Welcome to the GHS blog
Greenville Health System (GHS) has been advancing health care for generations. The stories below provide an inside look into GHS and how we’re transforming health care for the benefit of the people and communities we serve.
Greenville Health System (GHS) has been advancing health care for generations. The stories below provide an inside look into GHS and how we’re transforming health care for the benefit of the people and communities we serve.
“Hey, I just mopped the floor, so I’m skipping the gym today!” Sound familiar? Many folks confuse physical activity, exercise and physical fitness.
What’s wrong with household chores and why does this matter? All exercise (running, biking, swimming, resistance training, etc.) is some form of physical activity but not all physical activities (chores, gardening, knitting, dancing, etc.) are necessarily exercise. Many people think that they don’t need to exercise because they are already active. However, activity alone does not necessarily lead to improved physical fitness.
The American College of Sports Medicine (ACSM) guidelines for cancer patients/survivors does recommend physical activity. However, they specifically recommend 150 minutes per week of moderate intensity aerobic (cardiorespiratory) exercise along with strength building and flexibility exercises two to three days per week. Moderate aerobic activity increases both heart and respiratory rates. Moderate intensity activities allow you to talk but not sing while exercising…getting the picture?
So, what’s the answer? Studies show that a combined approach of an active lifestyle and a targeted exercise program achieve physical fitness goals best. That means parking at the end of the parking lot and walking to your final destination, carrying your own groceries and taking frequent movement breaks at work (and, yes, cleaning your house) are part of an active lifestyle. But it ALSO means maintaining a varied exercise program targeting at least 150 minutes of moderate aerobic activity weekly along with strengthening and flexibility sessions at least twice a week. As always, talk with your personal healthcare provider prior to starting an exercise regimen.
On July 14, 2014, the British Journal of Nutrition published a research article about the nutrition content of organic foods compared to conventional foods. The article reviewed 343 studies of organic compared to conventional foods. It concluded that the organic foods contained slightly more antioxidants, slightly fewer pesticide residues, and lower levels of the toxic metal cadmium. The next day, the Los Angeles Times published a story about the article with the headline, “Organic foods more nutritious, according to review of 343 studies.”
The LA Times article quoted the study co-author, Charles Benbrook, as saying, “This shows clearly that organically grown fruits, vegetables and grains deliver tangible nutrition and food safety benefits.” Dr. Benbrook went on to say, “Buying organic is the surest way of limiting exposure if you have health issues, but by all means, people need to increase their intake of fruits and vegetables whether it’s organic or conventional.”
There was, however, some disagreement with the conclusion that organic foods are more nutritious. The same day, Ian Musgrove, senior lecturer in pharmacology at the University of Adelaide in Australia, expressed an opposing opinion in a blog at www.theconversation.com. He pointed out that only a few of the many foods tested were more nutritious than conventional foods and those few that were better were only slightly better. He cited the slightly higher content of vitamin C, carotenoids and antioxidants in organic foods as examples where the difference between organic and conventional is too small to make a meaningful difference in a person’s diet. He went on to say that some organic foods do indeed have lower levels of pesticides and cadmium than conventional foods, but that the levels in both are far below the level at which they might cause harm in our diet.
I tend to agree that the advantages of organic foods are small and not significant enough to warrant the extra cost. One possible exception is milk for children. Organic milk may have less in the way of estrogen-like chemicals that are found in conventional milk and that may be linked to slightly increased rates of testicular, prostate and breast cancer. Any harm in conventional milk (from milk factories) compared to organic milk (from happy and contented, antibiotic-free cows) has yet to be proven, but it may be one case worthy of erring on the safe side.
How about you? Which argument is more persuasive? Are there certain foods for which you choose the organic option? Feel free to share your comments with the other readers.
Global recognition is coming to the Upstate Aug. 27 – Sept. 1 in the form of the 2014 UCI Para-Cycling Road World Championships. Greenville will play host to over 300 of the world’s best athletes for the first Para-Cycling Road World Championship in the United States since 1998. With over 40 countries represented, this five-day competition will bring diverse cultures and unrivaled talent to the Upstate for an unforgettable experience.
