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V.I.A. Health System

Showing posts with label cancer. Show all posts
Showing posts with label cancer. Show all posts

Monday, July 7, 2014

Ditch the Itch: A Poison Ivy Primer

We love being outdoors in the summer. That brings us closer to pesky plants like poison ivy, oak and sumac. Our Doylestown Hospital health expert, Cathy Hogan, MSN, CRNP COHN-S, shares some tips on prevention and treatment.

Learn How to Identify Poison Ivy, Oak and Sumac

It's poison ivy season: What you need to know
You can find lots of pictures on the internet. All of these plants are "woody" plants/vines that grow in predominantly wooded areas.

You should wear long pants, shirts, socks and fully enclosed footwear when walking in these areas. Wear gloves when working around these poisonous plants. It is best if you wear plastic gloves over cotton gloves. The urushiol (the oily, sticky resin that causes the rash) in poison ivy can seep through cotton gloves, and make you susceptible to contracting the rash.

Another way to prevent the oil from getting on your skin is to use a good barrier cream, like Stokoguard or Ivy Block. Presently there is no vaccination.

Urushiol, Poison Ivy Oil and You

The oil from the poisonous plants can be carried on pets, and interestingly enough, pets are not affected by it. Ponds, streams, rivers and lakes can harbor the oils from these plants without ever seeing the offending plant. In addition, oil transferred from the plant to other objects months or even years ago – such as gardening tools – can cause a reaction.

What to Do if You Are Exposed to Poison Ivy, Oak or Sumac

Wash exposed skin immediately after contact. Wash in cold water, since warm or hot water helps the toxins get into your pores. Also, if you think your fingernails may be harboring the toxic oil, use a toothbrush under the nail to remove the toxin, then throw away the toothbrush.

Remove and wash clothes (separately from other clothes) and any items exposed to the oil.

How to Treat a Mild Case of Poison Ivy

Apply calamine lotion 4 to 6 times a day to the affected area. Anesthetics and antihistamines applied to the skin play no role in alleviating the symptoms of the rash; however, oral antihistamines like Benadryl can offer minor relief, and probably should be taken at bedtime to offset the side effect of drowsiness. You can apply 1% hydrocortisone cream to decrease the inflammation.

Try This Treatment For More Severe Cases of Poison Ivy

If the rash is severe, meaning on a large part of the body or the face, steroids may be advisable and your pediatrician or physician will direct you appropriately. However, steroids should be reserved for the worst cases.

Also, if you do not have any open areas, you can use rubbing alcohol, which can prevent further spread of the toxic oil. In addition, Betadine can be painted on the area and left to dry to decrease the itch.

Another idea to pull the fluid from the blisters is to make a paste from Betadine and baking soda. Put the paste over the blisters then allow it to dry and crack off. Make sure the area has dried before putting on clothing to prevent staining from the Betadine.

Soothing the Itch

Oatmeal baths are comforting, but in a pinch good old-fashioned oatmeal added to lukewarm water works.

It is important not to scratch the rash to prevent bacteria from getting in. Do not pop blisters even if they are weeping. You should cover them. Cut your fingernails short, resist scratching, or wear socks over your hands to prevent opening areas up.

A comfort measure that works well is to apply ice, but not directly to your skin. Use a cover like a towel over the ice pack. Also, aloe vera secretes a cooling gel from its leaves. Just snap a leaf off and apply the gel directly to the rash. If you buy aloe vera in the store, make sure it contains at least 90% aloe.

Remember This When Dealing With Poison Ivy

  • The best option for controlling the spread of poison ivy is to remove the plants by hand, as the sprays and killers are not environmentally friendly.
  • Never burn the plants, since the oil is vaporized and can be inhaled, causing havoc in your lungs, possibly leading to respiratory failure.
  • Don’t skip the step of washing your clothes or gardening shoes and equipment, since poison ivy and oak residue can stay on objects for up to 5 years.
  • If you develop a fever more than 100 degrees Fahrenheit, see yellow scabs or pus, or have tenderness over the affected areas, see your doctor, you may have an infection.

About Doylestown Hospital

Doylestown Hospital is a comprehensive 238-bed medical center serving families throughout Bucks and Montgomery Counties and Western New Jersey. The hospital, along with The Doylestown Hospital Surgery Center at the Health & Wellness Center in Warrington; Pine Run Community and Health Center; Lakeview by Pine Run, and VIA Affiliates, comprise the VIA Health System.

For more helpful tips and information, connect with us on Facebook or Twitter.

Thursday, June 26, 2014

Loving Life as a Locavore

Our nutrition expert weighs in on the benefits of eating locally-grown food.

Locavore (noun): A person whose diet consists only or principally of locally grown or produced food.

Locavore Living
These days, the average produce item travels about 1,500 miles from farm to table. Locavores try to shrink that distance to about a 100-mile radius. Since we're all supposed to eat plenty of fruits and vegetables, summer is a great time to be a locavore. Produce grown at local farms – or your backyard – abounds.

"Consumers are more interested than ever about where and how their food is produced," according to Audrey Fleck of Healthy Directions Nutrition Therapy and Counseling. "Shopping at a farmer's market or local farm provides an opportunity to talk to the people who are at the center of bringing food from the farm to your plate."

There are several benefits of "going local," says Audrey.

Taste the Difference

Many people swear by the taste of local produce. One reason is the freshness – foods picked within 24 hours simply taste fresher.

Better Taste, Better For You

Produce loses nutrients and enzymes the longer it sits. Since local produce has a shorter time between harvest and your table, it is less likely the nutrient value has decreased.

Conventional farms generally grow fruits and vegetables they can mass produce and that will last a long time on the shelf, says Audrey.
Audrey Fleck, Nutritionist at Doylestown Hospital
Audrey Fleck

Audrey adds, "Because quantity and durability is a goal, conventionally grown food is more likely to use genetically-modified seeds (GMOs). There is controversy surrounding whether GMO foods are safe for human consumption. Because there is no long-term research on humans and negative health effects shown in animal studies, I caution against consumption of these foods. Local farms produce food with the goal of selling to the local and direct market (such as local restaurants and farmer's markets), so nutritional quality and taste would be more of a priority than durability."

