Thursday, August 30, 2018

The Doppler Ultrasound for Cancer Scanning; Not Your Obstetrician's Sonogram

When you think "sonogram", what might come to the average mind is probably a blurry scan of an expectant mommy's tummy from an obstetrician's clinic.  But the advancements in ultrasound technology has been widely expanded upon by European medical engineers and clinicians and is used more commonly to challenge the performance of all other imaging equipment to accurately capture complete diagnostics of some of the most complex examinations - such as CANCER.

Below is an excerpt from Dr. Robert Bard's interview at WIOX Radio (Soul Traveler Healing Journeys show with host, Kevin Misevis)

EUROPEAN SMART IMAGING RESHAPES U.S. MEDICINE
Sonography has been used for over 50 years for diagnosing everything from cancer tumors and cysts to microfractures on bone.  As the technology has gotten better and medical practice has taken advantage of the new computers, we can do so much more and do it better.   Most of the advances in ultrasound have occurred in Europe. The United States is slightly slow in recognizing some of the medical advances, particularly in the field of ultrasound imaging. A lot of the training I did was in Europe (Spain and France) so I brought back European technology and European ideas to New York.

With that said, my advanced American-made equipment shows not only the picture itself, but we can see the picture in motion in real-time. For example, we can see blood flow in a tumor. Now, the blood flow in a tumor is like seeing a hurricane or a storm on a weather map. We see the blood flow in an area that you're studying, (such as the prostate, for example) and it's got one or two cancer vessels, it's bad. If it has 10 cancer vessels, it's very bad.

This is the technology we have today that's widely available. We have regular ultrasound, safe sound waves, and we have the blood flow technology.  However, further development allows us to do three dimensional ultrasound imaging. Once you have 3D, you get the entire volume of an area.  What's even more interesting is with the special technology, if the exam is performed by a physician, as it generally is not in the United States, in Europe and Asia, the doctors who interpret the exam also do the sonogram, so once you've got an image on it, you can take a 3D picture and then using another modality on the machine, you get into 4D imaging, so anything you're seeing in three dimensions, you can expand or adjust so you can see the borders much more clearly.  That means if somebody's got a prostate cancer, for example, we can tell them not only how big it is, but also how aggressive it is. More importantly, with the 3D or 4D imaging, we can look at the capsule, the margins of a tumor to see if the margins are irregular or if the tumor has broken outside, say, of the prostate capsule that holds the gland intact. With all this new technology, we can do many things that didn't used to be possible and more than what other imaging devices fall short of.

Accuracy depends on the area being scanned. Specifically in skin cancer, we're 99% accurate. This means that a high resolution sonogram of the skin for melanoma specifically is more accurate than the biopsies, which can be random in nature on the skin, and this was first reported by the French Cancer Institute 20 years ago, so this is not a new technology. 20 years ago, it was 99% accurate at detecting the penetration of a malignant melanoma tumor.  For other areas such as the prostate, with the right technology, we have a 99% accuracy rate of telling a patient if there's no active cancer present, so we can determine with a high degree of certainty that whatever they're worried about, whatever the blood tests show or whatever the finger feels, it won't kill you.

Identifying the accuracy of a real cancer, we have I'd say a 95% accuracy with the specialized equipment. But the major test for the prostate is the PSA blood test.  In 2004, in the Journal of Urology, they said that the accuracy of the PSA test for detecting cancer is 2%,  It's not very accurate. Specifically, what I tell my patients is the finger is two times more accurate. The digital rectal exam of the prostate is two times more accurate for finding high grade prostate cancer than the PSA, and it goes up to 3% accuracy if I do it myself.


EVOLUTION & ADVANCEMENT OF DIGITAL IMAGING
In 1974, when I was in training as a resident in radiology, my chief of service said, "What area of radiology do you want to specialize in?" I said, "Diagnostic ultrasound," and he laughed at me.   Since then, ultrasound has become the primary diagnostic tool used throughout the world. In other words, it's the first study for almost everything, but then again, you've got to have the equipment and the training and the interest, and America has not kept pace with the world's usage of advanced modern technology.

This is highly accurate. Indeed, patients are finding problems and we can tell them if the problem is really serious or not, much  like a "digital biopsy". Basically, the accuracy is so high now that doctors are starting not to biopsy.  For example, we used to biopsy a cyst in the kidney 40 years ago, and now we see it on sonogram and we say if it's a cyst, you watch it. You don't biopsy anymore. The same thing, about 20 years ago, we stopped biopsying cysts in the breast because you can see it's a simple fluid-filled sac.

