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Research Shows Genetic Approaches to Breast Cancer Screenings Yield More Accurate Results
Clinical researchers with the Healthy Nevada Project co-author research paper with findings that emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. Breast cancer is a leading cause of cancer death among women in the United States. According to the American Cancer Society, about 1 in 8 women will develop breast cancer and about 1 in 39 women will die from breast cancer. Breast cancer is associated with increased age, hereditary factors, obesity, and alcohol use. Since 1990, breast cancer death rates have declined progressively due to advancements in treatment and detection. In Nevada there are an estimated 2,310 new breast cancer cases a year, and genetic mutations such as in the genes BRCA1 or BRCA2 remain a top risk factor for this prevalent disease. Recognizing the urgency for progress in breast cancer research, a collaborative effort between physicians, advanced practice providers and scientists from the Healthy Nevada Project® (HNP) and Helix have unveiled groundbreaking research. This study explores how genetic screenings are a necessary supplement to traditional testing methods, together offering more accurate insights into a patient's likelihood of developing breast cancer in the future. HNP is operated by Renown Genomic Medicine and the Institute for Health Innovation and is one of the largest community-based population health studies in the country. Their team works in collaboration with Helix, a leader in precision health that delivers comprehensive genomic solutions. Together, this dynamic partnership aims to understand breast cancer risk factors and pave the way for more effective preventative measures. The combined research team studied 25,591 female HNP participants to evaluate the performance of different genetic screening approaches to identify women at high risk of breast cancer. The results of this research suggest that a combined monogenic, or single-gene, and polygenic, or multi-gene, approach to breast cancer screenings helped produce more accurate results and more closely identify study participants who have a high genetic risk of developing the disease. "Based on this research, we are advocating a shift in approach which would improve breast cancer risk assessment through a combination of effective family history ascertainment and genetic screening,” said Joseph Grzymski, PhD, principal investigator of the Healthy Nevada Project, research professor at the University of Nevada, Reno School of Medicine and co-author of the breast cancer research paper. “This tailored approach, founded on the assessment of individual genetic risk, not only intends to elevate patient well-being but also will improve efficiency and equity in healthcare." Complementing the team’s research on leveraging genetics to identify women at low genetic risk of breast cancer that could safely defer mammogram screenings by five to 10 years that was released in late 2023 in JAMA Oncology, the study suggests that incorporating genetic information can assist in personalizing breast cancer screenings and optimizing the use of screening resources. "Existing disparities persist across various facets of breast cancer screening and treatment; however, genetic screening is clearly a powerful tool to help facilitate early intervention for those at higher risk,” said Jamie Schnell Blitstein, APRN, a primary care nurse practitioner at Renown Health and co-author of the breast cancer research paper. “By placing a heightened focus on risk, we underscore the pivotal role of preventative breast cancer screening.” Despite the availability of effective methods for early screening, co-authors of this research found that 78 percent of women with a family history of breast cancer had their risk ascertained only after a breast cancer diagnosis. The findings emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. “These findings that can profoundly impact how healthcare is delivered were only made possible by all the participants who were willing to consent to research,” said Alex Bolze, PhD from Helix and co-author of the publication. “Broad-scale collaboration projects like these between Renown Health and UNR that engage large populations where participants share both their genetic information as well as electronic health records drive advancements in preventative medicine, as well as fundamental biological research.” The research paper was officially accepted on Jan. 29, 2024, and will be published by Elsevier, Inc. on behalf of the American College of Medical Genetics and Genomics. The contents of the paper will appear in the international journal Genetics in Medicine Open. Read the full article by visiting sciencedirect.com. The Healthy Nevada Project is currently recruiting new study participants. Free to all Nevadans with a saliva sample or blood draw, participants and their referring providers receive access to whole-exome sequencing and clinical grade results that help provide insight into their unique genetic risks tied to heart disease and certain cancers. If you are interested in enrolling in the study, schedule a Virtual Consent Appointment through MyChart or contact the Renown Institute for Health Innovation at RenownIHI@renown.org or (775) 982-6914 to be connected to a Genomic Representative. About Renown Health Renown Health is the region’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in the largest community-based genetic population health study, the Healthy Nevada Project®. To join the Renown Health team, visit renown.org/careers. About Helix Helix is the leading population genomics and viral surveillance company operating at the intersection of clinical care, research, and data analytics. Helix enables health systems, life sciences companies, payers, and government partners to accelerate the integration of genomic data into patient care and public health decision-making. Learn more at helix.com.