Local Food Is Good for the Local Economy

Spending money at local farm markets keeps those dollars in your community to be reinvested with other local businesses. There are lots of farm markets in our area.

Every year, Penn State Extension publishes its handy guide "Fresh from Bucks County Farms: Guide to Roadside Markets & 'Pick Your Own' Farms" that includes a chart of what's in season, a list of 64 area farm markets (their location, contact info and hours of operation), a listing of Community Supported Agriculture (CSA's), community farm markets and more.

Benefits for the Environment

Keeping local farms in business means keeping farmland and open and/or green space preserved. With local food traveling a shorter distance (and using less fuel), locavores may also help conserve energy and reduce pollution. And, small farms often adopt environmentally-friendly practices.

"Many local farms are transparent in the way they grow their food and are happy to answer your questions," notes Audrey.

Seasons and the Value of Variety

From early summer strawberries to fall favorites like apples, local crops offer a variety of seasonal tastes at their peak of flavor. Local farmers are often able to try different crops and offer interesting varieties you might not find elsewhere.

Hungry for More?

Check out these sites for more information:

About Nutrition Counseling of Doylestown Hospital

Nutrition Counseling of Doylestown Hospital offers personalized nutrition plans for those with a current medical condition or those interested in preventive health and weight loss. For more helpful tips or to connect with us, find us on Facebook or Twitter.

Tuesday, June 24, 2014

Men's Health Made Simple

June is Men’s Health Month. Doylestown Hospital encourages men to be aware of potential health problems and take early action to fight them. We spoke to Brad Paddock, MD, about what men need to know – and do.

What are the main men's health concerns?

Men's Health Tips
Well, some things apply to everyone throughout their lives, including men. Everyone should exercise, avoid tobacco, see your doctor periodically, and make sure your immunizations stay up to date. Most adults are overdue for Tdap and/or other needed shots.

There are also things that are specific to men. A man can get a hernia at any age. If you notice pain, bulging, or asymmetry in your lower abdomen, groin, or scrotum, see your doctor to be checked for a hernia. Men get coronary artery disease about 10 years younger than women. That risk can be reduced by exercising, avoiding tobacco, and controlling blood pressure and cholesterol. Tell your doctor if you have chest pain.

What are other health issues specific to men?

Men in the second half of life can also have prostate problems. The prostate is a gland located in a man's lower pelvis. It can become enlarged and impair urination, or become cancerous and impair life expectancy. You should tell your doctor if you have any difficulty urinating.

Also, see your doctor when you turn 50, and annually thereafter, to be screened for prostate cancer. Impotence (erectile dysfunction) can occur in men. When it does, it is important to see your doctor to get tested for various conditions that can cause it.

Why do women find it easier to go to the doctor than men?

Women are taught to go to their doctor annually for a Pap test and pelvic and breast exam, to prevent gynecologic and breast cancers. So they get used to seeing their doctor regularly, and do not think it is a big deal to see a doctor for a checkup or when they have a problem.

Men are not taught to see their doctor regularly throughout their lives. So they get used to going for long periods without doctor visits. Men of every age should see their primary doctor for a physical at least every 5 years, and every year after 50. Getting men to make that change is important.

Why do women live longer than men?

Research shows that women generally live about seven years longer than men. Here are some reasons why:
  • Until menopause, women have estrogen, which is protective against heart disease. That is why men get coronary artery disease at a younger age than women.
  • Women are more likely than men to ask for help. That includes asking a doctor for help when they have a problem. Men tend to keep their problems to themselves rather than get help, thinking that will show strength. It does not. It causes prolonged suffering and delayed treatment of problems.

What can women do to help the man in their life stay healthy?

Encourage him to communicate. Find out what is going on inside his head. Be familiar with his problems, and be supportive. Encourage him to go to the doctor for periodic checkups and when he has a problem. Support his exercise. If he likes to go to the gym or play sports, encourage it. If not, start exercising with him, such as walking or riding bikes together, and you both will be healthier.

What advice do you have about testosterone replacement therapy?

When something is advertised heavily, like "Low T," it means the company really wants to sell it. It does not mean that you really need to buy it. Testosterone levels fall in some men as they age, become obese, or develop other diseases. In that way, the testosterone level is a measure of a man's overall health. The only way to know if yours is low is to get it measured. If it is low, the best thing to do is correct the underlying problem. For many men that means exercising and losing weight. Then the testosterone level will return to normal naturally.

If the underlying problem cannot be corrected, or if you do not want to exercise, then you can take replacement testosterone as a medication. It may improve weak erections and strengthen weak bones, but it will not fix the underlying problem.

Visit Our Men's Health Pinterest Board:



About Brad Paddock, MD

Brad Paddock, MD, is a graduate of Temple Medical School. He completed his residency at MCP-Hahnemann University and trained at Hahnemann Hospital, MCP Hospital, Saint Christopher's Hospital for Children and Warminster Hospital. He is board certified in Family Medicine. Dr. Paddock is director of the Ivyland Medical Center.

About Primary Care at Doylestown Hospital

Many screening or risk assessment tests start with your primary care physician – these include Family Medicine, Internal Medicine and Geriatric care providers. Visits to a primary care doctor on a regular basis help prevent health problems, promote wellness and treat illnesses before the become serious. When the need arises this physician can refer you to treatment with a medical or surgical specialist for more advanced care based on your condition.

Find a Physician online or call 215-345-2121 for a complete list of medical and surgical specialties at Doylestown Hospital. For more helpful tips or to connect with us, find us on Facebook or Twitter.


Thursday, June 12, 2014

The Facts About Men and Breast Cancer

June is National Men's Health Month. While it is rare, men can get breast cancer. Learn more from our expert, Donna Angotti, MD.

Do Men Really Have Breasts?

Men have breast tissue that usually does not undergo development because most men lack the ratio of female-type hormones to stimulate this tissue. When hormonal levels fluctuate in life, particularly in
Men Can Get Breast Cancer Too
adolescence, many young males will undergo temporary stimulation and enlargement of breast tissue behind the nipples that is frightening to them. A breast specialist can rule out any underlying serious condition and then reassure the patient and his family that the tissue will shrink once hormonal balance returns.

