At Xanit International Hospital, we want to offer you all the answers to cancer that are currently available, including but not limited to information on: potential treatments, their side effects, and recovery processes, as well as the psychological processes that patients may undergo throughout all these procedures.



The first mammogram, what should we know?

Posted by Xanit Internacional Xanit Internacional | Posted in ALL ABOUT CANCER, women's health | Posted on 07-01-2020

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According to the Spanish Association Against Cancer, “around 32,825 new breast cancer cases are diagnosed annually in Spain”. With such figures, we believe it is of utmost importance to raise awareness among the society of the importance of research and early diagnosis of breast cancer since it is the most frequent tumour in western women.

For that purpose Dr Fran Fernández, responsible for the Breast Unit at Vithas Xanit International Hospital, explains today what mammography consists of and everything you need to know before making your first mammogram.

A mammogram is an X-ray of the breast that allows detecting breast lesions before they even give symptoms (palpable lump, retraction of the skin or the areola-nipple complex, bloody discharge from the nipple, lumps in the armpits, etc.).

When should we undergo the first mammogram?

For risk-free patients, it is advisable to start with mammograms at the age of 40, however, the family history should also be taken into account. If there is a history of breast, ovarian, and/or prostate cancer, this test is usually started at the age of 35.

Mammography should be repeated every year or every other year if the results of the previous test came back normal. If you are a patient at risk, the doctor may indicate whether it is necessary to perform this test every six months or combine it with other imaging tests, such as ultrasound or MRI.

 

Some recommendations to keep in mind before performing a mammogram

  • If you have a very sensitive breast, to avoid pain from the breast compression, it is recommended to perform mammography after the end of menstruation, since the breast is less sensitive because it has less hormonal influence.
  • It’s important not to be afraid. Mammography lasts between 15 and 30 minutes, it is a fast process and carries no risk. Therefore, it is important to be relaxed, since it is a routine test and it does not involve any complications.
  • Try not to wear any metal objects on the day of the screening such as earrings, bracelets, etc., because you will have to remove them for testing.
  • It is also advisable to wear comfortable clothes that are easily taken off, as the chest must be bare for the test.
  • Only in the case of being pregnant could there be a contraindication to take the test because it can pose a risk to the baby, although your doctor will always advise you whether to do it or not.
  • If the patient is in the process of breastfeeding, it is advisable not to perform the mammogram because the breast is anatomically very transformed due to changes that occur during lactation; only in cases of high suspicion of breast cancer the mammogram is indicated.
  • In the case of patients with breast implants, you should be aware that the implants may decrease the sensitivity of the test. In these situations mammography can also be supplemented with ultrasound and resonance imaging.

According to AECC, the most important means for early diagnosis of breast cancer is mammography, and the chances of cure of cancers detected at the initial stage are almost 100%.

That is why it is essential to perform mammography, complemented by self-examination at home.

Multidisciplinary Treatment of Breast Cancer

Posted by Xanit Internacional Xanit Internacional | Posted in ALL ABOUT CANCER, women's health | Posted on 09-01-2018

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Breast cancer is the most common malignant tumour in women and is occurring more frequently at a younger age.

Throughout history there have been many changes in the management of this condition, both in terms of diagnosis and treatment. Developments have led to recovery being achieved in close to 85% of cases. But one of the most significant developments has been the multidisciplinary approach to this condition, which guarantees the most appropriate treatment for each patient according to current scientific standards. Breast cancer should be treated by a multidisciplinary team, specialised in the breast, offering individually tailored treatment in each case.

 

Multidisciplinary team in the treatment of breast cancer

Dr Fran Fernandez, from the Breast Unit at Vithas Xanit International, explains in this post the role of each of the professionals involved in the multidisciplinary treatment of breast cancer, a key part in the patient’s recovery process.

