Deep Infiltrating Endometriosis

By Riva Preil

In the past, I have blogged about endometriosis, a condition characterized by the development of endometrial glands outside of the uterine cavity, usually in the superficial peritoneal cavity, on the ovaries, the fossa ovarica, or on the uterosacral ligaments.  The symptoms of endometriosis include severe pelvic pain during one’s period, pain with intercourse, and infertility.  Endometriosis is commonly diagnosed through exploratory laparoscopic surgery which can confirm the presence of lesions, and the symptoms generally improve with menopause or removal of the ovaries.  However, a second version of the disease exists, and it is called deep infiltrating endometriosis (DIE).  The difference between this type of endometriosis and the classic form of the disease is the location and quality of the lesions.  DIE is defined as lesions that exist deeper than 5 mm below the peritoneal surface (usually on the pouch of Douglas or on the uterosacral ligaments), and the lesions are fibromuscular tissue and endometrial glands that look like little nodules.  DIE is considered more aggressive than regular endometriosis, and it may also include pelvic distortion and pain with defecation in addition to the previously mentioned symptoms.

Fortunately, a recent study in Journal of the Society of Laparoendoscopic Surgery (April-June 2013) discovered that robotic assisted laparoscopic colorectal resection (with the da Vinci system- refer to prevous blog, The da Vinci Mode) is an effective and safe surgical option for women suffering from the disease.  The average surgery lasted 157 minutes, and the average hospital stay for women in the study was three days.  Six of the ten women in the study were infertile prior to the surgery.  However, after the surgery, four of those six women were able to conceive naturally, and the remaining two women successfully became pregnant through in vitro fertilization.  Da Vinci strikes again as the many surgical benefits become revealed to the medical community.

Have a Healthy Prostate

By Roseanne Schoen

In acknowledgement of Prostate Cancer Awareness Month, here are a few more ways to stay prostate-healthy!

Schedule an Annual Prostate Exam: Annual prostate exams can help catch problems early and can diagnosis and treat preexisting problems such as an enlarged prostate, prostatitis, and prostate cancer.

Maintain Your Ideal Weight: If you need to lose weight do it. Studies showed that men with 43 inch waists or greater were 50% more likely than normal weight men to suffer from prostate enlargement. Eat adequate servings of fruits and vegetables, whole grains, and healthy fats. Limit your intake of salt and processed foods.

Abstain from Alcohol: Studies have shown that beer raises the body’s prolactin levels (prolactin increases the uptake of testosterone into the prostate and this increased testosterone converts into increased levels of DHT), and that the higher the alcohol intake the more likely a man was to suffer from prostate enlargement. Caffeine and sugar should also be avoided or moderated.

Avoid Drug and Pesticide Exposure: Drugs and pesticides may increase the 5-alpha-reduction of steroids and may put you at a higher risk for cancer.

Keep Cholesterol Down: Free radical damaged cholesterol may play a role in stimulating the prostate cell formation that may cause an enlarged prostate so it is important to keep your cholesterol level within a healthy range.


Promising Prostate Progress

By Riva Preil

Prostate cancer is the second leading cause of deaths amongst males in the United States, and nearly 30,000 men die annually from the disease.  Most of these deaths occur by the time the disease has metastasized (spread) to the bone.  Approximately 250,000 new cases are diagnosed each year. Clearly, the disease affects a significant portion of the male population, and it is no wonder that researchers have been focusing time, energy, and financial resources to search for the most effective treatments.  To date, the two most popular forms of treatment are with radiation therapy or prostatectomy (removal of the prostate gland).

Fortunately, recent research has proven that a new type of radiation therapy can increase the average life expectancy of men with advanced prostate cancer. The new medication Xofigo was approved by the Food and Drug Administration in May 2013. It involves emission of alpha particles from radium 223 instead of the smaller and less energetic beta particles (that were emitted from previous radiation treatment, strontium).  Dr. Chris Parker of London, lead author of the study which was published in the New England Journal of Medicine, concluded that men who were treated with Xofigo saw the average survival time increase from eleven months to fifteen months, an approximate 30% improvement.  Furthermore, men who were treated with the new drug experienced fewer side effects, such as muscle weakness and bone pain.

The benefits of Xofigo may not end with the prostate!  In fact, it may help treat bone metastases related to breast cancer and other cancers, according to Dr. Robert Dreicer of the Cleveland Clinic.  Future research is indicated to further assess the potential benefits offered by Xofigo.

To learn more about this study and Xofigo, please refer to this article in the New York Times from July 17, 2013.

Flax Facts

By Riva Preil

September marks Ovarian Cancer Awareness Month.  It is estimated that in the United States, 1.4-2.5% of women will develop the disease.  A recent trend in medicine has been aimed at DISEASE PREVENTION, and this holds true for ovarian cancer as well.  Is it possible to take preemptive steps to prevent the disease from ever developing in the first place?

