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A
My
name
is
justin
berk
mi
pana
nurse
practitioner
at
the
both
on
health
care
facility.
Albert
machine
little
background
on
me.
I
started
talking
here
about
six
years
ago:
I
McLaren,
Bay
region
has
a
open
partners,
went
into
management
within
the
facility
as
a
manager,
/,
heart
Department,
violent
landing
and
oncology,
pediatrics
and
outpatient
rehab
obtaining
my
master's
degree
in
education,
a
master's
degree
in
health
demonstration.
A
And
finally,
my
family
nurse
practitioner
agree
and
I
started
with
both
on
the
health
care
about
six
months
ago,
so
I
took
over
the
previous
provider
Terry's,
so
I'm
gonna
give
you
guys
a
presentation
on
breast
colon
and
prostate
cancer.
If
any
questions
during
the
presentation,
please
ask
or
we're
going
to
the
end
itself.
Okay,
so
first
we
talked
about
breast
cancer.
Breast
cancer
or
cancer
in
general
is
formation
of
malignant
cells
within
tissue-specific
breast
tissue
for
breast
cancer.
There
are
four
main
types
of
breast
cancer
present:
there's
ductal
carcinoma
and
sitting
you.
A
There
is
invasive
ductal
carcinoma,
triple
negative
breast
cancer
and
then
inflammatory
breast
cancer
I
will
go
through
one
of
our
we'll
go
through
each
one
by
one.
So
ductal
carcinoma
sit,
you
is
essentially
non
invasive.
Breast
cancer
within
abnormal
cells
within
the
tissue
of
the
breasts,
specifically
the
breast
milk
ducts
ductal
carcinoma,
like
I
said,
is
a
very
early
form
of
cancer.
If
left
untreated
undetected,
it
can
spread,
but
this
is
the
earliest
form
of
breast
cancer
that
we
will
find
as
a
provider
and
sit.
A
You
means
in
the
original
place
have
basically
had
an
appt
lignified
to
or
metastasize
to
other
strong
tissues
invasive
base.
Abduct
ductal
carcinoma
is
basically
breast
cancer
has
gone
from
Institute
to
invading
healthy
tissue
within
the
breast.
This
makes
up
about
seventy
to
eighty
percent
of
breast
cancers,
the
diagnosed
in
the
United
States,
and
it
is
also
the
most
common
type
of
breast
cancer
that
can
affect
a
man.
This
is
a
breast
cancer
that
you
will
normally
find
as
a
lump
or
nodule
in
the
breast
also
formed.
A
Breast
cancer
is
mostly
detected
using
mammogram
triple
negative.
Breast
cancer
is
a
not
necessary
a
rare
breast
cancer.
That's
a
very
threatening
breast
cancer
because
it
is
unresponsive
to
estrogen,
progesterone
and
her2
gene
therapy.
What
that
means
is
we
normally
use
progesterone,
estrogen
and
all
other
medications.
A
Specifically,
hormones
to
treat
breast
cancer
in
a
triple
negative
breast
cancer
you're
unable
to
use
those
hormone
treatment
options.
It
is
very
responsive
chemotherapy,
if
discovered
in
early
stages
of
breast
cancer.
If
it's
not
discovered
early,
this
can
become
a
very
devastating
breast
cancer
treatment
is
usually
through
chemotherapy
allow
surgical
intervention.
It
curves,
like
I,
said
about
ten
to
twenty
percent
of
breast
cancers
and
more
prominent
in
younger
people.
African-Americans
Hispanics
and
those
are
the
bracha
one.
A
Gene
mutation
which
we'll
talk
about
the
lid
on
presentation
is
also,
I
guess,
said,
very
aggressive
and
difficult
to
treat
and
can
spread
quickly.
Inflammatory
breast
cancer
is
breast
cancer
that
you
can
see
on
top
of
the
skin.
So
it's
a
fast
growing
breast
cancer
that
infiltrates
the
skin
and
lymph
vessels
and
the
tissue
of
the
breast
there's,
really
no
distinct
tumor
or
lump,
but
many
times
patients
will
present
with
an
itching
red
spot
on
the
breast
nipple
that
has
become
inverted
or
a
funny.
A
Lesion
on
the
breast
that
looks
like
an
orange
peel,
those
types
of
appearances.
