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Why family history can increase risk of breast cancer

May 26, 2016 by drjaffer

All cancer (not just breast cancer) is the result of a mutation in the cells. Sometimes this mutation is passed down from parents to their children in their genes. Other times, this mutation arises over the course of a person’s life – for example, from exposure to common carcinogens, like cigarette smoke. While one of the pillars of preventive medicine is avoiding disease-causing agents such as carcinogens, there is nothing we can do to modify the genetics we received from our parents. As a result, when mutations may have been passed down to us, it is important we practice proper screening techniques in order to determine how how our risk might be and to catch any potential diseases early, while they still may be treatable.

canstockphoto3960617Breast cancer is common enough that about 1 in 8 women will develop some form of it in their lifetimes. It is a disease that all women need to be aware of and should be screened for at the appropriate age. Even men can develop breast cancer; we all share some amount of risk.

But of these women, between 5 and 10% of them are thought to develop breast cancer as a result of hereditary mutations in their genes. This might seem like a relatively small number, but still impacts thousands of women each year. And some of these mutations result in cancer a very high rate – as much as 80% of women with the well-known BRCA1 may develop breast cancer over their lifetimes. And while other relatively common mutations may have lower rates of cancer, many of these cancers tend to develop in both breasts, or at earlier ages, during periods of women’s lives when they would not normally be tested for cancers. As a result, these cancers may go undetected for long periods of time, leading to much greater mortality. Last but not least, these mutations often go hand-in-hand with other forms of cancer, such as ovarian cancer, making them even more dangerous if undetected.

The reason it is important to be highlight these genetic risk factors is not to scare or upset you – it’s to help you understand the importance of your family medical history. The best defense (in fact, the only defense) against these genetic factors is being aware of any family history of breast cancer or other cancers, and knowing when it’s right to bring this information to your doctor. At that point, the two of you can work together to form a screening and prevention strategy that is right for your particular case. Through early detection and proper preventive techniques, we can take the fight to breast cancer, instead of letting it come to us.

For a detailed chart of “red flags” in your family history that can help you know when to alert your doctor, take a look at this breast cancer family history infographic.

Filed Under: Breast Cancer, Cancer Prevention, Featured, Women's Health Tagged With: brca1, brca2, breast cancer risk factors, family history breast cancer, genetic breast cancer, mother had breast cancer, mutation

Should you consider Genetic Testing for breast cancer risk?

May 26, 2016 by drjaffer

The most important thing to consider when it comes to genetic testing is family history. Typically, if you don’t have a family history of breast cancer, and are not of Ashkenazi Jewish heritage, you do not need to get genetic screening to determine if you might be a high-risk patient.

So what should you look out for when it comes to family history? We’ve made a handy infographic to help outline the major red flags.

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Filed Under: Breast Cancer, Featured, Women's Health Tagged With: brca1, brca2, breast cancer risk factors, family history breast cancer, genetic risk factors, mammogram, ovarian cancer, when to get tested

Gun Violence Screening E-book Live!

May 19, 2016 by drjaffer

Gun ScreeningThis marks the launch of our 3rd e-book in the Adult Guide: Health Screening and Prevention line: Gun Screening in the Doctor’s Office! This pamphlet focuses on medical screening for gun violence. It’s designed to help you understand your rights, why doctors may be asking you about gun ownership and domestic violence issues, and how that information can be used.

When we released the original Health Screening and Prevention guide, we expected the gun violence screening section to be one of the most controversial parts of the book. Our nation has suffered from a wave of violent shootings in recent years, and the Affordable Care Act (Obamacare) has introduced new controversy into the debate over doctors’ roles in helping screen for and prevent gun violence and dangerous incidences of mental health disorders.

This book is streamlined to focus on the reasons for screening while also providing information on the laws and regulations surrounding the practice. Medical screening for potential gun violence in on the rise, and while it is not mandated by the government many doctors consider it their professional duty to speak with their patients about potential risk factors and possible solutions.

We’ll be releasing these “mini-e-books” for each of the major chapters covered in the big e-book, and we’ll continue to update you here each time a new release goes live. Until then, we hope you find this guidebook to be useful!

If you have any questions, please feel free to e-mail us at drsalimjaffer@gmail.com, or leave a comment below!