  • Radiologists, they are fundamental to the whole process as they are “the gateway,” they initiate the whole process of breast cancer diagnosis, performing the necessary tests to arrive at a more accurate diagnosis. They not only play a part, they are essential in the marking of the majority of lesions for later removal in theatre.
  • Pathologists have acquired a distinct role in the last few years, no longer being simply those who confirm malignant disease, but those who perform diagnostic tests and provide reports with the great amount of information required to offer the most appropriate treatment for each patient.
  • Nuclear medicine physicians play a major role in our theatres for important sentinel node localisation, a technique which has prevented innumerable cases of axillary emptying and its subsequent problems. They work with the radiologists using other investigations focused on diagnosis, of great use in the management of breast cancer.
  • Gynaecologists are active participants at the very beginning of the process with screening of asymptomatic patients, detecting possible abnormalities during their examination.
  • Medical oncologists and radiation oncologists are another critical link in the chain. They are responsible for administering chemotherapy treatment or prescribing radiotherapy, both before and after surgery, to help shrink tumours and promote a higher cure rate with comprehensive treatment of the disease. They are also those responsible for research and better understanding of the disease, participating in the multiple research studies required to learn more about the disease and therefore improve treatment where possible.
  • The plastic surgeon, aesthetic appearance is also crucial, participation of the plastic surgeon is therefore essential to improve results.
  • The general surgeon, who in this case serves as a common link to the whole team, manages the patient’s journey in the agreed manner from the moment presented at the committee, deciding on technical aspects of the surgery when required.

 

Vithas Xanit Oncology Committee

The cases of patients who are newly diagnosed with breast cancer are presented weekly at the Oncology Committee. The committee’s radiologists, pathologists, medical and radiation oncologists, nuclear medicine physicians and surgeons decide together on the best treatment option for each, individual patient. From that point on, a multidisciplinary decision is taken in the same Oncology Committee regarding any new circumstance that may patient may develop. Thus, results following surgery, the end of treatment or any other incident result in further discussion of the case to ensure the best decision is made.

A multidisciplinary team provided for the patient, it achieves its objective: the complete recovery and rehabilitation of the patient, in 85% of cases. Prevention and regular mammograms are also an essential part of effective treatment.

Prevention and early diagnosis of melanoma: Body mole map

Posted by Xanit Internacional Xanit Internacional | Posted in ALL ABOUT CANCER, dermatology | Posted on 23-10-2017

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New advances in technology have always been a powerful medical tool, now one of these, the mole mapping technique, is using digital photography to assist with diagnosis. The mole map covers the patient’s total surface area of the skin enabling doctors to examine and log skin abnormalities (shape, size, location and colour) in detail. Every detail matters, a digital map of the patient’s body is obtained, which is then periodically repeated and stored, enabling dermatologists to analyse and contrast changes in blemishes, moles and other skin lesions, constantly alert to any alterations.

Benefits of body mole mapping

Using the test the dermatologist is able to obtain an accurate and complete map of the skin, he/she can then periodically and systemically review anything which requires particular attention, analysing and contrasting any variations that occur. This is advantageous for the patient since this analysis prevents unnecessary biopsies or excision of benign lesions and, in addition, facilitates the early detection and treatment of malignant lesions or melanomas, offering a higher recovery rate.

This method also makes it easier to discover moles in areas which are difficult for the doctor or patient to see, such as the scalp, behind the ears or on the back, etc.

Am I able to have a body mole map?

If you are wondering whether a mole map is appropriate for you, please note that it is suitable for everyone, but it is particularly indicated for people with atypical skin lesions, multiple moles or a family history of skin cancer. It is a simple and painless test with high quality photographs taken of skin lesions all over the body. The test is repeated after a reasonable amount of time with overlapping of the images to detect any changes, these are subsequently given to our specialists for study and treatment.

A dermatologist is responsible for planning the mole map for each patient. Generally, an annual mole map is recommended, but in some particularly sensitive cases, it may be necessary every 6 or even every 3 months.

You can depend on Vithas Xanit International Hospital’s Dermatology Department to resolve any queries you may have, please request your appointment online.

Breast Cancer – What now?

Posted by Xanit Internacional Xanit Internacional | Posted in ALL ABOUT CANCER | Posted on 19-10-2016

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Today, in connection with World Breast Cancer Day, Dr Carabantes from our Vithas Xanit Oncology Institute, would like to give us an overview of the protocol followed from the time that the specialist suspects that a patient may have a malignant tumour, up to the time that the diagnosis and possible treatment are confirmed. It is important to remember that early detection is fundamental for the effective treatment of breast cancer and that a quality healthcare service is fundamental to provide the patient with the necessary support and information from the very beginning. With this in mind, at the Vithas Xanit Oncology Institute we always aim to provide high quality, scientifically based, diagnosis and treatment of cancer along with a caring, empathetic approach. The Institute’s multidisciplinary teamwork in this area can make it is possible for the patient to receive their diagnosis, see the oncologist and undergo resulting surgery and treatment within one week. The most important steps are outlined below.