We
usually
think
about
finding
tori
breast
cancer,
usually
diagnosed
early
and
usually
diagnosed
by
the
symptomology
that
the
patient
presents
with
it
is
rapid
growing
and
it
does
require
local
and
systemic
treatment,
so
a
local
biopsy
removal
of
that
area
and
then,
like
a
sudden
system
treatments
with
either
hormone
replacement
therapy
or
hormone
therapy
and/or
chemotherapy.
A
So
early
detection
is
the
key
to
successful
treatment.
Women
should
perform
monthly
breast
self-exams
and
we'll
go
over
how
to
perform
those
appropriately
forty
percent
of
all
diagnosed
breast
cancers
in
the
form
of
a
lump,
it's
about
a
discovered
by
the
patient
and
usually
brought
to
the
primary
care
providers
attention
during
an
exam.
A
So
how
do
you
perform
self
breast
exam?
There's
three
components
of
a
self
breast
exam
it
may
be
completed.
The
first
is
usually
done
once
a
month,
while
in
the
shower,
women
will
actually
start
outside
in
work
with
the
pads
of
the
fingers
and
field
of
breast
tissue.
If
you
discover
any
lunch
or
abnormalities,
usually
we
say:
wait
one
week
repeat
the
exam.
A
If
that
lump
is
still
there
or
has
changed,
then
contact
your
primary
care
provider,
you
also
want
to
look
and
sure
that
there's
no
abnormalities
and
the
tissue
of
the
skin
top
of
the
breast
as
well
second,
is
actually
do
a
visual
inspection.
The
brass,
the
most
women
will
bend
over
in
front
of
the
mirror
and
then
also
raise
your
hands
is
abnormal
to
have
two
symmetrical
breasts.
Normally
one
is
larger
than
the
other,
or
one
hangs
farther
than
the
other.
So
you
want
to
look
at
make
sure.
There's
no
changes
in
the
breast
tissue.
A
It's
important!
You
do
this
monthly,
because
you're
the
ones
that
see
the
breasts
every
day.
So
it's
I
saw
a
Courtin
that
you
bring
any
changes
to
your
healthcare
provider
and,
lastly,
is
lying
down.
So
you
want
to
lie
down,
want
to
crop
your
shoulder
up
on
a
pillow
raise
your
arm
above
your
head,
and
this
is
a
similar
to
the
pressing,
send
us
to
shoot
down
the
office
by
the
primary
care
provider
again
working
a
circular
motion
from
outside
in
feeling
the
breast
and
ensuring
that
there's
no
abnormalities.
A
A
If
a
lump
or
mass
is
identified
or
if
you're
above
age
40,
our
usual
routine
mammogram
is
completed,
mammograms
are
a
special
x-ray
that
is
used
to
look
within
a
tissue
of
the
breast.
They
are
digital
and
they
are
much
more
comfortable
than
they
had
been
in
the
past.
Magma
grams
can
be
performed
on
men
as
well.
If
they
do
find
it
suspicious
lump
or
mass,
they
are
covered
by
most
insurance
for
women
aged
40
and
over
once
you
reach
age
65
or
follow
the
Medicare
health
care
guidelines.
A
They
will
pay
for
a
mammogram
every
two
years,
depending
on
your
secondary
insurance,
with
what
a
nap
cover
every
year.
If
a
mass
is
suspected
on
mammogram
or
a
density
is
discovered
within
the
tissue,
then
we
will
usually
do
an
ultrasound
of
that
breast
ultrasound
and
then
needle
biopsy,
if
needed,
another
form
of
detection-
and
this
is
kind
of
new
within
the
last
10
to
15
years-
is
what's
called
Baraka
testing
Baraka
one
and
brocco
to
our
genes.
A
That
predispose
should
say
were
predisposed
but
she'll
increase,
which
for
women
to
develop
breast
cancer
and
man
Brock
kiwanis,
West
Pacific
rocket.
To
is
all
very
specific:
normally
the
genetic
testing
is
done.
If
you
have
two
or
more
first
relatives
for
our
females
that
have
deposited
or
have
come
back
with
breast
cancer,
there
has
been
a
lot
of
debate
on
whether
or
not
it
should
be
done
for
everybody,
and
if
you
do
choose
to
have
testing
done
with
the
broccoli
gene
testing,
there
are
some
genetic
counselors
within
the
area
saginaw
in
Midland.
