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Colorectal cancer is the second-deadliest cancer in the United States – largely because it goes undiagnosed. Dr. Christi Matteoni, Division Chief of Gastroenterology at Renown Health, discusses the symptoms and key screenings used to detect this type of cancer, along with risk factors and lifestyle changes that could affect the likelihood of getting the disease. What are some of the signs and symptoms of colorectal cancer?  Many cases go undiagnosed because polyps can develop and become cancerous without any symptoms. Additionally, since colorectal cancer begins as small polyps, symptoms usually aren’t seen until later stages. This is why screenings are especially important.  For those who do experience symptoms, the signs are often tied to your bowel habits. This can include changes such as constipation or diarrhea, narrow or dark stool, rectal bleeding, abdominal cramping, weakness and fatigue or unintended weight loss.  What are some of the risk factors associated with this type of cancer?  There are risk factors that can and cannot be controlled. Uncontrollable factors include age, race, personal and family histories as well as certain genetic syndromes that are important to discuss with your provider.  This type of cancer is more common in people over the age of 50, African Americans and those of eastern European Jewish (Ashkenazi) descent. This type of cancer is also more common in those who have been diagnosed with polyps, Crohn’s disease, ulcerative colitis and long-term inflammatory bowel disease. important to discuss any of these risk factors with your provider.  There are also lifestyle factors that can help reduce your risk. Factors include being overweight, having a diet high in red and processed meat, as well as smoking and consuming excess alcohol.  Conversely, diets high in fruits and vegetables and a regular exercise routine can help lower your risk.  If someone has some of these risk factors, what should they do? Do they need to get tested?  If you are 45 or older and have any of these risk factors, we recommend you speak with your primary care provider about a formal colorectal risk assessment.  The most common form of screening is colonoscopy. This screening lets your doctor examine the length of your colon, map out any potential problem areas and remove polyps. For most people, colonoscopies are recommended every 10 years starting at age 50. However, depending on your results and risk factors, you may need to begin screening sooner or get screened more frequently.  What do diagnosis and treatment look like for this type of cancer?  There are several diagnostic options for colorectal cancer, including endoscopic ultrasound; CT, MRI and PET scans; and biopsy and pathology reports. These technologies allow your doctor to get images of your colon and evaluate what treatment is needed, as well as how the treatment is progressing.  Treatment varies for each individual working with their doctor. In the case of colorectal cancer treatment, the William N. Pennington Institute for Cancer offers chemotherapy, radiation therapy, surgery and clinical trials.

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Katherine Bunker, Physical Therapist and Certified Lymphedema Therapist (PT, DPT, CLT) at Renown, discusses how patients can manage lymphedema with changes to daily routines along with diet and exercise. Lymphedema is a condition that affects millions of people around the world. It is a chronic and progressive disorder that results in swelling of the arms, legs, or other parts of the body due to an accumulation of lymph fluid. Lymphedema can occur because of cancer treatments, surgery, or other medical conditions.   Managing Lymphedema Treatments to help reduce symptoms such as pain, swelling and discomfort associated with lymphedema can include compression garments, exercise, skin care, manual lymphatic drainage and pneumatic compression.  The goal is to avoid triggering the onset of lymphedema. Lymphedema can present itself immediately after surgery or radiation. It can appear months later or even years later. There are many factors that influence the development of lymphedema which is why prevention is so important. If you have had injury or disruption to your lymphatic system, then:  Avoid injuries to the skin near the affected area. For example: wearing gloves during gardening, using bug spray to ward off mosquitos, covering your limbs while playing with pets, keeping nails clean and avoiding cutting too close to cuticle, utilizing electric razors at the armpit (instead of a traditional razor).,   Avoid blood pressure readings to the affected limb or request blood pressure to be taken manually, not by a machine.   Avoid heat like saunas, hot tubs, sunburns, hot packs, and even massages.    Avoid tight jewelry like rings or bracelets, which can be too tight.