How Common Is Breast Cancer in Men?

Breast cancer in men is rare. In the United States there are about 2,140 new cases per year with 450 deaths.

What Are a Man's Risk Factors for Breast Cancer?

Men share a number of risk factors for breast cancer with women, including family history, Jewish origin, obesity, low exercise activity and prior radiation to the chest wall. There are also risk factors unique to men, including never having been married, testicular issues (undescended testes), liver issues (cirrhosis, alcoholic liver disease and schistosomiasis-a parasitic infection), and gynecomastia (enlarged breasts in men).

Men who take estrogen have higher rates of breast cancer as well. Men with Klinefelter Syndrome in which they have an extra female chromosome (such as XXY) have a higher rate of breast cancer, however it still does not meet the rate in females.

What Are Symptoms of Breast Cancer in Men?

Breast cancer in men usually presents as a painless, firm mass directly behind the nipple. Less commonly, the mass appears in the upper area of the breast.

How Is Breast Cancer in Men Usually Found?

Typically, the man or his partner will notice changes to the breast area and bring it to a physician's attention. The physician performs an evaluation including a physical exam, mammogram and ultrasound, followed by a tissue biopsy, if appropriate.

How Is Male Breast Cancer Treated?

Traditional surgical treatment for breast cancer in women has been mastectomy (removal of the breast). Since male breast cancer is rare and there is limited research on the effectiveness of treatment options, most physicians base their recommendations on the results of studies of female breast cancer.

Up to 20% of men have been treated with lumpectomy (removal of a tumor from the breast) followed by radiation therapy, with no local recurrences being reported after five years. Lymph nodes are evaluated and might be biopsied.

Radiation therapy after lumpectomy may be recommended to reduce the risk of local recurrence. For patients with 3 to 4 positive lymph nodes, radiation after mastectomy may also be recommended.

Medication to reduce the risk of cancer recurrence throughout the body may also be recommended, as it is for female breast cancer treatment. This might include estrogen-blocking medication, growth factor antibodies and chemotherapy agents.

Any male diagnosed with breast cancer should be referred for genetic testing, as up to 40% carry an identifiable BRCA mutation (an alteration of the BRCA1 or BRCA2 gene that could be inherited and lead to cancer).

Should Men Do Self-Breast Exams Like Women?

Since the risk of male breast cancer is low, routine self-exams are not recommended unless the man suffers from Klinefelter Syndrome. It is recommended, however, that men be aware of their bodies and bring anything unusual they feel to a physician's attention.

Why don't we hear more about male breast cancer?

Diseases that are not present to a high degree in a population are not given as much press or attention, but as people take more responsibility for their own health and desire more health-related information, pieces like this can help educate and inform.

About Donna Angotti, MD

Donna Angotti, MD, is a board-certified and fellowship-trained breast surgeon who specializes in breast health, the diagnosis and treatment of breast cancer and the care of high-risk patients. She is Medical Director of the Breast Center of Doylestown Hospital.

About the Breast Center of Doylestown Hospital

The Breast Center of Doylestown Hospital combines the compassionate care of experts with state-of-the-art technology to offer personalized breast cancer and well-breast care, close to home. Breast care services include early detection and advanced screening options at the Women's Diagnostic Center of Doylestown Hospital. Experienced surgeons offer complex treatments including nipple-sparing mastectomy. The Breast Center of Doylestown Hospital is your resource for total breast health, close to home.

For more helpful tips and information, connect with us on Facebook or Twitter.

Tuesday, May 20, 2014

Protect the Skin You’re In

Stop and think before you head out into the sun. Monthly self-exams and yearly skin exams by a family doctor, internist or dermatologist are beneficial in early detection. May is Melanoma/Skin Cancer Detection and Prevention Month. After a long, hard winter, many of us can’t wait to get out and enjoy the sunshine. Mary Toporcer, MD, Doylestown Hospital dermatologist, shares the basics about skin cancer and ways to protect yourself.

What age should people start checking their skin for unusual moles?

Unusual moles can occur at any age, but the incidence of melanoma is highest in adults over the age of 40 (1 in 50 adults will grow an invasive melanoma). Children can likewise develop melanoma, but the incidence is much lower, 1.6 cases in 100,000 between the ages of 10-19 years. Because early detection is the key to survival, everyone should have their skin screened on a yearly basis in the same way that a routine examination of the heart, lungs and dentition is beneficial.

What about those with a family history of melanoma?

A family history of malignant melanoma is indeed a contributing factor in a person’s risk for developing melanoma, along with fair skin, light hair and eyes, a high mole count and sunburns. The literature states that a person’s risk for developing melanoma, if you have a family history of melanoma, is two-fold higher than if there is no family history of melanoma.

What should people look for when they check their skin?

With regards to atypical nevi and melanoma, the American Academy of Dermatology touts the ABCDE’s of melanoma:
  • Asymmetry: One half does not match the other half.
  • Border irregularity: The edges are ragged, notched or blurred.
  • Color: The pigmentation is not uniform. Different shades of tan, brown or black are often present. Dashes of red, white, and blue can add to the mottled appearance, though melanomas may be pink or amelanotic (without color).
  • Diameter: While melanomas are usually greater than 6mm in diameter when diagnosed, they can be smaller.
  • Evolving: A mole or skin lesion that looks different from the rest or is changing in size, shape or color.

What about moles that look different than other moles?

Remember the "ugly duckling theory" or, to quote Sesame Street, "One of these things is not like the other." I explain to my patients that it makes perfect sense that an individual’s DNA is programmed to produce a certain pattern(s) of moles. If a mole deviates significantly from its prototype, then it’s worth calling it to a doctor’s attention. I try to give my patients "their prototype" when I examine their moles. I also explain to patients that moles do indeed change with age; they usually lighten or "gray" just like your hair and they often grow outwardly or undergo "fatty degeneration". These are attributes of a mature mole and are normal.

In addition to melanoma, what are other types of skin cancer?

