|ASK THE EXPERTS |
ASK THE EXPERTS
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.
If you think you or someone you know may be having a stroke, it is critical to get help immediately by calling 911.
Emergency treatments offered through Bridgeport Hospital’s Stroke Alert process can greatly reduce the damage
caused by a stroke. A medication called tPA may dissolve stroke-causing blood clots and lower the risk of permanent
disability. However, it is crucial to arrive at the hospital as soon as possible following the start of symptoms to
begin testing to determine if the stroke sufferer qualifies for this medication.
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,
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.