A
With
brackets,
you
will
have
some
type
of
cancer
about
each
70,
so
it
is
pretty
specific,
so
treatment
surgery
is
usually
number
one
treatment
on
which
would
be
a
mass
spec
to
me
either
unilateral
or
bilateral,
mean
removal
of
one
or
both
breasts
and
tissue
chemotherapy
is
and
other
choice.
It's
usually
used
in
combination
with
surgical
intervention,
radiation
therapy.
If
there's
a
small,
nodule
or
dense
noted
that
does
not
test
positive
for
any
of
the
estrogen
receptors,
you
can
use
radiation
therapy
to
try
to
target
that
area.
A
If
you
have
a
large
family
or
strong
kind
of
history
of
breast
cancer
than
we
all
usually
encourage
at
least
19
grand
before
age
40,
usually
around
age
35,
we
use
as
a
baseline
moving
forward
to
ensure
there's
no
changes
in
the
breast
tissue.
Honest
I
know
it's
also
very
important
that
you
have
the
same
facility
for
your
mammograms
only
because
they
have
recognition
appear
tissues
from
years
prior.
A
A
So
colorectal
cancer
is
a
cancer,
the
large
intestine,
the
lower
section
of
the
digestive
tract
it
is
on
the
less
and
rectal
cancers
within
the
last
several
inches
of
the
colon
colon
cancer,
as
will
kind
of
move
forward,
usually
starts
out
small
benign
polyps
called
anima,
toast
polyps,
and
then
they
over
time
these
polyps
will
grow
on
cells
change
within
the
polyps.
The
polyps
can
become
cancerous
many
times
when
a
polyp
is
discovered
during
a
colonoscopy,
those
pops
will
be
removing
tested.
A
So
what
do
you
want
to
look
for
with
symptoms
if
you've
never
had
a
colonoscopy
in
your
concern
about
colon
cancer?
What
one
is
changing
your
bowel
habits,
including
diarrhea
or
constipation?
We
look
to
see
if
there's
any
rectal,
bleeding
or
blood
within
the
stool,
the
feeling
that
your
hole
does
not
empty
completely
or
persistent
gas.
Crampy
film
within
your
abdomen,
any
unexplained
weight
loss
fatigue.
Your
weakness
I
should
prompt
some
investigation
along
with
changes
within
the
bow.
A
So
there
are
some
early
detection
devices
that
we
use
for
when
looking
out
for
colon
cancer
on
primary
care
side
on
one
is
called.
It
react
based
people
all
caught
blood
tests,
and
this
is
a
testing
you
can
do
within
your
home.
We
take
samples
from
school
at
different
areas
within
the
stool
and
we
look
for
blood.
What
does
come
back
positive
in
this
test?
Then
it
prompts
a
colonoscopy
or
Sigma
aspect
promise
that
we
have
based
testing
I'll
go
very
cheap.
A
There
are
some
instances
where
it
will
give
you
a
false
positive
specifically,
if
you
have
a
diet
high
in
bettany
you're,
taking
a
lot
of
vitamin
C
or
you're
lost
utilize,
a
lot
of
strokes
that
are
not
sterile,
anti-inflammatory
like
motrin,
etc
and
aspirin
and
so
forth.
So
if
you
do
take
those
medications,
if
you
have
you
have
a
diet
high
in
red
me,
we
ask
that
you
not
utilize
those
medications
or
eat
those
types
of
food
per
least
three
days
prior
to
the
testing.
A
Now
they
have
develop,
it's
called
the
fit
test,
which
is
the
fecal
immunochemical
test,
that
kind
of
takes
out
those
factors
of
the
money
and
the
dietary
restriction
medications.
But
then
again
it
only
test
for
blood.
It's
not
it's
as
specific
or
collection,
but
more
specific
than
react,
but
it
is
a
little
bit
more
expensive
as
well
this.
Both
those
tests
should
be
done
nearly
for
anybody,
age,
50
and
older.
They
can
be
done
in
your
primary
care
office,
502
provider
or
they
can
run
at
home
as
a
home
test.
A
If
one
goes,
tests
come
back
positive
or
if
your
age,
50
and
older
it
is
suggested,
you've
had
what's
called
a
flexible
sigmoidoscopy
or
a
colonoscopy.
The
advantages
to
a
sigmoidoscopy
is
one.
You
don't
have
to
take
any
medications
that
are
going
to
caution,
comes
sleepy
and
there's,
usually
no
bowel,
prep
and
fall
inside.
Maybe
an
animal.