Filed Under: E-book, Featured Tagged With: 2nd amendment rights, affordable care act, death by gun, ebook, firearms screening, gun violence screening, obamacare, why is my doctor asking me about guns

Why We Don’t Fund Gun Violence Research

May 19, 2016 by drjaffer

Original Title: 19 front 27b_5x
CDC Headquarters in Atlanta

Whether or not guns themselves are a problem in our society may be a matter opinion, but one thing that we should all agree on is that we should have good data on how and why gun violence is committed (as well as the who, what, where, and when).  Both private citizens and law enforcement deserve to know when they might be at risk and what they can do to protect themselves, while doctors would better understand how to identify high-risk patients with mental health issues that might predispose them to violence. This should make sense regardless of political affiliation or how you feel about gun ownership.

And yet we have very little data. In fact, we perform almost no research at all on gun violence in our country. And the reason is entirely political – provisions in the annual appropriations bill (which directs federal funds toward research) prevents any money from being spent on gun control… and for decades, the NRA has been successful at branding “gun violence prevention research” as a sub-category of “gun control”.

It was 1996 when we passed legislation intended to strip the CDC of the ability to fund gun control research. The law was taken a step further, however, and the CDC essentially stopped performing any gun violence research at all. Since then, this ruling has also been applied to the National Institute of Health (NIC). As a result, for the past 20 years the United States has collected virtually no data on gun violence that could be used to curb or head off future incidences before they happen. And the result is that we have only limited private studies to look at when trying to figure out what to do about gun violence outbreaks, leaving our law officers and doctors mostly powerless. Even the senator who wrote the bill expresses deep regret at the results of his actions, stating that the law has been over-interpreted and resulted in unnecessary loss of life.

On top of all this, the NRA has fought in recent years to restrict doctors from asking their patients questions related to gun violence prevention. While they have been unsuccessful in preventing doctors from doing their jobs, they still have managed to force language into the Affordable Care Act and other provisions preventing the collection of data. They have managed to keep medical professionals from treating gun violence deaths as a “preventable disease”, despite similar causes of death being treated as such.

While there have been efforts to reverse these restrictive laws and open up the field of research for the public good, so far these attempts have amounted to nothing. The NRA and legislative allies have decided that public knowledge is a threat to the 2nd amendment, despite the fact that most Americans support gun ownership. The most recent attempt to end the ban on gun violence research is likely to go nowhere, at least until public opinion changes on the matter enough to pressure congress into taking action.

For now, we’re firing in the dark.

Filed Under: Featured, Gun Violence Tagged With: affordable care act, appropriations act, cdc, gun control, gun research, gun violence, murder, NRA, obamacare

The Many Faces of Gun Violence

May 14, 2016 by drjaffer

Gun violence is not always a mental health issue.

Gun violence is not always an anger issue.

Gun violence is not even always intentional.

Gun violence has many faces, and it is impossible to identify them all in time to prevent it completely. Tragedies can spring from many sources: the disenfranchised loner with a score to settle, the mentally unstable man or woman on a mission, the road rage incident gone too far, the radicalized militant, or even the child who accidentally discharges his mother’s pistol in the back of the car.

There is no single profile for a person likely to commit gun violence. Even mental health issues is not a particularly good indicator of someone likely to commit violence. There are, however, a number of warning signs that we can use to paint a better picture. It is for this reason that doctors have started screening individual patients to determine whether they – or their family members – are at risk of committing, or being targeted by, gun violence.

 

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Some good red-flag questions to ask yourself that may indicate an increased risk:

  • Does your household contain unlocked guns that can be accessed by someone, such as a child or visitor, or are kept readily at hand to be quickly retrieved in an emotional moment, such as rage?
  • Do members of your household threaten each other with violence, either verbally or physically?
  • Has a member of your household ever pointed a gun, loaded or not, at another member of the household?
  • Does someone with mental health issues in your household have access to firearms? If so, do these particular mental health issues suggest an increased risk?

An important thing to note is that these questions largely focus on the behaviors of the people in proximity or possession of the guns, as well as how the guns are stored and accessed. Stopping gun violence is not so easy as focusing on a broad group of people – even those with mental health issues – but must instead start with looking at the individual’s relationship with guns and violence in general.

Filed Under: Featured, Gun Violence Tagged With: faces of gun violence, gun screening, gun violence, red flags, who commits gun violence

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About Dr. Jaffer

Salim A. Jaffer, MD, MS, practices clinical gastroenterology in Lansing, Michigan. He received his Doctor of Medicine degree from the University of Toledo in Ohio.

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