Holidays are typically a time to celebrate. A time for visiting, shopping, baking, decorating, wrapping and lots to do. However, sometimes people with cancer and their loved ones feel challenges and “out-of-sync” from the rest of the world. The holiday season can prompt new questions, such as: How do I take care of the holiday rush and myself at the same time? How can I celebrate when I have so many other things on my mind? What will my life be like next year?Sharing these concerns with the people you love and who love you can help you feel more connected.
Make plans to get together with friends, family or co-workers over the holidays but find the right balance between celebrating with family and friends and spending the time you may need on your own. Give yourself permission to pace activities and to decline invitations so that you have the energy to enjoy the gatherings that are most important to you. This might mean asking friends and family to come to you, so you can save your energy and still enjoy the visit and celebration. You have been participating and giving throughout all the holidays in your life. It is ok to let others give back to you now.
Some times patients have a hard time asking for what they want and need because they feel they have to ask for help more often than ever before. But allow friends, family and co-workers the opportunity to help you even more. Your support team of friends, family and co-workers want to help you! They want to make your life enjoyable and easier because they know that are you are dealing with cancer and the challenges that come with it. Allow them to be there for you as you have been there for so many others throughout your life. It’s time to receive. You are healing and facing perhaps the biggest life-changing circumstance in your life. It is times like these that you can ask for what you need and allow others to help get your needs met.
If you are still uncomfortable with asking for fear of “putting them out,” just let them know that you are seeking possibilities and you know every one is busy and it’s ok for them to say no. They will be honest with you. And 9 times out of 10, your loved ones will, not only be able to accommodate you, they WANT to. They want to help you! They feel good to ease the challenges in the battle you are fighting. Let them help! You’ll be so glad you did. And so will they.

If you’re concerned about shopping and gift giving, perhaps you can shop online. If that is not an option, ask your loved ones to write notes to each other expressing what they are grateful for in the receiver of the note. If writing is also a challenge, you can record something, a video or audio message.

You can create new traditions. Celebrate strengths you and your loved ones have developed. Many families who face the day-to-day challenges of cancer discover strengths and courage they didn’t know they had. Reflect on the strengths you have developed, and build on them during the holidays. Spend time asking each how much you have learned while facing cancer. This can even be done over the phone.

Express your feelings in ways that help you receive the support of the important people in your life. Tears can bring a sense of relief. Laughter can be relaxing. Sharing can be comforting. It is common to experience a mixture of anticipation, excitement and apprehension about the future. Let your feelings breathe, and talk them over with a loved one, friend or professional counselor.

If you typically cook big meals for family, ask for a potluck this year. Let everyone bring something to share. And if someone is not able to bring something, allow them to give the gift of cleaning up at the end.

Enjoy special moments. Try to focus on new traditions that have been established, rather than dwelling on how cancer has changed a holiday or special occasion.

Talk to your health care team about upcoming special events. They may be flexible about appointments in order to accommodate travel or other needs.

At Mid Florida Cancer Centers our team is always ready to help you in whatever you may be facing in your battle with cancer. You are not alone. We are caring for your life.

Melanoma/Skin Cancer Overview

Skin cancers include melanoma, basal cell, and squamous cell. Basal and squamous cell are common and treatment is very effective. Malignant melanoma can be difficult to treat. Early diagnosis and treatment can increase the survival rate from melanoma.

Skin cancers involve abnormal cell changes in the outer layer of skin.

It is by far the most common cancer in the world, accounting for 75% of all cancer diagnoses. Most cases are cured, but the disease is a major health concern because it affects so many people. The incidence of skin cancer is rising, even though most cases could be prevented by limiting the skin’s exposure to ultraviolet radiation.

Skin cancer is about three times more common in men than in women, and the risk increases with age. Most people diagnosed with skin cancer are between ages 45 and 54, although all forms of the disease are appearing more often in younger people. If you or any close relatives have had skin cancer, you are more likely to get the disease. Geography and race also factor into your chances of getting skin cancer, with the rate of skin cancer at its highest in places where fair-skinned Caucasians migrated from less sunny climes.

Every malignant skin tumor in time becomes visible on the skin’s surface, making skin cancer the only type of cancer that is almost always detectable in its early, curable stages. Prompt detection and treatment of skin cancer is equivalent to cure.

Skin cancer is often or usually caused by years of too much sun exposure. More than 90% of all skin cancers are found on body parts that get the most sun most of the time. The face, neck, ears, hands, and arms are common body parts that get skin cancer.

