Ask the BJC Expert

Ask the BJC Expert

Cancer Prevention

Karen Hampel and Kelly Tschannen, Siteman Cancer Center at Barnes-Jewish St. Peters Hospital

Published on Wednesday, June 07, 2017

Karen Hampel is a nurse coordinator and Kelly Tschannen is the medical oncology manager for the Siteman Cancer Center at Barnes-Jewish St. Peters Hospital. 

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Today we are going to focus on the Siteman Cancer Center. Joining me on the phone lines is Karen Hampel, nurse coordinator and Kelly Tschannen, medical oncology manager for Siteman Cancer Center at Barnes-Jewish St. Peters Hospital. We have some exciting things going on involving that facility that we are going to talk about. Ladies, good morning.

Good morning.

First let’s talk about cancer and treatment of cancer. What are some of the more common types of treatment for people with cancer?

We use a team approach and multimodality treatments that include surgery; when the tumor itself can just be removed and sometimes it is curative. Often surgery is used in combination with radiation therapy with the radiation oncologist,chemotherapy and immunotherapy which is under the expertise of the medical oncologist. It is a team and these things are used together often to treat cancer.

How often should someone be screened for cancer?

That varies by different sites. The most common screening we know is for breast cancer. We have mammography which is the gold standard for screening and begins at age 40 annually. The recommendations have changed so you should really discuss it with your doctor to determine what is appropriate for your age and risk. Women over 55 may get mammography every year or every two years.  Barnes-Jewish St. Peters and Progress West Hospitals both offer screening through mammography, both digital mammography and 3D screening along with a diagnostic work-up. Then doctors team with Siteman Cancer Center for treatment with our surgeons, radiation oncologists and medical oncologists.

For colorectal cancer, the gold standard is the colonoscopy which is recommended every ten years for people at average risk. For all of these screening recommendations, if you are at high risk by family history or personal history, screenings may be done more often or earlier. Colonoscopies begin at age 50. Normally they are done every ten years unless there is a change.

Other things can be used for screening, like a sigmoidoscopy or checking for fecal occult blood. Cervical cancer, again, is a more personalized recommendation basically starting at age 21 or when the woman becomes sexually active and then every three years. In vitro cancer doesn’t really have a screening but it is important for women who are post-menopausal to know that if they have any abnormal bleeding, spotting or uterine bleeding, they need to call that to the attention of the doctor immediately.

What recently has been approved is lung cancer screening and this has been shown to substantially reduce the risk of dying from lung cancer by finding small cancers. This screening is done for a certain population of high risk people. This would be people 55 to 74 years of age, in good health, who have at least a 30 pack a year smoking history and who are either still smoking or quit smoking within the past 15 years. A pack year is determined if you smoke a pack a day for 30 years. Two packs a day for 15 years is a 30 pack year. This screening is an annual low dose CT scan of the lungs. The goal is to find early cancers and this procedure is often covered by insurance so it is something to talk to your doctor about.

Obviously there are a lot of different cancers out there, but a few little lifestyle changes, I am going to assume, can help us prevent cancer. What can we do to help prevent cancer?

Actually I am so glad you asked that because lifestyle is huge. It has a huge impact in prevention of cancer. Really the gap is in what we know about it and what is being done. Are people actually doing it? Most people believe that there is more of a genetic predisposition to cancers. In reality 90 to 95 percent of cancers develop in people who do not have a genetic predisposition. What is key here is no surprise.

First:  Don’t smoke and if you do smoke quit because 90 percent of lung cancers and 30 percent of all cancers are related to smoking and it is not just lung cancer. It includes bladder, breast, kidneys, cervical, pancreatic, colon and certain types of leukemia so that is number one.

Second:  Maintain a healthy weight. People underestimate this as well. Approximately 120,000 cancer deaths per year are related to being overweight or obese with a body mass index (BMI) of greater or equal to 30. You will have to Google your BMI and calculate that online. There are a number of cancers related to this.

Third:  Exercise, it doesn’t sound good, but once you get going you can’t stop. So get outside and play. Find something you enjoy doing. This is related, of course, to helping you maintain a good weight. There is a big benefit for young women in decreasing their risk of breast cancer later in life through exercising in those years between when they start having period and when they have their first child. So just move.

Fourth:  Eat healthy. There are a lot of good resources online but be careful. I suggest that you use the Siteman Cancer website and the American Cancer Society website. What is difficult about eating healthy is that there are a lot of things that make headlines. There are super foods and this and that and then recommendations change. One year these products are good for you and the next year they are bad.  Overall, the most important thing is to limit calories. Again going back to managing your weight, eat classic food which is what your mom said. Eat your vegetables, eat your fruit, less red meat and keep your diet low in animal fat. There are really not a lot of risk recommendations anywhere on supplements alone. Drink alcohol in moderation, if at all. There is a strong link to increased risk of certain cancers with alcohol intake and it is dependent on how much you drink.

What about the role of support people? You are diagnosed with cancer. You get the diagnosis but it affects so many of those around you. What role do the support people play in that?

The family and friends that you have help you get through the difficult times. We try to think of cancer as a blip in the road. It is all consuming at the time that it is going on but in the big picture of your life it is just a small period of time. Those friends and family that are with you and support you through treatment make a huge difference. We often have families with two or three people who come on a regular basis with their relative to get their chemotherapy treatments. People think that treatments are a sad time, but really there is always laughter in there. They get to know the treatment nurses. The support that they give helps you get through this difficult time.

We've seen this big building going up for months now.  We’ve seen it rising from the ground, if you will. Tell me a little about the expansion at the Siteman Cancer Center there at Barnes-Jewish St Peters Hospital?

We are very excited to finally be in our new building. We have expanded a great deal. We now have 14 exam rooms, 2 procedure rooms, 32 treatment chairs, and 4 bedrooms for when people don’t feel well or want some privacy. They can get their treatment there. Our surgeons now are in the same location. Previously they were in a different building so now we surgery, radiation and chemotherapy all seeing patients in the same facility. We have nice family lounges for those who have a large group of people with them for the treatment. They can go into the family lounges. Of course, we have our social worker and dietitian all on site. Siteman has access to over 500 clinical trials; more than anyone else in the region. We are the only federally designated comprehensive cancer center in Missouri. We received the highest federal rating possible which is, exceptional, by the National Cancer Institute. This new building allows us to combine our services with radiation, surgery and make it a comfortable experience for our patients.

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