2 diabetes and other issues?

    The phrase "too many cooks in the kitchen" can sometimes apply to the world of medicine. It may be helpful to get a sub-specialist opinion on each topic but then bring all the ideas back together with a general internist or family practitioner who can help sort through all the recommendations and prioritize which to focus on first.

  • Guys, as you mature, your diet should too! Stay healthy as you age with these tips

    Last week, in observance of Men's Health Month, I wrote about some of the medical recommendations for men by age group - now I will cover some of the dietary recommendations to keep our guys as healthy as possible. It is never too late to start being mindful about your dietary choices, but it's best to start before something goes wrong! Here we go...

    In your 20s

    It is time to change your diet habits. In your 20’s is when your levels of muscle-building hormones (testosterone, DHEA, growth hormone) hit their peak, so now is the best time to pack on muscle!