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Jason M. Schwalb, M.D., director
Movement Disorder & Behavioral
CARPET
August 20 2009
breast cancer history to be tested for
the BRCA1 and BRCA2 genetic muta-
tions ("Male Breast Cancer: My Life-
Altering Experience, July 23, page A34).
There have been many advance-
ments in breast cancer care at
Beaumont Hospitals in the eight years
since Mr. Levine consulted with a
Beaumont breast surgeon.
For example, the mammography
process at our Marilyn and Walter J.
Wolpin Comprehensive Breast Care
Center at Beaumont Hospital, Royal
Oak, now accommodates the needs
of men requiring mammography, as
well as women. This includes a spe-
cific patient history form for men and
accommodations for men to disrobe
and dress in private.
In November 2003, Beaumont, Royal
Oak launched an expedited breast
cancer diagnosis program designed to
eliminate delays in patients receiving
results. Thanks to this program, women
or men with breast problems receive
their diagnostic mammogram and
breast ultrasound results before they
leave the appointment. When possible,
a biopsy and/or aspiration is offered the
same day. This greatly reduces patient
anxiety and allows any necessary treat-
ment to begin as soon as possible.
Beaumont also added a cancer
genetics program that has grown to
be the largest genetic breast cancer
program in Michigan offering testing
and counseling to Ashkenazi Jews and
others at high genetic risk of cancer.
Nurse navigators are available at
our Royal Oak and Troy Breast Care
Centers giving one-on-one assistance
to patients for scheduling tests, physi-
cian consultations and treatments dur-
ing a very stressful time in their lives.
These programs, along with a com-
prehensive, multi-disciplinary treat-
ment approach, advanced technology
and research, helped us become the
first breast care program in Michigan
to earn national accreditation through
a program administered by the
American College of Surgeons.
Our focus has been, and will con-
tinue to be, on providing the highest-
quality breast care efficiently, effec-
tively and respectfully. Our patients
deserve nothing less.
Neurosurgery
Henry Ford West Bloomfield Hospital
CERAMIC
Frank Vicini, M.D., FACR
Chief of Oncology
Beaumont Advances
CORK
We applaud Fred Levine for coura-
geously sharing his story as a man with
atypical ductal hyperplasia, a precursor
of breast cancer, and for advising your
Ashkenazi male readers with a family
AREA RUGS
COMMERCIAL
RESIDENTIAL
1530610
6
someone who treats Complex
Regional Pain Syndrome (CRPS) surgi-
cally, I would like to add to the discus-
sion of medical options in "Searching
for Answers" (July 23, page A29).
There is significant scientific evi-
dence that CRPS is mediated by the
spinal cord and can be modified with
spinal cord stimulation (SCS). SCS is a
technology invented by Norm Shealy
at Case Western Reserve University in
Cleveland in 1967, whereby an elec-
trode is placed over the spinal cord
and connected to a pacemaker battery
that can be programmed through the
skin. Electrical currents are delivered
to the spinal cord, producing tingling
in the painful area and reducing pain.
Depending on the power usage, the
batteries tend to last two to five years,
or longer for rechargeable batteries.
Dr. [Marius] Kemler and colleagues
in Maastricht [the Netherlands]
reported the results of a randomized,
controlled trial of SCS with physi-
cal therapy versus physical therapy
alone in the New England Journal of
Medicine in 2000. Adults who under-
went implantation of the SCS systems
had statistically significant improve-
ment in pain and quality of life com-
pared to those who received physi-
cal therapy alone. This benefit was
maintained at two years. There was no
effect on the ability to feel cold, hot or
painful stimuli. However, the initial
differences between the treatment
groups were no longer present at five
years. Despite the diminishing effec-
tiveness of SCS over time, 95 percent
of the patients who underwent SCS
implantation said they would repeat
the treatment for the same result.
I would think that there would be
some value in gaining even transient
relief for an adolescent going through
a critical time in her social develop-
ment. In addition, the group from
Astrid Lindgren Children's Hospital
in Stockholm recently published very
promising results in a group of seven
adolescent girls in the January 2008
issue of the European Journal of Pain.
Beaumont Hospitals
Nayana Dekhne, M.D., FACS
Interim Director
Breast Care Center
Beaumont Hospital, Royal Oak