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Breast cancer is the leading cause of cancer deaths in women in the U.S. That’s why early detection is so important. Dr. George Krakora, a radiologist with Renown Institute for Cancer, explains what to watch for and how new technology can lead to early detection. Most women know the importance of breast health and staying current with annual breast exams, but may not know that both screening guidelines and technology is evolving. So we asked George Krakora, MD, a radiologist for the Renown Institute for Cancer, what every woman should know about breast cancer detection and which screening method is right for them. First off, when should women start getting breast exams? Generally, women should start getting breast exams using mammography or ultrasound after they turn 40 years old. But we also want women ages 18 to 39 to talk to their primary care provider and ask for what’s called a formal risk assessment to see if screening is needed sooner. And you want to make sure your care provider is giving you a breast exam starting at age 25. It’s also a good idea to be familiar with how your breasts look and feel so you can report any changes to your care provider. What are the risk factors for breast cancer? Are there any preventive steps women can take? There a few risk factors you can’t control, like your age, family history of breast or other cancers, and if you have dense breast tissue. Your risk for breast cancer increases as you get older, and most breast cancers are diagnosed after age 50. Knowing your family history is important because a history of cancer and shared lifestyle can raise your risk. Your breast density can also increase your risk: Women with high breast density are four-to-five times more likely to get breast cancer than women with low breast density. But the good news is there are quite a few things you can do to prevent breast cancer, like not smoking, watching your alcohol intake, and maintaining a healthy weight with good diet and exercise. There are a lot of newer screenings out today. What is the difference between 2-D and 3-D mammography? In a 2-D mammogram, the tech takes X-rays of the breast. These pictures can show the radiologist if there are any lumps or tumors you might not be able to feel. In 3-D mammography, the process is largely the same but more X-rays are taken and it takes a few seconds longer for each image. This kind of exam detects 41 percent more cancers and reduces the number of false-positive results given to patients. This improvement in technology is great for both patients and their care providers. 3-D mammography provides better images of the breast, which allow doctors to more clearly diagnose and avoid false positives, especially in women with dense breast tissue. And what about a whole breast ultrasound. What is that? A whole breast ultrasound uses sound waves to detect cancerous tumors in the breast without using any radiation — it’s an ultrasound just like pregnant women get to check up on their baby. And the exam only takes about 20 minutes. We recommend these exams for patients whose mammograms have shown that they have dense breast tissue. Dense breast tissue can make it harder for doctors to see any abnormalities, lumps or tumors in a mammogram, so this technology ensures better early detection.

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Did you know certain medications can interact with everyday food and drink? We asked Pharmacy Manager Adam Porath how to take these important medications safely. One in five Americans between the ages of 40 and 75 are currently taking a statin drug to reduce their cholesterol level or to prevent atherosclerosis (hardening of the arteries). Many others also take anticoagulants (blood thinners) to prevent blood clots from forming, which can increase the risk of stroke. Adam Porath, pharmacy manager with the Renown Institute for Heart and Vascular Health’s Anticoagulation Program, explains how to safely take these medications. What is a statin? A statin is a drug that can lower cholesterol by helping your body absorb cholesterol or by blocking a substance your body needs to make it. The American Heart Association cites a global study reporting the benefit of statins to help reduce heart attacks and strokes. Common statins include atorvastatin (Lipitor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). Which foods or drinks should be avoided while taking statin drugs? Grapefruit juice is the only food or drink that has a direct interaction with statins. Statins do not directly interact with any food but people taking statins should moderate their intake of saturated fats to help lower their LDL cholesterol and overall risk of cardiovascular disease. What is a blood thinning drug? Blood thinning drugs, such as warfarin, rivaroxaban (Xarelto), apixiban (Eliquis), dabigatran (Pradaxa) and edoxaban (Savaysa), are used to prevent stroke. Which foods or drugs should be avoided while taking blood thinning drugs? If taking warfarin, alcohol and cranberries (including juice) should be avoided. Patients taking warfarin should be aware of foods that contain Vitamin K (green leafy vegetables) and try to maintain a consistent diet of these foods. Warfarin interacts with many over the counter and prescription medications. Patients should consult a pharmacist when starting, stopping, or changing doses of any medication when taking warfarin. Also, patients taking any blood thinning medication should avoid over-the-counter pain relievers (i.e. aspirin, ibuprofen, etc.) How do I know whether to take my medication with food or not? Consulting with a pharmacist is the best resource to determine if a medication should be taken with or without food. In general, all statins and blood thinners can be taken with or without food. The only exception is Xarelto (rivaroxaban), which should be taken with the largest meal of the day If you are a Renown patient you can also review your prescriptions online, request a refill or ask a question via MyChart. With MyChart, you can access all your healthcare information securely 24/7.

