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Don’t Let COVID Delay Your Regular Screenings
Dr. Blake Evernden, a diagnostic radiologist with Tenet Health Central Coast, explains the importance of regular diagnostic screenings during the COVID-19 pandemic.
Featuring:
Prior to practicing radiology, Dr. Evernden completed internal medicine residency at Salem Hospital, Salem, Massachusetts, and UCLA-San Fernando Valley Program and had practiced internal medicine for a number of years. Dr. Evernden is Board Certified in Internal Medicine by the American Board of Internal Medicine and Board Certified in Diagnostic Radiology by the American Board of Radiology.
Blake Evernden, MD
Blake I. Evernden, MD, is a Diagnostic Radiologist at Templeton Imagining and Twin Cities Community Hospital in Templeton, CA. Diagnostic radiology is a medical specialty that uses a range of procedures to obtain images of inside the body. A diagnostic radiologist carefully interprets these images to diagnose illness and injury. Diagnostic imaging tests can include x-rays (including mammography and fluoroscopy), CT (computed tomography), MRI (magnetic resonance imaging), ultrasound, nuclear medicine imaging and PET (positron emission tomography). Dr. Evernden received his undergraduate degree from Harvard University and his medical degree from Boston University School of Medicine. He completed his radiology residency at UCSF-Fresno and has practiced on the Central Coast since 2003.Prior to practicing radiology, Dr. Evernden completed internal medicine residency at Salem Hospital, Salem, Massachusetts, and UCLA-San Fernando Valley Program and had practiced internal medicine for a number of years. Dr. Evernden is Board Certified in Internal Medicine by the American Board of Internal Medicine and Board Certified in Diagnostic Radiology by the American Board of Radiology.
Transcription:
This Healthy Conversations COVID-19 podcast was recorded on September 14th, 2020.
Prakash Chandran (Host): With all that’s happening in the world, preventative screening exams may not be on the top of your mind. However, when we’re not being proactive about our health, we may be neglecting our wellbeing and ignoring potential diseases. By prioritizing screening exams, we can make life saving decisions for our health and that of our loved ones. We’re going to learn about it today with Dr. Blake Evernden, a Diagnostic Radiologist at Twin Cities Community Hospital and Templeton Imaging.
This is Healthy Conversations, the podcast from Tenet Health Central Coast. I’m Prakash Chandran. So, first of all Dr. Evernden, great to have you here today. What exactly do you do as a Radiologist?
Blake Evernden, MD (Guest): Radiologists are medical doctors that specialize in the diagnosis and treatment of disease and injury with medical imaging procedures. Radiologists have five years of internship and training following medical school with many Radiologists choosing to do additional training such as interventional radiology, neuroradiology, pediatrics and other subspecialties. We’re certified by the American Board of Radiology who also in addition to certifying Radiologists like myself, Diagnostic Radiologist, they also certify Radiation Oncologist who are trained in using radiation in treating disease.
Host: I see. So, maybe just to give us a little bit more detail there, talk to us about what the typical workday looks like for you.
Dr. Evernden: Well for me as a Diagnostic Radiologist, I spend most of my day just reviewing studies such as plain x-rays, CT studies, those are CAT scans, ultrasounds, MRIs, nuclear medicine studies and mammograms. These studies are produced by radiologic technologists who are trained in producing images and then presenting them to us, the Radiologists. And so, then we review them. We go over all the relevant findings, compare to previous studies if we have them and then we provide our findings and conclusions to the ordering physicians. Sometimes we call them immediately depending on what we see, some things are emergent. But generally, things are in report, they go out to the ordering physicians. We also consult with ordering physicians as to the appropriateness of which study to use in working up a patient.
Host: Got it. That’s really helpful. Obviously, we are in the midst of a pandemic right now. And I’m wondering how the world of COVID has changed your daily worklife.
Dr. Evernden: Well, I still go to work every day. I clean my work space. I do all the commonsense things that anyone would do at work. We wear masks. I stopped shaking hands with patients. Those sorts of things. The patient experience is definitely changed. We have these screening tents in which patients are asked about symptoms. We take their temperature. Lots of plexiglass barriers. We have a well socially distanced waiting room. And everyone wears masks. And so, things have changed but I think everything is under control.
Host: Absolutely. And I know how many precautions have been put in place to make sure that the patients experience is as safe as possible. I’m curious to see if you have received or reviewed a lower number of images than normal since COVID began.
Dr. Evernden: Oh yeah. ever since the shutdown, when the shutdown first came, that first six to seven weeks of shutdown all through the month of April as well, I’d say our volume of cases probably went down at least 50%, probably more at the imaging center. We actually stopped doing screening mammograms for about six or seven weeks. There were no elective surgeries at the hospital. They closed down the clinics for a while. And so, the amount of patients coming through was definitely decreased significantly.
