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Hospice Care for Cancer Patients

Mitch Roberts: Dr. Kris Gast joins us this morning from Fort Smith Radiation Oncology, she’s here to talk about hospice care for cancer patients. Good morning to you.

Dr. Kris Gast: Good morning.

Mitch Roberts: Why don’t we start off with you telling us why hospice care is so important for cancer patients and how we can help them out with some information on that this morning.

Dr. Kris Gast: Well I think a lot of patients and families have a misrepresentation of what hospice care is. There’s actually two branches of hospice care now. There’s general hospice where the patient is cared for, they’re terminally-ill, it is the only Medicare benefit that is covered in the sense that the patients are eligible for both medicines, equipment, 24/7 days a week care and post-care for the family after the patient passes. The main thing about hospice is that it takes such good care of patients in the process of the end of their life no matter what they’re diagnosis. The criteria for Medicare is that they have less than six months to live based on what their physician has assessed. The other branch of hospice care is called palliative medicine. It’s completely different in the sense that there’s no limitation in terms of diagnosis. This is just basically a extra layer of care for patients to have that have a very serious illness and it helps keep them and their family better cared for. It’s an extra asset for them on top of their regular patients.

Mitch Roberts: Ok we were wondering exactly if we could break down the difference between hospice and the palliative care you’re describing. Sometimes when a family is facing the death of a family member it is so tough for everyone to weed thru all the information and decide what’s the best step and what’s needed for each individual family might be different than the next family.

Dr. Kris Gast: Palliative medicine is for patients who are undergoing treatment of any type, they have a multiple list of diagnosis ranging from heart failure to COPD, Alzheimer’s patients, cancer patients as well. Those patients aren’t necessarily expected to be terminal. They’ll be going thru active curative treatment. But it’s just an additional branch of medicine that helps take care of them while they’re doing that. Hospice medicine is specifically for the end of life care. When patients are at the end, they’ve gone thru everything and it’s time to help them passionately and compassionately get thru to death basically.

Mitch Roberts: Well I know the clinic also has some updates they’d like to share with people, when it comes to women with diabetes and certain medications. I know you want to share that with folks this morning. The medication is Metformin? Do I have that correctly pronounced?

Dr. Kris Gast: That’s correct. It’s a very commonly used medicine for diabetes and there was a study that came out just last week that was a very large study, it was part of the Women’s Initiative Group. The data from that, which was almost 70,000 women in it showed that women who were taking Metformin actually had a 25% lower incidence of breast cancer. So, Metformin is a good medicine, it has lots of side effects but it’s always nice to find out when you have an actually good side effect.

Mitch Roberts: Yea, you always here those commercials on TV with every side effect in the world that you wouldn’t want. Finally, you bring us a good news story. Well we certainly appreciate that. For more information or questions if you’d like to email Dr. Gast, you can do so at Dr. Gast is a monthly guest on 5 Sunday Morning, we’ll see her again in July. She is now the exclusive oncologist for Health Connections and soon to be on 5 Noon News Online. Dr. Gast thank you very much for joining us.


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Benefits of PSA Testing for Prostate Cancer


Ashley Beck: Dr. Kris Gast with Fort Smith Radiation Oncology is back with us this morning. This time around we are talking about the benefits of PSA testing for cancer. Thanks for being here, we are learning so much from your segments and this time around we want to talk about detecting prostate cancer, a PSA.

Dr. Kris Gast: That is the standard blood test for detecting prostate cancer, usually your primary care physician will draw that during your annual blood test. There has been in the last week a new study that came out, that was put out by a task force that has caused some stir even in my practice already, that said that the PSA screening was actually more harmful than beneficial. That’s causing a lot of controversy this last week in terms of trying to figure out where does that actually fall, in terms of what are we doing with this.

Ashley Beck: How big was the study or who was the panel behind it.

Dr. Kris Gast: Well, the task force is part of a non-profit volunteer panel of sixteen health care professionals that are basically trying to just make Americans healthier. They’re from the fields of preventive medicine, primary care, OB/GYN and nursing. There are no Oncologists on the panel. Basically what they did is look at epidemiological data and they gave the PSA testing a grade D meaning that it appeared that it was more harmful to just standardly screen healthy men between the ages of 50 and 70 and detect cancer, than go ahead and use it and find your cancer at an earlier stage. So that’s been very confusing to a lot of my patients. They made no recommendations in terms of once you’ve been diagnosed with cancer, in terms of treatment. There’s no recommendations on that. They’re recommendation was that we don’t use the PSA for screening anymore.