The world championships will begin with the Parade of Nations on Wednesday, August 27th at 6 p.m. at the TD Stage in downtown Greenville. The following four days will be packed with time trials and road races to cater to the athletes’ abilities.
There will be four categories of competition:
These events will take place at the Clemson University’s ICAR Millennium Campus and the BMW Performance Center. For a full list of the 2014 UCI Para-Cycling Road World Championship events and their locations, click here.
This event is the chance for these dedicated athletes to demonstrate their wide range of abilities and skill. Greenville Health System is proud to be the presenting sponsor for this world renowned event and is looking forward to a strong community turn out to support each athlete and especially the eight members of our own Team Roger C. Peace who are competing for Team USA.
We are thrilled to host the world for the 2014 UCI Para-Cycling Road World Championship. We look forward to seeing you in the crowds among the rest of the world supporting these strong and dedicated athletes.
Study after study has shown that exercise reduces the risk of cancer recurrence for cancer survivors. More than 200 studies have shown that the most physically active survivors have a lower risk of cancer recurrence than the least active cancer survivors. The data favoring exercise is strongest for survivors of breast cancer, colon cancer, endometrial cancer and prostate cancer.
The American Cancer Society recommendations for cancer survivors include 30 minutes of moderate to vigorous physical activity (above usual daily activities) five days a week for a total of 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise. The ACS also recommends strength training. Despite these expert recommendations, only 50% of Americans report that their weekly exercise meets these guidelines. The glass may be a lot less than half full because studies have shown that people frequently overestimate how much time and with how much intensity they exercise.
How much intensity is enough? Dr. Jennifer Trilk is an exercise physiologist at the USC School of Medicine Greenville. She reports that the talk test is a simple way to measure relative intensity. As a rule of thumb, if you’re doing moderate-intensity activity you can talk, but not sing, during the activity. If you’re doing vigorous-intensity activity, you will not be able to say more than a few words without pausing for a breath. Another way is to measure your heart rate. You can do this by feeling your wrist for your pulse, counting the heartbeats for 15 seconds and multiplying by four. Or you can purchase an inexpensive heart rate monitor. Moderate-to-vigorous exercise should raise your pulse to 50% to 85% of your maximum heart rate.
Your maximum heart rate is 220 minus your age in years. For example, if you are 60 years old, subtract 60 from 220 and that equals 160 beats per minute. Fifty percent of 160 is 80 beats per minute and 85% of 160 is 136 beats per minute. So the target heart rate for moderate-to-vigorous exercise for a sixty year old is between 80 and 136, with 103 in the middle. Overall, moderate intensity includes brisk walking, dancing, gardening and tennis. Vigorous intensity includes jogging, running, swimming laps and heavy gardening.
How much time is enough? The United States Physical Activity Guidelines recommend 150 minutes per week to obtain significant health benefits. That amounts to 30 minutes for an outing, five days per week. However, if you can’t reach 30 minutes per day, newer evidence suggests that any exercise is still beneficial. A recent study published in the Journal of the American College of Cardiology suggests that there may be some benefit to as little as five or 10 minutes of exercise per day. Researchers reviewed questionnaires filled out by 55,137 healthy men and women seen at the Cooper Clinic in Dallas, Texas, over 15 years. The 24% of the people who reported any running or jogging had a 30% lower rate of death compared to those who did not exercise. Among those who exercised at all, the benefits were the same for those who ran a lot or for those who ran for as little as five or 10 minutes per day. This encourages me to exercise at least five or 10 minutes on days when I cannot fit in 30 minutes.
If you are not exercising at all, I suggest that you start with a goal of five minutes per day and work your way up to 30 minutes. Exercising with a friend or with a group may help you establish a routine. If you would like to learn more about the benefits of exercise and nutrition for cancer survivors, call the Center for Integrative Oncology at (864) 455-1346. You may wish to schedule an integrative oncology consultation, where you can receive personalized exercise and nutrition recommendations.
On Jan. 25, 2010, my life changed forever. It started as a regular colonoscopy and endoscopy due to terrible acid reflux, with me thinking the worst outcome would be a stomach ulcer.
After I woke, I heard the doctor telling me he found a quarter-sized tumor in my colon that he was 95 percent sure was cancerous. It seemed impossible. I was 27 years old and two short months from marrying the love of my life. I was looking forward to starting our life together with years of happiness ahead, instead of facing a life-changing obstacle.