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Let Those Ears Breathe! Increased Headphone and Ear Bud Use Leads to Ear Wax Build Up; Renown Urgent Cares Offer Relief
Wearing headphones or earbuds is a daily activity for many of us. Listening to music, podcasts, meetings, phone calls; there are endless reasons to stick them in or on your ears. However, if your ears start to feel plugged, full; or you feel dizzy, lightheaded or hear ringing in your ears; you may be experiencing ear wax build up where your ear canals become blocked and affect your hearing. If you’ve tried to clean your ears (please don’t use Q-Tips®), but still have symptoms, pain, or hearing loss, it’s time to see your physician, nurse practitioner, physician assistant or visit Renown Urgent Care. “Ear wax isn’t dirty. It’s normal,” says Ryan Bristol, APRN, Advanced Practitioner of Nursing at Renown Urgent Care. “Ears are self-cleaning miracles, and naturally clean themselves with the help of jaw movement and skin migration. However, wearing headphones or earbuds for hours blocks earwax from naturally draining from the ear. Additionally, the dirt and bacteria that these headphones often carry can cause an infection on their own, and earwax buildup can trap dirt in the ear and block the canal completely. The snug fit of headphones can create a conducive environment for the accumulation of ear wax. It's crucial for individuals to be mindful of this and take necessary precautions to prevent complications." “Individuals experiencing symptoms such as ear pain, decreased hearing, or a sensation of fullness in the ears are encouraged to seek evaluation and treatment at their nearest urgent care facility,” says Rahul Mediwala, MD, CEO of Renown Medical Group. “By addressing ear wax build-up promptly, individuals can mitigate the risk of complications and maintain optimal ear health. Fortunately, prompt, pain-free and effective treatment is available at Renown Urgent Care. We offer professional ear wax removal procedures performed by trained staff, providing relief to those experiencing discomfort or hearing impairment due to excessive ear wax build-up.” The experts at Renown Health gave us some background. What is ear wax and why is it healthy? Ear wax is a protective substance called sebum made of fat, skin cells and sweat. Ear wax is produced by glands in the ear canal. It helps protect the ear from germs and dirt and prevents the sensitive skin of the ear canal from becoming irritated. It is normal and healthy to have a thin lining of ear wax on the canal. Ear wax will sometimes accumulate and move to the outer ear canal, where it would typically fall out or be wiped away. This is also normal. When should I seek care? An ear canal has too much wax if the ear feels plugged or hearing is affected. The accumulation of wax happens very gradually, so ears do not necessarily feel waxy. The problem is usually noticed because of changes in hearing. Over the counter remedies may offer relief. However, in some cases, the earwax has built up or become impacted, and ears need to be treated. What is the treatment? At Renown Urgent Care, we offer professional ear wax removal procedures performed by trained staff, providing relief to those experiencing discomfort or hearing impairment due to excessive ear wax build-up. Wax is flushed from the ear canal using a syringe filled with warm water and saline or diluted hydrogen peroxide. Most patients find the procedure is fast, pain free and effective. How can I prevent earwax buildup from headphones and ear buds? Most people who wear headphones or use earbuds occasionally or intermittently don’t have difficulties with excessive ear wax. Wax accumulation also depends on the size of the ear canals and the productivity of the oil glands in the ear canal. You can choose to use over the ear headphones. If you prefer to use in-ear headphones, the best modes of excess ear wax prevention are to: Clean headphones and earbuds regularly with a cloth or disinfectant wipes; Avoid sharing headphones or earbuds with other people; Take breaks from headphones and earbuds so ears can breathe and get back to normal; Pay attention to your ear health. Should we talk about Q-tips? Yes! Q-tips (and similar products) are rarely helpful for managing ear wax. The cotton on the end of the Q-tip is usually unable to pull the wax out of the canal. Worse, they can push the wax deep inside the ear canal, and it can end up impacted. Where should I seek care? Individuals experiencing symptoms such as ear pain, decreased hearing, or a sensation of fullness in the ears are encouraged to seek evaluation and treatment at a medical facility. By addressing ear wax build-up promptly, individuals can mitigate the risk of complications and maintain optimal ear health. Renown Urgent Care sees patients 365 days a year for medical concerns that are urgent but not life-threatening at many locations across northern Nevada. Book ahead to reserve a time slot at one of our ten urgent care locations. If you do not see time slots that work for you, you can still go to any location that has "walk-ins available" listed. For more information, or to book an appointment, go to renown.org/Health-Services/Urgent-Care. Renown Health is the region’s locally governed, not-for-profit integrated health care network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,200 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health.