The other most common types of skin cancers are Basal Cell Carcinoma and Squamous Cell Carcinoma. These affect 1 in 5 Americans during their lifetime and are able to be fully treated if caught early. My patients have taught me that basal cells usually present like "pimples that don’t want to heal over a few months". They are usually pink, shiny and may ulcerate or bleed if they are allowed to grow untreated. Squamous cell skin cancers often look like "pink warts". They are usually scalier than basal cells and likewise will thicken, crust and bleed over time. In comparison to basal cell carcinoma, squamous cell carcinoma has a higher risk of spreading to lymph nodes if left untreated.

What are the best ways to prevent skin cancer and keep skin healthy year-round?

Prevention and early detection are paramount in dealing with skin cancer and melanoma. Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. You can have fun in the sun and reduce your risk of skin cancer. In 2010, new research found that daily sunscreen use cut the incidence of melanoma, the deadliest form of skin cancer, in half.

Here’s how to prevent skin cancer:
  • Generously apply a broad-spectrum, water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 30 to all exposed skin. "Broad-spectrum" provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Reapply approximately every two hours, even on cloudy days, and after swimming or sweating.
  • Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.
  • Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow is shorter than you are, seek shade.
  • Use extra caution near water, snow and sand as they reflect the damaging rays of the sun, which can increase your chance of sunburn.
  • Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
Alarming Melanoma Facts:
  • On average, one American dies from melanoma every hour.
  • Approximately 75 percent of skin cancer deaths are from melanoma.
  • Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for adolescents and young adults 15-29 years old.
  • Melanoma is increasing faster in females 15-29 years old than males in the same age group.
  • Melanoma in Caucasian women under the age of 44 has increased 6.1 percent annually, which may reflect recent trends in indoor tanning.
"Pale is the new tan!" – Mary Toporcer, MD

About the Cancer Institute of Doylestown Hospital

Accredited by the American College of Surgeons Commission on Cancer, the Cancer Institute of Doylestown Hospital offers patients the quality care they expect from a leader in cancer diagnosis and treatment — close to home. Comprehensive services include oncology-certified patient navigators, a state-of-the art infusion suite, Penn Radiation Oncology on site, and access to cutting-edge therapies and innovative clinical trials through the Penn Cancer Network. Visit the Cancer Institute of Doylestown Hospital or connect with us on Facebook or Twitter.

Thursday, May 8, 2014

3 Things You Learned From Mom About Cancer Prevention

Breast surgeon Donna Angotti, MD, shares wisdom about preventing breast cancer

When it comes to cancer, are we destined by our genes and environment to fall prey to this tricky enemy?

Can cancer actually be prevented?

Medical science now knows the answer to the second question is a resounding "Yes!" And the secret is as simple as listening to what our mothers told us, over and over again. While growing up, my mother would say, "get to sleep," "go out and play," and "eat your vegetables."

Most of us have heard these mantras many times, but it turns out that there is an inherent wisdom, not only for everyday family life, but for disease prevention.

A Good Night’s Sleep Really Is Good For You


In 1910, when American life was predominantly agrarian, we slept and woke according to natural cycles. The average American needed and obtained 9 hours of sleep per night. When we conquered the night and could extend working hours, this changed.

The average American in 2014 obtains only 6.5 hours of sleep per night. We have not evolved the requirement for less sleep, we just afford ourselves less of it and it has adverse consequences on our health.

Lack of sleep and interruption of the usual day/night cycle disturbs our natural hormonal rhythms and results in more stress hormones being released in our system. Science confirms that chronic stress states are associated with higher rates of cancer, and workers who work the night shift also have higher cancer rates.

Get Moving And Get The Benefits Of Exercise

While "Go out and play!" was probably uttered more for relief of a mother’s frazzled patience, regular exercise does reduce cancer risk, as many studies have documented. A sedentary lifestyle results in a higher body mass index, or BMI, which is associated with higher rates of hormone-related cancers such as breast and endometrial cancers.

And, studies show it doesn’t take much exercise to make a difference -- just three, 30-minute sessions per week will significantly reduce a person’s cancer risk, and will also improve cardiovascular and mental health.

The Role Of A Healthy Diet In Cancer Prevention

"Eat your vegetables!" A United States President told us he hated a green one, but vegetables, especially those in the cruciferous, or cabbage family, are rich in anti-oxidants. These chemicals help our body detoxify potentially harmful chemicals and repair cellular damage. They are also proven to be associated with lower cancer rates.

Donna Angotti, MDThanks Mom!


So, as we may often be reluctant to admit, mom was right in her words and her care of us. We can heed her words and make changes in our lifestyle choices to reduce our risk of cancer.

Happy Mother's Day!

About the Breast Center of Doylestown Hospital

The Breast Center of Doylestown Hospital combines the compassionate care of experts with state-of-the-art technology to offer personalized breast cancer and well-breast care. Breast care services include early detection and advanced screening options at the Women's Diagnostic Center of Doylestown Hospital. Experienced surgeons offer complex treatments including breast-sparing procedures. The Breast Center of Doylestown Hospital is your resource for total breast health, close to home.

Wednesday, May 7, 2014

A Peaceful Ending to a Beautiful Life

Planning for end-of-life care and including palliative care and hospice can help ease burdens and create comfort.

Barbara Stitzinger called it a "life-changing journey."

She was the primary caregiver who saw her m
other-in-law, Elizabeth, through the ravages of age and declining health until the very end. Elizabeth was comfortable, well cared for and at peace when she passed.

"I was with her until her last breath," said Barbara.

Elizabeth died on March 7 at age 92 in the beloved kitchen of the family home where she had lived for nearly 50 years.

Elizabeth’s last weeks were the result of thoughtful planning and diligence on the part of her caregivers. Both she and her husband of nearly 70 years, Jim, had living wills that specified that no extraordinary measures be taken if they became seriously ill. They wanted to remain at home.

For about a year the family saw Elizabeth’s health waning as she succumbed to heart issues. The family enlisted the help of visiting nurses. Eventually there came a point when they decided to place Elizabeth in hospice care so she could live out the rest of her days on the family farm in Doylestown.

Until several months ago, Barbara had not been familiar with hospice. "I didn’t realize the broad scope of care," she said. "But it was all well explained."