READING BLOOD FLOW TO STUDY TUMORS
Now, with the advances in blood flow technology, which are confirmed by the CT and MRI technology, which I use concomitantly, in other words, if you see something on a 3-D Doppler Sonogram in the prostate, you do get a confirmatory MRI. Oftentimes, people decide to get treated and be followed because we can non-invasively watch the treatment progress.  In other words, remember I said 10 cancer blood vessels in a tumor? If you start a treatment and it goes down to five in a month, you're winning, and if it goes down to one after six months, you're definitely winning. It's a way to follow up a cancer treatment as well as to tell people how aggressive it is.

Wednesday, August 15, 2018

Cancer Alert: Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Note: The original publishing of this article is from AWARENESS FOR A CURE and PinkSmart News on July 31, 2018. (LINK)  This article is an overview reflecting a recent health alert from various medical centers and clinicians about a possible cancer risk resulting from a specific type of breast implant.  If you may recognize yourself to be a candidate or have received a similar notice from your reconstructive surgeon, please contact your physician to get more details.

Since 2011, the FDA identified a confirmed link to a specific type of breast implant and breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL - a form of cancer of the immune system called non-Hodgkin’s lymphoma.  The World Health Organization (WHO) describes BIA-ALCL as a T-cell lymphoma that may arise within 7-8 years after the insertion of breast implants with textured surfaces.  Half of the reported cases were diagnosed with persistent SEROMA, a buildup of fluid around the implant region (see image) and presenting symptoms of swelling, pain, and redness and breast asymmetry of the affected breast.

By 2017, 359 cases of ALCL has been reported thus far and 9 deaths (2.5%) have been identified since the inception of this study where the majority of cases reported had textured implants versus smooth implants.  The very texture of the implant's coating has been said to cause inflammation and scarring that can led to lymphoma, while others attribute the texture to trap bacteria which leads to cancer.

According to the FDA, certain manufacturers have been reviewed and connected with implant-specific risks since 1999 associating their textured implants with ALCL.  Worldwide, approximately 1.4 million breast augmentations were performed in 2015. In the United States, 290,467 breast augmentations were performed in 2016; this represented a 37% increase from 2000.  BIA-ALCL most commonly occurs in patients of a median age of 52 years. The median time interval between breast implant and diagnosis is 9 years and ranges from 1 to 32 years.

Jennifer Cook, a diagnosed victim-turned advocate of BIA-ALCL awareness is promoting a global mission and educational program to support all women who are potential sufferers of this problem. "...there is extreme urgency because this disease can go from being curable with surgery to a disease that may take your life quickly-- because it's advanced...(in) a matter of a few months." In a private interview, she detailed her personal research and her actual experience of self-checking and finding anomalies and unusual feelings that breast surgeons addressed only with minimal concern. Her pro-activeness and perseverance led her to a powerful direction of self-preservation. "it was the biopsy of that lump that led to my diagnosis. I actually had a mass that was diagnosed before the explant ... like most cancers, you know the sooner you get to it, the much better chances you have.  The situation is obviously a huge concern because currently experts are advising women who test negative, that their seromas are benign and that they do not necessarily need to have their implants removed. We feel that this is misleading given the fact that at least five women we know of have recently had negative fluid but positive capsules."

Because BIA-ALCL has generally only been identified in patients with late onset of symptoms, implant removal in patients without signs or symptoms is not recommended.  Dr. Robert Bard, a NYC based cancer imaging diagnostician recommends a regular monitoring schedule for any adjustments or shifts in the current stasis of the implant and its surrounding area. "Fluid build up may be easily imaged by 3D sonography although it can be detected by MRI scans as well (9). Under ultrasound guidance, fluid may be aspirated and analysed in real time without rupturing the implant or puncturing nearby arteries."

It has been noted that among operable patients, total capsulectomy with removal of suspicious lymph nodes is the first line of treatment and complete surgical excision (capsulectomy and implant removal) resulted in better overall survival and event-free survival compared to patients who underwent a limited surgery or treatment with systemic chemotherapy or radiation therapy.

..............................................................................................................................................................