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According to the American Cancer Society, approximately 14,100 new cases of invasive cervical cancer will be diagnosed, and 4,280 women will die from cervical cancer. However, cervical cancer is preventable with regular screening tests and the HPV vaccine. It’s important to note that medical advances have allowed progress in diagnosing and treating cervical cancer. While it used to be one of the most common causes of cancer death for American women, the incidence of death has significantly declined. What to Know About the HPV Vaccine HPV vaccination is the best way to prevent cervical cancer and is recommended for all youth starting as early as age 9, or for teens and adults up to age 45 who didn’t start or finish the series. In Nevada, only 50.1% of teens ages 13-17 have been vaccinated for HPV.  There are 13 types of HPV, and the vaccine Gardasil 9 protects against 9 of those HPV strains, greatly reducing the incidence of cervical cancer among vaccinated individuals. What to Know About Cervical Cancer Screenings The CDC says the most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. And there are two common tests that can detect early stages of cervical cancer (or precancer) and improve health outcomes. The pap test (or pap smear). This screening looks for precancers. Women should begin getting pap smears when they’re 21. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. Cervical Cancer Screening Schedule The American Cancer Society offers the following guidelines for screenings: All women should begin cervical cancer screening at 21. Women between 21 and 29 should have a pap test every three years. Beginning at 30, the preferred way to screen is with a pap test combined with an HPV test every five years. This is called co-testing and should continue until age 65. A pap test (or pap smear) is performed during a regular screening appointment to look for precancers, cell changes on the cervix that might become cervical cancer if they are not evaluated or appropriately treated. Typically outpatient procedures can reduce the risk of long-term health impacts that prevent pre-cancerous cells from becoming cancer cells. Women over 65 who have had regular screenings in the previous ten years should stop cervical cancer screening as long as they haven’t had any severe precancers found in the last 20 years. How to Get Screened Request an appointment with your primary care physician or OBGYN to schedule a screening.

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Lung cancer is the leading cause of cancer deaths in both men and women in the U.S. The good news is the five-year survival rate increases dramatically if lung cancer is treated before spreading to other parts of the body. Julie Locken, MD, of Renown Health Imaging, explains more. What are the signs and symptoms of lung cancer? As you might expect, most lung cancer symptoms appear in the chest and can affect your breathing. Watch for signs such as: Persistent cough Constant chest pain Shortness of breath Wheezing Bloody or rust-colored phlegm Hoarseness Swelling of the neck Pain or weakness in the shoulder, arm or hand Recurring pneumonia, bronchitis or other lung infections Loss of appetite and loss of weight can also be signs of lung cancer That said, there are usually no symptoms in the early stages of lung cancer, which means getting screened can truly be a lifesaver. If you have a history of smoking, you should get screened as a precaution.  What are the risk factors of lung cancer?  Around 80% of lung cancer cases stem from a history of smoking tobacco. But there are other known causes, such as secondhand smoke, radon, asbestos and diesel exhaust. It’s important to do what you can to eliminate exposure to all of these to reduce your lung cancer risk.  People with an immediate relative – a parent, sibling or child – diagnosed with lung cancer and people between 50 and 80 years old are also at higher risk and may need to consider screening.  People who are at the highest risk are those with a history of smoking tobacco, particularly smokers who averaged one pack of cigarettes per day for 20 years or more, as well as former heavy smokers who quit in the last 15 years.

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Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.

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With more than 3 million cases in the United States each year, human papillomavirus (HPV) is a common sexually transmitted disease and can lead to the risk of several cancer diagnoses. Fortunately, a vaccine can prevent more than 90% of HPV cancers when given at the recommended ages. We talked to Renown Pediatrician Vanessa Slots, M.D., to learn more about HPV and the importance of getting your child fully vaccinated.   What is HPV?   Talking about sexually transmitted infections can be uncomfortable, but learning how HPV is spread is important for prevention. HPVs are spread via skin-to-skin contact. According to the National Cancer Institute, there are low/medium-risk HPVs that can cause warts and cervical dysplasia (abnormal cells on the cervix), and there are high-risk HPVs that can cause various cancers. HPV is perhaps most known for causing cervical cancer. Other cancers related to HPV are anal, vaginal, vulvar, penile and oropharyngeal cancers. In fact, men are four times more likely than women to suffer from HPV-associated oropharyngeal (mouth and throat) cancer. HPV is so common that nearly all sexually active people will be exposed at some point in their lifetime, with around half of infections being a high-risk virus.  Benefits of the HPV vaccine   Immunizations are safe and effective and have successfully reduced the transmission of many deadly diseases. The CDC (Centers for Disease Control and Prevention) states the HPV vaccine protects against infections that can lead to HPV related cancers and abnormal cells that can lead to cancer (precancers), as well as genital warts.   The recommended HPV vaccine schedule   The American Cancer Society states that the HPV vaccine is most effective when two doses are given to girls and boys between the ages of 9 to 12. There should be at least 6 months between the first and second dose. “You might be asking why your child needs to get the HPV vaccine at this young age when they are not sexually active,” says Dr. Slots. “Research shows that people have a better immune response to the vaccine when younger than in their late teens and early 20s.”   For teens and young adults ages 13 through 26 who have not been vaccinated, getting the HPV vaccine is still highly effective in preventing cancers and genital warts.   CDC recommended HPV vaccination suggestions:  2-dose schedule for people who get their first dose before their 15th birthday.  3-dose schedule for people who get their first dose on or after their 15th birthday.   “By following the recommended HPV vaccine schedule and getting your child the correct number of doses, this will ensure they have adequate protection against HPV associated diseases including cancer,” says Dr. Slots.