"Hospice is that ‘something more’ when aggressive treatment options have been exhausted and your disease has progressed," said Priscilla Kraut, Doylestown Hospital hospice coordinator. "The focus of hospice care is on quality of life while providing excellent symptom management."

The Doylestown Hospital Hospice team includes a patient's own physician, registered nurses, social workers, home health aides, chaplain, bereavement counselors, and trained volunteers. Patients and their loved ones are central to the care plan. The goal is to enable individuals to live as fully and comfortably as possible at home or in a home-like setting such as a care facility.

According to research, most people say they would prefer to die at home, yet only about one-third of adults have an advance directive outlining their wishes for end-of-life care.

Why? Often stated reasons include denial, lack of awareness and confusion. According to the Centers for Disease Control and Prevention (CDC), "Planning for the end of life is increasingly being viewed as a public health issue, given its potential to prevent unnecessary suffering and to support an individual’s decisions and preferences related to the end of life." (CDC 2010).

Awareness efforts continue.

Ira Byock, MD, who served as director of palliative medicine at Dartmouth-Hitchcock Medical Center from 2003 until 2013, is an author and public advocate for improving care through the end of life. In a 2012 blog for ABC News he states, "Being prepared starts with a conversation. Illness and dying are only partly medical; they are mostly personal. It’s critically important for your family to know what is most important to you personally – in your life."

The Stitzinger family had those conversations. A hospital bed was placed in the kitchen for Elizabeth.

Barbara describes the German-born matriarch as a "legend." She and Jim had five children who grew up with a strong spiritual background and faith. Elizabeth was a tremendous baker who taught Barbara how to cook. "She was a wonderful mother to her daughter and daughters-in-law," said Barbara.

The days preceding Elizabeth’s death were intense, she added. Having hospice care helped ease the burden. "I don’t know how I would have done it without them."

Doylestown Hospital Hospice has been serving patients and families in Doylestown and surrounding communities for more than 25 years, making it one of the most experienced hospice programs in the region. Last year, Jane Gallant, MD, joined the Doylestown Hospital Medical Staff as director of the palliative care program. While hospice care and palliative care each have their own characteristics, both specialties focus on comfort for the patient and support for loved ones.

"I felt valued," added Barbara.

In addition to a hospice nurse, the health aides, social workers and volunteers provided personalized, compassionate care to Elizabeth. They also cared for Barbara, who felt "safe" even in the middle of the night when she’d call the 24-hour hotline for guidance.

Said Barbara, "Elizabeth was at peace with dying. She was so happy to be home surrounded by those who loved her. Being at peace with your surroundings and yourself is a big part of your end of life."

Interested in learning more about Palliative Care?

Mark your calendar for this free community program presented by nationally-recognized Palliative Care and end-of-life care speaker, Ira Byock, MD, from Dartmouth-Hitchcock Medical Center.



The Best Care Possible Through the End-of-Life


Monday, May 19, 2014, 7:00 to 8:30pm
Lenape Middle School,
313 West State Street, Doylestown, PA

Learn more about The Best Care Possible Through the End-of-Life program.





About Doylestown Hospital Hospice

Doylestown Hospital Hospice, a non-profit organization, has been serving patients and families in Doylestown and the surrounding communities for more than 25 years. Founded in 1983, Doylestown Hospital Hospice is one of the oldest Hospice programs in the region. In 1985 we became the third Hospice in the state to be accredited by the Joint Commission and in 1990 we received Medicare certification.

Tuesday, March 25, 2014

A New Era in Breast Care at the Breast Center

When Donna Angotti, MD joined Doylestown Hospital in January, she said, "I feel like I’m home." For more than 20 years, this accomplished surgeon has specialized in the diagnosis and treatment of both benign and cancerous breast disease in her practice in Bucks and Montgomery counties.

Breast Center of Doylestown Hospital
She had her children at Doylestown Hospital and has lived in the local area for years. "I think being a part of the community you serve is huge. I’ve seen how the community has developed and grown, and Doylestown Hospital has also grown tremendously. I am excited to be part of the Breast Center of Doylestown Hospital and further develop it into something truly pioneering."

Early Detection and Prevention of Breast Cancer

Chances are you or someone you know has been affected by breast cancer. It is the most common cancer among women in the United States.

The Breast Center of Doylestown Hospital provides the spectrum of care for women, from preventive screening through diagnosis, treatment and survivorship.

Early detection of breast cancer is key to successful treatment. Doylestown Hospital routinely diagnoses breast cancer in the earliest stages and outperforms its Pennsylvania peers on this critical measure.

  • The American Cancer Society recommends an annual mammogram beginning at age 40.
  • Doylestown Hospital is designated a Breast Imaging Center of Excellence by the American College of Radiology.
  • More than 25,000 digital mammograms are performed every year at the Women’s Diagnostic Center of Doylestown Hospital.
  • Doylestown Hospital earned accreditation by the National Accreditation Program for Breast Centers (NAPBC), and is a Comprehensive Community Cancer Program.

Talk Philly: Breast Center of Doylestown Hospital

Kate Bilo speaks with Dr. Donna Angotti about breast cancer and the best forms of prevention, including mammograms.


Individual Treatment with a Team Approach

Dr. Angotti's philosophy of care emphasizes respect for each individual. She considers herself a partner in their care.

"It is important that patients understand their choices will be respected and they will be seen as a whole being whose emotional and spiritual needs will also be met. I’m here to serve the patient. That's what I’m called to do."

The Breast Center of Doylestown Hospital provides a team approach to individualized treatment, with education and support at every step.

Dr. Angotti is continually impressed by the courage of her patients who are faced with their own mortality. "These women have made a choice to live and to thrive through all this. We focus on the current situation and look forward to health in the future."

About Donna Angotti, MD

Donna Angotti, MD, is a board-certified and fellowship-trained breast surgeon who specializes in breast health, the diagnosis and treatment of breast cancer and the care of high-risk patients. She is Medical Director of the Breast Center of Doylestown Hospital.

About the Breast Center of Doylestown Hospital

The Breast Center of Doylestown Hospital combines the compassionate care of experts with state-of-the-art technology to offer personalized breast cancer and well-breast care, close to home. Breast care services include early detection and advanced screening options at the Women's Diagnostic Center of Doylestown Hospital. Experienced surgeons offer complex treatments including nipple-sparing mastectomy. The Breast Center of Doylestown Hospital is your resource for total breast health, close to home.