REFERENCES:

9) Bard R, 8th International Workshop on PET in lymphoma, Menton, France 2018

10) ALCL In Women With Breast Implants BIA-ALCL:

..................................................................................................................................................................................................
DISCLAIMER:

The information provided in this article is a compiled report from public websites whose links are listed in the REFERENCE section and the statements and quotes included are from actual interviews by those whose names are stated who provided express consent to the publishing of this material.  This article is not meant to be used to diagnose, treat or advise others about what actions they should take with regard to any medical condition.  No one should undertake or discontinue any treatment as a result of what they read on our blogs. The publisher(s), editors, sponsors or other  "supporting members" of AwarenessforaCure.org are providing a strictly educational service and are not responsible for the diagnosis or treatment of any specific health needs. and are not liable for any damages or negative consequences from any treatment, action, application or preparation to any person(s) reading the information in this article or its thread. Readers with medical needs should obtain appropriate professional medical supervision. References are provided for any informational purposes only and do not constitute endorsement of any websites or other sources.

Sunday, July 8, 2018

LONG ISLAND BREAST CANCER & THE ROAD TO DOPPLER IMAGING

By: Dr. Robert Bard


In 1976, during my early days as a young radiologist, I was approached by Dr. Henry Leis Jr., the pioneer doctor who wrote the very first text on breast cancer and developed mammography 18- a means of early diagnosis and instrumental in the use of many of the less invasive procedures used in the treatment of breast cancer today.

He confessed with great concern that he had all these patients with lumpy or cystic breasts developing tumors that he could clearly feel but the mammogram kept missing it.  Seeking my help through sonogram technology, we worked on his patients together and the sonogram clearly identified and quickly diagnosed a mass as either a cancer or a benign cyst, in a dense, lumpy breast.  Since then we've incorporated the sonogram in high-risk patients’ regimen every six months religiously because it finds tumors while they're small and “lumpectomy” surgery is curative if the mass is less than 1 cm.  This is alongside doing mammograms once a year in women over 50 or unless they have a history of cancer- at which case, we do it starting at age 45.

LONG ISLAND CANCER- THEN AND NOW
Since the early 1940’s, Long Island became riddled with countless cases of toxic waste and hazardous dump sites contaminating groundwater and wells with volatile organic chemicals and carcinogens.  Much of this was known as the Bethpage Plume thanks in part to the Grumman manufacturing plant, Naval Weapons Industrial Reserve plant and Hooker Chemical/Ruco Polymer site.  Record levels of radioactive materials such as chromium and radium continue to plague its drinking water today despite decades of cleanup efforts and water treatment plant upgrades.  Scientists have speculated a direct connection between Long Island’s reportedly high rate of breast cancer (alongside other cancers) over the national average and this cancer plume.

In 1985, a major study of Long Island patients in the NY State Journal of Medicine showed over 90% of the suspect calcifications that showed up in mammograms were proven benign after surgical biopsy, resulting in unnecessary treatments that nowadays are avoidable.  Unfortunately, the increase in inflammation in the breast which was causing the calcification was what instigated the greater risk of developing actual breast cancer. The current 2018 American College of Radiology statistics state that women with dense breasts are 500% more likely to develop benign, or malignant tumors than women without dense or lumpy breasts.

To address this overdiagnosis, they started using the MRI to detect breast cancer in the 1990’s- but this too showed inconsistent levels of inaccurate readings as far as things that looked suspicious and looked like breast cancer- similar to Dr. Leis’ negative mammogram readings.   By the advancement of the new 3D ultrasound systems, we were able to find and discern a true cancer from a cyst, or one of these benign post-inflammatory reactions mimicking a cancer on the MRI and the mammogram.

Some women (with diabetes as one example) tend to have inflammation that forms lumpy areas in the breast which causes scarring - scarring that can give a false reading and actually feels like a breast cancer.  Scenarios like these tend to trick the less experienced diagnostician or older technologies into false reports.   Since the introduction of the Doppler blood flow technology, we are able to see the entire cancer vessels and actually gives you a road map to the tumor. The 3D technology allows you to look at the map and measure how many cancer vessels there are. In patients who are taking non-traditional treatment or on immune or chemotherapies, you can see if the number of cancerous vessels are larger, which means the treatment is failing. Or, if it goes from five blood vessels down to one tumor vessel- an indication that the treatment is working.