Skin cancer can often be prevented by avoiding overexposure to the sun’s ultraviolet rays (UV rays). UV rays from artificial sources, such as tanning beds or sunlamps, are just as dangerous as those from the sun.

The three main types of skin cancer are basal cell cancer, squamous cell cancer, and melanoma.

The ABCDE system is a guide to detect signs of skin cancer in moles or growths on the skin.

• Asymmetry. One half doesn’t match the other half.
• Border irregularity. The edges are ragged, notched, or blurred.
• Color. The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance. Changes in color distribution, especially the spread of color from the edge of a mole into the surrounding skin, also are an early sign of melanoma.
• Diameter. The mole or skin growth is larger than 6 mm (0.2 in.), or about the size of a pencil eraser. Any growth of a mole should be of concern.
• Evolution. There is a change in the size, shape, symptoms (such as itching or tenderness), surface (especially bleeding), or color of a mole.

Bladder cancer can often be successfully treated if found and treated early. Fortunately, most bladder cancer is found early.

The most common type of bladder cancer is called transitional cell cancer. This cancer starts in the inner layer of the bladder. It happens most often in people who are over 60 years old or older.

Experts don’t know what causes bladder cancer. But smoking cigarettes or being exposed to certain chemicals can raise your risk. Like other cancers, changes in cell DNA seem to play a role in bladder cancer as well.

Blood in the urine is the main symptom of bladder cancer. Other symptoms may include having to urinate often or feeling pain when you urinate.

Head and neck cancer is a term to describe a number of different malignant tumors that develop in the mouth, nose, sinuses, salivary glands, throat, and lymph nodes in the neck

Most of these cancers are squamous cell carcinomas. Squamous cell cancer begins in the flat cells that make up the thin layer of tissue on the surface of the structures in the head and neck. These cells are called squamous cells. Directly beneath this layer of tissue or lining, which is called the epithelium, some areas of the head and neck have a layer of moist tissue, called the mucosa. If the cancer is found only in the squamous layer of cells, it is called carcinoma in situ. If a cancer has grown beyond this cell layer and has  moved into deeper tissue, then it is called invasive squamous cell carcinoma.

There are five main types of head and neck cancer. Each type is named according to the part of the body where they develop.

• Laryngeal and Hypopharyngeal Cancer. The larynx is commonly called the voice box. It is a tube-shaped organ in the neck that is important for breathing, talking, and swallowing. It is located at the top of the windpipe, or trachea. The hypopharynx is also called the gullet. It is the lower part of the throat that surrounds the larynx.

• Nasal Cavity and Paranasal Sinus Cancer. The nasal cavity is the space just behind the nose where air passes on its way to the throat. The paranasal sinuses are the air-filled areas that surround the nasal cavity.

• Nasopharyngeal Cancer. The nasopharynx is the air passageway at the upper part of the throat behind the nose.

• Oral and Oropharyngeal Cancer. The oral cavity includes the mouth and tongue. The oropharynx includes the middle of the throat from the tonsils to the tip of the voice box.

• Salivary Gland Cancer. The salivary gland is tissue that produces saliva, which is the fluid that is released into the mouth to keep it moist and that contains enzymes that begin breaking down food.

Other types of cancer can also be located in the head and neck region, but the diagnosis and treatment are very different. There are brain tumors, eye cancer, esophageal cancer, thyroid and  parathyroid cancer, and sarcomas.

People with head and neck cancer often experience the following symptoms or signs. Sometimes, people with head and neck cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer.

• Swelling or sore that does not heal; this is the most common symptom
• Red or white patch in the mouth
• Lump, bump, or mass in the head or neck area, with or without pain
• Persistent sore throat
• Foul mouth odor not explained by hygiene
• Hoarseness or change in voice
• Nasal obstruction or persistent nasal congestion
• Frequent nose bleeds and/or unusual nasal discharge
• Difficulty breathing
• Double vision
• Numbness or weakness of a body part in the head and neck region
• Pain or difficulty chewing, swallowing, or moving the jaw or tongue
• Ear and/or jaw pain
• Blood in the saliva or phlegm, which is mucus discharged in mouth from respiratory passages
• Loosening of teeth
• Dentures that no longer fit
• Unexplained weight loss
• Fatigue

If you have one or more of these symptoms or signs on this list, please talk with your doctor.

Gallbladder cancer and bile duct cancer are rare. For this reason it’s very important to learn the signs and symptoms to spread awareness.