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Tuesday, March 18, 2014

Colonoscopy: What Are You Afraid Of?

Gastroenterologist Sandhya Salguti, MD, answers your questions and concerns about colonoscopy.


Why is colonoscopy important?

Colon cancer is one of the most preventable cancers. About 90 percent of deaths can be prevented through early detection—colonoscopy— and treatment.

Why don’t more people have a colonoscopy?

Most people who avoid having a colonoscopy are scared—of the possible test results, the bowel preparation and the procedure. Everyone over age 50 should have a colonoscopy and followup colonoscopies as recommended by their physician. Individuals with risk factors, such as a personal or family history of cancer, are often advised to start sooner.

What is it like to prepare for and have a colonoscopy?

Most people say that the worry is worse than the preparation and test. A successful colonoscopy requires a clean colon. One day before the test, you will stop eating solid foods, and drink only clear fluids such as water, tea, coffee, clear juices, clear broths, Popsicles and gelatin (but nothing red or purple). Starting the evening before the procedure, you take a liquid that clears out your bowels. Specific instructions depend on the bowel prep prescribed, the time of your colonoscopy and any prior experience with bowel preps.

The overwhelming majority of people are asleep during a colonoscopy. The sedative puts you into a pleasant, sleepy, relaxed state in which you don’t feel or remember anything.

Is there anything new that makes the prep easier?

Low-volume bowel preps work for most people. Instead of taking a whole gallon (4 liters) of liquid the night before the colonoscopy, low volume bowel preps require you to drink only 2 to 3 liters of liquid—a more manageable amount.

Learn more about colorectal cancer screening guidelines and schedule an appointment.

About the Cancer Institute of Doylestown Hospital

Accredited by the American College of Surgeons Commission on Cancer, the Cancer Institute of Doylestown Hospital offers patients the quality care they expect from a leader in cancer diagnosis and treatment — close to home. Comprehensive services include oncology-certified patient navigators, a state-of-the art infusion suite, Penn Radiation Oncology on site, and access to cutting-edge therapies and innovative clinical trials through the Penn Cancer Network. Visit the Cancer Institute of Doylestown Hospital or connect with us on Facebook or Twitter.

Tuesday, March 11, 2014

6 Steps to Prevent Colon Cancer

Did you know that colon cancer is one of the most preventable cancers in the nation? The American Cancer Society estimates the United States will see 96,830 new cases of colon cancer in 2014, but through screenings and lifestyle changes you can prevent this deadly disease. 

To kick off National Colon Cancer Awareness Month, we're sharing tips on how to have a healthier colon and take steps to prevent the number 2 cancer killer in the United States.

Screenings

Screenings are extremely important in the prevention and early detection of colon cancer. Men and women age 50 and older, or those with a family history of the disease, should be screened for colon cancer on a regular basis. Learn more about colorectal cancer screening guidelines and talk to your provider about the most appropriate screening options for you.

Food and Nutrition

To prevent colon cancer, the American Cancer Society recommends focusing on eating at least 2 ½ cups of fruits and vegetables daily, as well as whole grain breads and cereals, and limiting or avoiding red meat (including pork), foods with high fat content and highly processed foods.

Weight and Your Body Mass Index (BMI)

An increased risk of colorectal cancer has been seen among men with higher BMIs. The strongest association of risk for colon cancer has been seen among those who have a higher distribution of body fat throughout the midsection. The same is true among women, although the risk seen in women appears to be much weaker.

Exercise

As we all know, exercise and physical activity have countless health benefits and the same is true in preventing colon cancer. To protect against colon cancer, the American Cancer Society recommends at least 30 to 60 minutes of moderate physical activity daily.

Limit Drinks

Increased alcohol intake, especially among men, has been associated with a higher risk of colorectal cancer. The American Cancer Society recommends no more than 2 drinks for men and 1 drink for women daily.

Quit Smoking

Smoking has not only been linked to lung cancer, but also to colorectal cancer. If you smoke, learn how to reduce your risk of developing colorectal or other types of cancer, and prevent other conditions and diseases through smoking cessation.

Visit Our Colon Cancer Awareness Pinterest Board:




About the Cancer Institute of Doylestown Hospital

Accredited by the American College of Surgeons Commission on Cancer, the Cancer Institute of Doylestown Hospital offers patients the quality care they expect from a leader in cancer diagnosis and treatment — close to home. Comprehensive services include oncology-certified patient navigators, a state-of-the art infusion suite, Penn Radiation Oncology on site, and access to cutting-edge therapies and innovative clinical trials through the Penn Cancer Network. Visit the Cancer Institute of Doylestown Hospital or connect with us on Facebook or Twitter.

Tuesday, March 4, 2014

Women, Breast Density and Cancer: Know the Facts

A new state law went into effect in February concerning women and breast cancer detection. How will it affect you or a woman you know?

It’s estimated that 32 women are diagnosed with breast cancer in Pennsylvania every day. In 2013, there were about 232,340 new cases of breast cancer in the U.S. Breast cancer is the most common cancer among women (followed by lung and colorectal cancers).

The Breast Density Notification Act signed by Pennsylvania Gov. Tom Corbett in November 2013 requires mammography providers to inform women in writing about their breast density. The law went into effect in February.

What is breast density?

Breasts are made up of a mixture of fibrous and glandular tissue and fatty tissue. Breasts are considered dense if a woman has a lot of fibrous or glandular tissue but not much fat. Age affects breast density with younger women tending to have more dense tissue while older women have more fatty tissue.

How does a woman know if she has dense breasts?

Breast density is determined by the radiologist who reads a mammogram. There is a density scale, and a woman’s doctor should be able to tell her whether she has dense breasts based on where she falls in the density scale. About 80% of women are categorized as having mildly to moderately dense breasts.

Why is breast density important?

Dense breast tissue can make it harder to find cancer on a mammogram, and that increases the risk of a late-stage diagnosis in many women. Having dense breast tissue may increase the risk of breast cancer.