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Some people drive for hundreds of miles just to pitch a tent in what we're fortunate enough to call our backyard. From alpine hiking trails and miles of remote forest to desert lakes and spectacular night skies, there's no better way to unwind and explore the outdoors than camping. If you've been daydreaming of hiking trails and swimming holes or looking for a tranquil and adventurous family vacation,  it's time to clear your schedule, pack up the car and venture into the Great Outdoors.  We've got six fun and beautiful camping getaways you need to experience this summer that will leave you feeling relaxed and rejuvenated. And best of all, they're just a short drive away.  Emerald Bay State Park South Lake Tahoe, Calif. Highway 89 Summer Boat-In Camping: Available by reservation. Accessible by boat or foot.  Cost: $35 per night Dogs? Allowed in campground on a 6 foot leash. They cannot be on trails or roads into Emerald Bay or on the beach.  Information/Reservations: 530-525-7232 or www.reserveamerica.com To say this camping location is stunning is an understatement. If you're seeking a view from your campsite of blue lake waters, thick forest and jutting rocks, than this is the spot for you. This campsite is located on the north side of Emerald Bay, at old Emerald Bay Resort, and offers hiking and walking trails and easy access to Lake Tahoe. There are also large rocks you can jump from into the lake.   Davis Creek Regional Park West Side of Washoe Valley US 395 South  Cost: $20, cash only Dogs? Yes. $1 per night fee per pet and they must be leashed. Information/Reservations: (775) 823-6501 or www.washoecounty.us/parks Located in the foothills of the Carson Range 20 miles south of Reno, Davis Creek campground offers over 60 overnight sites along with equestrian trailheads that provide access to the Toiyabe National Forest. The campsite is well-known for outstanding views of Washoe Valley and Slide Mountain and includes picnic areas, a small pond and nature trails. Showers are also available.  Donner Memorial State Park Truckee, Calif.  12593 Donner Pass Road Cost: $35 per night Dogs? Contact for information. Information/Reservations: (530) 582-7892 or www.parks.ca.gov If you're looking for a little more to your camping adventure than what nature has to offer, Donner Memorial State Park may be the ideal campground for you. The park includes the Emigrant Trail Museum, with historical and regional exhibits including the Donner Party tragedy during the severe winter of 1846, as well as hiking trails, Donner Lake swimming and picnic areas. Fallen Leaf Campground South Lake Tahoe, Calif. 2165 Fallen Leaf Road Cost: $33 to $84/day Dogs? Allowed at tent and RV sites (a maximum of two pets per site); prohibited on beaches. Information/Reservations: (530) 544-0426 Nestled among pine and aspen trees and wildflower meadows, Fallen Leaf offers campers the best of both worlds: mountain landscapes and lake recreation. Located less than a mile away from the south shore of Lake Tahoe, the campground features more than 200 camping sites including tent, RV and several yurt rentals.   There are many shady campsites for campers to choose from, as well as food lockers, toilets, showers and a general store. The lake is only a short walk from the sites and features views of Cathedral Peak (8,200 feet) and Mount Tallac (9,738 feet) and there are several trails for hikers. Pyramid Lake Marina & Beach Camping Pyramid Lake Pyramid Lake Store, 29555 Pyramid Lake Road Cost: $9 per day Dogs? Allowed without restrictions. Information/Reservations: 775-476-0555 or www.pyramidlake.us The largest natural lake in Nevada, just 40 miles from Reno, is located between the Virginia and Lake Mountains on Paiute Indian land -- the Pyramid Lake Reservation. It's an ideal locale for boating and fishing and for those who are looking for remote beach camping and easy access to swimming. There are multiple camping spots around the lake -- including an RV park and designated and open camping -- but campers must obtain a tribal camping permit prior to settling in. Note: This is a desert lake and therefore, has limited shade. Campers should plan accordingly with shade sails and pop up shade tents.  Camp Richardson Resort South Lake Tahoe, Calif.  1900 Jameson Beach Road Cost: Contact for specifics.  Dogs? No.   Information/Reservations: 800-544-1801, reservations@camprichardson.com  Whether you're seeking the solace of a shaded forest or craving lazy beach days, Camp Richardson offers a wide variety of camping and lodging needs. Located on the south shore of Lake Tahoe, Camp Richardson features over 30 cabins, 26 lodge hotel rooms, a beachside inn, duplex and house, as well as 200 tent camping sites and 100 RV sites.  The resort campground offers year-round camping and a wide variety of services, including a marina, sports center, restaurant and a store.