The
disadvantages
of
a
flexible
sigmoidoscopy
is
that
you
only
really
look
at
the
first
one
third
of
poland,
so
you'll
get
what's
called
a
descending
tractor
pull.
A
Unfortunately,
cancers
do
format
a
sending
and
transverse
sections
we're
pulling.
So
if
it's
flexible,
sigmoidoscopy
is
utilized
infusion
repeated
every
three
to
five
years,
where
colonoscopy
has
done
every
ten
years,
if
they
are
normal,
as
you
said,
a
colonoscopy
is
a
test
where
they
look
at
the
whole
color
from
anus
all
the
way
to
the
junction
of
the
small
intestine.
It
does
require
a
prep,
so
you
will
be
drinking
a
mixture
of
medications
that
will
help
you
cleanse
your
bowel.
Usually,
patients
are
enfield
a
night
before
and
I
love
liquid
supplier
to
the
test.
A
Patient
will
be
brought
to
a
surgical
center
or
a
hospital
where
they
will
be
given
medications
to
make
them
sleepy
and
the
procedure
to
perform
the
advantages
to
a
colonoscopy
over.
All
the
other
tests
explain
is
that
during
colonoscopy,
samples
can
be
taken
from
the
tissue,
pouch
can
be
removed
and
it
gives
you
a
full
visualization
of
the
colon.
They
are
pitted
every
10
years
and
a
healthy
individual.
A
Without
me,
colon
cancer
symptoms
of
polyps,
if
you
do
have
polyps
or
any
abnormalities
they
over
your
gated
more
often
by
a
healthcare
provider
or
GI
specialist
colorectal
cancer,
is
basically
station
for
different
stages
stage.
One
would
be
like
the
palace
we
spoke
of
earlier,
where
it
hasn't
really
grown
through
the
colon
mucosal
layer.
As
we
go
down
the
stages,
the
cancer
itself
becomes
larger
and
more
aggressive.
A
A
We
talked
about
that
screen
test
as
outlined
by
a
kinder
care
provider,
as
we
spoke
of
earlier,
so
many
providers
will
begin
to.
We
are
fit
testing
at
every
visit,
either
in
the
office
or
at
home,
and
then
flexible
sigmoidoscopy,
York
Alaska
should
be
done
at
either
three
to
five
year
mark
or
every
10
years
for
colonoscopy.
A
So
this
is
a
illustration
of
the
prostate
gland.
As
you
can
see,
it
is
located
below
the
bladder
and
behind
the
testicles.
Sinus
symptoms
of
enlarged,
prostate
or
prostate
cancer
is
usually
trouble.
Urinating,
multiple
trips
to
the
bathroom,
the
patient.
You
should
tell
you
he
gets
up
three
or
four
times
during
the
night,
the
restroom,
and
it
would
feel
like
a
completely
empty.
A
His
bladder
decrease
stream
of
a
force
in
the
urine
stream,
blood
and
semen
during
ejaculation,
because
of
what
the
prostate
gland
does
for
men
discomfort
in
the
pelvic
area,
especially
discomfort,
while
sitting
for
long
periods
of
time
bone
pain.
Usually
that's
a
sign
of
metastasis
at
usually
testifies
to
the
pelvic
and
femur
bones
and
then
erectile
dysfunction.
If
you
have
any
of
these
symptoms
or
you
knowingly
has
these
symptoms,
it's
important
that
they
come
into
the
primary
care
office
and
get
checked.
A
We
can
do
two
types
of
exams
with
an
office
which
we'll
talk
about
age.
Normally,
you
see
prostate
cancer
increases
with
age.
So,
as
I
said
earlier,
most
men
by
the
age
of
90
would
have
had
plastic
hands
or
current
you
had
prostate
cancer.
Like
I
said
it's
also
very
slow,
growing
cancer.
So
it's
not
something
that
we're
we
get
too
concerned
about.
Until
we
start
looking
at
PSA
levels
and
seeing
metastasis
african-american
men
have
greatest
risk
of
prostate
cancer.
A
Family
history
plays
a
role
in
prostate
cancer,
as
we
spoke
of
earlier,
there's
Brock
one
umbraco
to
check
Rocko
and
Rocko
to
testing
that
can
be
done
for
breast
and
ovarian
cancer,
and
you
do
see
a
strong
correlation
of
prostate
cancer
and
I
were
tested
and
obesity.
