Q: My father had a stroke in his 60s and I’m very worried that history will repeat itself with me. What can I do to prevent having a stroke?

Neurologist Philip Barasch, MD, co-medical director of Bridgeport Hospital’s Stroke Center, responds:

A: While research has determined that genetic factors for stroke are real, pinning down a person’s exact risk still cannot be determined. Nonetheless, you can reduce your chances of having a stroke by controlling certain risk factors with medication and by making a few lifestyle changes.

There are many risk factors that you and your physician can control. Perhaps the most important is control of high blood pressure which, through medication and lifestyle modifications, can reduce your stroke risk by up to 40 percent. Losing weight, eating plenty of fruits and vegetables, exercising for about 30 minutes a day and quitting smoking also contribute to your overall cardiovascular health. Other important factors to lessen risks include controlling diabetes and high cholesterol, and avoiding heavy alcohol consumption.

People with certain heart conditions, such as atrial fibrillation, have a high risk of developing a stroke. Anticoagulant (blood thinning) therapy and surgery can reduce that risk. [See cover story.] You may also want to talk to your physician about aspirin and vitamin therapies.

If you (or a loved one) develop stroke symptoms, an emergency evaluation at a Joint Commission-certified stroke center, like the one at Bridgeport Hospital, can limit the brain damage that a stroke can cause.

Q: My father’s doctor has recommended IMRT as a treatment for prostate cancer. What is IMRT and how does it compare to other treatments?

Paul Berger, MD, Chief of Radiation Medicine at Bridgeport Hospital, responds:

A: Radiation therapy kills cancer cells and can shrink or eliminate cancerous (malignant) tumors. The Norma F. Pfriem Cancer Institute at Bridgeport Hospital offers cancer patients a range of sophisticated radiation treatment options, such as external beam radiation therapy and brachytherapy, which involves placing radioactive pellets (also called seeds) in or near a tumor. Thanks to new technologies that permit ultra-precise dose delivery, radiation therapy is becoming increasingly more effective.

Intensity-Modulated Radiation Therapy (IMRT) is among these technologies. IMRT delivers a precise radiation dose directly to a tumor or areas within the tumor. Targeting exactly where the dose is delivered minimizes radiation exposure to the surrounding normal tissue. As a result, higher and more effective radiation doses can be safely delivered to tumors with fewer side effects compared with conventional radiation therapy techniques.

The accuracy of IMRT for treating prostate cancer, however, requires that the target is defined and treated every single day. Due to its location, the prostate can naturally shift or move around from day to day, affecting the precision of the treatment delivery. To handle this, Bridgeport Hospital recently added Image-Guided Radiation Therapy (IGRT) for prostate radiation. With this system, gold seeds are placed in the prostate before treatment begins. During treatment, the location of the seeds is identified, and very small targeting adjustments are made, if necessary. Once the targeting is assured, treatment can be delivered.