Host: Yeah, and I bet a big reason for that is I know there’s just a lot of apprehension and concern around going anywhere, really, during this pandemic. So, during this time, we’re a couple of months into it now obviously, more than that, would you still encourage your family and friends to continue to get their annual screenings?
Dr. Evernden: Oh absolutely. I have no problem with my wife, my mother, my sister and my aunt going down and getting their screenings done. I figure that since this pandemic began, I figure there are thousands of women within our county that have delayed or even decided to skip their annual screening exams, and we’re talking about mammogram screening exams. And I know within these thousands of patients, there are undetected cancers that were it not for the pandemic, would have already been diagnosed and been under treatment by now. So, my object today is to try and get as many women back into their screening routines as possible.
Host: Okay so let’s talk a little bit about that because I know even for my wife, she got screened last year but she was saying, you know I just got screened, what feels just like a year ago, so do I really need to go in again? So, maybe talk a little bit about how often women should be coming in and what happens if the regular screening is potentially put off several months?
Dr. Evernden: Well we recommend that women begin annual screening exams at the age of 40, earlier if you have a family history or other reasons to do so. And the whole point about doing screening exams is to find cancers in their earliest stages. And if you can find a cancer confined to the breast; there’s a 99% five year survival. As soon as it starts to spread outside of the breast into the lymph nodes; then the survival starts to go down. So, even delaying I think even months is going to increase the odds of not finding this cancer in time.
Host: Yeah, I think what I’m reading from that is that cancer can spread pretty quickly and the sooner you catch it, the more you can actually do something about it. Isn’t that correct?
Dr. Evernden: That’s right. I’m in the business of finding cancer and the earlier we find it, the better it is all the time.
Host: Now you mentioned before if someone has a family history to come in before 40, for example my mother in law, she got cancer at 43 years old, breast cancer. So, when should my wife be going in?
Dr. Evernden: It would depend on what the – what her physician would recommend. But I would probably have maybe some initial mammogram done in their mid-30s, maybe earlier and then that will serve as a baseline for which you can then compare future mammograms. Reading mammograms is one of these modalities where comparing to previous studies is very important. Because you look for changes, you look for subtle changes and subtle clues as to what may be developing.
Host: Right, so the more data points you have, the better. And what might you say to those people who are for example, self-examining themselves in lieu of going in for a mammogram? There is a difference isn’t there?
Dr. Evernden: Well there is, and I would still encourage women to continue their monthly self-breast exams. Because that’s something they can do on their own. And in fact, many cancers are discovered by women themselves doing their own breast exams. And then they are brought to our attention and then we can look at them closer. But continuing to do the self-breast exam is a good idea but that has to be augmented with the screening mammogram and even visits to your physician as well.
Host: Right. And I know there’s also something that I’ve heard about called dense tissue and that’s something that with the evolution in mammogram technology that we have today, you can make the difference between dense tissue and what might be cancerous cells. Is that correct?
Dr. Evernden: Well that’s right. We do have a new modalities to evaluate dense breast tissue. We have 3-D mammogram now which is where you can peer into the breast a lot better than we could in the past as far as being able to detect small lesions. But even in dense breasts, it doesn’t work as well as with non-dense breasts. With dense breasts now we also have the ability to do automated breast ultrasound where a machine will ultrasound the whole breast and then we will go over all these images and try and detect any problems on the ultrasound as well. So, in addition to 3-D mammogram that we have now we also have this automated breast ultrasound which is good for screening dense breasts.
Host: Got it. Well that definitely sounds reassuring and I can see why it’s so important that women come in early and often. Just as a Diagnostic Radiologist, besides doing mammograms, which I imagine is the majority of what you’re doing in terms of that annual visit and annual screening; are there any other types of screenings that you see, or you might recommend to someone that’s listening to this?
Dr. Evernden: Well maybe not in the realm of screenings but I know there are patients out there who need to have regular scans done to monitor the progression and course and response of their disease to treatment. Those are still important to be done when scheduled. If we’re scheduled in the middle of the pandemic, it’s safe to come back and get it done now. And so, I would encourage those patients to maintain their schedule of getting their exams done. Also, there are patients who we monitor small nodules within the lungs, too small to do anything about at the current time, but we want to make sure that they don’t change or get any bigger or require any future treatment. And so, I would encourage those patients as well who are on a schedule of having their exams done to come on back and get their exam done.
Host: And one thing that I always like to ask before we close is as a Diagnostic Radiologist, I’m sure you see and catch many things in all of the work that you’re doing. Is there one piece of advice that you wish more patients knew before they came in to see you?
