July 6, 2017

Dr. John Williams on health screenings for men

ARA’s Dr. John Williams explores the different types of screenings available that radiologists use to help detect early onsets of more serious diseases, like cancer, heart attack and osteoporosis.

Transcript

Anchor: Welcome back to We Are Austin. You know catching a health issue early really makes a big difference in how it’s treated. Dr. John Williams from ARA is here to walk us through the screening’s that are available to help us keep the men in all our lives healthy. Good morning thanks for joining us!

Doctor: Hello, Good morning. Thanks for having me.

Anchor: So, screenings really are very important because its our way to catch something that could be could be dangerous early.

Doctor: Absolutely. Yeah, so that’s the whole idea, right? As they catch these processes whenever we can affect, you know have a positive effect on long-term treatment and prognosis and, you know, quality of life and then the length of life.

Anchor: And you’re going to show us a few things that you do at ARA, the screenings that you provide and some of the conditions that you’re looking for.

Anchor: We’re gonna start right here. What are we looking at?

Doctor: So, I started with coronary artery disease because it’s so prevalent. We’ve talked about that on here before, actually, that coronary artery disease accounts for 1 out of every 4 deaths in the United States every year, which is incredible.

Anchor: Oh ok, wow. It’s significant.

Doctor: And so, the coronary arteries are basically these blood vessels here that supply oxygenated blood to the heart so that it can pump. Those arteries can accumulate plaque over time, which narrow the lumen and block the lumen and that can create a heart attack. So, the examination we do for this is called a CT calcium scoring. And so, those plaques can calcify and we can see that calcification.

Anchor: Here we’re looking at something healthy.

Doctor: This is a healthy heart and this is that vessel without any evidence of plaque.

Anchor: Get back there.

Doctor: And so, the next slide would show us basically again the heart, but now we have all these white areas along the vessel.

Anchor: Oh, these areas here.

Doctor: Exactly. So, that’s heavy extensive calcification, which indicates that this patient has a high likelihood of having a significant narrowing that can cause symptoms or a heart attack. So, that’s that screening examination so we’re looking for that plaque so we can identify that patient and get them treatment.

Anchor: Uh huh, and you’ve caught it, this screening, you’ve seen the indications that treatment is probably necessary.

Doctor: Exactly.

Anchor: Excellent. Ok, what about this one?

Doctor: So, another important disease is lung cancer. And lung cancer, by and far,  for men and women is the leading cause of cancer death in the United States.

Anchor: Is it?

Doctor: It is still and that’s primarily related to smoking. And so the examination we do for that is a CT low-dose lung screening. And so, for the cardiac exam we’re just looking at the heart, so for the lung studies, we’re looking at the whole chest because we want to see all of the lungs. And so the reason why we do this again is to catch it early because there is  a high-risk population which is patients basically between the ages of 55 and 75 who have a 30 pack-year history of smoking. So, that’s basically the equivalent of a pack a day for thirty years. That’s heavy smoking. If these patients get this examination, they have a 20% reduction in mortality versus those patients who don’t.

Anchor: Oh wow.

Doctor: Because, we catch this disease early, and so, if you could go back one for me, this image on the left.

Anchor: It’ll pop back to the last one. Ok. That’s ok. Yeah.

Doctor: Well, this is what we don’t want. So, basically, there’s an image that shows that shows basically the small lung nodule. We identify those, we keep a close eye on them in short intervals and if they change we will pull the trigger on having that diagnosed with a biopsy, and you know, move towards treatment. What can happen if you don’t do this screening examination is that you know patients don’t present until they have some sort of symptoms which can be a bloody cough or pain. At this point often, unfortunately, the horse is kinda out of the barn, and the disease may already be systemic and the prognosis is not going to be as good as if you were to catch it early.

Anchor: Goodness, so at this point, you know I won’t use the words “too late,” but at this point, something could have happened earlier with a screening.

Doctor: This would be a much more difficult course and the chances of having a good outcome are decreased.

Anchor: What do we have next?

Doctor: So, prostate cancer is obviously an important disease in men. It’s the third leading cause of cancer in men, behind lung and colon. So, we do an MRI for prostate screening, and the MRI gives us an image that looks like this. So, on the left, this area, within the red circle, this is all the prostate gland. The bright area,that’s what’s called the peripheral zone, and we sort of just concentrate most of our search there because statistically, you know, prostate cancer occurs there. And this image on the right shows what we’re looking for. Basically this dark dot, with sort of irregular margins, that’s concerning. That’s basically what prostate cancer looks like. We bring attention to that and recommend that to be biopsied. Now, that said, you know, prostate cancer, even though it’s common, has a great prognosis if we identify early when it’s confined to the prostate gland and hasn’t spread elsewhere.

Anchor: Which is the key usually to the screening.

Doctor: Exactly.

Anchor: We’ll do one more here and then we’ll talk a little bit about insurance. What’s next?

Doctor: Sure, so osteoporosis, I think there’s a good awareness about how important that is in the female population.

Anchor: Yeah

Doctor: But it actually occurs in the men as well.

Anchor: [in audible]

Doctor: It just occurs later, you know, because of hormones. So men, basically, 70 and older and they can be at high risk if they smoke or have alcohol use, you know, their bones can be kind of get weak over time as well, which then predisposes them to fracture, and a fracture can be catastrophic.

Anchor: Sure.

Doctor: In older populations. So, there’s a study called a dexo density scan which is a dual energy x-rays. And basically, we typically look at the femur which is what we’re seeing here located in the hip, the proximal, here is the femur, this is your leg bone and then part of your pelvis here and the hip. So we look at the hip and then the next image we look typically at the lumbar spine, and basically what the computer does is tell you how much bone density you have versus someone of your own age and also against versus young healthy cohort. It tells you how much bone that you’ve lost, and maybe you look great which could be wonderful but, you know, depending on how much bone you’ve lost you may need to undergo some sort of therapy or diet change.

Anchor: Yup. So that’s why screenings are so important. I wanted to mention very quickly a lot of insurance are willing to help pay for these things because they want to catch it early like you do, correct?

Doctor: Absolutely. Proven benefits of screening.

Anchor: Exactly, and if people want to know a little more about ARA and how they can get these screenings, where can they go for this information?

Doctor: So, you know, ausrad.com has a lot of this information and little snippets on it and we have 17 clinics around town.

Anchor: Excellent. It’s really important, that really is, the early diagnosis, the catching. I think that it’s really important and I appreciate you being here.

Doctor: Thanks for having me.

Please note: When talking to your health care provider about getting a CT calcium scoring, be sure and discuss any symptoms you may be having, including chest pain or pain in the arms, back neck, jaw, or stomach; shortness of breath; palpitations; nausea; and fatigue.