Greensburg Daily News, Greensburg, IN

February 5, 2014

February is cancer prevention month

By Rob Cox Daily News
Greensburg Daily News

---- — GREENSBURG — The passage of January into February means the American Cancer Society is turning its calendar to National Cancer Prevention Month.

For Decatur County Memorial Hospital (DCMH) hematologist/oncologist Dr. Jaime Ayon, M.D., EVERY month – indeed, every week and day – is a time to educate about and encourage cancer prevention. In fact, you might say cancer is Dr. Ayon’s life; it’s certainly an important part of his livelihood.

Ayon took time from a busy schedule last week to speak with the Daily News about how cancer prevention relates to his own patients, who generally suffer from cancers of the colon, breast, lung and/or bladder. He also treats other types of cancer, including leukemia, bone cancer and others.

He began the interview with a simple definition of what it means to be a hematologist. Hematology, he said, is the study and treatment of both “benign and malignant processes in the blood,” and of “blood disorders.”

Oncology, of course, is the study and treatment of cancer.

The Ecuador native comes from a middle-class background, and his interest in medicine started at a young age, with both parents being radiologists. While attending high school, he regularly assisted them in their practice, which instilled in him a deep, lasting interest in medicine.

He attended medical school in Ecuador, practicing there before being accepted to train in the United States at Nassau University Medical Center in Long Island, N.Y.

There, he started in internal medicine and, as part of his rotation, eventually landed in oncology, where he soon realized he’d found his calling.

He credits his mentor, Dr. Linda Carmosino, M.D., Nassau’s director of oncology and vice chair of internal medicine, with helping foster his interest in oncology and with helping guide his training into a successful, compassionate, patient-focused oncologist. “She was a big patient advocate,” Ayon said of his mentor. “She was extremely patient-care focused and compassionate.”

Of course, having an extremely accomplished mentor was only part of Ayon’s development into a respected oncologist. The other part of the equation was – and still is – his inherent love of the field itself.

“These patients require complex care,” he explained. “As a doctor, you must be able to guide these patients.” The complexity of treating cancer patients makes favorable outcomes all the more rewarding, he added.

Interestingly, the treatment of this potentially multifaceted, frequently life-threatening disease often (but not always) starts with a fairly simple, straightforward line of defense. “Prevention,” Ayon said, “is the best medicine.”

The doctor offered a general set of guidelines patients can follow to help avoid several types of cancer, as well as several, more-specific preventative measures related to colon, breast, lung, and bladder cancers.

Throughout the interview, which was also attended by members of Ayon’s staff, one piece of advice emerged again and again regardless of the type of cancer discussed: Stop smoking – or better yet, don’t start.

Moreover, while quitting smoking can aid patients in the fight to prevent several cancers, the health benefits of stopping extend much further. Smoking, the doctor explained, has a destructive impact on a patient’s overall health and wellbeing, with a pronounced effect on heart disease, diabetes, bronchitis and a range of other ailments.

Ayon also recommended regular exercise and a healthy diet as further general measures people can observe in the battle to prevent cancer.

“We have so many screening tools to find cancer, too,” he added, advising that regular patient checkups with primary care physicians (PCP) can be especially effective in helping detect colon, breast and lung cancers as early as possible; early detection – effectively stopping cancer in its tracks – is a critical aspect of prevention.

With breast cancer, Ayon continued, prevention and early detection is also largely up to the patient. Regular, monthly self-exams, he explained, play a vital part in preventing this potentially devastating disease from progressing to advanced stages. Any woman who finds bumps or lumps in the breasts or armpits during a self-examination should see her doctor as soon as possible.

Regular mammograms are another tool for helping detect breast cancer as early as possible. Ayon recommended that most women – those with a normal, cancer-free history – should begin having yearly mammograms at age 40.

He noted, however, that women with a specific mutation in the BRCA gene should begin regular mammograms at least 10 years earlier – at age 30. This hereditary mutation causes a disposition toward the development of breast and ovarian cancers compared to women without said mutation.

Ayon further recommended that women with a family history of breast cancer should also begin regular mammogram screenings at age 30.

Another group at a greater risk for breast cancer is women with “dense breast tissue.” Because dense breast tissue and lumps are both white on a mammogram, cancerous tissue can go undetected in these patients. The state of Indiana, in fact, requires women with dense breast tissue to be notified and consulted regarding the increased risk.

In regards to lung and bladder cancer prevention, the oncology specialist again returned to smoking cessation. “Stop smoking,” he said, “and avoid second-hand smoke.” Moreover, anyone with a longstanding history of smoking (20 years and up) should undergo regular low-dose radiation chest CT screening, he added.

Most people might not consider smoking as a significant risk factor for the development of bladder cancer; indeed, the risk of bladder cancer itself often tends to be overlooked, Ayon agreed. Smokers, however, should be aware of their increased risk for this form of cancer.

“All the toxins [produced by smoking] are deposited in the bladder,” Ayon explained.

With early detection, the prognosis for bladder cancer tends to be positive. However, if the disease has spread into surrounding muscle tissue – also known as muscle invasion – the outlook isn’t quite as positive, with many such patients requiring a cystectomy – a complete or partial removal of the bladder, which greatly affects the patient’s quality of life.

One big problem surrounding early detection of bladder cancer, Ayon added, is that screening for the disease is a more difficult proposition compared to other cancers. Also complicating efforts at prevention and early detection is the fact that the disease is largely asymptomatic in the early stages.

Still, this form of cancer isn’t without early warning signs. Although the early onset of bladder cancer tends to be painless, patients who suffer from frequent, never-ending bladder infections should, in the least, consider such infections a possible sign of an underlying health problem.

Blood in the urine without accompanying pain is an even bigger red flag regarding bladder cancer – perhaps the most significant of all, in fact, Ayon added. Patients in the early stage of bladder cancer also tend to experience severe weight loss.

In regards to colon cancer, bloody stools, abdominal pain and changing bowel habits (repeated fluctuations between diarrhea and constipation) are all warning signs. Patients, Ayon said, should begin having regular colonoscopies – the procedure to screen for the disease – at age 50.

Moreover, eating a healthy diet can have a pronounced impact on the risk for colon cancer. People should eat less red meat in general, Ayon advised, because anecdotal evidence has suggested a link between increased red-meat intake and an increased risk of colon cancer.

Another important factor in early detection and prevention, Ayon further noted, is the team approach to care doctors at DCMH practice, with OB/GYNs, PCPs and specialists working in conjunction to communicate and consult regarding each patient’s best course of care and treatment.

Lynzee McDowell, DCMH marketing and communications manager, who also sat in on Ayon’s interview, stressed that the types of screening Ayon mentioned are all available at DCMH. In fact, she added, DCMH offers some of the latest and most advanced screening tools in healthcare.

“We want [patients] to understand,” she said, “that they can get specialized care right here at home, without needing to drive to Indianapolis or some other larger community. We want them to be aware of the resources that are available right here in Decatur County.”

Ayon came to DCMH in 2010, part of a private hematology/oncology group that was eventually purchased by IU Health. His first few years at DCMH, Ayon saw patients once a week. He recently increased that to two days weekly, telling the Daily News his Decatur County practice has recently been growing sufficiently to merit the increase.

He’s also become a partner of the Franciscan Physician Network (FPN), based out of St. Francis Hospital, Indianapolis. DCMH partners with St. Francis through many specialties, and only recently added hematology/oncology to that list, explained FPN operations director Rita Nevitt, who also sat in on Ayon’s interview.

Contact: Rob Cox 812-663-3111 x7011; robert.cox@greensburgdailynews.com