WHY GO DOPPLER?
There are other ways of looking at blood flow in tumors. CAT scans and CT radiation imaging was spectacular at finding breast cancer except the radiation dose was so high that patients were developing lung cancer from it. Also, claustrophobic people couldn't fit into the CT or the MRI tube. MRI also uses the blood flow technology but some people are allergic to the contrast from the CT or the MRI. We also learned that the MRI contrast is depositing now in the brain, causing other problems that we're just being aware of. 

The Doppler Sonogram is technically instantaneous. You put the probe on the breast, find the area, pinpoint it, press a button and seconds later you have the map showing the types of vessels, the location of the  vessels. You have a program on the computer to give you a vessel density measurement which shows how aggressive this is. Instead of the genetic markers, which are very popular, showing how aggressive a tumor will be, this is a visual way in seconds that's being used worldwide to show cancer vessel aggression. Tumor aggression by blood flow evaluation is used worldwide in nuclear medicine, CT  scans and MRI technology, however, the simplest way is the non invasive 3D Doppler breast procedure.


Additional References:
1) Local clustering in breast, lung and colorectal cancer in Long Island, New York

2) Breast Cancer Incidence- Nassau County, 2005-2009

3) 3-D Doppler Ultrasound Helps Identify Breast Cancer

4) Doppler ultrasound scoring to predict chemotherapeutic response in advanced breast cancer
...................................................................................................................................................................

For more information or to discuss the many benefits of ADVANCED ULTRASONIC DOPPLER IMAGING, contact us directly at:  212.355.7017 or email: appt@barddiagnostics.com

Monday, April 30, 2018

Advanced Diagnostics and the Rise of Post 9/11 Aggressive Cancers


by: Dr. Robert Bard

I started my career in medicine in 1968 and enlisted in the US Air Force during the Vietnam era as a radiologist. There I learned the discipline of immediate response to the call of duty, whether it be for the protection of our country or rescuing human life. The 9/11 tragedy brought out that same spirit when our first responders called for help.

I extended my practice to the many police personnel, firefighters, contractors and volunteers who were exposed to toxins or were injured in ground zero during and after that fateful attack, and one by one, cases of knee and hand injuries from rescuers who struggled with the many flights of stairs of the towers or dug out hot and heavy rubble to respond to cries for help. I also handled other TRAUMA cases like eye injuries where my technology was the most effective way to quickly and accurately identify a dislocated lens, retinal detachment and foreign matter (glass or splinter) that made its way behind the swollen eye lid or into the blood stream.  My group tackled each injury with the best of care, compassion and the highest commitment to recovery using minimally invasive sonogram diagnostics.

A decade or so later, news broke of unique and advanced cases of CANCER arising in droves.  The same individuals exposed to the toxic fumes and plumes of hazardous particles of the danger zone contracted aggressive cases of CANCER and were in immediate demand for medical care and support.  My practice was no stranger to this dilemma as I began meeting and diagnosing cancer tumors in the lung, liver, kidney, brain, skin and eye probably related to 9/11 exposure.

I personally met James Zadroga in 1992 at a public event. The name did not impact me until way past his untimely demise on 2006. Having connected with John Feal of the FealGood Foundation, we put all the pieces together as far as the extensive yet never-ending work that still has yet to be done to bring much needed support, compensation and political awareness to help the many survivors and affected rescuers of the 9/11 disaster.  The Zadroga Compensation Act was established (2011) by a group of D.C. advocates who drove legislation to ensure that those exposed to the 9/11 disaster continue to receive monitoring and treatment services for 9/11-related health problems through at least until 2090.

My practice, BARD CANCER DIAGNOSTIC IMAGING (NYC) has isolated and scanned countless cases of cancers using the most advanced diagnostic imaging technologies worldwide.  We provide early detection and real-time "digital biopsies" of many tumor types using 4D Doppler innovations bringing accuracy and expedience to the most comprehensive report- within MINUTES.  For our patients, this is a priceless advantage that cuts down the wait time, decreases travel (to multiple diagnostic centers) and reduces the insurmountable level of stress and intolerable problems of today’s increasing medical bureaucracy.  Our technology outperforms the advantages of MRI, X-ray and CT scans by 20-to-1.  We have an uncompromising system that’s unique to the industry whereby our combined experience and technical advancements are called upon by many university hospitals and private practices today.  My services were recently utilized during the terror attack in Nice by the truck driver who mowed down innocent civilians on the French Riviera where-x-ray and CT services were overwhelmed (I am a current member of the French Radiology Society-Societe Francaise de Radiologie and have been since 1999)

If you may have been recently diagnosed or have realistic concerns about 9/11-related cancers, contact us immediately at 212.355.7017.  We are available to discuss your options and work with your physician on the many ways that our advanced 4D Digital Diagnostic System for post 9/11 trauma or cancer cases can help you.  We are ready to work with the current compensation benefits fund to get you the best noninvasive diagnostic treatment available.