Obesity
men
have
been
diagnosed
with
prostate
cancer
more
often
than
not
obese
men
and
find
more
difficult
to
treat
so
there's
two
exams
that
are
done
in
the
office
word:
man
who
think
they
may
have
been
a
large
party
or
possible
prostate
cancer.
A
First
one
is
a
digital
rectal
exam
and
that's
actually,
where
the
provider
doesn't
manual
exam,
the
patient
can
feel
the
size
of
the
prostate.
As
we
said,
apostate
shaped
like
a
walnut,
so
there's
two
halves
on
that
go
into
like
a
cleavage
area
and,
as
you
feel,
a
prostate,
you
want
to
press
on
the
prostate.
If
it
is
large,
if
firm,
1
side
of
the
other,
then
we
draw
what's
called
a
PSA.
That's
your
prostate
specific
antigen.
It's
actually
a
blood
test,
that's
drawn
average
is
4
point
or
less.
A
Anybody
above
four
does
appear
to
have
an
active,
prostate
gland
and
active
prostate
gland,
usually
signifies
that
there's
potential
for
prostate
cancer.
If
either
those
tests
come
back,
positive
or
suspected
of
a
large
cross
right
over
after
prostate,
we
do
what's
called
a
transrectal
ultrasound
with
biopsies.
So
as
it
sounds
just
like
a
transvaginal
ultrasound
and
women,
transrectal
ultrasound
is
that
you
actually
inserted
ultrasound
probe
into
the
rectum
they
take.
Biopsies
of
the
prostate
prostate
biopsies
are
utilized.
Are
you
util
or
prostate
biopsies
are
done
using
a
thin
needle?
A
It's
inserted
a
prostate
to
clip
the
tissue
tissue
is
analyzed
within
the
lab
to
determine
whether
or
not
there
are
prostate
cancer
cells
present
or
not
again,
with
staging
a
prostate
stage.
One
is
where
it's
very
early
confined
to
the
prostate.
There
are
many
times
where
treatments
not
even
offered
to
patients
and
I
say
offered
a
fact
that
the
treatment
on
risks
outweigh
the
benefits
on
a
stage.
One
prostate
cancer
patient
stage,
two
is
where
it
becomes
more
aggressive.
A
Prostate
has
got
larger
and
may
occlude
urination
or
issues
with
ejaculation,
then
stage
three
and
three
stage
fours
with
a
prostate,
has
actually
transferred
outside
the
prostate
gland
itself
into
surrounding
tissue
metastasize,
at
which
point
treatment.
Dom
is
an
option
for
most
patients
now
treatment.
A
There's
multiple
different
treatments,
as
I
said
earlier,
early
stages
of
prostate
cancer
there's
usually
no
treatment
because
the
risks
outweigh
the
benefits,
but
as
the
prostate
cancer
develops
and
grows,
which
is
monitored
every
six
months
by
healthcare
provider
urologist
there
are
choices
such
as
radiation
therapy,
which
is
on
actually
either
utilizing
external
and
focusing
on
a
prostate
or
doing
what's
called
brachytherapy,
and
that's
actually,
placement
of
radioactive
seeds
inside
the
prostate
gland
itself
to
help
shape
the
prostate
gland
hormone
replacement
therapy,
specifically
hormones
to
stop
the
production
of
testosterone.
The
prostate
enjoys
testosterone.
A
That's
what
helps
make
it
grow,
so
we
either
do
what's
called
orchiectomy,
which
is
removal
of
one
or
both
testes
or
actually
utilize,
medication
to
staff.
The
testes
are
introducing
testosterone
and
then,
if
what's
called
a
radical
prostatectomy,
that's
the
removal
of
prostate
either
they
can
do
a
fun
approach
through
the
abdomen
wall,
which
is
more
invasive,
but
a
lot
of
spirit
of
nerves,
so
that
men
that
can
later
on
and
their
sexual
life
still
maintain
or
get
an
erection
or
they
can
go
through.
A
As
we
spoke
of
earlier,
it's
very
important
for
men,
especially
men,
age,
50
and
older,
to
begin
getting
the
dir
ease
and
PSA
levels
tested
a
digital,
rectal
exams
and
prostitutes
to
the
antigen.
There
is
some
lindstrom
mixing
that
men
at
age
40
should
begin
digital
exams
on
PSA
levels,
actually
have
to
tell
you
the
patient,
the
primary
care
provider
and
make
that
decision.
A
Literature
is
really
upsetting,
conclusive
regarding
screening
and
then
the
test
date
ranges.