Ashley Beck: Well this is obviously one study, so where do we go, I know you said this is so early, in protocol, where do we go from here?

Dr. Kris Gast: Well, I think, they’re main thrust right now is that we use this information to basically open dialog between the man and the doctor. To sit and really talk about what does this PSA mean, what is it going to lead to if it comes back elevated, and what are the procedures that are going to have to be done. And then if there is cancer, what are the options. But, the task force was looking at the population as a whole. You know, a group of patients, the population, not each individual patient. On an individual level, each person still has to make their own decision. This won’t make any changes in terms of reimbursement from Medicare or insurance carriers. It’s not like it becomes a new wall where you can’t have a PSA but it should open up some dialog between the patient and their physician.

Ashley Beck: So really, to take away from this, you really just need to be talking with your doctor, you need to have that open conversation so that you can determine what’s best for you. Because what’s best for me may not be best for the next person.

Dr. Kris Gast: Exactly, and that’s really the way that most of radiation oncologists and neurologists approach prostate cancer. Each individual patient is looked at specifically. Even when we get to a process of a man who has a diagnosis of prostate cancer, we don’t just shotgun and treat everyone. I follow a number of men who are on what we call watchful waiting which means they’ve had no treatment whatsoever but we check their PSA’s periodically and just keep an eye on them. There’s a lot of different options in terms of male screening vs not screening and also treatment. Each one has to be individually made for each patient.

Ashley Beck: Let me ask you this, have we seen the death rate fall because we’ve been doing PSA testing?

Dr. Kris Gast: Well that’s another thing that was somewhat concerning as well, since we’ve been using the PSA screening, the death rate from prostate cancer has fallen. Prostate cancer is our #2 cancer, #2 killer in men for prostate. It’s right behind lung cancer in that respect. One in thirty-six men, or one out of thirty-six men, will die of prostate cancer. It’s not necessarily a cancer that you can really fool around with too much. Now with that being said, it’s very difficult to determine which of your prostate cancer patients are going to eventually have problems from the prostate cancer. That’s where we get into that individual discussion and trying to decide what to do.

Ashley Beck: There are options, there is treatment and obviously this study that’s just out, we’ll be talking about this more. Before I let you go quickly I wanted to talk about National Cancer Survivors Day.

Dr. Kris Gast: This is a world-wide event, this is our 25th year. It’s basically just a celebration of life for our cancer survivors, our prostate patients as well. Reynolds Cancer Support House is our sponsor, they’re really going all out this year, they’re having it at the Phoenix Expo on Saturday June 2nd, from 1 to 4. It’s kind of a drop in type of thing, but there are a couple of different things that are happening. At 2 o’clock I’ll be talking, at 3 o’clock there’s the survivors recognition but there’s a lot of other activities. There’s kids things, I think they’re going to be fingerpainting kids and all, there’s games. My team at work has put together gifts for each survivor that shows up.

Ashley Beck: Well, come out so we can all celebrate together, a big day. Don’t forget if you have any questions just email Dr. Gast at, they’re in Fort Smith, you can also mail in your questions as well. Dr. Kris Gast thank you for being here, we’ll be seeing you guys soon.

Dr. Kris Gast: Thank You

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Dr. Gast Interview: Cancer Prevention


Ashley Beck:Fort Smith Radiation Oncology is the only local owned and operated radiation cancer treatment facility in the River Valley. Here to give us some tips on what
you can do to prevent cancer, Dr. Kris Gast joining us this morning. Thank you for being here. February, a very important month when we’re talking about cancer. Tell us more about that.

Dr. Kris Gast: February is actually cancer prevention month and I think we kind of forget about that, you know October is breast cancer month but February is cancer
prevention month so I thought that we could just wrap up the month by reviewing some of the different ways that your viewers can try and decrease the risk of getting cancer.

Ashley Beck: This is going to be a very important topic that we have the next few minutes to talk about. First thing we wanted to touch on is someone who has already survived cancer, what they can do with their treatments to prevent it from coming back.

Dr. Kris Gast: Right, well basically those patients really can do the same things that you and I can do. Maintain a healthy weight, which basically means eating a healthy
diet. Cancer wise, not to get into too many specific details, but that basically means less fat and less calories.