............................................................................................................................................................

John Feal and the FealGood Foundation: ENSURING CANCER CARE FOR 9/11 FIRST RESPONDERS

Nesconset, NY (April 20, 2018) - Meet Long Island's own John Feal- an injured Ground Zero contractor turned national super-advocate and champion for the prevalence of the 9/11 VICTIMS COMPENSATION FUNDTHE WORLD TRADE CENTER HEALTH PROGRAM and the JAMES ZADROGA ACT. He founded the FEALGOOD FOUNDATION, the largest 9/11 support organization in the country-borne from frustration to the inaction and lack of governmental support. He built a life-long career out of helping the many health victims from the 2001 disaster receive the financial compensation they deserve and gain a complete understanding of their rights for all 9/11 related injuries. His non-profit org is recorded as one of the largest fundraisers for this mission- amassing over $8.5M of active funding for the compensation bill plus another $5M raised to add to the WTC fund for first responders (since the inception of FGF in 2005) from online donations and public fundraising. John Feal became a major voice for all first responders working tirelessly between local and national fronts to gain legislative stakes for the rights of all those exposed to the many health hazards of ground zero.

By 2010, a new form of devastation appeared out of the shadows: a significant number of advanced and aggressive cancer cases suddenly grew within the many surviving rescuers and ground zero exposed. These victims were formerly cleared of any illnesses at first testing are now showing surprising numbers of cases of over 68 cancer types in the blood, brain, lung, liver, thyroid and skin. The 2010 bill was passed at a time when there were NO cancer cases, hence funds and congressional support was not prepared for any of this. The tsunami wave of new cancers that mutated after 8-10 years of dormancy does not even (yet) account for the "asbestos cancer... because that takes 20 years on average to manifest in the body, and we're now going on year 17," says Feal. Hence, new lobbying efforts for advanced cancer care treatment are now in full swing and Mr. Feal faces an even larger hurdle to upgade his mission to meet the current needs. (Complete interview coming soon.)

To learn more about the FealGood Foundation or to Donate, visit: www.fealgoodfoundation.com

...................................................................................................................................
Science Feature as seen on Rejuvenate! E-magazine

Tuesday, April 24, 2018

John Feal and the FealGood Foundation: ENSURING CANCER CARE FOR 9/11 FIRST RESPONDERS

Nesconset, NY (April 20, 2018) - Meet Long Island's own John Feal- an injured Ground Zero contractor turned national super-advocate and champion for the prevalence of the 9/11 VICTIMS COMPENSATION FUND, THE WORLD TRADE CENTER HEALTH PROGRAM and the JAMES ZADROGA ACT. He founded the FEALGOOD FOUNDATION, the largest 9/11 support organization in the country-borne from frustration to the inaction and lack of governmental support. He built a life-long career out of helping the many health victims from the 2001 disaster receive the financial compensation they deserve and gain a complete understanding of their rights for all 9/11 related injuries. His non-profit org is recorded as one of the largest fundraisers for this mission- amassing over $8.5M of active funding for the compensation bill plus another $5M raised to add to the WTC fund for first responders (since the inception of FGF in 2005) from online donations and public fundraising. John Feal became a major voice for all first responders working tirelessly between local and national fronts to gain legislative stakes for the rights of all those exposed to the many health hazards of ground zero.

By 2010, a new form of devastation appeared out of the shadows: a significant number of advanced and aggressive cancer cases suddenly grew within the many surviving rescuers and ground zero exposed. These victims were formerly cleared of any illnesses at first testing are now showing surprising numbers of cases of over 68 cancer types in the blood, brain, lung, liver, thyroid and skin. The 2010 bill was passed at a time when there were NO cancer cases, hence funds and congressional support was not prepared for any of this. The tsunami wave of new cancers that mutated after 8-10 years of dormancy does not even (yet) account for the "asbestos cancer... because that takes 20 years on average to manifest in the body, and we're now going on year 17," says Feal. Hence, new lobbying efforts for advanced cancer care treatment are now in full swing and Mr. Feal faces an even larger hurdle to upgade his mission to meet the current needs. (Complete interview coming soon.)