 

When a woman discovers a suspicious breast lesion it is important that a biopsy is performed as soon as possible to confirm the nature of the lesion. If the diagnosis is breast cancer, a targeted action protocol will be implemented for treatment of the disease and support provided to deal with the emotional impact associated with the diagnosis.

 

Current advances in biological knowledge relating to breast cancer have shown us that it is not a single disease but a group of diseases, with differences clinically, therapeutically, and from prognostic point of view. As a result more individualised treatment is increasingly necessary. However a multidisciplinary approach is also required involving pathologists, radiologists, nuclear medicine physicians, surgeons, medical and radiotherapy oncologists, psychologists, volunteers… Effective coordination between them is essential, for this reason the successful functioning of a tumour committee with representation from all specialities is highly important. In our hospital this committee provides support to enable the appropriate decisions to be taken, always offering the patient the best solution, specifically adapted to their requirements.

 

Within this team every specialist has an important role, both in the final diagnosis as well as in the treatment to be followed. For example, the pathologist has to define the histological characteristics of the disease: type of tumour, size and histological grade, lymph node involvement, hormone receptors, etc.

Along with the clinical, pathological and radiological information, both the locoregional and systemic treatment to be followed will be decided, with the aim of finally achieving successful treatment of the tumour.

 

Treatment

 

Conservative breast surgery with Sentinel lymph node biopsy or axillary emptying will always be preferred if possible, depending on the axillary involvement. In many cases nowadays axillary emptying can be avoided, without compromising survival rates, and with the great advantage of reducing the risk of lymphoedema and swelling produced in the arm after axillary emptying.  When mastectomy is necessary (due to tumour size or poor aesthetic result with conservative surgery), it is often feasible to start the breast reconstructive process during the same operation. An expander can be sited which allows insertion of a permanent prosthesis afterwards, especially if radiotherapy is not required after surgery.

 

Not all breast cancer patients require radiotherapy or systemic treatment (chemotherapy, hormone therapy or biological therapy) after surgery. This depends on the pathological characteristics of the disease, its clinical progression (lymph node or distant) and its biological characteristics based on the analysis of expression of multiple tumour genes (genome platforms).

 

Radiotherapy consists of the administration of ionising radiation targeted at a selected volume (breast and lymph nodes) to eliminate tumour cells in these areas. It is delivered using linear particle accelerators and is indicated after conservative surgery or, in some cases, after mastectomy depending on the tumour size and lymph node involvement.

 

Systemic treatment includes chemotherapy, hormone therapy and biological therapy. Chemotherapy may be given after surgery when the cancer is infiltrating (when it has had contact with the blood and lymphatic system) depending on the pathological, clinical and biological characteristics of the disease, to destroy disseminated tumour cells via the blood and lymphatic system. It can also be administered prior to surgery with the aim of reducing the disease to enable resection and allow breast conservation. These drugs can often be administered intravenously (some are oral) over 21 day cycles, usually with a duration of 3 to 6 months.

 

Treatment may also be necessary with hormone therapy when the tumour expresses hormone receptors. This is given over a period of 5 to 10 years. In the cases of HER-2 positive tumours, monoclonal treatment with monoclonal antibody (trastuzumab) is also recommended for 1 year, it can be given alongside chemotherapy and hormone therapy. In the case of metastasis there are more known biological treatments available such as antiHER2.

 

During treatment it is important to keep patients informed of all the possible side effects which may occur, enabling them to face the entire process, drug side effects are different for example, to those of chemotherapy.

 

Throughout treatment and afterwards we always advise patients to follow a healthy lifestyle including stopping smoking, consuming moderate amounts of alcohol, following a balanced diet rich in fruit and vegetables, moderating fat and sugar consumption, and avoiding a sedentary lifestyle. Physical exercise is recommended, including during chemotherapy treatment, but carefully, adapting it to the patient’s physical condition.

 

 

 

 

Lung Cancer – What is it and what are its effects?

Posted by Xanit Internacional Xanit Internacional | Posted in ALL ABOUT CANCER | Posted on 15-09-2016

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Dr. Cristina Quero, lung cancer specialist, is here today to talk to us about this condition, one of the most commonly occurring cancers in the Spanish population.

 

What is lung cancer?

Lung cancer is a malignant tumour disease in which normal cells change into tumour cells, these cells lose their normal function and grow uncontrollably.

 

What are the main symptoms?

Occasionally lung cancer does not produce any symptoms and is often a casual finding on a chest X-ray requested for other reasons.