The gallbladder is a small 4″ organ below the liver in the upper right side of the abdomen. It plays an important role by storing the bile that the liver produces. Bile aids digestion by breaking down fat. Though the role of the gallbladder is important, you can live without it. The liver seems to function the same without it by storing the bile in bile ducts.

Risk Factors And Causes

While gallbladder cancer is rare, gallstones are the most common affliction associated with the gallbladder and gallstones are also the most common indicator of being at risk for gallbladder cancer. This does not mean that gallstones will always indicate cancer. However they are associated with some people who get gallbladder cancer. In addition to gallstones, the following are also risk factors:

• Gallbladder polyps. Polyps are small growths made from a buildup of cholesterol and are usually harmless, however on rare occasion they can be small, cancerous tumors.
• Being over 65 years old. Gallbladder cancer risk increases with age with the average age at  diagnosis being 72.
• Being female. Women are twice as likely to develop gallbladder cancer.
• Native American or Hispanic ethnicity.
• Having a family member who has had gallbladder cancer.
• History of an abnormality in the bile ducts.
• Being obese or overweight.
• Having a porcelain gallbladder, a condition in which the gallbladder walls harden with calcium deposits.

Risk factors for Bile Duct Cancer are similar to the risks for gallbladder cancer including obesity, having a family history of bile duct cancer and being of Native American or Hispanic ethnicity as well as the following risk factors:

• Having inflammatory bowel disease, Crohn’s disease or ulcerative colitis.
• Having diabetes can increase a person’s risk for bile duct cancer.
• High alcohol consumption. Alcohol consumption is a higher risk factor for those who have alcohol-related liver problems and also a risk for other diseases and cancer.
• Other diseases of the liver or bile ducts. Conditions such as bile duct stones, cirrhosis, hepatitis B or hepatitis C, and other conditions that cause chronic inflammation.
• An exposure to Thorotrast, which a substance that was used for x-ray contrasts before the 1950s. Thorotrast is not used any more.

Signs And Symptoms

Because of its rarity, many of these symptoms can be related to another condition so it is always best to see your doctor when you experience any of these symptoms.  

• Abdominal pain, especially below the ribs on the right side.
• Yellowing of the skin and eyes. This called jaundice and occurs when the liver has a blockage and cannot get rid of bile. This is common symptom of bile duct cancer, but is often a symptom of something else, such as gallstones. Be sure to see your doctor for evaluation.
• Losing weight without trying and loss of appetite.
• Itchy skin.
• Fever.
• Dark urine.
• Nausea or vomiting. Although these are rare symptoms, nausea or vomiting can be the result of a blockage in the bile duct and should always be checked by your doctor.

Prevention

Reducing risk for any cancer can be choosing lifestyle changes such as staying at a healthy weight, exercising and eating a heathy diet. In addition, the American Cancer Society offers these tips for reducing your risk:

• Stay as lean as possible without being underweight.  Avoid gaining extra weight at any age.
• Be physically active regularly.  Adults need 150 minutes of moderate exercise or 75 minutes of intense exercise every week.
• Limit staying seated for long periods and other sedentary activities such as watching TV.
• Eat a plant-based diet. Eat five cups of fruits and vegetables a day and limit your consumption of red meat and processed meat.
• Choose whole grains over processed grains.
• Limit alcohol consumption. This means one drink a day for women and two drinks a day for men.
• Don’t smoke, or quit if you do smoke.

Help spread awareness about gallbladder and bile duct cancer. Make good choices for yourself and family and help others to understand the importance of healthy lifestyle choices by sharing this blog or posting on social media.

Please call Mid Florida Cancer Centers for an appointment or if you have any questions regarding this blog or any questions regarding evaluation or treatment for yourself or family member, 386-774-1223

The holidays are supposed to be a time of sharing and love. It’s the time of year we spend with with those we care about, and feel grateful for what we have. Having to manage everything that goes along with the festivities can be challenging and even stressful. If you have been diagnosed with cancer, or your loved one has, or worse, it’s the time of year that reminds you that a loved one passed on and you miss them terribly, then the holidays are not just challenging and stressful, but also filled with difficult emotions, feeling physically sick, dealing with appointments and wondering how you will make it through. This can equate to perhaps, some of the most stressful times you’ve had to handle. There are ways you can help yourself and your loved ones. It doesn’t have to be as challenging as it seems. There are options for people diagnosed with cancer, their caregivers and advice for those seeking peace in a difficult time.