To learn more about the FealGood Foundation or to Donate, visit: www.fealgoodfoundation.com

...................................................................................................................................
Science Feature as seen on Rejuvenate! E-magazine



............................................................................................................................................................

Friday, March 30, 2018

Dr. Bard Receives Top International Honor in 2018 CME Convention- NYC


March 28, 2018, NYC-  As only the second American recipient of the Spanish Medical Society CME Diploma, Dr. Robert Bard (of Bard Cancer Diagnostics, NYC) was an honored recipient at the American Institute of Ultrasound in Medicine (AIUM) Annual Convention on March 28 at New York Hilton in NYC. This medical event is for ultrasound professionals from various medical disciplines and specialty areas who perform and interpret ultrasound examination.

Grantees of this special award include Dr. Ximena Wortsman (center) publisher of 2 major textbooks on skin sonogram-from Santiago Chile. Also presenting this award to Dr. Bard is the President of the International Dermal Ultrasound Group- Dr. Fernando Alfageme - one of the leading dermatologists from Madrid, Spain who wrote the first textbook of Dermal Sonography.  This award grants Dr. Bard an Honorary Membership to the Spanish Ultrasound Society recognizing his teaching work in European and Spanish Congresses. Only a small handful of American professionals are awarded this honor- including Dr Marnix Van Holsbeeck, president of the International Musculoskeletal Society and Sports Doctor for the Detroit Redwings and The Denver Broncos.


MEDICAL EXPERTS NEVER STOP LEARNING: 
Participants of this event gained advanced knowledge in:
  • basic science and instrumentation
  • cardiovascular ultrasound
  • contrast-enhanced ultrasound
  • dermatologic ultrasound
  • fetal echocardiography
  • general and abdominal ultrasound
  • gynecologic ultrasound
  • high-frequency clinical and preclinical imaging
  • interventional-intraoperative ultrasound
  • musculoskeletal ultrasound
  • neurosonology
  • obstetric ultrasound
  • pediatric ultrasound
  • point-of-care ultrasound
  • sonography
  • ultrasound in resource limited-areas and 
  • therapeutic ultrasound

Presentations also exposed all attendees to new information about state-of-the-art ultrasound research, practice advanced ultrasound skills for more effective diagnosis-- all for the directive of applying new knowledge and clinical skills from this event for improving patient care.


#    #    #

Wednesday, March 14, 2018

PREVENT POST-PROCEDURE COMPLICATIONS WITH 4D DIGITAL IMAGING


A SURGEON'S BEST PRE-OP PARTNER
by: Dr. Robert Bard

As health practitioners, we are so fortunate to be part of an era where information and technology is at its highest; where our performance is strongly advanced in accuracy, response and safety.  This has been made possible due to  artificial intelligence (AI) innovations in digital diagnostic scanning equipment.

Let it be scanning potential cancer tumors & malignant disorders or implementing additional 'detective work' on a curious anomaly on or under the skin, the use of  4D Doppler Sonographic technology captures so much more information with absolute precision and accuracy than the latest MRI's, X-rays and CT Scans, and we  cover more ground in REAL-TIME (give or take 5 minutes).

For all my friends in the practice of Cosmetic Surgery, DIGITAL PRE-OP is a highly useful stage for many patients who may carry hidden issues that can turn into a pandora's box of complications. I have performed this vital service for European plastic surgeons since 2001 in their centers  while currently performing domestically as a digital diagnostics partner for serious physicians and surgeons fulfilling similar needs.

Pre-operative imaging is widely performed to verify tissue planes and measure fat depth.  Since patients may have forgotten prior treatments, new scans sometimes reveal extensive sub-dermal calcium deposition, unsuspected fluid collections or thick fibrosis distorting the expected anatomy.  Anatomic variants may be observed and avoided. Moreover, patient confidence is enhanced by the extra care provided by this advanced technology.