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Elementary Schoolers: Take Part in Free Virtual Vision Screening
Renown Children’s Hospital pediatric ophthalmologist Dr. Mitchell Strominger hosts state-wide virtual event to provide routine vison screenings for children and Walk with a Doc. Renown Children’s Hospital pediatric ophthalmologist Dr. Mitchell Strominger is set to host a virtual Walk with a Doc event on Sunday, June 14 at 10 a.m. for elementary school children and their parents. During this free event, Dr. Strominger will give a brief, kid-friendly talk about the importance of routine vision screenings and show parents how to conduct a vision screening with their kids at home. He will close out the morning session with a live Q&A. Following the event, families are encouraged to get outside and enjoy a walk in the great outdoors. The event is sponsored by Renown Children’s Hospital and free to participants, however you must register to receive the link to attend. “Vision is important for learning, experiencing new things and interacting with others, which is why it’s critical for children to get vision screenings early and routinely,” said Dr. Strominger. “The best time to screen a child’s vision is kindergarten through third grade as the cells in the brain responsible for vision are continuously developing up until age eight. If we detect vision problems early, we here at Renown Children’s Hospital have the expertise and technology to correct these vision problems and enable children to live healthy, productive lives.” Individuals who register for this event will be emailed a vision-screening sheet to help facilitate an at-home screening, as well as a form to send back to their child’s pediatrician or pediatric ophthalmologist upon completion to determine the best course of action. Dr. Strominger added, “Many parents and schools have put off vision screenings due to COVID- 19 school closings, hesitations of safely leaving their homes or potential financial costs. I am pleased to host this virtual event on behalf of Renown Children’s Hospital, to engage kids and parents in a conversation on the importance of vision and to remind the community that we are here to help and provide the care they need, both in-person and virtually—be it over a smart phone, tablet or computer screen.” This virtual event will take place in the newly renovated Fianna’s Healing Garden which re-opens later this month and has been funded 100% by donations through the Renown Health Foundation. Located in the heart of Renown Regional Medical Center, the healing garden serves as place to enjoy the serenity and beauty of the outdoors. Dr. Strominger is one of 26 pediatric subspecialists recruited to Renown Children’s Hospital since 2016, thanks to the Pennington Foundation's $7.5 million donation made to the non-profit Renown Health Foundation to expand children’s health services. June marks the four-year anniversary of the Nevada Chapter of the American Academy of Pediatrics’ (Nevada APP) participation in the national Walk with A Doc event. Dr. Strominger is the secretary and treasurer for the Nevada AAP. From pediatric specialties, 24/7 ER care and surgery, to imaging, pediatric ICU and child life specialists, Renown Children’s Hospital is dedicated to helping kids feel welcome, safe and well cared for. Through each visit, parents can expect the highest level of care for their child’s health and well-being from birth and beyond. To support Renown Children’s Hospital and help local children in need get access to vital health services like routine vision screenings, please visit the Renown Health Foundation. About Renown Health Renown Health is a locally governed and locally owned, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, Renown Children’s Hospital, Renown Rehabilitation Hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to continually improve the care and the health of our community. For more information, visit renown.org.
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Breast Surgical Oncology
Breast Surgery Care at Renown Health Renown Breast Surgery Care, located within the Center for Advanced Medicine B, is a comprehensive, fully integrated breast surgery clinic, addressing a wide spectrum of breast problems ranging from benign to cancerous: Benign breast conditions such as fibroadenoma, phyllodes tumors, and nipple discharge Breast cancer risk assessment and genetics High risk breast lesions such as atypical ductal hyperplasia, atypical lobular hyperplasia, LCIS, papillary lesions, and radial scars Advanced breast cancer surgical techniques including oncoplastic surgery for best aesthetic outcomes possible and nipple sparing mastectomies, working closely with skilled plastic reconstructive surgeons. Our highly experienced breast surgical oncologists are continuing to expand our team to better meet the evolving needs of our community and beyond. We are excited to soon be incorporating an oncology wellness team who can further support our patients with focused nutritional guidance, functional assessments for prehabilitation needs prior to surgery or medical treatments, and guidance for development of physical activity and other exercise programs, for best outcomes in cancer treatment as well as future risk reduction. The National Accreditation Program for Breast Centers (NAPBC) is a rigorous process designed to ensure high quality care for breast centers by meeting thoughtfully created standards that are constantly being reviewed and updated for ongoing improvement of patient care. We are the only NAPBC-accredited program in Northern Nevada.
