HealthNotes

For retired nurse Pamela Lovett, 68, decades of smoking came home to roost in 2016 - even though she'd kicked the habit nearly two years before.

"I developed pain in the back of my ribs and went to see my primary care physician," the La Quinta resident says. "He ordered a CT scan that showed chronic obstructive pulmonary disease (COPD)."

COPD, which includes chronic bronchitis and emphysema, is a long-term lung disease that makes it difficult to breathe. The airways in the lungs become narrowed due to swelling and thickening, and the airways and tiny air sacs lose their ability to stretch and shrink back.

The leading cause of COPD is smoking; however, one in four diagnosed with the condition never smoked. Other risk factors include a history of childhood respiratory infections and smoke exposure from coal or wood-burning stoves or secondhand cigarette smoke. 

Lovett was referred to Anil Perumbeti, MD, Board Certified in Pulmonary Disease, Critical Care Medicine and Internal Medicine at the Eisenhower Pulmonary, Critical Care and Sleep Clinic.

PHYSICIANS' ROUNDTABLE

In this Physicians' Roundtable, Eisenhower physicians discuss advancements in the detection and treatment of breast cancer and how the team at Eisenhower is working collaboratively to ensure the best experience and outcomes for their patients. The panel includes Vasudha Lingareddy, MD, FACRO, Board Certified in Radiation Oncology; Edgar Staren, MD, PhD, Board Certified in Surgery and specializing in Surgical Oncology; Paul Sylvan, MD, Board Certified in Radiology and Internal Medicine; and Manasa Vulchi, MD, Board Certified in Medical Oncology. The Eisenhower participants were joined by Lisa Madlensky, PhD, CGC, Genetic Counselor and Professor of Medicine, UC San Diego Health, who works with Eisenhower Health patients through Eisenhower's affiliation with the UC San Diego Health Cancer Network. Justin Thomas, MD, Board Certified in Pulmonary Disease, Interventional Pulmonary Disease, Critical Care Medicine and Internal Medicine, moderated the discussion.

Dr. Thomas:    How common is breast cancer in our country?
Dr. Staren:    Very common. It is the most common cancer in women. One in eight women in the United States can be expected to develop breast cancer during the course of their lifetime.

Dr. Thomas:    One in eight women. And what about in men?
Dr. Staren:    It's much less common, but one percent of breast cancers do occur in men.

Dr. Thomas:    What are the signs and symptoms of breast cancer? What should women be looking out for?
Dr. Vulchi:    Most early stage breast cancers are mammographically detected during screening. One of the symptoms to look out for is a mass, or lump, in the breast. Sometimes, skin changes like redness, thickening over the skin can be early signs, or other things like nipple inversion. In more advanced cases, palpable lymph nodes in the axilla [armpit] can be a sign of cancer as well. 
Dr. Staren:    Bloody and perhaps clear spontaneous nipple discharge may occur as well.
Dr. Vulchi:    These are the signs for early stage or local regional breast cancer. If it's metastasized, some of the signs we can see depend on where it has spread. If the cancer has spread to the lung, people can present with cough or shortness of breath. Sometimes we see pain in the lower back or bone pain if it metastasized to the bone.