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With skin cancer affecting one in five Americans and 3.5 million new skin cancer cases diagnosed yearly, being proactive about prevention is vital to your health. Dr. Angela Walker, a dermatologist with Renown Dermatology, Laser and Skin Care, explains. The 5 stages of melanoma How should someone examine their skin for moles? I recommend practicing monthly head-to-toe self-examination of your skin, so you can find any new or changing moles or marks that might be cancerous or precancerous. Skin cancer is the most common of all cancers. It is also the easiest to cure if diagnosed and treated early. Therefore, self-examination can alert you to changes in your skin and aid in early skin cancer detection. Self-examination tips: Make sure you have a bright light, full-length mirror, hand mirror and a blow-dryer. Examine your face, especially your nose, lips, mouth and ears, both front and back. Thoroughly inspect your scalp, using a blow-dryer and mirror to expose each section. You might need to get a friend or family member to help. Check your hands carefully: palms and backs, between the fingers and under the fingernails. Continue up the wrists to examine your forearms' front and back. Standing in front of the full-length mirror, begin at the elbows and scan all sides of your upper arms. Don't forget the underarms. Next, focus on the neck, chest and torso. Women should lift their breasts to view the undersides. With your back to the full-length mirror, use the hand mirror to inspect the back of your neck, shoulders, upper back and any part of the back of your upper arms you didn't already check. Scan your lower back, buttocks and backs of both legs. Check the front and sides of both legs, thigh to shin, ankles, tops of feet, between toes and under toenails. Examine the soles of feet and heels.

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Michael Millman was all set to move to Reno from the Bay Area when he noticed a pimple-like growth on his forehead, and he decided to get biopsied "just in case." It was July 2020, less than six months into the COVID-19 pandemic, when Michael got the call that the biopsy came back cancerous. He was in shock. Still living in the Bay Area at the time, he immediately scheduled to have the basal cell carcinoma removed in August. After the removal, he thought he was in the clear, but a few months later, Michael noticed that his lymph nodes felt weird, and he even cut himself shaving because of some persistent swelling in the area. Given his recent history of skin cancer, Michael immediately scheduled an appointment with a specialist in the Bay Area. "I met with an ear, nose and throat doctor who suggested a fine needle biopsy of my lymph nodes, tongue and an MRI, both with and without contrast," Michael said. "I remember feeling dreadful and that I couldn't believe this was happening yet again." A Hard Decision Michael's squamous cell carcinoma, determined by the pathology report to be significantly influenced by the HPV virus, had metastasized to his lymph nodes on both sides of his neck, and his doctor said it could be stage four cancer. He remembers feeling like he was in quicksand, unsure if he should follow through with his move to Reno, or stay in the Bay Area for treatment. By now, it was early December 2020, and hospitals in the Bay Area and across the world were at limited capacity due to COVID-19. But, in what Michael describes as a positive twist of fate, the San Francisco ear, nose and throat provider he had seen about his biopsy results mentioned that he knew many providers in the oncology department at Renown, including Abhinand Peddada, MD. The San Francisco provider called Dr. Peddada's office with a referral, and Michael even remembers that Renown called him to hear more about his diagnosis before he even got the chance to call them "To be honest, I was feeling shut out in the Bay Area, and Dr. Peddada said he could help me expedite the treatment process," Michael said. "I finally felt a sense of relief." And so began Michael's 7-week chemoradiation cancer treatment program at Renown.

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Unfortunately, men are less likely to visit their doctor for exams, screenings, and consults than women. So with the help of Bonnie Ferrara, MD of Renown Health, we've put together a list of eight screenings to help men stay on top of their health game. 1. Blood Pressure Tests Ages 20+ Blood Pressure tests measure the pressure in your arteries as your heart pumps. Biennial (every two years) checks are recommended if you have normal blood pressure or more frequently if you have high blood pressure (hypertension) or low blood pressure (hypotension). The United States Preventative Services Taskforce cites normal blood pressure below 120 systolic (top number) and 80 diastolic (bottom number). 2. Cholesterol Screening Ages 20+ High levels of cholesterol increase your risk of stroke and heart disease. A simple blood test will help your healthcare provider determine your numbers and if you're at risk. If you have a family history of diabetes or heart disease, you may need yearly screenings. But, again, your doctor can provide the best course of action.