Dr. Evernden: Well what I would say would be to maintain your schedule of your screening mammograms. Come in when you are due. Like I said, before, because of this pandemic, I’m sure there are thousands of people – thousands of women within our county that are delaying or decided to skip their screening mammogram. And I know within that group of women, there are cancers that have yet to be detected and treated. And so, I encourage everybody to maintain their annual screening mammograms.
Host: Well Dr. Evernden, I think that is a perfect place to end. Thank you so much for your time again. That’s Dr. Blake Evernden, Diagnostic Radiologist at Twin Cities Community Hospital and Templeton Imaging. Thanks for checking out this episode of Healthy Conversations. For a referral to Dr. Evernden or another provider call the Tenet Health Central Coast physician referral line at 866-966-3680. If you found this podcast helpful, please subscribe at www.tenethealthcentralcoast.com/about/podcast and share it on your social channels. Be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations, the podcast from Tenet Health Central Coast. Thanks and we’ll see you next time.
This Healthy Conversations COVID-19 podcast was recorded on September 14th, 2020.
Prakash Chandran (Host): With all that’s happening in the world, preventative screening exams may not be on the top of your mind. However, when we’re not being proactive about our health, we may be neglecting our wellbeing and ignoring potential diseases. By prioritizing screening exams, we can make life saving decisions for our health and that of our loved ones. We’re going to learn about it today with Dr. Blake Evernden, a Diagnostic Radiologist at Twin Cities Community Hospital and Templeton Imaging.
This is Healthy Conversations, the podcast from Tenet Health Central Coast. I’m Prakash Chandran. So, first of all Dr. Evernden, great to have you here today. What exactly do you do as a Radiologist?
Blake Evernden, MD (Guest): Radiologists are medical doctors that specialize in the diagnosis and treatment of disease and injury with medical imaging procedures. Radiologists have five years of internship and training following medical school with many Radiologists choosing to do additional training such as interventional radiology, neuroradiology, pediatrics and other subspecialties. We’re certified by the American Board of Radiology who also in addition to certifying Radiologists like myself, Diagnostic Radiologist, they also certify Radiation Oncologist who are trained in using radiation in treating disease.
Host: I see. So, maybe just to give us a little bit more detail there, talk to us about what the typical workday looks like for you.
Dr. Evernden: Well for me as a Diagnostic Radiologist, I spend most of my day just reviewing studies such as plain x-rays, CT studies, those are CAT scans, ultrasounds, MRIs, nuclear medicine studies and mammograms. These studies are produced by radiologic technologists who are trained in producing images and then presenting them to us, the Radiologists. And so, then we review them. We go over all the relevant findings, compare to previous studies if we have them and then we provide our findings and conclusions to the ordering physicians. Sometimes we call them immediately depending on what we see, some things are emergent. But generally, things are in report, they go out to the ordering physicians. We also consult with ordering physicians as to the appropriateness of which study to use in working up a patient.
Host: Got it. That’s really helpful. Obviously, we are in the midst of a pandemic right now. And I’m wondering how the world of COVID has changed your daily worklife.
Dr. Evernden: Well, I still go to work every day. I clean my work space. I do all the commonsense things that anyone would do at work. We wear masks. I stopped shaking hands with patients. Those sorts of things. The patient experience is definitely changed. We have these screening tents in which patients are asked about symptoms. We take their temperature. Lots of plexiglass barriers. We have a well socially distanced waiting room. And everyone wears masks. And so, things have changed but I think everything is under control.
Host: Absolutely. And I know how many precautions have been put in place to make sure that the patients experience is as safe as possible. I’m curious to see if you have received or reviewed a lower number of images than normal since COVID began.
Dr. Evernden: Oh yeah. ever since the shutdown, when the shutdown first came, that first six to seven weeks of shutdown all through the month of April as well, I’d say our volume of cases probably went down at least 50%, probably more at the imaging center. We actually stopped doing screening mammograms for about six or seven weeks. There were no elective surgeries at the hospital. They closed down the clinics for a while. And so, the amount of patients coming through was definitely decreased significantly.
Host: Yeah, and I bet a big reason for that is I know there’s just a lot of apprehension and concern around going anywhere, really, during this pandemic. So, during this time, we’re a couple of months into it now obviously, more than that, would you still encourage your family and friends to continue to get their annual screenings?
Dr. Evernden: Oh absolutely. I have no problem with my wife, my mother, my sister and my aunt going down and getting their screenings done. I figure that since this pandemic began, I figure there are thousands of women within our county that have delayed or even decided to skip their annual screening exams, and we’re talking about mammogram screening exams. And I know within these thousands of patients, there are undetected cancers that were it not for the pandemic, would have already been diagnosed and been under treatment by now. So, my object today is to try and get as many women back into their screening routines as possible.