Ashley Beck: Ok

Dr. Kris Gast: So dietary restrictions in that respect. That’s always very hard for everyone.

Ashley Beck: It certainly is right? So hard, ok. That’s a very important factor, very important.

Dr. Kris Gast: The other thing that goes along with the dietary intake is the alcohol. You know we do have some recommendations from the cardiac arena if you will that a
small glass of dry red wine is extremely good for a cardiac status but we really have to limit the alcohol intake. Alcohol is a very potent toxin in terms of causing cancer. That’s kind of the three dietary things. Along with that exercise. Exercise has been shown to descrease risk of a certain number of cancers. Breast cancer, prostate cancer, lung cancer, so that’s also very important. While you’re out excersizing we also want to be aware of the sun exposure. A lot of my elderly patients already have skin cancer. Their exposure came at a time when we didn’t know of the link between skin cancer and sun exposure. But it’s basically take care of your skin now that we know.

Ashley Beck: So all these tips are things that you can do, you can start doing right now, it’s not going to cost you any money and of course we can help prevent cancer in
the long run.

Dr. Kris Gast: And there’s one thing that you can do that will actually make you money or save you money and that’s stop smoking or chewing tobacco.

Ashley Beck: Which leads us to the next thing we wanted to talk about because we know that it really plays a role in cancers.

Dr. Kris Gast: Yes, smoking, tobacco, either chewing or smoking are linked with so many cancers that, there’s just, if we could eliminate that from our lifestyle, I would
be out of business and I would be so happy.

Ashley Beck: That would be a definite big cure, something you can prevent and like you said save yourself some money as well. We talked about how important it is to eat right and to get outside to exercise, to wear your sunscreen while you’re doing all of this. So how does healthy weight and staying active, in terms of numbers, lower a
persons risk for cancer.

Dr. Kris Gast: Well, if you think about the, the different cancers that are linked to those factors, I mean you’re talking about your very top, you know, cancers, breast
cancer, prostate, colon. You’re top three or four cancers are linked with these behaviors, so it’s going to dramatically decrease. And of course, lung cancer is so tied with smoking. The head and neck cancers which are cancers of the oral cavity and the mouth and throat, extremely linked with chewing tobacco and smoking and alcohol. You know, all those would be just dramatically reduced.

Ashley Beck: That would be so wonderful.

Dr. Kris Gast: Yes

Ashley Beck: You know, things you can do yourself. There is another we wanted to touch on, STD’s and these infectious diseases, how they lead to cancer as well.

Dr. Kris Gast: Right, and these are kind of newer things, that I think that the public are just becoming more aware of. Hepititas B is linked with liver cancer and there is a vaccine for that now. And of course HPV which is the human paploma virus is now linked with several different types of HPV or linked with cervical cancer and there are vaccines for those. And those are all basically tied with having safe sex. And AIDS of course has a link with safe sex, and AIDS patients are much more susceptible to different types of cancers.

Ashley Beck: It’s a scary thing. We know early detection, so important. Reiterate why early detection is so important.

Dr. Kris Gast: Well, just remember that early detection, you find it earlier, you have a much higher rate of cure. And that’s the whole name of the game with cancer. So, find
it early, incorporate the early detection as part of your prevention plan, keep up with your mammograms, your PSA, colonoscopy, you know, your skin checks, and you’ll be on top of it.

Ashley Beck: Well then, February being prevention month for cancer as Dr. Kris Gast is saying, eat right, excersize, you know, do all those things, take care of yourself. And if you are in a position where you are dealing with this, or your loved one, they are there to help you out.

Ashley Beck: 8500 South 36th Terrace in Fort Smith is where you’ll find Dr. Gast and her team at Radiation Oncology, you can also give them a call, they’re phone number is
648-1800 or logon to, which stands for Fort Smith Radiation Oncology.

Ashley Beck: Thank you for being here. We always are so informed and of course right now we also wanted to put this information up where you can email as well. If you have any questions, Dr. Gast is more than happy to help you, so there’s the email address and I’ll give you a second if you’ve got a pen handy to write it down. Or you can also write those questions in, it’s a PO Box 5710 in Fort Smith, the zip code is 72913.

Ashley Beck: Thanks for being here, thanks for answering the questions and we hope to see you very soon.

Dr. Kris Gast: Thank you, it’s always a pleasure to be here. I’ll see you next month.

Ashley Beck: You are waking up with 5 Sunday Morning, we’ll take a break, we’ll see you right after it.


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