Medical Tests & Procedures Archive

Worry is driving some women to unnecessarily have both breasts removed.

Living through the physical and emotional toll of breast cancer is so traumatic that some women can't bear the thought of doing it again. That's why a growing number of women who have already been diagnosed with cancer in one breast are taking drastic measures to avoid getting cancer in the other, by having both breasts surgically removed (a procedure called prophylactic mastectomy).

Which is a better predictor of memory loss?

Two tests are available to determine if you are at increased risk for getting Alzheimer's disease: a test for a gene known as APOE4 and a brain imaging test called a PET scan. A recent study in the journal Neurology finds the brain scan is a better predictor.

The PET scan can detect a protein called beta-amyloid that is found in the plaques observed in the brains of people who are later diagnosed to have Alzheimer's disease. The recent study performed both tests in 141 older people who had no cognitive impairment and then followed them for 18 months. Those with high levels of beta-amyloid in the brain were more likely to have a deterioration in mental function than those with the APOE4 gene.

Treating seniors requires attention to more than heart disease.

A Harvard team's breakthrough may make it possible.

A fundamental strategy in the war against cancer is to catch it early—before it has spread, when it's easiest to remove. Unfortunately, some cancers, such as brain cancer and ovarian cancer, remain difficult to detect until the end stages. But that's changing. A Harvard team has discovered a simple, noninvasive way of catching cancer early—by looking at a blood component that's been ignored by the medical community for decades.

Harvard researchers develop a tool to improve decision-making.

Treatment for a herniated disc—the rupture of one of the cushions between the bones of your spine—can range from physical therapy to pain-relieving injections to surgery. But when you and your physician decide on a treatment plan, are you well informed about its possible effect on your quality of life down the road? "It's a big problem if patients don't know what the disease is and what their options are. Research shows that if we did a better job of informing and engaging patients, there would likely be fewer major surgeries," says Dr. Karen Sepucha, assistant professor of medicine at Harvard Medical School.

Finally, lasers for cataracts, thanks to 3D imaging.

We often think of three-dimensional (3D) images and lasers in terms of science fiction movies. But these two technologies are now being used in the very real realm of cataract surgery. "They both already exist, and we are just now bringing them together for novel use," says Dr. Roberto Pineda, director of refractive surgery at the Harvard-affiliated Massachusetts Eye and Ear Infirmary.

Cataract surgery

When the natural lens of your eye becomes cloudy—often with age—it's called a cataract. It can be removed and replaced with an artificial lens implant. This is a common outpatient procedure. An ophthalmologist uses surgical instruments and ultrasound power to break up, remove, and replace the eye's cloudy lens.

Zeroing in on who might be eligible for this first-line treatment.

For the first time, dermatologists now have official guidelines for Mohs surgery, a procedure that removes skin cancer while minimizing damage to surrounding healthy tissue. The new Appropriate Use Criteria (AUC) for Mohs surgery, approved by a number of dermatologic associations, will help doctors better select patients for the procedure. "There can be a slight bias toward using it for almost all nonmelanoma skin cancers, since Mohs surgery offers the highest cure rate of any surgical procedure for skin cancer," says Dr. Tom Rohrer, a Mohs surgeon at Harvard-affiliated New England Baptist Hospital.

For people with non-small cell lung cancer that carries a mutation in the gene KRAS, a combination of the drug selumetinib and the chemotherapy drug docetaxel may be more effective than chemotherapy alone.

New approaches from Harvard offer hope.

Finding a way to prevent Alzheimer's disease (AD), or to reverse the damage it does, is one of medicine's great challenges as we enter 2013. Over the past 20 years, great progress has been made in understanding the changes in brain chemistry that lead to AD. Yet translating this knowledge into treatments has been difficult. Witness the collapse of two major AD drug trials this past autumn (solanezumab and bapineuzumab). But two Harvard doctors are forging ahead with entirely new approaches that offer hope for meaningful treatment in the near future.

Q. My dermatologist is recommending Mohs surgery to remove a basal cell cancer on my nose. What does this involve?

A. Mohs micrographic surgery is named after Frederic Mohs, who developed the technique in the 1930s. It's a specialized surgical procedure used to eliminate skin cancers that spread locally (but do not spread through the body) and are likely to return unless all the cancer is cut out. The goal of Mohs surgery is to remove all of the cancer cells while preserving as much of the normal tissue as possible. To do this, the surgeon removes the cancerous tissue layer by layer, examining each layer under a microscope, until the outer edge of the removed layer (the margin) is free of cancer cells.