As the tumour grows symptoms start to appear, the most frequent ones being: tiredness, cough, weight loss, difficulty in breathing (dyspnoea) or the presence of blood stained sputum (haemoptysis).

When the tumour spreads and metastases appear they in turn can produce symptoms related to the affected organ (bones, liver, brain, adrenal glands).

 

What factors cause it to occur?

The main known risk factor in the development of lung cancer is exposure to tobacco smoke, the majority of lung cancers occur in people who smoke.

We also know that asbestos (a mineral occurring in many types of rock and used in insulation) is another risk factor in the development of lung cancer. Its fibres can irritate the lungs when inhaled by workers who are exposed to it (naval shipyard workers, miners).

 

Which are the most common types of lung cancer?

There are 2 main types of lung cancer: small cell and non-small cell, being named in accordance with the cell from which they originate.

It is important to differentiate between the two types as they are treated in very different ways.

 

What investigations are required to detect lung cancer?

If a patient is suspected of having lung cancer a series of tests will be performed to help us to confirm our suspicions, and to know the extent of the disease so that the most appropriate treatment can be given.

The first diagnostic test usually performed is a chest X-ray followed by a CT scan. These help to confirm the location and spread of the disease.

For confirmation of the diagnosis, and to know the subtype of the lung cancer, a biopsy is essential, this is generally performed via bronchoscopy. This test involves introducing a tube through the mouth into the bronchi to take a specimen for analysis. Occasionally the tumour is out of reach of the bronchoscope and the biopsy has to be performed by introducing a needle between the ribs, under CT guidance, to locate the biopsy site.

 

 

 

 

What treatments are currently available to treat this disease?

It is important to identify the subtype of the lung cancer as well as the location and spread of the disease. Depending on these parameters we follow the different treatment options available:

– Surgery: Performed by a thoracic surgeon, consists in the removal of the tumour, with sufficient margins, as well as local lymph nodes.

– Radiotherapy: Small daily doses of radiation targeted at the tumour, with sufficient margins.

– Chemotherapy: Intravenous or oral medication targeted at destruction of the tumour.

 

In non-small cell lung cancer, when the tumour presents in its initial stages, curative treatment includes surgery, and in those cases where there is more advanced local disease it is treated with chemotherapy and radiotherapy. If the disease presents at an advanced stage, with metastatic involvement, the condition is considered incurable and treatment is based on chemotherapy. This helps to increase survival time and improve quality of life.

Small cell lung cancer is more difficult to control and treatment does not usually include surgery. When the patient presents with more localised disease, treatment includes chemotherapy and radiotherapy. If other organs are affected treatment is based on chemotherapy.

 

How can we prevent lung cancer?

The main strategy in lung cancer prevention is to avoid the risk factors in its development such as tobacco smoke.

Smokers can reduce their risk of developing this type of cancer by stopping smoking but they will always have a higher risk than someone who has never smoked.

Health tips for coping with chemotherapy during summer

Posted by Xanit Internacional Xanit Internacional | Posted in ALL ABOUT CANCER, Xanit salud | Posted on 08-08-2016

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Cancer involves treatment regimens which can be particularly hard-going for the patient. These include chemotherapy, a treatment which is very aggressive and which can have multiple side effects. Today we are going to cover some of the most common problems which can occur during the summer months with Dr Trujillo, Oncologist at Vithas Xanit Oncology Institute, including those involving sun related photoallergic reactions and hypersensitivity.

People undergoing chemotherapy or radiotherapy develop certain skin conditions which require them to take extreme precautions in the sun. However this doesn’t mean that they can’t: enjoy the beach, the pool, a walk on the seashore… They simply need to adopt certain measures to minimise the impact of skin exposure.

At Vithas Xanit Oncology Institute we have a few recommendations specifically targeted at the hot months

Some health tips are very easy to follow:

  • Avoid going in the sun in the middle of the day; sun radiation is at its highest between 12pm and 4pm.
  • Keep skin adequately hydrated. It is important to be hydrated on the outside, as well as the inside, each person using a cream appropriate to their needs. Just as the importance of drinking two litres of water a day is common knowledge, oncology patients must also be aware that the treatments which they are undergoing can cause abnormalities in epithelial tissue, these combined with the effects of solar radiation increase the skin’s fragility.
  • Use complete sunblock and apply it correctly. Oncology patients must use sun screen of factor 50 or above to block ultraviolet rays, both A and B. It must also be applied correctly, before sun exposure and then reapplied frequently, after time it loses its effectiveness and if only applied once there is the risk of leaving areas of skin without protection.
  • Use physical protection such as a hat, sunglasses and gloves as well as sunscreen. Consider wearing a swimsuit made from material which has sun block properties for improved protection if necessary.

