Category Archives: Uncategorized

Mom was Right–Eat Your Veggies

 

Eating a variety of vegetables is important for maintaining and achieving a healthy body.  Why?  Vegetables are a great source of many nutrients including potassium, folic acid, vitamin A, vitamin C, and dietary fiber.

According to the USDA:

  • Eating a diet rich in vegetables and fruits as part of an overall healthy diet may reduce risk for heart disease, including heart attack and stroke.
  • Eating a diet rich in some vegetables and fruits as part of an overall healthy diet may protect against certain types of cancers.
  • Diets rich in foods containing fiber, such as some vegetables and fruits, may reduce the risk of heart disease, obesity, and type 2 diabetes.
  • Eating vegetables and fruits rich in potassium as part of an overall healthy diet may lower blood pressure, and may also reduce the risk of developing kidney stones and help to decrease bone loss.
  • Eating foods such as vegetables that are lower in calories per cup instead of some other higher-calorie food may be useful in helping to lower calorie intake.

There are three types of vegetables:  Leafy Greens, Colorful, and Cruciferous

Leafy Greens:

Loose leaf greens are the most nutritious and iceberg lettuce is probably the least nutritious of the green leafy vegetables. The darker the color of the green, the more nutrition as well.

Deep green, leafy vegetables are notoriously rich in beta-carotene, vitamins, and minerals. Types: beet, Swiss chard, collards, dandelion, kale, lettuce – romaine, spring greens, butternut, spinach, and turnip.

Serving Size: 1 cup

Colorful:

A fun way to eat more vegetables is to eat a rainbow of vegetables.

The skins of vegetables contains phytonutrients, which are natural compounds that are promoters of health. Specifically, phytonutrients stimulate enzymes that help the body get rid of toxins, boost the immune system, improve heart health, promote healthy estrogen metabolism and stimulate death of cancer cells.

Red fruits include apples, blood oranges, cranberries, cherries, goji berries, grapes, plums, pomegranate, raspberries, strawberries, watermelon, and rhubarb

Red Vegetables: radish, tomatoes, potatoes, sweet red peppers, beets, beans

Blue/purple/black fruits include a wide variety of berries: blueberries, blackberries, boysenberries, huckleberries, and figs, grapes, prunes, plums and raisins.

Blue/purple/black vegetables listed are purple bell pepper, purple cabbage, purple carrots, purple cauliflower, eggplant, purple kale, black olives, purple potatoes.

Green fruits listed here are apples (Granny Smith), avocado, limes, olives, and pears.

Green vegetables on this list are numerous: artichoke, bamboo sprouts, bean sprouts, bitter melon, bok choy, broccoli, broccolini, Brussels sprouts, cabbage, celery, cucumber, edamame/soy beans, green beans, green peas, greens of all types (beet, chard, collards, dandelion, kale, lettuce, spinach, and turnip), okra, snow peas, and watercress.

Yellow fruits to choose from such as Golden Delicious apples, Asian pears, lemons, pineapple, and starfruit.

Yellow vegetables include yellow bell peppers, corn, and potatoes.

Orange fruits include apricots, cantaloupe, mango, nectarine, oranges, papaya, persimmon, and tangerines.

Orange vegetables on this list are acorn squash, orange bell pepper, butternut squash, carrots, pumpkin, and sweet potatoes.

Serving Size: 1/2 Cup

WHITE/TAN/BROWN

White/tan/brown fruits are fairly sparse on this list, but include apples and applesauce (the non-skin part of the apple), coconut, dates, lychees, and peas.

White/tan/brown vegetables include cauliflower, garlic, mushrooms, onion, sauerkraut, and shallots.  Mushrooms encompass more than just the standard white mushroom as there are several types that are considered to have significant medicinal benefit because of their ability to help the immune system. Examples of mushrooms to try include: Shiitake, button, portabello, crimini, and chanterelle.

Cruciferous:

Cruciferous vegetables are known to help detoxify the body should be eaten every day. Cruciferous vegetables have a phytonutrient which has been shown to be anti-cancer. These phytonutrients change the way estrogen is broken down in the body. As a result, eating these vegetables is associated with the decreased risk of hormone or estrogen related cancers such as breast and uterine cancer. Eating these vegetables either raw, lightly sautéed, or steamed is best. Cruciferous vegetables are also known as important sources of fiber, vitamins, and minerals.

They include Arugula, Broccoli, Cauliflower, Cabbage, Kale,  Brussels sprouts, broccoli, and watercress, are considered to be excellent anti-cancer foods.