First of all, do not pressure yourself. Don’t try to do everything and definitely don’t do everything that you do decide to you, by yourself.  Ask friends and family for help with things, shopping, event rides, wrapping etc. There are people in your life that want to help you. Many times your loved ones aren’t sure how to help but they really want to. This is a great opportunity to ask! It’s empowering for you to let others help you. A lot people are very strong and also headstrong. They don’t want to ask or “burden” people to help them. But chances are if you are one of those people, you’ve been giving away your time and energy your whole life and it’s time to let others give back to you! AND your loved ones WANT to help you and will most likely be ready, willing and able to be there for you.

Secondly, get plenty of rest. It’s tempting to over do it, and exhaust yourself to “get it all done” But you may need more rest than anything else right now. And if you rest and take care of yourself, you will be able to truly enjoy those activities that you are able to do.

For those of you who have a loved one undergoing cancer treatment, you may be wondering what type of gift you can get them. Well, of course, as mentioned above, offer to help them with anything they need, whether holiday related or just help with appointments or offering comfort and support. But if you want to get them a gift, selecting something may feel like a delicate matter.

It’s important to consider a person’s cancer treatment plan when selecting a gift for them, but also give something that lifts their sprints and motivates them to stay strong and full of hope.

A good way to approach the situation is to find alternatives to typical gift giving ideas. Instead getting lots of candy or goodies, perhaps a gift card for lunch or dinner or deliver a home-baked  dinner. Instead of tangible items, if the person is able, give an art or music class. Perhaps a cooking class for healthy eating. Time becomes even more important than ever when a person is diagnosed with a serious illness and enjoying their time is valuable and very uplifting.

Gifts that are getaways are also wonderful! My best friend has stage IV breast cancer and loves to get away, though she is not always able. When I give her getaway gifts, I let her physical condition and treatment plan decide when and where we go. I may give a gift card or homemade coupon for a night away and let her choose when she feels up to going. People undergoing cancer treatment usually stay home a lot and can get “stir crazy” or “cabin fever.” Many times the only place they go is to the doctor for treatment. It can be very motivating to get away from the same 4 walls that they’re used to seeing every day. Even a trip to a park to watch a sunset or a drive on the beach with the windows down can lift their spirits.

Other gift ideas are a journal for writing, it helps get their mixed emotions.  A massage gift certificate helps, they can be very sore and stressed.  Aromatherapy such as scented candles and body creams, especially lavender as it helps to relax. Movie tickets are great if they are able to go. Take them to a comedy or buy them comedy DVDs. Its important to laugh and forget about cancer for a while.

It’s important to choose how to spend your time. Spend it wisely, choose what you really want to do. And it’s ok if you are not happy all the time. You are facing a challenging time in your life and it’s not easy. When times get emotional, let it out and take good care of yourself. Good self care is about making yourself a priority.

For those of you who have had a loved one pass on, be compassionate with yourself. If you are sad, be sad. If you are exhausted, get extra rest. Do try to spend time with those who love and support you, but it’s completely ok to have your sad time.  Where ever you are in your emotions, just let it be ok. Laugh, cry, scream into a pillow, allow yourself to feel whatever you feel this holiday season. People say the wrong things and it may be upsetting. Others don’t want to see you suffer,  yet they often say the wrong things. They may tell you it’ll get better, or to “cheer up, its the holidays” but unfortunately grief has its share of suffering. The only way to move through grief and struggle is to meet it head on. We cannot get through something without actually going through it. Feel whatever comes up for you, but try not to live in sadness, allow yourself to move through it and look for ways to enjoy some moments of the holiday season.

One thing everyone learns when cancer strikes their family, is that time is precious. We have healing to do and we also have a life to experience. Look for moments of peace and share them with others. Many people are holding deep pain and sorrow. We don’t know every one’s heart. But I do know a smile, a kind deed, or a helping hand can really give someone comfort at any precious moment.

Happy Holidays from Mid Florida Cancer Centers!

Dr. Gregory Ortega was recognized as a dedicated and caring doctor in our community. Vitas Healthcare honored Dr. Ortega at their annual hispanic physicians’ dinner with the Spirit of Life Award for his service to patients in Orange City, Deland and Sanford over the last 20+ years.

Mayor Laputka of Orange City was also there to honor Dr. Ortega for his dedicated and compassionate care for taking care of so many cancer patients over the years . Mayor Laputka read a proclamation recognizing Dr. Ortega’s caring service for the citizens of our community and proclaimed October 29 forever more to be recognized as Dr. Gregory Ortega day.

Dr. Ortega humbly accepted the award with a touching speech thanking the Mayor, Vitas Healthcare, his family and his fellow Mid Florida Cancer Center Physicians for this great honor.