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You may recognize her from billboards around town or the cover of Renown's latest annual report, but what you might not know is the story behind the now-familiar face. Paola Espinoza-Patino is the oncology unit's associate nurse manager at Renown Regional, and she grounds her work in hope and determination daily. Meet Paola:

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We talked to Heidi Nicol, licensed aesthetician with Renown Dermatology, Laser and Skin Care, to learn about the 7 best morning skincare tips that will provide all-day protection. “Your skin uses the nighttime hours to repair itself, secreting oils and toxins in the process,” says Heidi Nicol, a licensed aesthetician with Renown Dermatology, Laser and Skin Care. “Cleansing your skin in the morning is very important. It removes these oils and toxins and any nighttime products you use that are not suitable for daytime use — such as retinol and exfoliating acids.” Nicol’s process includes choosing the right products for your skin type, using them in the proper order and applying them correctly. Steps to Perfect Your Morning Routine Step 1: Cleanser. Use a cleanser tailored to your skin type. Many lines of products produce unique formulas for your specific skin, including dry skin, oily skin, and a combination of the two. Be sure to rinse, rinse, and rinse again! Step 2: Toner. After cleansing, you should apply a toner quickly. This is like a big drink of water for the skin and helps trap moisture into your skin and prevent evaporation. Step 3: Serum. Choose a serum that addresses your skin’s needs. If you use more than one type of serum, alternate them instead of layering. Nicol recommends using a Vitamin C serum, an antioxidant serum, and hydrating serums. Step 4: Moisturizer. Select a daily moisturizer that fits your skin type. Step 5: Eye Cream. “A good eye cream is refreshing and can help the delicate skin around the eyes,” says Nicol. Step 6: Sunscreen. This is the most essential step when it comes to protecting your face. Some sunscreens come tinted, which can replace foundation. “Do not forget to also apply to the neck, chest, and hands,” says Nicol. “It is important to reapply every few hours when you are out in the sun.” Step 7: Makeup. After you’ve completed the above steps, proceed with your make- up routine. This is a crucial step for protecting your skin. Many aestheticians recommend wearing makeup every day.

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Colorectal cancer is the number two cancer killer in Nevada, only second to lung cancer, yet it is also one of the most preventable. Still, in 2020, 20.7% of Nevadans said they had never been screened for this deadly disease, according to the Nevada Cancer Coalition. At the start of the COVID-19 pandemic, unfortunately many healthcare services were halted, including colorectal cancer screenings. Those delays in screenings can lead to delays in diagnoses of colorectal cancer, resulting in poorer outcomes. Per the American Cancer Society, if colorectal cancer can be found early the relative 5-year survival rate is approximately 90%. Screening is key, and it is important to engage in preventative care. Even if you have no personal or family history of colorectal cancer, ask your doctor about colorectal risk factors and when to start screening, and if you’re up to date on your screenings, talk to loved ones and make sure they are too. According to the American Cancer Society, most colorectal cancer cases are found in those without a family history. This month let us help raise awareness for colorectal cancer and the importance of routine, life-saving screenings. To learn more, we spoke to Renown Health oncology nurse Christina Alsop, APRN. What is Colorectal Cancer Colorectal cancer is a disease in which the cells in the colon or rectum grow out of control. It usually forms from precancerous polyps, or abnormal growths, in the colon or rectum, which can become malignant without presenting any symptoms. How do Screenings Work Screening tests like stool tests, colonoscopies and others can detect these precancerous polyps, so they can be removed by a physician before turning into cancer. Screening tests can also find colorectal cancer early, resulting in better treatment outcomes. As of 2021, the U.S. Preventative Services Task Force recommends adults begin colorectal cancer screenings beginning at age 45, through 75. Screening methods include a blood stool test, which needs to take place every year or a colonoscopy, which takes place every 5-10 years. Healthy Habits Can Help Stave Off Risk Routine screenings are the only way to determine colorectal health, yet some healthy habits may reduce your risk for colorectal cancer. These factors include maintaining a healthy weight, being physically active, eating a diet rich in fresh fruits, vegetables and whole grains, limiting alcohol intake and not smoking.

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