2021

By Dr. Olivia Hightower

We are making advancements every year in breast cancer treatment. Patients are being cured at a higher rate, and even those whose cancer is detected at later stages are living longer, as chemotherapy options are improving.

Breast cancer is the most common cancer in American women, excluding skin cancers. About one in eight U.S. women will develop invasive breast cancer over the course of her lifetime — constituting approximately 12 percent of women. Early detection of breast cancer is key to improved survival rates. Annual mammograms and self-exams are important components of finding the disease early. Mammograms will detect the vast majority of early breast cancers. 3D mammograms have become more readily available, and they are more sensitive with fewer false positives. If a mammogram is negative but a woman finds a lump on self-exam, she should see her doctor and pursue further workup with breast ultrasound and biopsy. 

Breast cancer treatments are improving every year. Five-year survival rates are very high for stage 1 breast cancers at greater than 99 percent. Regional disease involving the lymph nodes have an 86 percent survival rate at five years with appropriate treatment. Treatments include surgery with lumpectomy or mastectomy, chemotherapy, radiation and endocrine therapy with hormone-blocking pills. Patients will need to discuss with their doctor which of the above treatments are needed. 

Genetic testing of hormonally driven breast cancer cells helps determine the recurrence risk for each woman and the benefit that chemotherapy will provide, allowing us to make better decisions about adjuvant treatment and to educate the patient on the risks and benefits. Chemotherapy options also are improving and becoming more targeted. For example, if a patient has a protein that is overexpressed called HER2, there are more targeted options for chemotherapy, in combination with traditional chemotherapy, that allow for better response rates and recurrence prevention. 

Risk factors for breast cancer include being female, increasing age, family history of breast or ovarian cancer, postmenopausal hormone replacement, increased age of having first child or not having children and increased age of transition to menopause. Patients can reduce their risk of developing breast cancer by maintaining a healthy body weight, limiting alcohol and avoiding hormone exposure. Women with strong family history should be genetically tested for mutations that increase their risk, as 5-10 percent of breast cancers are hereditary. If patients have these mutations, genetic counseling is undertaken, and preventative surgeries can be considered. 

Patients in the high-risk group also can take hormone-blocking treatments such as Tamoxifen that decrease their risk of developing breast cancer. Thorough preventative care with annual breast exams, mammograms and monthly self-exams, lives can be saved. Women with no family history should start at age 40 with mammograms and continue yearly. Women with family history should start 10 years earlier than the youngest relative was diagnosed or age 35, whichever is earlier. 

We are making advancements every year in breast cancer treatment. Patients are being cured at a higher rate, and even those whose cancer is detected at later stages are living longer, as chemotherapy options are improving. 

Advances in fighting breast cancer are frequent, as clinical trials are continuing to produce breakthroughs in chemotherapy options every year. I am excited about the continued progress that is being made and the lives that are being saved. 

Dr. Olivia Hightower is a medical oncologist at Gulfport Memorial Hospital. Reach her at (228) 575-1234. 

Some patients may still fear the dentist’s chair, but according to Dr. Clifford Cook, the old days of painful dentistry are over. 

“Lasers have created better work and require far less anesthesia — many times none …,” says Cook, a dentist with Broadwater Dental in D’Iberville. “Oral health is important to overall health, and I think many people are realizing that and are more accepting of seeing the dentist.” 

Born and raised on the Coast, Cook has wanted to be a dentist since he was 6 and his brother went to college to pursue the field. The profession proved a great fit, he adds, because he loves people and enjoys working with his hands. 

“Dentistry is very procedural and technical; it allows me to do what I love,” Cook says. “I love the challenges and connections of oral health to overall health. Now more than ever, the systematic/oral connection creates new and exciting things to study and implement for my patients.” 

The dentist acquired a strong work ethic by following his brother’s example and by helping on his dad’s two farms while growing up. Cook says his early experiences taught him to “never stop until the job is done” — an attitude that has served him well in his education and career. 

After graduating from the University of South Alabama with a degree in biomedical science, Cook earned a master’s degree from Mississippi College and completed his studies at the University of Mississippi Medical School.

Having practiced for a dozen years, seven of those in D’Iberville, Cook has learned to balance his many roles, including husband, dad of three daughters, dental provider and boss. 

“I use my background of growing up to push myself to the greatest of limits,” he says. “I want to learn more and be the best. I have the greatest staff on Earth, and they give me the drive to have the best team possible.” 

