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  • Redefining herself – and her lifestyle

    For years, no decades, Michelle Milliner walked through department stores and dress shops admiring the designer labels and their elegant styling. She looked but never for very long. She knew her size 30 body was not going to fit into any of those clothes.

  • An Emergency Readiness Guide for People with Disabilities

    About 20 percent of Americans — or nearly 57 million people — have some form of disability, according to a U.S. Census report.

  • Building Health Literacy: How to Empower Patients with Health Information

    With all the health information available online, in doctor’s offices and during doctor-patient interactions, it can be difficult for patients to make sense of it all.

  • Playing Contact Sports? Why You Need a Mouthguard

    This blog was written in conjunction with Daryl Osbahr, MD. 

  • The Health Risks of Depression in Cancer Caregivers

    When a loved one is diagnosed with cancer, it can be stressful and challenging for the entire family.

  • Reducing The Sodium in Your Diet is Easier Than You Think

    As I discussed in my previous blog, “The Decline of Salt? A Look at America’s Eating Habits,” consuming too much sodium in your diet can increase the risk of developing or worsen several health issues, especially high blood pressure or hypertension. Sodium is a mineral essential for life, and needed in the right amounts for different functions in our bodies. In general however, most people will benefit from decreasing the total milligrams of sodium they consume daily. Always check with your doctor or registered dietitian nutritionist to know the amount that is right for you.

  • 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.

  • What Online Resources Can You Trust for Health and Nutrition Information? Here's a List of Our Favorites

    The amount of nutrition misinformation is unreal. Many times I find myself wondering if what I am looking at is right. It would be so nice to be able to identify one or two foods that cure cancer or a special supplement that makes weight loss a breeze while eating anything you want. Unfortunately, the truth is usually hidden somewhere between the lines. When I am faced with this situation at work or when I'm putting together a family meal, I want a credible resource to guide me in the right direction. I have compiled a list of websites that I have found to have accurate and credible nutrition information. My selection includes websites that base their information on current research and many of the sites are government sites that contain several nutrition resources.

    The Academy of Nutrition and Dietetics

    This is a resource I search regularly for updates on the latest nutrition news. The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) is the supporting organization for Dietitians/Nutritionists and is the world's largest organization of food and nutrition professionals. As such, the site offers accurate, up to date nutrition information on timely topics. Some topics include childhood obesity, healthy weight loss, and nutrition for life and disease management/prevention.

    The Sports, Cardiovascular and Wellness Nutritionist (SCAN)

    The SCAN website is where I go for sports nutrition questions, as well as information for disease prevention. SCAN provides sound, evidence-based information for athletes, consumers, and health and fitness professionals. A sampling of topics include disordered eating in adolescent athletes, quitting smoking/how to fight cravings, and eating for teens.

    The National Institute of Health (NIH)

    The NIH is part of the U.S. Department of Health and Human Services. It is the nation’s medical research agency that provides leadership and direction to programs designed to improve the health of the Nation by conducting and supporting research. The NIH is designed to enhance health, lengthen life and reduce the burdens of illness and disability. Topics include clinical trials, health/wellness, and health for child, teen, men, women and seniors.

    Medline Plus

    MedlinePlus is produced by the National Library of Medicine, offering information about diseases, conditions, and wellness issues. The health information is reliable and up-to-date and covers the latest treatments and drugs or supplements. You can also find out about clinical trials on a disease or condition.

    The National Heart, Lung, and Blood Institute (NHLBI)

    The National Heart, Lung, and Blood Institute (NHLBI) is a government program providing research, training, and education programs to promote the prevention and treatment of heart, lung, and blood diseases. The site has a tab named “public” which takes you to a page that has “Health Information for the Public”. A menu of topics offer information onheart & vascular, lung, and blood diseases, as well as, sleep disorders.

    Choose My Plate

    The Center for Nutrition Policy and Promotion, an organization of the U.S. Department of Agriculture, was established in 1994 to improve the nutrition and well-being of Americans. The Department is responsible for Choose My Plate, which is a nutrition program based on the Dietary Guidelines for Americans. The site has a “SuperTracker” for tracking daily food and exercise. It as has nutrition tips, sample menus, recipes and daily food plans.

    Dietary Guidelines for Americans, 2010

    The Dietary Guidelines are the federal government's evidence-based nutritional guidance to promote health, reduce the risk of chronic diseases, and reduce the prevalence of overweight and obesity through improved nutrition and physical activity. The site contains the Dietary Guidelines Policy. The policy has very specific information on weight management, foods to include and reduce in the diet, eating patterns and healthy food choices.

    National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 

    The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conduct and support medical research and research training. They offer science-based information on diabetes and other endocrine and metabolic diseases; digestive diseases, nutritional disorders, and obesity; and kidney, urologic, and hematologic diseases.

    Livestrong

    Livestrong was created as the Lance Armstrong Foundation in 1997 by cyclist Lance Armstrong. Livestrong has content on overall health as well as nutrition issues. It is based on a premise that healthy living is essential to the prevention of cancer and other illnesses. Livestrong offers information on health and nutrition, however, at times purely facts are presented and the reader still has to decipher if it is a good choice.

    WebMD

    WebMD is a resource that uses health experts to answer timely health questions. A search of the database may be able to give insight into a health question.

    Mayo Clinic

    Mayo Clinic offers useful and up-to-date information and tools that reflect the expertise of the Mayo Clinic. Mayo health professionals offer insight into a variety of health issues. Mayo is a site that has sound nutrition principles offered by registered dietitians. So, next time you are uncertain if a nutrition fact is true, try searching for the answer from one of these more credible resources.

  • Dr. Akash Nanda, Radiation Oncologist, Discusses Proton Therapy Center

    At the Orlando Health Cancer Institute, we are committed to providing unparalleled care to patients with cancer. Our multidisciplinary approach sets us apart from other local centers in Florida. Our breadth of expertise from subspecialty-trained oncologists results in an evidence-based, consensus-driven approach to cancer care for our patients.

  • First patient at Orlando Health undergoes transcatheter aortic valve replacement

    Catheter used during transcatheter aortic valve replacement (TAVR) procedure. The transcatheter aortic valve replacement (TAVR) procedure is designed for high-risk patients living with severe chest pain, congestive heart failure or symptoms of aortic stenosis — an age-related heart disease that develops when calcium deposits cause the aortic valve to narrow, forcing the heart to work harder to pump enough blood through a smaller opening.