Fast-forward to the present more than four and a half years later. I have had about 300 rounds of chemotherapy. My original diagnosis of stage 3 has moved up to stage 4, and I’ve met some amazing people along the way.
Surprisingly, I wouldn’t change a thing. There have been times of great struggle, but also some amazing moments that wouldn’t have occurred without my cancer diagnosis.
The statistics for a diagnosis like mine are grim. I’m one of the lucky few to have made it as far as I have; in fact, most people are shocked to discover I have advanced colon cancer. I attribute this success to the efforts of my oncologist, nurses and the rest of the Greenville Health System Cancer Institute team. Their work inspired my wife and me to take a philanthropic approach to my situation through a foundation, started by friends of ours, called BrightLife. It was never a question whether the recipient of our annual fundraising efforts would be GHS’ Institute of Translational Oncology Research (ITOR).
Cancer takes away many things, including a sense of control, the feeling of safety and – most important to your survival – hope. We wanted a way to be able to give back to those playing such a huge role in our lives and to help others when it seems all hope is lost.
The GHS Cancer Institute and ITOR have become a second family to my wife Jenny and me. The patient care I have received is second to none. Our wish is that anyone diagnosed with cancer in the Upstate will be able to receive such a high standard of care.
The nearly $7 million National Cancer Institute grant awarded to the GHS Cancer Institute will allow patients like myself to receive this personalized care for many years to come. The GHS Cancer Institute is one of just 34 programs in the U.S. named by the NCI as a leader in community-site care delivery and research. GHS and MUSC are the state’s only NCI programs.
The advanced care available here allows patients to receive new groundbreaking treatments without travel far from home. A cancer diagnosis is challenging financially, emotionally and physically; having to also leave everything you know to receive treatment takes an extreme toll on body and mind.
“What if” is never far from the mind of a cancer patient. My wife and I have learned to take things one day at a time and try our best not to let this disease run our lives. We’re glad that this grant allows the hospital to provide patients hope and even more of a fighting chance.
This blog previously ran as a guest column in the Greenville Journal on August 15, 2014.
Recently, an article about aspirin and cancer risk was published in the medical journal Annals of Oncology. It has received a lot of attention in the press, including local television right here in Greenville. Headlines have said that an aspirin a day can “dramatically” reduce the risk of colon cancer. I want to review the study and take a closer look at the benefits and risks discussed in the study.
The Annals of Oncology study is not new research. It is a review of prior research of groups of people who participated in studies where they either took daily aspirin or did not for a number of years. The summary of the studies was that aspirin at between 75 and 325 mg per day for a minimum of five years would reduce the incidence of colon cancer by 30% and of esophagus and stomach cancer by 25%.
Before we all jump on the bandwagon, we need to consider the size of the benefits and the size of the risks. For example, the risk of getting colon cancer in the next ten years for a sixty-year-old man is 1.32%. A 30% reduction reduces the risk to 0.92%. That is, taking aspirin for 10 years reduces this man’s risk of getting colon cancer by only a fraction of 1%.
One of the complications of taking aspirin is bleeding from a stomach ulcer or from another place in the intestines. For the same sixty-year-old man with no history of stomach ulcer, the risk of intestinal bleeding in the next 10 years is 2.4%, which is the same or a little greater that the risk of colon cancer! The risk of intestinal bleeding is tripled if the person is taking an NSAID drug like ibuprofen or naproxen.
Having said this, there are some good reasons for some people to take aspirin. Some people at high risk of stroke or heart attack derive a great benefit compared to the risks of intestinal bleeding. My point is that this news about aspirin cutting the risk of colon cancer is a reason to check with your doctor, who can weigh your other medical factors that contribute to relative risks and benefits. With your medical situation in mind, your doctor is the best person to advise you about taking a daily aspirin.
The evidence that aspirin can reduce the risk of colon cancer is interesting, but it is not a reason for everyone to start taking a daily aspirin. The best (and safest) thing to do to prevent colon cancer is still to eat a high-fiber, low-fat diet with five or more servings of fruits and vegetables per day and to start getting screening colonoscopies at age 50. This information is not in the headlines and sound bites, but it is worth digesting.