Host: Okay so let’s talk a little bit about that because I know even for my wife, she got screened last year but she was saying, you know I just got screened, what feels just like a year ago, so do I really need to go in again? So, maybe talk a little bit about how often women should be coming in and what happens if the regular screening is potentially put off several months?
Dr. Evernden: Well we recommend that women begin annual screening exams at the age of 40, earlier if you have a family history or other reasons to do so. And the whole point about doing screening exams is to find cancers in their earliest stages. And if you can find a cancer confined to the breast; there’s a 99% five year survival. As soon as it starts to spread outside of the breast into the lymph nodes; then the survival starts to go down. So, even delaying I think even months is going to increase the odds of not finding this cancer in time.
Host: Yeah, I think what I’m reading from that is that cancer can spread pretty quickly and the sooner you catch it, the more you can actually do something about it. Isn’t that correct?
Dr. Evernden: That’s right. I’m in the business of finding cancer and the earlier we find it, the better it is all the time.
Host: Now you mentioned before if someone has a family history to come in before 40, for example my mother in law, she got cancer at 43 years old, breast cancer. So, when should my wife be going in?
Dr. Evernden: It would depend on what the – what her physician would recommend. But I would probably have maybe some initial mammogram done in their mid-30s, maybe earlier and then that will serve as a baseline for which you can then compare future mammograms. Reading mammograms is one of these modalities where comparing to previous studies is very important. Because you look for changes, you look for subtle changes and subtle clues as to what may be developing.
Host: Right, so the more data points you have, the better. And what might you say to those people who are for example, self-examining themselves in lieu of going in for a mammogram? There is a difference isn’t there?
Dr. Evernden: Well there is, and I would still encourage women to continue their monthly self-breast exams. Because that’s something they can do on their own. And in fact, many cancers are discovered by women themselves doing their own breast exams. And then they are brought to our attention and then we can look at them closer. But continuing to do the self-breast exam is a good idea but that has to be augmented with the screening mammogram and even visits to your physician as well.
Host: Right. And I know there’s also something that I’ve heard about called dense tissue and that’s something that with the evolution in mammogram technology that we have today, you can make the difference between dense tissue and what might be cancerous cells. Is that correct?
Dr. Evernden: Well that’s right. We do have a new modalities to evaluate dense breast tissue. We have 3-D mammogram now which is where you can peer into the breast a lot better than we could in the past as far as being able to detect small lesions. But even in dense breasts, it doesn’t work as well as with non-dense breasts. With dense breasts now we also have the ability to do automated breast ultrasound where a machine will ultrasound the whole breast and then we will go over all these images and try and detect any problems on the ultrasound as well. So, in addition to 3-D mammogram that we have now we also have this automated breast ultrasound which is good for screening dense breasts.
Host: Got it. Well that definitely sounds reassuring and I can see why it’s so important that women come in early and often. Just as a Diagnostic Radiologist, besides doing mammograms, which I imagine is the majority of what you’re doing in terms of that annual visit and annual screening; are there any other types of screenings that you see, or you might recommend to someone that’s listening to this?
Dr. Evernden: Well maybe not in the realm of screenings but I know there are patients out there who need to have regular scans done to monitor the progression and course and response of their disease to treatment. Those are still important to be done when scheduled. If we’re scheduled in the middle of the pandemic, it’s safe to come back and get it done now. And so, I would encourage those patients to maintain their schedule of getting their exams done. Also, there are patients who we monitor small nodules within the lungs, too small to do anything about at the current time, but we want to make sure that they don’t change or get any bigger or require any future treatment. And so, I would encourage those patients as well who are on a schedule of having their exams done to come on back and get their exam done.
Host: And one thing that I always like to ask before we close is as a Diagnostic Radiologist, I’m sure you see and catch many things in all of the work that you’re doing. Is there one piece of advice that you wish more patients knew before they came in to see you?
Dr. Evernden: Well what I would say would be to maintain your schedule of your screening mammograms. Come in when you are due. Like I said, before, because of this pandemic, I’m sure there are thousands of people – thousands of women within our county that are delaying or decided to skip their screening mammogram. And I know within that group of women, there are cancers that have yet to be detected and treated. And so, I encourage everybody to maintain their annual screening mammograms.
Host: Well Dr. Evernden, I think that is a perfect place to end. Thank you so much for your time again. That’s Dr. Blake Evernden, Diagnostic Radiologist at Twin Cities Community Hospital and Templeton Imaging. Thanks for checking out this episode of Healthy Conversations. For a referral to Dr. Evernden or another provider call the Tenet Health Central Coast physician referral line at 866-966-3680. If you found this podcast helpful, please subscribe at www.tenethealthcentralcoast.com/about/podcast and share it on your social channels. Be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations, the podcast from Tenet Health Central Coast. Thanks and we’ll see you next time.