Some of the most common POST-PROCEDURE COMPLICATIONS include:
- Suture loosening and granuloma formation following blepharoplasty
- Lipoatrophy or fat necrosis following PRP or abdominoplasty
- Filler complications and implant migration 
- Doppler verification of vascular compromise (venous or arterial) following facial therapies allowing immediate intervention to prevent blindness or tissue necrosis



CLINICAL LANDMINES
 Foreign body reaction created pigmented lesion simulating malignant melanoma

• Subcutaneous “fatty” tumor detected as lymphoma prior to liposuction

• Post PRP scalp swelling/seroma determined to be thrombosed traumatic AV fistula prior to needle aspiration

•  Post facial "thread tightening" hemorrhage rediagnosed as bacterial cellulitis



BENEFITS OF DIGITAL  PRE-OP  IMAGING 
1)Targeted biopsies means less scar formation: Sonogram differentiates cysts / lipomas / sebaceous hyperplasia from cancer

2) Blood vessel mapping for improved preoperative planning: Aberrant glabellar/periorbital vessels detected prior to filler injection/fat transfer

3) Healthy tissue spared for better cosmetic appearance: 3D/4D real time imaging guides operative intervention

4) Fat depth diagnosis leads to optimized thermal treatments: Unsuspected veins diagnosed / avoided prevents dvt-thrombosis    

5) Treatment follow up for early assessment of effect: Postop seroma / inflammation / hemorhage / necrosis diagnosed and scanned serially with non invasive modality

6) Midline subcutaneous lesion investigation: Sinus pericranii/sacral cystic connection to nervous system

7) Foreign body localization avoids surgical exploration: Tissue reaction may produce changes mimicking focal lesion and foreign bodies quickly removed under direct visualization
..................................................................................................................................................

IMAGING ASSISTS SURGICAL PLANNING OF INDICATED BIOPSIES
In my extensive career as the medical director of an advanced imaging diagnostics practice, I have provided great assistance to many surgeons with my work using advanced Doppler Scanning of Tumors and Cosmetic Disorders.  I have uncovered countless dermal and subcutaneous issues that would have otherwise gone undetected with less effective technologies, leading to potential complications in the surgical procedure and patient recovery.  The advancement in this innovation empowers any upcoming surgical procedure with remarkable confidence of a safer end result.  Where biopsies are becoming a thing of the past, our non-invasive 4D Digital imaging replaces weeks of lab work  and radiologic tests and often provides more useful information.



DIGITAL BIOPSY CASES: WHAT ARE YOU ABOUT TO BIOPSY?  WHAT HAPPENS AFTER THE NEEDLE  INSERTS?

Here we have 2 subdermal masses which are mobile, non tender and firm without history of trauma.

Case A: The oval mass (dark echoes=suspicious) with irregular vessels (red) was referred as a probable cyst or lipoma. The tumor is highly vascular and connected from the aorta by way of the subclavian feeding artery. Liposuction would result in massive hemorrhage and spread of tumor cells into the circulation.







Case B: The ovoid white region ( bright echoes=benign) is ossified as confirmed by the CT scan of the coccyx. The sonogram allows you to reassure the patient it is NOT CANCER. It prompts one to avoid a standard needle that would bend, crack or dislodge into the soft tissues requiring exploration to locate/retrieve the broken metal fragment.









For more information or to discuss the many benefits of Digital Pre-Op Imaging, contact us directly at:  212.355.7017 or email: appt@barddiagnostics.com

You can also find us on: Linkedin
..................................................................................................................................................
Reference:
JOURNAL AMERICAN ACADEMY DERMATOLOGY  2012
IMAGE GUIDED CANCER TREATMENTS  Springer Publ. 2014
MELANOMA IMAGING  AM ACAD DERMATOLOGY  DENVER 2014
3D/4D DOPPLER SCANS WORLD FEDERATION ULTRASOUND 2015
DERMATOLOGIC CLINICS SYMPOSIUM Elsevier Publ. 2017
MT SINAI DERM/SURG WINTER SYMPOSIUM  NEW YORK 2017
AMERICAN INSTITUTE OF ULTRASOUND  NEW YORK  2018









Thursday, February 8, 2018

HOW TO SPOT & READ A TUMOR: By Dr. Robert Bard


You can usually catch a tumor that starts to grow. It's like a construction site in that the blood vessels have to build roads towards the site before a tumor can actually happen.

You can actually read parts of the body with a medical Doppler machine  (like the weather radar that shows tornados) and see where there might be problems. You could often read whether a tumor is benign or malignant  based on how the blood vessels are flowing to it.

For instance, I had a patient who showed me abnormal MRI results. In my office, I did my Doppler sonogram scan, which is a 3D specialized scan. Because it's digital technology, it only takes five minutes - and while I was scanning him, I said, "Yes, you have a tumor. But there are no blood vessels in it-just one or two nearby vessels." So, I said, "This won't kill you."   This imaging diagnostics works for many tumors and most stages of cancer.