Serving Size: 1 cup

HOW TO EAT MORE VEGETABLES

Try Cauliflower Rice: you can find it in the frozen food section already riced or you can easily make your own with a food processor–just cut head of cauliflower into smaller pieces and pulse till cauliflower is in size of rice grains.  Sauté onion, garlic in olive oil or coconut oil and then add rice to cook. Frozen cauliflower rice can be microwaved. Add cilantro for Mexican flavor or ginger for Asian.

Try Spaghetti Squash: easy to make in the microwave. Halve and put in microwave dish with a little water, clean out seeds first. Microwave 4-8 minutes. Use a fork to make into angle hair fine strands that can be used instead of spaghetti.

Keep a bowl or container of fresh cut vegetables on the top shelf of refrigerator, within easy reach.

Keep a fruit bowl on kitchen counter, table, and desk at work.

Pack fruit and vegetables in purse/briefcase to eat as a snack. Bring moist towelettes to clean them off before eating if you do not have time to wash.

Choose fruit for dessert (fruit kabobs, berry compotes, fruit salads, etc.).

Have dishes with lots of vegetable variety (e.g., soups, stir-fry).

Toss in red pepper, tomatoes, garlic, onions or broccoli to omelets.

Add some greens into your morning smoothie.

Make grilled Brussels sprouts and drizzle with olive oil.

By adding more vegetables into your diet, you will be on your way to a healthier lifestyle.

Supplied by Dr. Linda Jager, MD  Iowa Cancer Specialist

Guest Post from an ICS Patient!

Henry Ford said, “You can’t build a reputation on what you are going to do.”  We at Iowa Cancer Specialists are proud to have a built a reputation on what we do everyday–provide quality healthcare in a warm environment with a caring and knowledgeable staff.  But you don’t have to take our word for it.  Here is what one of our patients had to say:

“The new building for Iowa Cancer Specialists is designed with attention to excellent parking and functional features as you study the floor plan of the building interior. Selection of color tones with attention to artistic painting and objects create a warm welcoming environment. I have appreciated the fact that though office hours are 8:00 a.m. to 5:00 p.m., when I arrive on an early morning, doors are unlocked and allow me to step into the comfort of the waiting area. Individuals involved with scheduling, managing telephones, and greeting of arrivals are positive
and within a few short weeks know patients by name. In fact, all the employees are energetic and reach out to patients with greetings for the day.

Care and concerns for my health are foremost in the minds of those who have been attentive to my needs. Professional treatments are with both an efficient use of time and the efforts to develop a personal relationship. Lab results, medications suggested, and recommended
actions are shared with clarity. Good skills are practiced in listening to my questions. Professional communication with other physicians and University of Iowa Hospitals demonstrate a team approach in sharing thoughts regarding treatments. Dr. Susannah Friemel has created a culture where positive energies lead to staff being an integrated team working with each of us as patients. And Dr. Friemel has addressed each of my questions, demonstrated an in-depth knowledge of her field, and has given me complete confidence that she knows who I am and what the continuous changes in my health program should entail.”  David Fairweather

See what all the talk is about–schedule your appointment at ICS today!

Coping With a Sore Mouth

Mouth sores (oral mucositis) are a common side of cancer treatment.  Mouth sores may develop  with chemotherapy or radiation therapy either alone or combined and usually appear 7-10 after the start of treatment.  The mouth sores, also called ulcerations, can be mild or severe and cause treatment to be delayed.  Symptoms of mouth sores include swollen gums, burn-like sores, a coating on the tongue, painful swallowing, chewing, or painful breathing.

Mouth sores occur because cancer treatment is intended to kill rapidly growing cancer cells. Some cells in your body, like those in your mouth, grow rapidly and the treatment mistakes those cells for cancer cells and tries to eliminate them, which causes the ulcerations.  However, there are ways to reduce your risk getting mouth sores as well as treating them if they develop.

One way to reduce your risk is to maintain good oral hygiene.  It is important to keep your mouth clean so bacteria will not build up.  See your dentist before you begin treatment to ensure your mouth/teeth are in good condition.