Prostaglandin E2 (PGE2) is associated with the production of two enzymes, COX-1 and COX-2, both of which are linked with ovarian carcinomas.  The theory is that flaxseed, an omega 3 fatty acid and phytoestrogen lignans enriched vegetable source, is associated with interrupting the inflammatory PGE2  pathways which results in decreased levels of COX-1 and COX-2 production. This in turn helps prevent the development of ovarian cancer.  A recent controlled experiment with white leghorn hens, an animal that develops ovarian cancer in a similar manner to humans, revealed very promising results.  The flaxseed fed experimental group demonstrated a significant reduction in late stage ovarian tumors compared to the control group.  Future research with humans is warranted and important.  But in the meanwhile, load up on those flaxseeds, because if they benefit us in the same way that they do hens, it may be a step in the right direction for cancer prevention.  For some creative and yummy suggestions on how to incorporate flaxseed into your diet, please refer to the link here.  Enjoy!

Ovarian Cancer Awareness in September

By Roseanne Schoen

I was first diagnosed with ovarian cancer in January 2005- I was 27 at the time. I had gone in for a follow-up 2 weeks after a second surgery to remove cysts on my ovary. I remember how my doctor sat me down and told me, “I’m sorry, but you have cancer.” I had stage 1c ovarian cancer, meaning that the cancer is in one or both ovaries and is either on the outside of an ovary, grown through the capsule of an ovary, or is in fluid taken from the pelvis. I was in shock.  I didn’t have a family history of ovarian cancer. I was also only 27 and I never thought that, at my age, I would develop this type of cancer. Two weeks later, I had my left ovary and fallopian tube taken out and then had chemotherapy for 4 months- my oncologist wanted to treat me as if I had stage 2 cancer-as if the cancer had spread into the pelvic tissue.

Luckily for me, the doctors caught my cancer early. Early cancers of the ovaries often cause no symptoms. I had initially gone to the doctor with symptoms of abdominal bloating and pain and irregular periods. Other symptoms may include difficulty eating or feeling full quickly, and/or urinary symptoms (having to go urgently or often). When ovarian cancer causes symptoms, they tend to be symptoms that are more commonly caused by other things. Most of these symptoms can also be caused by other less serious conditions. These symptoms can be more severe when they are caused by ovarian cancer, but that isn’t always true. What is most important is that they are a change from how a woman usually feels.

By the time ovarian cancer is considered as a possible cause of these symptoms, it usually has already spread beyond the ovaries. Also, some types of ovarian cancer can rapidly spread to the surface of nearby organs. Still, prompt attention to symptoms may improve the odds of early diagnosis and successful treatment. If you have symptoms similar to those of ovarian cancer almost daily for more than a few weeks, and they can’t be explained by other more common conditions, report them to your health care professional — preferably a gynecologist — right away.

I am now at almost nine years of being cancer-free and I feel pretty good. I am a cancer survivor and I am proud to be able to tell my story!


September is Prostate Cancer Awareness Month!

By Roseanne Schoen

According to the American Cancer Society, approximately 217,730 men will learn they have prostate cancer and more than 32,050 men will die from the disease this year.
Today, 1 man in 6 will get prostate cancer during his lifetime, but only 1 man in 34 will die of this disease. More than 2 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. When detected during these earliest stages the 5-year survival rate is close to 100%. In an effort to educate and inform the public, the American Cancer Society recognizes September as National Prostate Cancer Awareness Month. Here are some tips to prevent prostate cancer:

1.     Keep a healthy weight and exercise regularly.

2.     Eat more fruits and vegetables. Tomatoes, watermelons, pink grapefruits, guava and papaya contain lycopene, a powerful antioxidant. Cruciferous vegetables such as broccoli, cauliflower, cabbage, Brussels sprouts, bok choy and kale also are good choices.

3.     Let your doctor know if you have a family history of prostate cancer. Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease.

4.     Include more soy in your diet from sources such as tofu, soy nuts or soy flour or powders.

5.     Don’t smoke.

6.     Eat more selenium-rich foods such as wheat germ, tuna, herring and other seafood and shellfish, beef liver, kidney, eggs, sunflower and sesame seeds, cashews, mushrooms, garlic and onions. Selenium reduces risk of prostate cancer.

7.     Get a PSA blood test and digital rectal exam annually, beginning at age 50. Men at high risk, such as African American men or men with a strong family history of prostate cancer should begin testing at age 45.

Now Offering Nutritional Services!

We are excited to announce Nutrition and Fitness Coach Stacey Grant will now be offering nutritional services at Beyond Basics for patients suffering from chronic pain related to inflammation of the pelvic floor and GI. Grant has a masters degree and is certified in Clinical Nutrition. She also works as a diet and lifestyle expert for media outlets BlogHer and DailyHITT. Welcome aboard, Stacey!

See her latest newsletter here– Fall Newsletter-1–and call us at the office (212.354.2622) for more information!

Bridge for Pelvic Pain

We are excited to announce and support Bridge for Pelvic Pain, a new non-profit being developed by Carin Willis, who has “lived with chronic pelvic pain conditions for many years and has spent the past four and half years connecting with patients worldwide through her website and blog:” We hope that you’ll take a look at and support the Bridge for Pelvic Pain Indiegogo campaign, which you can find here.

As Willis writes, “Millions of men, women and children suffer from chronic pelvic and sexual pain conditions around the world. There is a need to form a global non-profit to provide advocacy, education and resources for these patients and for the community.” We completely agree, and hope you will spread the word!