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Alzheimer’s Disease – How to Spot the Signs
Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place. According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)
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Healthy Veggie Chili, Ready to Eat in Less than an Hour? Yes Please!
We’re always in search of cozy comfort foods for crisp winter evenings, but you know what’s even better? When the recipe takes less than an hour, start to finish. Here’s a recipe for healthy vegetarian chili that you can customize with your favorite beans. Remember those Choose Your Own Adventure books you used to read as a child? Well here’s a Choose-Your-Own-Adventure-inspired veggie chili. The adventure: Customizing it with your favorite beans! And once your selections are made and the veggies are chopped, this recipe should take about 40 minutes to prepare, from beginning to satisfying end. Vegetarian Chili Feeds the Crowds Here’s the recipe, which is fully customizable based on bean preferences and can also be adapted to slow cooking.
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Wholesome Raspberry Thumbprint Cookies
There is no shortage of sweet treats during the holiday season, making it hard to keep our health on track. With all of the delicious aromas mixed into holiday cookies -- vanilla, peppermint, molasses, ginger, pecans and chocolate --the dessert table could use a healthy makeover that doesn’t compromise flavor. We challenged Caitlin Bus, Registered Dietitian with Renown Healthy Heart Program, to come up with a healthier cookie recipe to share with your family and friends this holiday season. These vegan thumbprint cookies are soft, slightly chewy, nutty and sweet, made with almond flour, a hint of maple flavor and topped with raspberry jam (or the jam of your choice). Even better, these holiday cookies require just eight simple, healthy ingredients and are gluten-free, dairy-free, egg-free, oil-free and optionally sugar-free too!
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Tasty Turkey and Veggie Chili with Kale
Meet your new go-to healthy chili recipe for fall. Made to share or freeze the leftovers for an easy lunch or dinner. There’s nothing like homemade chili to warm you up on those cold winter nights. With just the right amount of comforting flavors and garden-fresh veggies, this crowd-pleasing favorite could prove to be your go-to healthy comfort meal.
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Easy Gluten-Free Pumpkin Spice Bread
Pumpkin spice is a wonderful reminder of all things fall and cozy. This tasty pumpkin bread recipe is a favorite of both adults and kids. It incorporates fragrant fall spices – cinnamon, nutmeg and clove into a moist and surprisingly healthy bread. We replace regular flour with ground gluten-free whole grain oats courtesy of a blender. You won’t even notice our healthy substitutions of nonfat Greek yogurt and unsweetened applesauce. You’ll not only love the taste of this pumpkin bread, but also the wonderful aroma as it bakes filling your house with a mouthwatering scent. This generous recipe makes two loaves, one to keep and another to share with a friend or neighbor.
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Oat Flour Pumpkin Bread
Who knew that pumpkin bread can be nutritious and delicious? Caitlin Bus, Registered Dietitian with the Renown Healthy Heart Program shares her expertise on how to make a healthy and hearty pumpkin bread with homemade oat flour and natural substitutes for sugar. Give it a try!
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Bruschetta Chicken Bake
Bruschetta Chicken Bake is quick, affordable, and super easy to prepare on a busy schedule. The best part is that you don’t even have to pre-cook the chicken! Instead, serve this meal with a bagged salad and a crusty loaf of bread, and you’ll have a healthy, homemade dinner on the table in no time!
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Healthy Zucchini Manicotti
Often, when we think of Italian dishes, we think of pasta. In fact, there are more than 600 different pasta shapes, each holding the task of delivering Italy’s flavors. While we all crave pasta, according to the U.S. Department of Agriculture (USDA), a cup of pasta shells contains about 166 calories, 6 grams of protein and 32 grams of carbohydrates. When you add all the other comforting ingredients that comes with cooking Italian, it’s nearly impossible to keep it healthy. Caitlin Bus, Registered Dietitian with the Renown Healthy Heart Program shares a healthier version of an Italian favorite –deconstructed manicotti using zucchini as a substitute for noodles. If you’re looking for a healthier Italian dish and wondering how to use a spiralizer to turn vegetables into noodles, this recipe is for you.