Here are some other ways to ensure good oral hygiene include and to minimize the discomfort of mouth sores:

  • Use a mouth rinse mixture with ½ tsp salt to 8 oz of water, or ½ tsp of baking soda and 8 oz of water   Use after eating and prior to bed.
  • Avoid mouth washes with alcohol as can cause dryness and may sting.
  • Choose lukewarm or cool foods that are soothing. Extremely hot or cold foods cause mouth distress.
  • Carry a water bottle when away from home and sip water frequently. Try drinking through a straw.
  • Blend and moisten foods that are dry or solid sue soups or with sauces, and casserole.
  • Choose soft, creamy foods.
  • Use a soothing lip balm to keep lips moist.
  • Use a soft toothbrush or, if needed,  disposable sponge swabs.
  • Avoid flossing if platelet count is low or gums are bleeding.
  • Don’t wear dentures.
  • Avoid alcohol and alcohol.
  • Avoid tobacco as smoking inhibits healing.
  • Avoid rough textured foods .
  • Avoid tart, acidic, or salty beverages and foods, such as citrus fruit juices, pickled and vinegary foods, tomato based foods.
  • Avoid strong spices such as chili powder, cloves, curry, hot Sauces, nutmeg, peppers.

In addition to the above recommendations, your doctor may prescribe a topical pain reliever.

It is important for you to manage your mouth sores as they can delay treatment due to infection and the pain/discomfort may cause you reduce caloric intake and lose weight.

If you develop mouth sores, please notify your physician at Iowa Cancer Specialists for further recommendations.

ICS Welcomes Tami Sheldon, ARNP

Iowa Cancer Specialists is proud to announce the addition of Tami Sheldon, ARNP to our staff.

Tami is an undergraduate of Illinois State University with a degree in Exercise Science and Fitness.  She did undergraduate work at Chamberlain University of Cincinnati graduating with a Bachelor of Science in Nursing.  Tami also has a Master’s degree in Nursing from the University of Cincinnati and is a board certified nurse practitioner.

Tami always knew she wanted to be involved in medicine, but it wasn’t until after she received her degree in Exercise Science and Fitness that her interests directed toward nursing.  She has expertise in labor and OB/GYN, and she served on the Open Heart Team  at Trinity Medical Center.  Recently, she worked in pain management intervention, but says her passion has always been for women’s health.

Being more than just another health care worker is important to Tami.  She states she is excited about her new position at ICS as it will give her an opportunity to connect with patients while providing both educational and emotional support.  ICS plans to primarily utilize Tami’s training in OB/GYN health with our ovarian cancer patients, and as a liaison between ICS and the University of Iowa Gyn/Onc department.

Tami was raised in the Quad City area.  She enjoys watching the Chicago Cubs and the Bears with her Navy Veteran husband, Josh.  She has two small children and a greater Swiss mountain dog named Gunner.

Be sure to stop in to Iowa Cancer Specialists to meet Tami.  She looks forward to serving  your health care needs.

 

Dr. Linda Jager Joins ICS

Iowa Cancer Specialists is happy to welcome Dr. Linda Jager to our team!

Dr. Jager is a graduate of the Indiana School of Medicine.  Her diverse medical background in family medicine, wound care, emergency room care, pathology, functional and palliative care is  an asset at Iowa Cancer Specialists.

At ICS, Dr. Jager will primarily be working with our patients who need palliative/supportive care.  Dr. Jager knows this field well as she formerly was the Palliative Care Director for Genesis Family Medical Center.  Palliative care is for patients who have a chronic illness and to help them manage their pain, symptoms, as well as help improve their quality of life.  Palliative care also helps with advanced care planning and supports patients and families as they face a life changing disease.

Dr. Jager will also use her experience in functional medicine with her patients at ICS.  Functional care is an individualized, science-based approach that addresses the root cause of disease.  It leverages the patient’s genetics, lifestyle, and biochemical components to personalize treatment plans including  lifestyle modifications, stress reduction, and dietary changes to promote optimal wellness.  According to Dr. Jager “watching the body heal is phenomenal.”

In addition, Dr. Jager intends to utilize her skills as a medical educator derived from teaching at Mary Crest College and St. Ambrose University while working with her patients at ICS.  She states that education and teaching is her passion and it is important to her that “patients be heard, and that the truth be spoken. ”

Dr. Jager is originally from Pennsylvania, but has lived in Louisiana and Indiana before settling in the Quad City Area.  She has three children, a daughter and two sons, and enjoys gardening, and playing tennis.  She also loves hiking and spending time in the woods.  A woman of faith, one of her core beliefs is that “you should live to use the gifts God has given you to serve others.”

Dr. Jager is enthusiastic to live out this belief while serving her patients at Iowa Cancer Specialists.

 

Exciting Changes

We are thrilled to let you know that Iowa Cancer Specialists is moving, and we will be ready to announce our new location soon!

