Albert Dabbah, MD PA
Albert Dabbah, MD PAOCTOBER 2010
In This Issue
Mammogram or Not...
Salon UV Lights
High Risk Cancer Patients Options
Reconstruction Following Mastectomy
Our Insurance System At Work
Fall Into Apples Soup
Quick Links
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To Our Patients and Friends, 
As I am sure you know, this month is Breast Cancer Awareness Month. I tend to be skeptical about the research I read, but I thought these issues were interesting enough to inform.  And, being that I am always keeping up with the evolving health care issue (crisis?), I thought I would update on the new events.
Stay healthy and enjoy the new soup!!
Robin  
Mammograms In Your 40s - Yes? or No?
A study in Sweden of 1 million women in their 40s has shown that mammograms can help lower the risk of dying from breast cancer to approximately 26%, stirring up controversy in the United States.  Last year it was determined by a US panel of scientists that the benefits were so little that breast cancer screening in this age group was not recommended.  And last week there was a study in Norway suggesting that the benefit to screening women in their 50s was less than once believed. FoxNews.com, 9/30/10
What to do?? As always, speak to your doctor.
Salon UV Lights - Skin Cancer?
Nails and Lamps
One source of ultraviolet radiation which is overlooked is the UV nail lamp found in nail salons.  These lamps are emit predominantly UVA rays, which penetratre the skin deeply. Although there are no large studies, the Archives of Dermatology described two cases of healthy middle-aged women without family histories of skin cancer who developed non-melanoma skin cancers on their hands. If you consider that a person uses a nail lamp 2 to 4 times a month, the amount of UV radiation adds up. The New York Times, 8/2010.  This was disuputed by three nail industry scientists in the Nail Magazine Blog. 8/18/2010, who stated that the amount of UVA radiation was overestimated and improperly characterized in the Archives. They state that the amount of UVB radiation is less than the natural sunlight.
High Risk Patients Cut Cancer Risk by Breast, Ovary RemovalWomen's Breast Cancer Logo
Women have many options if diagnosed with the BRCA gene mutations: surgery, preventive chemotherapy, or a stepped-up screening regimen that includes frequent mammograms. The Journal of the American Medical Association confirms that preventive mastectomy and (oophorectomy (ovary removal) in patients carrying the BRCA-1 and BRCA-2 gene mutations, slashed the risk of developing cancer. For 4 years, researchers at 22 institutions across Europe and the US followed approximately 2500 women with the BRCA gene. Here are the statistics, as I understand them: None of the women who underwent preventative mastectomy developed breast cancer during the study, whereas 7% of those who opted against, did. One percent of women who opted for at least one ovary and fallopian tube (salpingo-oophorectomy) removal got ovarian cancer, compared to 6% of women who didn't have the surgery. The rate of breast-cancer diagnosis was lower in women who had the ovary and fallopian tube removed (11%) compared to those who did not (19%). The women who had an ovary and fallopian tube removed cut their risk of dying from ovarian cancer by 79% and breast cancer by 56%.
Being that this is Breast Cancer Awareness Month, I decided to write this emotional and, possibly, politicizing article. This article undoubtedly gives patients information requiring further discussion with their doctors. JAMA,9/1/2010 Health.com, 8/31/2010
Did You Know?
 
A study by Steven Katz, MD of the University of Michigan Medical School and health management and policy at the UM School of Public Health found that only 1/3 of the patients who undergo mastectomy go on to have reconstruction. The reason? In those 1/3 cases, plastic surgeons have been a team member during the initial treatment decision.  "This is a deeply intimate and important decision that women have to make.  It should be made with the right information about reconstruction options in consultation with a plastic surgeon involved up front in the treatment planning." Dr. Katz adds, "breast reconstruction is a very complex treatment issue and requires a lot of discussion."  There are many reasons why a woman may not have reconstruction, but the researchers concluded that 31% of the variation could be attributed solely to how often a woman's surgeon talked to a plastic surgeon prior to mastectomy
.
University of Michigan, news release, 9/1/2010. Health.com, 9/3/2010.
"Child-Only" Insurance Plans - No More
Little Boy Holding Dad's Hand
One result of the new healthcare mandate is affecting Floridians now.  The private insurance companies, Cigna, Humana, Aetna, United and Blue Cross/Blue Shield have stopped writing new policies for children only.  Their concern is that parents will wait until their children get sick to purchase insurance.  "The [new] regulations that were issued provide a very powerful incentive for patents to wait until their children are sick to buy coverage - which drives up costs for everyone else", said Robert Zirkelbach of America's Health Insurance Plans.
FALL INTO APPLES SOUP
Bringing together sweet potatoes with their vitamins a and c, dietary fiber and minerals like manganese and copper, and apples with vitamin c, dietary fiber and phytonutrients, proves to be a delicious combination.  This soup will be perfect for those, hopefully, chilly nights ahead.
Curried Sweet Potato and Apple Soup (serves 4)
3 medium sweet potatoes
3 TBL unsalted butter
1 small onion, chopped
2 cloves garlic, smashed
1 2-inch piece of ginger, peeled and grated
1/4 teas freshly grated nutmeg, plus more for garnish
1 1/2 teas Madras curry powder
Kosher salt and pepper
2 cups low-sodium chicken broth
1 1/4 cups chunky applesauce
1 TBL extra-virgin olive oil
1 TBL apple cider vinegar
1 to 2 TBL chopped fresh cilantro
 
Preheat oven to 425. Peel and dice 2 1/2 sweet potatoes. Melt 2 TBL butter in a large pot over medium heat. Add the onion and garlic and cook until soft, about 5 minutes. Stir in the ginger, nutmeg, 1 1/4 teas curry powder, and salt and pepper to taste and cook until toasted, 1 more minute.
Add the died sweet potatoes, chicken broth and 2 cups water to pot, cover and bring to a boil over medium-high heat.  Reduce the heat to medium-low and stir in the applesauce. Simmer, covered, until the sweet potatoes are soft, about 20 minutes.  Puree the soup with a blender until smooth. Season with salt and pepper; keep warm.
Meanwhile, peel and thinly slice the remaining 1/2 sweet potato and toss with the olive oil, and salt and pepper to taste. Spread thinly on the baking sheet and bake until crisp, 7 to 10 minutes.
Heat the remaining 1 TBL butter in a skillet over medium heat. Add the remaining 1/ teas curry powder and cook, stirring, until browned; remove from the heat and add the vinegar. Top with the curry butter, cilantro and sweet potato chips.
FoodNetwork.com
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