How does this law affect women when it comes to mammograms?

The new law requires hospitals and other diagnostic facilities to notify women of their breast density and offer other screening options in addition to their routine mammograms. The written notice suggests a conversation with a physician about these options, which include MRI (magnetic resonance imaging) and breast ultrasound. The law does not require insurance companies to cover the additional screenings.

No matter what a woman’s breast density is, annual mammograms are still recommended for all women starting at age 40, earlier if there are other risk factors like a family history. A mammogram is the only medical imaging screening test proven to reduce breast cancer deaths. Many cancers are seen on mammograms even if a woman has dense breasts.

What is Doylestown Hospital doing about the new law?

Michele Kopach, MD, is medical director of the Women’s Diagnostic Center of Doylestown Hospital. "As the law will raise public awareness about the limitations of mammography, we will use all available resources to continue finding breast cancer at its earliest stages," she said.

At Doylestown Hospital, physicians find breast cancer at earlier stages than other cancer centers in Pennsylvania, according to the National Cancer Data Base. Doylestown is accredited by the National Accreditation Program for Breast Centers and is an American College of Radiology Breast Imaging Center of Excellence.

About the Cancer Institute of Doylestown Hospital

Accredited by the American College of Surgeons Commission on Cancer, the Cancer Institute of Doylestown Hospital offers patients the quality care they expect from a leader in cancer diagnosis and treatment — close to home. Comprehensive services include oncology-certified patient navigators, a state-of-the art infusion suite, Penn Radiation Oncology on site, and access to cutting-edge therapies and innovative clinical trials through the Penn Cancer Network. Visit the Cancer Institute of Doylestown Hospital or connect with us on Facebook or Twitter.


A physician's order is required for all services at the Women's Diagnostic Center. Managed care patients also require a referral for certain studies. For more information or to schedule an appointment, please call Central Scheduling at 215-345-2274.

Tuesday, February 11, 2014

The Biggest Little Star for Breast Cancer Awareness

"I stopped believing in Santa Claus when I was six. Mother took me to see him in a department store and he asked for my autograph."— Shirley Temple

Shirley Temple, who rose to fame as one of the most popular child stars in Hollywood, died late Monday night at 85 years old in her home in Woodside, California.

Shirley Temple was probably best known for movies such as Curly Top, The Little Princess and Heidi, but she was much more than that for breast cancer patients. She was their ambassador and a voice that broke the stigma of talking publicly about breast cancer.

In 1972, she underwent a mastectomy to remove a malignant tumor from her left breast and although at that time operations for cancer were shrouded in secrecy, she rose above the silence and held a news conference in her hospital room to speak out about her mastectomy, urging women to take preventative actions and to do a breast self-exam. She later went on to publicly educate women about her surgery and the disease in addition to raising awareness and funding for breast cancer research.

She may have stopped believing in Santa Claus at a young age, but she never stopped believing in her mission of educating people about breast cancer prevention and screenings.

The Cancer Institute of Doylestown Hospital encourages women to follow the American Cancer Society’s (ACS) guidelines for breast cancer screening.

Breast Cancer Screening

  • Breast Self-Exam (BSE)
  • Clinical Breast Examination (CBE)
  • Screening Mammogram
Visit the Cancer Institute of Doylestown Hospital for more information or to learn more about breast cancer screenings available.

Visit Our Breast Cancer Awareness Pinterest Board:



About the Cancer Institute of Doylestown Hospital

Accredited by the American College of Surgeons Commission on Cancer, the Cancer Institute of Doylestown Hospital offers patients the quality care they expect from a leader in cancer diagnosis and treatment — close to home. Comprehensive services include oncology-certified patient navigators, a state-of-the art infusion suite, Penn Radiation Oncology on site, and access to cutting-edge therapies and innovative clinical trials through the Penn Cancer Network. Visit the Cancer Institute of Doylestown Hospital or connect with us on Facebook or Twitter.

Tuesday, January 21, 2014

Soothing Symptoms, Comforting Families

Caring or overseeing care for a loved one who is very ill can be challenging. It can be hard to take in all the information, understand options and know all the resources available. You are not alone.

Doylestown Hospital has a Palliative Care program to help patients who are seriously ill and their families and loved ones who are caring for them. Jane Gallant, MD, directs the program.

"At Doylestown Hospital, the service supports patients with chronic, life-threatening illnesses and their families, to help them make decisions about care," says Dr. Gallant.

Patients who can benefit the most have serious health problems such as end-stage heart disease or lung disease, later-stage cancers or later-stage dementia. Their needs are complex. Dr. Gallant helps them develop a plan of care, which can change over time. She does not make decisions for the patients and families, but rather provides them information about their options and serve as a resource.

"We work with their attending physician at the hospital, as well as their other physicians and social workers, as needed," Dr. Gallant says. "At the end of the day, decisions about care rest with the patient and their family."

Palliative Care is a consult service for hospitalized patients and their families and caregivers. The patient’s physician can decide to request a palliative care consult or the patient or family member may ask the physician to do so.

What is Palliative Care?

Focuses on providing relief from pain and suffering for patients regardless of the diagnosis. The patient's quality of life is the overarching goal.

Who Provides Palliative Care?

Palliative Care is provided by doctors, nurses and specialists who devise a care plan to provide the patient with an extra layer of support. Massage therapists, pharmacists, nutritionists and others might also be part of the team.

What are the Benefits of Palliative Care?

Palliative Care has been shown to:
  • Controls pain
  • Controls common symptoms of serious illness such as fatigue, anxiety, shortness of breath, nausea, depression and constipation
  • Improves quality of life

Who Can Receive Palliative Care?

Patients can receive palliative care at any age and at any stage in a serious illness and can be provided with a curative treatment, not only at the end of life.

How Do I Know if Palliative Care is Right for Me?

If you are experiencing pain, stress or other symptoms due to a serious illness Palliative Care may be an option. Discuss your options with your doctor as it relates to your condition.

Interested in learning more about Palliative Care?

Mark your calendar for this free community program.