 

 

Use of wigs

In summer the heat is the main reason a wig feels uncomfortable. The following advice can help to make wearing it  more pleasant:

  • Use finishing products such as mousse, wearing a wig with a “wet look” is an easy way of allowing it to be damp during the day, without it becoming frizzy.
  • Wear a wig made of natural hair, making sure it isn’t too thick.
  • Alternate the wig with headscarves and hats.

The headscarf, an essential accessory

Throughout treatment, the headscarf becomes an essential companion. It is therefore important that it is comfortable and practical, as well as looking good. Unlike a conventional headscarf, it needs:

  • To have no seams and be made of soft material on the inside which doesn’t rub the scalp.
  • To be made of natural, breathable material which does not trap heat, usually cotton.
  • To stay securely in place.
  • To provide greater coverage and volume
  • To be available in colours and prints which complement skin tone.

If you have any queries, please come to see us at Vithas Xanit International Hospital’s Onco-Aesthetic Unit. A team of specialists who offer oncology patients a free personal image consultation, with advice on styles and accessories suitable for everyone.

We also provide dermatological and cosmetic consultations to give you tips and advice on caring for, soothing and protecting your skin and scalp, as well as your hair.  We can also provide nutrition and dietetic services, helping you to reduce the side effects from treatment and improve your quality of life during the summer months.

 

Sun protection, skincare for summer

Posted by Xanit Internacional Xanit Internacional | Posted in ALL ABOUT CANCER | Posted on 20-06-2016

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Fotoproteccion

With the arrival of the summer heat we spend more time at the beach, in the swimming pool and doing other outdoor activities, increasing our skin’s exposure to the sun’s rays, leading to the need to take greater care of our skin. We would like to share the importance of taking care of your skin in the sun. Sun exposure without adequate sun protection can result in conditions such as skin cancer, sun sensitivity and photoageing (pigmentation, wrinkles, severe dryness, etc).

In summer, when spending so many hours at the beach and the pool, it is necessary to protect yourself from UVA rays, especially if you are pale skinned. Pale skinned people suffer most as the paler your skin the more quickly you burn and the less time you should expose yourself to the sun. Applying sunscreen every day and reapplying it every two hours whilst in the sun is recommended with avoidance of exposure to the sun in the middle of the day (from 12.00 to 16.00). Remember to take extra care with young children who need considerably more protection from the sun, especially in comparison to winter.

When carrying out outdoor activities wearing a hat, T-shirt and sunglasses is recommended in addition to sunscreen. These help to protect you from the direct effects of the sun on your skin. Keeping your body continuously hydrated is also advisable.

It is also important to make sure that your skin is adequately hydrated, although this is something we should do all year round, increasing hydration even more is recommended during summer. The use of soap appropriate for your skin type will also help you to protect it.

Although it might not be apparent, nutrition is a significant factor in the care of your skin as well as your body. Intake of antioxidants such as fruit, vegetables or vitamin supplements for example, can help to reduce skin damage that may be caused by the sun. A balanced diet helps to improve your general health and the health of your skin.

Remember to check your skin periodically and visit the dermatologist if you notice anything unusual. In summer the appearance of skin blemishes is common, they are normally caused by the sun. If you notice a mark/blemish appearing after sun exposure then you should visit the dermatologist for a diagnosis, as they can occur for many reasons.

If you have a lot of moles, especially more than a total of 50, if you have a personal or family history of melanoma or if you notice a change in any mole (asymmetry, edges, colour, diameter, elevation…), you should also visit the dermatologist who will check to make sure that there is no reason for concern.

Advice for protecting your skin

  • Use high factor sunscreen appropriate for your skin type.
  • Apply sunscreen every two hours and avoid sun exposure in the middle of the day.
  • Increase sun protection in young children.
  • Wear a hat, T-shirt and sunglasses.
  • Continuously hydrate your body.
  • Use an appropriate soap for your skin type.
  • Take antioxidants and vitamin supplements
  • Have a periodic skin check-up.

 Dr. HERRERA ACOSTA

Head of Department of Dermatology at Vithas Xanit International Hospital.