Even though we will have a new office, be assured some things will not change:

  • Same friendly nursing and reception staff that you have come to know and trust.
  • Same knowledgeable in-house billing team.
  • Same convenient medical dispensary.
  • Continued compassionate care by the physician team of Susannah Friemel, MD and Katie Browne, NP-C

We are also welcoming new staff members:

  • Dr. Linda Jager, specializing in palliative care management.
  • Tami Sheldon, NP, specializing in pain management and ovarian cancer.

We look forward to providing you with the same quality care you have come to expect from ICS.

 

September: Ovarian and Prostate Cancer Awareness Month, part 2

Along with ovarian cancer awareness month, September is also prostate cancer awareness month.  Prostate cancer is a very common cancer that affects the male sex gland which produces seminal fluid and transports the sperm.

Statistics:  It is expected that one in nine men will have a prostate cancer diagnosis during his lifetime.  It is the second leading cause of death in men after lung cancer.  Although it is considered a common cancer, most men with a prostate cancer diagnosis do not die from it and almost three million men in the United States with prostate cancer are still alive.

Who is at risk?  Prostate cancer usually affects older men with age 66 being the average age for a diagnosis.  It is rare for a man to have prostate cancer under the age of 40, but it does happen.  A man’s risk increases rapidly after age 50.

African-American men are also at higher risk as well as men from the Caribbean.

There may be a genetic link to prostate cancer, as it does run in families–especially brothers.  However, family history does not always to play a part.

Also, obese men are more at risk as obese men sometimes have more advanced disease which is harder to treat.

Symptoms:  Typically, prostate cancer has no symptoms in its early stages.  In later stages a man may notice:

  • Difficulty urinating
  • Decreased urine stream
  • Pain in pelvis
  • Bone pain
  • Blood in semen
  • Erectile dysfunction

Possible treatment options include:

  • Surveillance
  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Immunotherapy
  • Brachytherapy
  • Hormone therapy
  • Stereotactic radiosurgery

How to prevent:  There is no sure-fire way to prevent prostate cancer, but there are some things you can do to reduce your risk.

  • Eat a healthy diet consisting of lots of fruit and vegetables.
  • Exercise regularly.
  • Maintain a healthy weight.

As always, talk to your doctor about your risk–especially if you notice any of the above symptoms or have any questions or concerns.

For more information:

https://www.medicalnewstoday.com/articles/150086.php

https://www.cancer.org/cancer/prostate-cancer/causes-risks-prevention.html

https://www.webmd.com/prostate-cancer/default.htm

https://www.cancercenter.com/prostate-cancer/

https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087

 

 

 

September: Ovarian and Prostate Cancer Awareness Month, part 1.

September is ovarian cancer and prostate cancer awareness month.  Today we are focusing on the ladies.

A woman’s risk of getting ovarian cancer during her lifetime is about 1 in 78, and her lifetime chance of dying from ovarian cancer is about 1 in 108.  Ovarian cancer is the number one cause of  death due gynecologic cancers of the female reproductive system.  According to the American Cancer Society, approximately 14,240 women in the United States will die of ovarian cancer this year, a number which has not changed much over the last 50 years and is why early detection is so important.

Unfortunately, there is no accurate screening test for ovarian cancer.  Only rarely does a Pap smear detect ovarian cancer.  Women should have rectal and vaginal pelvic exams every year.

Some of the symptoms of ovarian cancer include:

  • Lack of appetite due to becoming full quickly
  • Bloating
  • Abdominal or pelvic pain
  • Back pain
  • Pain during intercourse
  • Menstrual changes
  • Fatigue
  • Heartburn
  • Constipation
  • Frequent need to urinate

If  any of the above symptoms persist daily for two weeks, consult your doctor.

Ovarian cancer does have some risk factors which your should discuss with your doctor. These include:

  • Age. Ovarian cancer is most common in women ages 50 to 63 years, but can occur at any age.
  • Family history of ovarian cancer.
  • Inherited gene mutations known as BRCA1 AND BRCA2 along with Lynch syndrome increases risk.
  • History of hormone replacement therapy.
  • Early age or late age of onset of menstruation

If ovarian cancer is suspected, imaging and blood testing will be performed.  However, the only way to definitively diagnose ovarian cancer is with a biopsy.  Again, if you have any of the above symptoms or are at risk for ovarian cancer, see your doctor right away.

For more information:

Is a Clinical Trial Right for You?

Iowa Cancer Specialists is committed to bringing our patients the best treatment options possible.  This is why we partner with the Genesis Health System to offer many clinical trials available for patients in our community.  Through Genesis, ICS has access to approximately 25 clinical trials offered locally.