As
we
said
earlier.
If
you
are
diagnosed
of
the
stage
1
prostate
cancer,
you
may
have
more
exams
or
more
lab
tests
wrong.
More
often
versus
someone
who
may
not
diagnosed
with
a
stage
with
prostate
cancer
only
because
it's
important
to
monitor
the
growth
of
the
prostate.
A
Depends
what
kind
of
cancer
were
talking
about?
Prostate
cancer?
No
because,
like
I
said
the
presentation,
almost
I'll
burn,
my
age
90
or
above
Washington,
colon
cancer.
It
depends
on
a
lot
of
family
history.
If
you
have
had
you
know
two-
colonoscopies,
you
know
that's
a
discussion.
You
should
have
with
the
GI
specialist
who
actually
completed
colonoscopies
in
regards
to
whether
or
not
further
foul
testing
many
patients
at
age
70
to
80.
B
B
B
A
B
B
B
A
Are
other
forms
of
cancer
genetic
testing,
but
when
you're
speaking,
specifically
of
like
breast
or
ovarian
cancer
Brock
one
bracket,
2
is
kind
of
become
the
gold
standard.
There
are
other
cancer
testing
that
we
can
do
in
healthcare,
but
it's
not
as
specific
as
those
two
and
like
I
said
before.
Just
could
you
test
positive,
for
it
does
not
mean
that
you're
necessarily
going
to
develop
the
disease.
A
Also
I,
don't
know
how
true
this
is,
but
a
lot
of
information
through
the
genetic
counselors
that,
if
testing
is
done,
aquino
can't
affect
outcomes
of
life
insurance
and
so
forth.
Healthcare
moving
forward,
depending
on
what
the
outcomes
show
so
a
lot
of
the
genetic
counselors
in
the
area.
Actually,
unless
you
have
a
really
strong
family
history
of
it
and
would
consider
having
a
bilateral
mastectomy
done
based
on
the
testing
are
telling
patients,
that's
not
something
that
they
would
recommend,
because
with
information,
what
are
we
going
to
do
with
it?
A
You
know
if
you're
not
willing
to
have
the
surgery
done
or
begin
therapy
right
away,
and
you
want
to
wait
till
the
master
won't
develop
its
kind
of
when
those
tests
where
you
know
it
puts
a
lot
more
stress
on
the
patient
and
the
provider
without
knowing
whether
outcomes
we're
going
to
be
there.
Yes,.
B
B
A
B
A
And
that's
the
nest
of
discussion.
I
had
with
a
lot
of
patience.
I
want
to
go
through
the
testing
and
I
refer
to
a
few
to
the
genetic
counselors,
and
they
still
have
not
going
to
test
it,
because
the
risk
factors
don't
really
outweigh
the
benefits
and
the
patients
would
not
consider
having
the
surgery
like
I
said
it
can
affect.
You
know
your
future
planning.
A
A
Well,
that's
actually
a
good
point.
There's
actually
been
some
changes
in
research.
Literature
lately
that
states,
if
you've
been
a
smoker
or
working
in
industries
where
you've
been
exposed
to
asbestos-
or
you
know,
building
coal
mining
so
forth
that
they
are
starting
to
do
low
weights.
Ct
scans
of
the
lungs
I
want
to
see
it
starts
at
age,
55
and
it
is
covered.
If
you
do
need
some
of
the
criteria
now,
one
can
turn
itself
on
is
one
of
the
disease
process.
Where
usually
it's
found
because
of
a
cough
or
some
other
symptom
ology.
A
A
It
could
be
there's
a
whole
school
of
other
reasons
why
the
cabana
bowling
it
early
in
childhood.
That
does
basically
encapsulate
itself.
So
at
that
point
we
normally
would
do
repeat
cts
if
the
CT
show
any
enlargement
of
that
area,
that
we
do
what's
called
a
biopsy
and
we
kind
of
go
from
there.
But
there
is
also
new
guidelines
out
for
me
for
lung
cancer
did.
A
B
A
It's
very
important
that
every
way
to
Rome
here,
except
for
maybe
Jason
and
a
couple
of
patients,
have
their
yearly
mammograms
done
colonoscopies
every
ten
years,
so
there's
any
questions
that
were
at
toll
fun.
Hopefully,
healthcare
were
more
than
happy
to
answer
them.
Give
us
a
call
we'd
be
happy
to
talk
about
it.
So.