In this blog, we have repeatedly recommended five servings of fruits and vegetables per day. Considerable data indicate a benefit in terms of reducing the risk of cancer, feeling better and living longer. One question that comes up is which fruits and vegetables are better or worse. One view of the question is to consider pesticide residues. The Environmental Working Group publishes a list each year of the fruits and vegetables with the lowest and highest levels of pesticide residues, as reported by government testing (www.foodnews.org). The list with the lowest levels is called the Clean Fifteen and includes cabbage, frozen sweat peas, onions, asparagus, mangos, papaya, kiwis, eggplant, grapefruit, cantaloupe and cauliflower.
The list with the highest levels (although still low enough for the Department of Agriculture to consider safe) is called the Dirty Dozen, Plus. It includes apples, strawberries, grapes, celery, peaches, spinach, sweet bell peppers, imported nectarines, cucumbers, cherry tomatoes and imported snap beans. The additional vegetables that constitute the “Plus” are hot peppers, kale and collard greens. These were added because they have tested high for pesticide residues in the past although they did not in the most recent year.
The Dirty Dozen contains some fruits that are close to my heart, such as apples, grapes and peaches. How do I deal with their presence on the list? There are four ways:
It is hard to know how much benefit there is in avoiding pesticides in our food. I believe, however, that the upside from a diet rich in fruits and vegetables, low in animal fat, and using whole grains is much greater than the possible downside from pesticide residues in our produce. How about you? Do you make an effort to avoid pesticides in you food?
For more information about healthy nutrition for cancer survivors and cancer prevention, call (864) 455-1346 or check out our website at www.ghs.org/cios.
Cancer. It’s a word that elicits strong emotion and fear. The fear is not irrational. Cancer is a disease that has or will affect every one of us. In fact, by 2030, the number of new cancer diagnoses in the United States will have increased by 45 percent, and due to the nation’s aging population, cancer will become the nation’s leading cause of death.
The National Cancer Institute is the leading authority on cancer research in the United States. In addition to conducting research in its own labs and clinics, the NCI supports and coordinates research projects conducted by local hospitals and health systems through research grants and competitive agreements. The NCI does this because it understands that, for research to be relevant, it must be conducted in the communities where care is being delivered.
In the last 30 or so years, the NCI has conducted hundreds of clinical trials and research studies across the country in communities like Greenville. The NCI and the broader medical community have learned a few things. First, we have a clearer understanding that cancer, at its core, is a molecular disease, and finding the specific molecular characteristics of each cancer in each patient takes a special effort. Second, the cost of medical care, especially cancer care, is unsustainable. And third, advances in cancer care are not equally distributed, and communities are the best proving ground to ensure everyone has access to the best technology and care.
Over the last year, the NCI has been working to develop the NCI Community Oncology Research Program (NCORP), a new community-based research program that seeks to build upon the work that’s already been done and also expand it to include research focused on quality of life and understanding the diverse and multi-level factors that affect access to and quality of care. Funding opportunities were announced in November 2013, applications were then submitted, and after review by an expert panel, funding decisions were announced on August 1.
The NCORP grant application process was competitive and open to organizations across the country. It is fair to say that most of our nation’s major hospitals and health systems applied. However, only 34 of them were selected to receive funding as a grantee organization, and the Cancer Institute of Greenville Health System was one of them.
The success of our application demanded a demonstration of capabilities that frankly do not exist everywhere. The GHS Cancer Institute has been ahead of the curve in evaluating specific cancers molecularly to determine if more targeted, easier-to-tolerate therapies might be appropriate. We were also ahead of the curve when we first launched our oncology multidisciplinary center, which allows a patient to be seen by a team of specialists and develop a treatment plan all in one visit. Our nurse navigators, who see patients through diagnosis, treatment and survivorship, and our genetic counselors, who help identify those at increased risk for hereditary cancer, are also standouts, as is our ability to offer specialized cancer care to our pediatric population.
And, at a time when the incidence of cancer is rising, so, too, is the number of survivors. GHS’ Center for Integrative Oncology and Survivorship, now in its third year, is dedicated to meeting both the physiologic and emotional needs of survivors. This holistic approach to cancer care exists in few places, but one of those is here in Greenville, making the GHS Cancer Institute an ideal location to conduct NCI-sponsored research on quality of life.