Clinical trial are studies designed by researchers to offer new ways to either treat cancer, find and diagnose cancer, prevent cancer, and/or manage the symptoms and side effects of treatment.

Before a trial is offered to patients  researchers spend years in the laboratory evaluating the trial at the cellular level and on laboratory animals.

Patients on clinical trials help researchers determine the safe dosage of treatment, record side effects,  and evaluate how the trial compares to current forms of treatment.

ICS has the support of  Genesis with research nurse Kim Turner, RN MSN to make sure all trials are approved and monitored by the Genesis Health System Institutional Review Board (IRB) as there are many guidelines to follow.  These study guidelines are called protocols.  The protocol dictates who is eligible for the study, how often drugs and treatment are to be given,  and how often tests like laboratory workup and imaging need to be performed.

As mentioned, each clinical trial’s protocol directs who can participate. The criteria often includes, but is not limited to–

  • the type and stage of the patient’s cancer,
  • patient’s age group
  • patient’s genetic history,
  • patient’s health status.

Like all treatments, there is a cost involved.  Hopefully insurances will cover the patient care costs which include doctor visits, standard cancer treatment, drugs to reduce side effects, and laboratory and imaging studies.

However, often with a study extra doctor visits along with extra laboratory and imaging workup is required to evaluate the study’s efficacy.  These costs may be paid for by the sponsor of the study.

A patient is never enrolled in a study without their knowledge.  Patient rights are protected and each patient must sign an informed consent.  If you are considering taking part in a clinical trial,  we encourage you to ask questions such as–

  • What is the purpose of the study?
  • What are the goals?
  • What are the potential risks and side effects?
  • How long will be I be on the study?
  • What is the protocol?
  • What costs am I responsible for?
  • Whatever questions and concerns you may have.

If there is not a trial available to you locally and you wish to explore this option, a search can be done for treatment elsewhere.

By choosing to take part in a clinical trial, you are taking an active part in your treatment which may, in effect, help others in their cancer journey.

However, a trial is a trial–it is not a guarantee that the treatment is better than the current standard of care.  But, it may be better than the standard of care.  As with any type of treatment, some treatments that are effective with one person may not be effective for another.

And please know,  you may leave the study at any time.

Before you agree to a study, research all your treatment options.  An informed patient is a powerful one.

Your First Visit

It’s natural to feel apprehensive on your first visit to an oncologist’s office. We at Iowa Cancer Specialists would like to ease your anxiety and let you know what you can expect.

We are located at Genesis West Medical Center inside the Cancer Center which is just off of the glass atrium.  When you walk through the Cancer Center entry, go to the reception desk on the left side of the room where you will be greeted by one of our friendly receptionists.  Our office should have sent you forms to be filled out in advance, and this is the time to turn them in.  If you forgot to bring the forms, please plan a few extra minutes as you will be asked to fill them out again.  Also, have your insurance cards ready as well as your co-pay.  You will be asked to sign other forms that give us permission to bill your insurance and information on the patient information and privacy act. We strive to keep patient wait time to a minimum.  But, while you do wait, help yourself to the coffee, tea, or water provided in the waiting area.

When the nurse or medical assistant calls your name, you will be ushered into our exam room.  There she will have you step on and off the scale and will take your vitals.  She will ask you questions regarding the reason for your visit, habits you many have, any concerns or current health problems, and family history.

When you see the doctor, he/she will ask you more questions.  Sometimes a full physical exam is required; sometimes not—depending on the diagnosis.   Your referring physician should have sent us your records for our review.  Our doctors will go over this information with you.  We recommend you have a family member or friend with you to help you digest the information covered, as well as as notebook to write down instructions.  Be sure to ask your questions.  We want you to leave our office with all of your questions answered.

Treatment varies from individual to individual.   Of course, you may request a second opinion at any time, and we will be happy to assist you in scheduling one.

Expect our physicians to order lab work.  This is important, especially if chemotherapy is recommended.  Also, CT scans may be ordered.  These are necessary and used to evaluate how well the treatment is working.

Our physicians may order other tests as well.  This is because not all cancers are the same, nor do they respond the same way to treatment.  It is important for us to gather as much information to determine how to best treat you.

For your convenience, we have a lab in our office if blood work is ordered. Also, we have an in-clinic dispensary to assist in filling your prescriptions.

We will keep your referring physician updated on your progress.  We are always available to answer any questions.

Having a cancer diagnosis is stressful enough.  Our goal is to make this journey as easy as possible.