On a given day, Cook performs anywhere from 10 to 20 procedures — and utilizing the latest technology has helped him streamline the processes. He’s especially excited about laser therapy, which he says has revolutionized dentistry, and implant advances are reducing the burden of tooth loss. 

“Most treatments have less post-op complications; same-day treatments are increasing,” he says. “We have really become a well-oiled profession invested in the overall health of the patient.” 

Over the next 20 years, Cook expects technology to continue to make treatment easier and more comfortable. He’s also optimistic about eradicating tooth decay in the coming decades, as dental professionals know what causes it and have the power to target and eliminate it. Cosmetic dentistry is another area in which he expects big advancements. 

“We have drastically improved materials over the years, and they will only get better,” he says. “This will help many more find their confidence.” 

To those who are reluctant to visit the dentist, Cook suggests, “If nothing else, just go for an exam.” 

“We want to hear our patients’ concerns, and we want to help,” he says. “Your overall health is our greatest concern, and it all starts with great oral health.” 

For Dr. Tamara Harper, the pandemic has highlighted the fragility of life — but also its strength. 

Harper, a pediatrician affiliated with Singing River, may have to wear masks and protective gear all day, but she and her patients still somehow understand each other. 

“It’s amazing how babies are so resilient,” she says, “seeming to notice even my smiling eyebrows while never having seen my teeth and genuine smile.” 

Medicine may not have been Harper’s first career goal — that was becoming a McDonald’s cashier at age 6 — but it has been her most abiding passion. The Moss Point native decided she wanted to become a doctor when she was hospitalized at Singing River Hospital, Pascagoula, with a septic knee. 

Her interest continued to grow throughout her childhood and culminated with a summer science academy at Xavier University in Louisiana, where she would go on to complete her undergraduate studies. She earned her medical doctorate from the University of South Alabama College of Medicine in 1998 and completed her pediatrics residency there in 2001. 

Harper chose pediatrics as her specialty for a simple reason: “Kids are fun!”

“I am certain that I am walking in my calling as a pediatrician. I consider pediatrics my ministry.”

“Yes, even those who scream at the mere site of a stethoscope or white coat, or those who suddenly develop lockjaw when you present a tongue depressor, will be the same child who later runs down the hall screaming your name and clinging to your leg with the skill of a koala,” she says. “I am certain that I am walking in my calling as a pediatrician. I consider pediatrics my ministry.” 

In that ministry, the doctor has seen several seemingly hopeless situations turn around. In fact. she considers pediatrics a miracle profession in and of itself. 

“I am always reminded of God’s beauty in the advancement of medicine,” she says, “especially when I get to serve a patient from infancy into adulthood (and see them) matriculate into college after having been born extremely premature, weighing in at barely over 1 pound, and perhaps not having a chance of survival 25 years ago.” 

Of all the medical advances Harper has witnessed, few are as impressive to her as immunizations. Diseases like polio, smallpox, measles, mumps, and rubella have been essentially eradicated, she notes, to the point that most of her peers have seen few, if any, cases, of them. 

“The world at large has benefited immensely from the power of immunizations,” she says, “and pediatricians have the privilege of standing on the front line of protecting children and the public at large. 

“As a pediatrician, with the latest surge of Covid, I am excited and hopeful for the approval of a Covid vaccination for children under the age of 12 in the very near future.” 

In five, 10 and even 20 years, Harper expects pediatricians will continue to serve an important role in growing families. She considers it an honor and privilege to offer reassurance, support, and healing as her patients grow and thrive from infancy into adulthood. 

“At this stage in my career, I am even starting to see former patients return as they become parents,” she says, “which is definitely a gratifying feeling.” 

As an oncologist, Dr. Olivia Hightower is used to nervous patients. 

But if a difficult diagnosis puts her in someone’s life, she does everything possible to make the experience a positive one. 

“I encourage patients that knowledge is power,” says the doctor, who practices at Gulfport Memorial Hospital, “and there is so much we can do.” 

Hightower herself has always loved learning and wanted to be a doctor from the age of 6. The University of Mississippi Medical School graduate became interested in oncology in high school, when her grandmother was diagnosed with breast cancer — from which she eventually recovered. 

Driven by a desire to use her knowledge and skill to help others, Hightower has been practicing on the Coast since completing her fellowship in 2013 and has locations in Gulfport, Biloxi and Wiggins. 

“As I got further into my medical career, I realized that my goal was to make the best situation possible for my patients given their specific illness and stage,” she says, “whether that be a curative intent, if possible, or life-prolonging palliative chemotherapy in hopes of maintaining a good quality of life….” 