Receiving an NCORP grant is an affirmation and recognition of our ongoing efforts to find and develop innovative ways to improve all aspects of cancer care delivery. It’s a vote of confidence in our ability to take research to the next level. GHS is among the best in the nation when it comes to cancer research, and the work that we do here will positively impact the lives of cancer patients in our community and beyond.
With this grant comes great responsibility. A responsibility to find ways to reduce costs, improve quality and enhance the patient experience, and a responsibility to share what we learn with others so that those factors or barriers that prevent people from accessing care can be removed. This is not an insignificant challenge, but it’s one that we intend to meet and exceed.
This blog previously ran as a guest column in The Greenville News on August 9, 2014.
Greenville Health System’s Cancer Institute recently was awarded a multi-million-dollar grant to conduct clinical trials and research studies aimed at improving patient outcomes and reducing health disparities. Our institute is the only community-based site in South Carolina — and one of only 34 institutions nationwide — to receive such a grant from the National Cancer Institute Community Oncology Research Program, which is part of the National Institutes of Health.
We are proud the nearly $7 million grant distinguishes us as a national leader in cancer care. But more important, we are excited that it supports the growth of innovative research and collaboration with the state’s leading academic and research universities to improve care and outcomes for all South Carolinians.
Our research with the University of South Carolina, Clemson University and Furman University involves a shared academic health center we call the Greenville Health System’s Clinical University, and it is essential to developing new therapies, treatments and prevention programs. The National Cancer Institute’s program, a network of investigators, cancer-care providers and academic institutions, recognizes the value of these physician-researcher partnerships in improving and extending care beyond a single community or region. The grant will allow our Cancer Institute to conduct more clinical trials and research studies to the benefit of people across the entire state.
Cancer care doesn’t stop at the county line. It’s imperative that health systems, universities, cancer-support communities and biotechnology companies work together to find solutions, as they do through our Institute for Translational Oncology Research.
While we are the only community grant site in South Carolina, other S.C. hospitals have partnered with out-of-state community grant sites or have received diversity/minority grants. This is great news for South Carolina, which results in more cancer patients getting better care.
Our clinical trials will focus on improving cancer prevention, cancer control, screening for early cancers and post-treatment surveillance, while cancer-care-delivery research will focus on quality of life and understanding the diverse and multi-level factors that affect access to and quality of care.
Transportation, technology, finances and pre-existing chronic diseases are all examples of factors that contribute to poor health outcomes. Our research aims to find new therapies and delivery approaches that improve access and outcomes for all patients, throughout South Carolina and surrounding states, not just in the Upstate.
In some cases, the breakthrough may be a new drug. In other cases — such as a recent trial at Greenville Health System for women with early breast cancer — what’s being tested is care delivery itself; women in the trial were sent a text message to remind them to take their pills at a specific time.
When it comes to our health, knowledge truly is power. By accelerating the transfer of knowledge gained from cancer clinical trials and cancer-care-delivery research into clinical practice, we have an opportunity to improve outcomes and ultimately save lives.
Federally funded grants are a big win for South Carolina. They provide additional resources to expand medical services and further game-changing health research. Examples at Greenville Health System include a study on the effects of exercise on cancer-related fatigue and a lung cancer clinical trial that compares effectiveness of targeted therapy versus combinations of standard therapy. (Another study by the USC School of Medicine Greenville and the hospital is using state-of-the-art, non-invasive techniques to study the effects of chemotherapy on survivors’ skeletal muscle health and cellular metabolic rate and how this ties into patient fatigue.) Meanwhile, Clemson University and MUSC researchers — working with our physicians — recently won an $11 million National Institutes of Health grant for their ongoing work in how lab-grown tissue can treat a variety of diseases.
Such cooperation — and the grants that derive from it — also are strong economic catalysts, growing intellectual capital as well as attracting additional financial support. According to Research! America, a national non-profit advocacy group, $2 million in new state business activity is generated for every $1 million that the National Institutes of Health invests.
For S.C. health systems and universities, working together is simply working smarter.
This blog previously ran as a guest column in The State newspaper on August 12, 2014.
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