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According to the American Cancer Society, approximately 14,100 new cases of invasive cervical cancer will be diagnosed, and 4,280 women will die from cervical cancer. However, cervical cancer is preventable with regular screening tests and the HPV vaccine. It’s important to note that medical advances have allowed progress in diagnosing and treating cervical cancer. While it used to be one of the most common causes of cancer death for American women, the incidence of death has significantly declined. What to Know About the HPV Vaccine HPV vaccination is the best way to prevent cervical cancer and is recommended for all youth starting as early as age 9, or for teens and adults up to age 45 who didn’t start or finish the series. In Nevada, only 50.1% of teens ages 13-17 have been vaccinated for HPV.  There are 13 types of HPV, and the vaccine Gardasil 9 protects against 9 of those HPV strains, greatly reducing the incidence of cervical cancer among vaccinated individuals. What to Know About Cervical Cancer Screenings The CDC says the most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. And there are two common tests that can detect early stages of cervical cancer (or precancer) and improve health outcomes. The pap test (or pap smear). This screening looks for precancers. Women should begin getting pap smears when they’re 21. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. Cervical Cancer Screening Schedule The American Cancer Society offers the following guidelines for screenings: All women should begin cervical cancer screening at 21. Women between 21 and 29 should have a pap test every three years. Beginning at 30, the preferred way to screen is with a pap test combined with an HPV test every five years. This is called co-testing and should continue until age 65. A pap test (or pap smear) is performed during a regular screening appointment to look for precancers, cell changes on the cervix that might become cervical cancer if they are not evaluated or appropriately treated. Typically outpatient procedures can reduce the risk of long-term health impacts that prevent pre-cancerous cells from becoming cancer cells. Women over 65 who have had regular screenings in the previous ten years should stop cervical cancer screening as long as they haven’t had any severe precancers found in the last 20 years. How to Get Screened Request an appointment with your primary care physician or OBGYN to schedule a screening.

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March is Colorectal Cancer Awareness Month, and we want you to receive the best preventative care possible. Early detection can help prevent serious illness, yet many people still choose to skip their annual exams and routine screenings. Bonnie Ferrara, MD, MPH, Section Chief for Primary Care at Renown Medical Group, further explains the importance of this simple, easy way to stay healthy. Why are annual exams so important? The benefits of early detection and prevention to save lives and reduce the impacts of disease have been proven. These exams are the perfect opportunity to get your health questions answered. “This is your chance to sit down with your provider and talk about your overall health and your family’s health history as well as your concerns for the future,” says Bonnie Ferrara, M.D., family medicine. “It’s the opportunity for your provider to talk with you about your lifestyle, tobacco use, exercise and alcohol use, all of which make a difference in your future longevity.” The annual wellness exam is also an ideal time for most adult patients to discuss health screenings. In addition, these visits are the perfect time to address issues that may not directly relate to a particular medical problem or immediate illness. A good rule of thumb is to schedule these appointments around your birthday each year to make sure you and your provider are both updated on your care. Why would you need an annual exam if you aren’t feeling sick? According to Dr. Ferrara, seeing your care provider when you aren’t sick is one of the best times. “It is better if you try to arrange this visit when you are not feeling ill,” she says. “It is an opportunity to talk about wellness. Not only how to contribute to your wellness but also the changes that you can make that will make huge dividends in the future for your wellness. In addition, it allows us to do some education about what to expect in the coming years as far as your health and lifestyle changes.” What can you expect at an annual exam? Annual exams usually check your: History – lifestyle behaviors, health concerns, vaccination status, family medical history Vitals – blood pressure, heart rate, respiration rate and temperature General appearance – your care provider can find out a lot about you just by watching and talking to you Dr. Ferrara adds, “If this is a Medicare annual wellness exam, it is an opportunity to talk to your provider about depression and dementia as well as be tested for those.” You can also leverage your annual exam to speak to your provider about managing your chronic health problems. "As a provider, these visits give us the opportunity to hear how the medications and lifestyle changes we have recommended are working and if you are having problems with these, we have the opportunity to make suggestions of how to do things better for the future," Dr. Ferrara.

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