Contrary to what some may believe, Hightower stresses that chemotherapy is not the only tool oncologists have for treating cancer. 

“We do use a lot of chemotherapy,” she acknowledges, “but a significant number of these chemotherapies are more targeted based on the genetics of the tumor involved, usually leading to better results with fewer side effects. We also work together with surgeons and radiation oncologists to get optimal results based on the individual case.” The impact of a good support system and a positive attitude, the oncologist adds, can’t be overstated. 

Given how much and how quickly her specialty is evolving, Hightower continues, “I expect to have significantly more targeted treatment options in the years to come based on genomic profiling of tumors.” 

In the meantime, being proactive remains the best defense against cancer, Hightower says, as early detection makes the illness easier to treat. Screenings can save lives, including mammograms starting at age 40, colonoscopies starting at age 50 (or sooner if there is a family history) and regular pap smears. 

She may enjoy her specialty because it’s exciting and intellectually challenging, but Hightower’s favorite part of her job is getting to know her patients and their families and walking them through a tough time in their lives. 

“Some days are challenging,” she says, “but I always feel blessed for having the opportunity to help someone during their time of need.” 

COVID has affected everyone’s life, from job changes to remote learning to mask wearing in public. Perhaps the most impacted have been health care workers. When COVID first hit our emergency room, a complete shakeup came down, from protocols to our very dress, with physicians and nurses outfitted in spacesuit attire. 

Anne Musgrove is the director of advanced practice at Memorial Hospital of Gulfport. At the pandemic’s onset, she was tasked with developing the hospital’s community-based response to the crisis. She had to determine how to set up clinics and programs to deal with all these new patients. 

Here was a whole new disease without established protocols. New orders and diagnostic and treatment protocols had to be established. She found herself working 15 hours a day, seven days a week, researching blogs and forums and consulting with infectious disease specialists. Her teenage children were tasked with taking care of the household, including shopping for groceries, preparing food and doing laundry. 

Anne leaned heavily on her assistant, Kristian Spear, who already had a full plate. Kristian has young children, whom she home schooled. Adding the responsibilities of managing the county-wide response to this pandemic burdened her with late hours as well as the two developed the plans for outpatient clinics. 

At first, they set up outpatient testing centers where the hospital already had walk-in clinics, at Cedar Lake in Biloxi, on Broad Street in Gulfport and on Beatline in Long Beach. 

“We didn’t want to set up where private businesses might be bothered by having personnel walking in the parking lots dressed in full contagion resistance gear and scaring away their customers,” Anne says. 

All these new clinics required staffing, and that soon became a major issue. Mississippi already had a nursing shortage. The stress of exposure to the potentially deadly virus precipitated many of the older, experienced nurses to take early retirement. Younger nurses left as well, enticed by high contract offers from states like New York and California where the COVID crisis was hitting hard. 

Anne began closing some of the smaller walk-in clinics to use their staff for the testing and treatment clinics. The walk-in clinic at Tradition, off Highway 67, had experienced nurse practitioners. She had the walk-in aspect partially closed to use those nurses’ expertise in carrying out the reporting and scheduling. 

Some of the nurse practitioners who hadn’t done bedside nursing in as long as 15 years had to be pulled into the hospital or the clinics. In the hospital, nurses were giving exhaustive efforts to try to keep COVID patients alive and despairing when they failed. These nurses, totally drained mentally, emotionally, physically and spiritually, had to go home and deal with their family demands: “With elective revenue down, we couldn’t even financially reward those who were giving so much.” 

One of the issues Anne faced was finding answers to questions posed by the front-line nurses. One of the nurse practitioners in the testing clinic might ask, “How long after exposure to COVID could a patient with a negative test go back to work?” Anne would have to research and get back to the nurse as promptly as possible. 

When the monoclonal antibodies treatment became available, Anne and Kristian had to set up that program as well, beginning in November of 2020. Its success saved many lives, but it also put more demands on the nursing staff; finding locations and trained nurses to provide the treatments was another challenge. 

When you go by a clinic, and you see the cars filled with people waiting to be tested, think about the nurses and aides giving everything they can to help the community. It’s asking a lot of these staff to work outside in the heat, to work in situations they’re unfamiliar with, to deal with the dangers of a deadly disease. Without their devotion, where would we be? 

Dr. Philip L. Levin is a retired emergency medicine specialist in Gulfport. Learn more or contact him at www.Doctors-Dreams.com.