One of the things we've learned about cancerous tumors is that when they get treated and start dying, they may swell with fluid.  This means a tumor getting larger does not necessarily mean the tumor is getting worse.  That's why we study the blood flow. If the tumor has 15 blood vessels before treatment and gets larger but has 3 blood vessels, this often means it's really dying.  In 2013, the definitive R.E.C.I.S.T. European study of cancer treatment verified this phenomenon.

SKIN CANCER TREATMENT
To best describe this is to review a basal cell tumor (image-L); it's a skin cancer. Basal cell is the most common kind of human cancer worldwide and the tumor in the red circle shows up as a dark area. Unlike what a dermatologist tends to assess, our technology can see below the skin.  We can usually tell if these patients need  a 10 minute biopsy or a half-day surgery because we see the depth of the tumor made visible with ultrasound technology.

(Image-R) Here we have another dark spot. This is particularly important in summertime because any dark spot (pigmented lesion) could be a benign mole or might be a malignant melanoma cancer. The Doppler shows the red feeding  arteries and blue draining veins on the right side allowing measurement of  the blood supply in the tumor to determine its aggressive nature or map the blood supply to the tumor showing the surgeon how to minimize blood loss by pointing out  any arteries or veins  to be avoided.


PROSTATE (and BREAST) TREATMENT (both are GLANDS)
Any man over 60 has got a 60% chance of having cancer.  In many cases, the body may kill cancers off without the benefit of surgery which is why most men with prostate cancer do not need any treatment.  At the end of their life, they don't die from prostate cancer-- only 3% of prostate (and breast) cancers are fatal. This is important for prostate cancer treatment. The reason doctors say they need to operate and cut out the whole prostate is if the biopsy finds a low grade tumor when they cut out the whole prostate and examine it, they often find there's a bigger tumor that the biopsy missed.

(Image-R) The problem with random biopsies is the six core biopsies are 16% accurate and  the 12 or 24 or 98 core biopsies have many side effects. This image shows the standard  red biopsy guidline at 12mm and the biopsy core is  11mm so  you're going to find the low grade cancer. You're completely missing the much larger, more aggressive cancer that's broken out of the prostate. Fortunately, using outpatient laser and thermal treatments (HIFU-cryosurgery), even large FOCAL tumors may be treated under image guidance with sonograms, CT or MRI giving men (and women) the option to avoid the side effects for radical surgery.

................................................................................................................................................................

Reference: Textbook by Dr. Robert L. Bard "IMAGE GUIDED PROSTATE CANCER TREATMENT"--  SPRINGER BERLIN 2014

ABOUT THE AUTHOR:
Robert L. Bard, MD, PC, DABR, FASLMS is internationally known and recognized as a leader in the field of 21st Century 3-D ULTRASONOGRAPHIC VOLUMETRIC DOPPLER IMAGING. Dr. Bard specializes in advanced 3-D sonography to detect cancers in numerous organs including the breast, prostate, skin, thyroid, melanoma and other areas. Dr. Bard’s images are used to accurately guide biopsies, target therapy and provide focused follow-up after treatment.  As of Jan '18, Dr. Robert Bard spearheaded a partnership with a host of cancer educators, medical practitioners and non-profit foundations (allied under AwarenessforaCure.org) to form a public resource program to aid in the advancement of the public's understanding about self-preservation from cancer and other chronic diseases. EARLY DETECTION & PREVENTION is a global health movement that promotes a higher regard for "clean living" - from toxins and a toxic lifestyle. Our program consists of four main efforts: EDUCATION, COMMUNITY CONNECTION, CURRENT NEWS & CLINICAL RESOURCES. EARLY DETECTION & PREVENTION brings the empowerment of wellness through group seminars, videos and the distribution of current articles & newsletters published/shared to all the major cancer charities and their members. 

For more information or to subscribe to our EARLY CANCER DETECTION & PREVENTION PROGRAM newsletter, contact Bard Cancer Diagnostics today at: 212.355.7017 (www.CancerScan.com)- or email us at: bardcancercenter1@gmail.com

The Doppler Ultrasound for Cancer Scanning; Not Your Obstetrician's Sonogram

When you think "sonogram", what might come to the average mind is probably a blurry scan of an expectant mommy's tummy from ...