The Best Care Possible Through the End-of-Life
Monday, May 19, 2014, 7:00 to 8:30pm
Lenape Middle School,
313 West State Street, Doylestown, PA

A community education program presented by nationally-recognized Palliative Care and end-of-life care speaker, Ira Byock, MD, from Dartmouth-Hitchcock Medical Center.

Tuesday, December 17, 2013

Concerned About Lung Cancer? Get the Facts.

Watch Dr. James McClurken, cardiothoracic surgeon at Doylestown Hospital, discuss lung cancer treatment at Doylestown Hospital.




Who is at risk for lung cancer?

Having one or more risk factors for lung cancer does not mean you will get cancer. The known risk factors for lung cancer are:

  • Tobacco smoking or second-hand smoke
  • Contact with radon
  • Contact with asbestos or other cancer-causing agents
  • Having had certain other cancers or lung diseases
  • Family history of lung cancer

What are the symptoms of lung cancer?

Signs and symptoms of lung cancer typically occur only when the disease is advanced, which is why lung cancer screening is important. They include:

  • A new cough that doesn’t go away 
  • Changes in a chronic cough or "smoker’s cough"
  • Coughing up blood, even a small amount
  • Shortness of breath
  • Chest pain
  • Wheezing
  • Hoarseness
  • Losing weight without trying
  • Bone pain
  • Headache

Is there a screening test available?

Studies have shown that low-dose CT lung screening can lower the risk of death from lung cancer by 20 percent in people who are at high risk. High-risk individuals include anyone between the ages of 55 and 74 who have a 30 pack-year history — and if not still smoking must have quit within the past 15 years. Individuals who meet the high-risk criteria should talk to their provider to see if a low-dose CT scan to detect cancer is appropriate.

Beginning in January 2014, Doylestown Hospital will offer lung cancer screening for high-risk patients.

Who treats lung cancer?

Lung cancer care requires a team approach to treatment. Patients may come in contact with physicians from many specialties including medical oncology, radiation oncology, surgery and pulmonary medicine, among others.

How is lung cancer treated?

"There have been significant advances in treatment options for lung cancer in recent years," says Dr. James McClurken, cardiothoracic surgeon at Doylestown Hospital. "We utilize genetic testing and analysis of tumor markers to develop personalized treatment plans for patients when appropriate. Multi-modality therapy with a team approach allows for more effective treatment options and better outcomes."

Can lung cancer be prevented?

The best way to prevent lung cancer is to stop smoking, or never start. For help with quitting smoking, please call 215-345-2121 for information about our smoking cessation program. If you have already quit smoking, congratulations and keep it up!

To ensure patients receive the most comprehensive care available, the Cancer Institute of Doylestown Hospital's Lung Cancer Program brings together top doctors from every discipline to collaborate on personalized treatment plans for patients. This multidisciplinary approach includes experts from medical oncology, radiation oncology, surgery, pulmonary medicine and other specialties who meet regularly to collaborate on personalized treatment plans for each lung cancer patient.

Learn more about the Cancer Institute of Doylestown Hospital's Lung Cancer Program or to find a physician call 215-345-2121.

About the Cancer Institute of Doylestown Hospital

Accredited by the American College of Surgeons Commission on Cancer, the Cancer Institute of Doylestown Hospital offers patients the quality care they expect from a leader in cancer diagnosis and treatment — close to home. Comprehensive services include oncology-certified patient navigators, a state-of-the art infusion suite, Penn Radiation Oncology on site, and access to cutting-edge therapies and innovative clinical trials through the Penn Cancer Network. Visit the Cancer Institute of Doylestown Hospital or connect with us on Facebook or Twitter.

Tuesday, November 26, 2013

Thankful for the Simple Things In Life

"Somebody led me down this path so I could help the ones I love."

Karen Quinlan is retiring after a more than 20-year career specializing in cancer care. She became director of Cancer Services at the Cancer Institute of Doylestown Hospital in 2003. Personally, she has lost a brother and mother-in-law to cancer, had a close call with her husband, and lost dear friends to the disease.

Karen has made many friends among her colleagues and the patients whom she has cared for. During this season of thanks, we ask her what she is grateful for.

Karen describes the patients she has known as "an amazing group of people." "I will always remember the wonderful patients and families that I have met along the way…and the lessons they taught of courage, strength and humor during difficult times. Their appreciation of the simple things in life is a powerful lesson that we should all learn to live."

Her field is not depressing, she reminds people who mistakenly believe so. "Sure we have days when your heart is broken, sure that happens. But you learn to take pleasure out of each moment you were able to help a person. That’s what you get the satisfaction from."

As for her staff and colleagues at Doylestown Hospital, Karen says, "It’s our culture that we care for each other. We’re such a wonderful team. I am so thankful for them and for all they have done for me and most especially our patients."



A number of volunteers, many of them affected by cancer or survivors themselves, give their time at the Cancer Institute. "Their experience, kindness, and altruistic nature lead them to give of themselves and help others."

And finally, family. Karen comes from a family of 10 children. She and husband, Bryan, have two daughters and two grandchildren. Karen helped Bryan with his business for 20 years. Then it was his turn to help her as she started a nursing career, earning a Master’s degree and certification in oncology nursing. "I’m thankful for my husband’s support. And that is what marriage is about. You just go through and you help each other."

Karen is thankful for the "gift of insight", that immutable "whisper from God" that told her to force her husband to get a colonoscopy and chest x-ray for his birthday. He had early stage lung cancer and a pre-cancerous colon mass that were treated successfully. Those screenings "turned out to be the gift that saved his life."


In addition to spending time with family, Karen plans to continue to help others in her retirement, perhaps as a volunteer or with her church. "I want to get back to being able to help somebody in a positive way."

Thank you,

Karen

About the Cancer Institute of Doylestown Hospital

Accredited by the American College of Surgeons Commission on Cancer, the Cancer Institute of Doylestown Hospital offers patients the quality care they expect from a leader in cancer diagnosis and treatment — close to home. Comprehensive services include oncology-certified patient navigators, a state-of-the art infusion suite, Penn Radiation Oncology on site, and access to cutting-edge therapies and innovative clinical trials through the Penn Cancer Network. Visit the Cancer Institute of Doylestown Hospital or connect with us on Facebook or Twitter.

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