Attending the dinner with Dr Ortega, his wife, daughter and his physician assistant, Lynn Coleman, PA, were fellow oncologists of Mid Florida Cancer Centers, Dr. Neeraj Sharma, Dr. Giselle Mery, Dr. Seema Harichand, Dr. Gary Graham, Dr Roderick Paras and Dr. Santosh Nair.

Dr Paras, Dr Harichand, Dr Mery, Dr Ortega, Lynn Coleman, PA, Dr Nair and Dr Sharma (left to right)

Dr Paras, Dr Ortega, Dr Nair, Dr Sharma, Dr Harichand and Dr Mery

Dr Ortega, Mrs Glennys Ortega and their Daughter Glennys Rubin

Dr Ortega and Dr Sharma with the Vitas Spirit of Life award

Dr. Ortega and Mayor Laputka of Orange City

Luz Melendez, Hispanic Community Liaison with Vitas Healthcare and Jill Jordan, Marketing and Public Relations Executive for Mid FL Cancer Centers.

Most of us know that October is the official month for breast cancer awareness. And just as many people have had their lives touched by breast cancer. It may their own diagnosis, or their family members, friends or colleagues. There are very few people who have not been touched by this disease in some way.

So, what does that mean for October? What do we do? We wear pink of course! But more importantly, we get screened with a routine mammogram. We encourage others to get screened. We do our self-exams and encourage others to do theirs. Self exams should be done every month! A close friend of mine felt her lump for couple months before seeing her doctor and it could have made the difference in her staging and treatment. She wishes she would have gone sooner.

Your body can give you signs. Listen to your body. If something doesn’t feel right or if you don’t feel right, it’s best to see a doctor. And yet sometimes we won’t get any signs, that is why it is so important to get an annual screening. October is a good reminder and there are also many reduced and free rates available to help those who can’t afford a mammogram.

In Florida, check this link for free and reduced rates.
http://florida-listing-of-organizations-that-offer-free-mammogram-scre.friendshelpingfriends.aidpage.com

Also LAD Imaging in Volusia County is offering patients without insurance a total cost of $80 for everything, which includes the mammogram imaging and the radiologists impression of the images.

If you haven’t had one yet this year, Please get your mammogram. Encourage your mothers, your sisters, aunts, daughters, girlfriends, cousins, colleagues and everyone you can!

Both lymphoma and leukemia result from problems of the white blood cells that is why we have the awareness month for both cancers in the same month.

In leukemia, bone marrow produces too many white blood cells that do not naturally die off the way that typical aging blood cells do. Bone marrow is the substance in your bones that produce red blood cells. In leukemia, healthy red blood cells get taken over by white cells that keep dividing and ultimately take over. Your body depends on for normal oxygen and nutrient transport in the red cells. Most blood cells form in bone marrow.
There are several different types of Leukemia.

The four main types are:
Acute myeloid leukemia (AML)
Chronic myeloid leukemia (CML)
Acute lymphocytic leukemia (ALL)
Chronic lymphocytic leukemia (CLL)

The type of leukemia depends on the type of blood cell that has become cancerous.
Leukemia can also start in the lymph nodes.

Lymphoma often begins in the lymph nodes. Lymph nodes are small tissues that help in your body fight against infection. Certain types of lymphoma may also occur due to the spread of abnormal white blood cells in other parts of the body.

There are several types of Lymphoma.
Lymphoma of the Skin
Hodgkin Disease
Non-Hodgkin Lymphoma
Non-Hodgkin Lymphoma in Children
Waldenstrom Macroglobulinemia

Many risk factors can be considered when diagnosing any type of cancer, however it is important to know, even with risk factors it does not mean you will get cancer. Many risk factors can be reduced such as not smoking, staying away from chemical and radiation exposure, living a healthy lifestyle, eating healthy and getting regular check ups with your doctor.

As always, pay attention to your body. It is better to ask your doctor then to just wait and see if something doesn’t feel right.

Mid Florida Cancer Centers wishes you and your family a wonderful July. We also want to make sure you take good care of your skin this summer. The American Cancer Society has named July UV Safety month to remind us to protect our skin from UV rays from the sun. Too much sun exposure can cause skin cancer.

Current estimates are that 1 in 5 Americans will develop skin cancer in their lifetime.
More than 3.5 million cases of nonmelanoma skin cancer, including basal cell carcinoma and squamous cell carcinoma, are diagnosed in more than 2 million people in the United States every year.
In 2015, it is estimated that 1 in 50 Americans will develop melanoma in their lifetime. (American Academy of Dermatology -see below for more info)