Dr. Susan B. LeGrand MD
Oncologist | Medical Oncology
9500 Euclid Avenue T34 Cleveland Ohio, 44195Rating
4/5
About
Dr. Susan LeGrand is an oncologist practicing in Cleveland, Ohio. Dr. LeGrand specializes in the care and treatment of patients with cancer. As an oncologist, Dr. LeGrand manages and oversees the treatment of a cancer patient after he or she has been diagnosed with the disease. Oncologists will care for their patients throughout the course of the disease. Types of oncologists include medical oncologists, surgical oncologists, radiation oncologists, gynecologic oncologists, pediatric oncologists and hematologist oncologists.
Dr. Susan B. LeGrand MD's Videos
Education and Training
University of South Carolina School of Medicine
University of South Carolina School of Medicine 1983
Board Certification
American Board of Internal Medicine- Oncology
American Board of Internal Medicine- Internal Medicine
American Board of Internal Medicine- Hospice and Palliative Care
Internal MedicineAmerican Board of Internal MedicineABIM
Provider Details
Dr. Susan B. LeGrand MD's Expert Contributions
Cancerous?
You should see a dermatologist immediately. This could very well be melanoma and needs to be removed Susan LeGrand MD READ MORE
How can we get this treated?
She has ductal carcinoma in situ which means the disease is confined to the duct based on current knowledge i.e. the path report. She needs to have it surgically removed and tested to make sure there is no invasive disease that would require different therapy. DCIS is not really cancer it is a pre-cancer that left alone can become invasive disease, It still needs to be treated appropriately-surgery,+/- radiation depending on pathology. Is it estrogen positive:? READ MORE
Stage 4 liver cancer?
Based on what you have described it sounds like hospice would be appropriate. They can help better with his pain control as that is part of their responsibility. He should he on a sustained release medication such as SR morphine or ER morphine in addition to the oxycodone. Doses should be enough to relieve his pain. As to future symptoms, pain can certainly escalate and would need to be addressed by the hospice. The most difficult to manage if it occurs is confusion. If his liver fails there may be significant confusion that would require medications. The other thing you will notice is he will eat less and less and get more and more fatigue and then not get out of bed at all. You cannot help his nutritional status so let him eat what he wants no matter how little. READ MORE
How do chemotherapy and radiation differ?
The two therapies are quite different. Chemotherapy is given to impact disease in any location in the body (does not always get to the brain) so it is a systemic treatment with the hope of prolonging life. Radiation is focused on a single area, therefore local therapy, with the hope of improving symptoms. Therefore with the goal of improving pain control, preventing fracture and treating local complications of the cancer. Sometimes in pancreatic cancer a combination of chemotherapy and radiation will be used with the goal of shrinking the tumor enough to have a surgical procedure. READ MORE
How long do side effects typically last with chemotherapy?
It depends on what medications you are getting. Fatigue is the most common side effect and gradually improves. There are side effects day 1 of treatment and then sometimes for several days after again depending on which drugs. READ MORE
Cannabis and breast cancer?
There is a lot of scientific evidence that CBD oil is not effective in cancer and I evidence that THC has any value nor is there any reason they should. If you do not have metastatic disease then tumor markers have no role and should not be monitored. They are not specific enough to predict recurrence. There is good evidence that no scans/labs should be done unless there is a symptom to monitor. This is something the American Society of Clinical Oncology strongly discourages. READ MORE
How is medical marijuana used in the treatment of cancer?
There is no particular role for medical marijuana managing the cancer itself. CBD oil information on the Internet that it impacts on cancer survival but this is not true. There is also something called RSO oil the gentleman who sells it feels it cured his cancer. there is no cancer based research that can to manage improvement in cancer with medical marijuana Medical marijuana can be of use is the management of nausea and appetite. For more than 20 years there has been a product called dronabinol which was a legal THC initially approved for help in managing chemotherapy induced nausea. Better anti-nausea drugs came subsequently and this has not been used for this indication since then. In palliative medicine we sometimes use dronabinol for the nausea and the appetite stimulation. I work at the Cleveland clinic and we are not allowed to recommend medical marijuana since the data is so poor and it is not FDA approved for any indication. Susan B. LeGrand MD, FACP, FAAHPM READ MORE
Is radiation therapy recommended for breast cancer?
The two things have different purposes. Radiation works with surgery to control the disease in the breast. It is recommended in certain tumors of large size and/or positive lymph nodes. If she has a lot lumpectomy then radiation is needed. Chemotherapy or hormone therapy is there to try and prevent or postpone any spread of the cancer to other organs. Whether it is the right thing to do depends on several issue 1) how big was the cancer 2) were lymph nodes involved 3) what type of breast cancer is it. Different types need different therapies. 4) was there an Oncotype done? If so what I as the number result So many things to consider. Surgery +/- radiation is for local control in the breast and on the chest. Chemotherapy and/ or hormone therapy is for the rest of the body READ MORE
Will I definitely lose my hair during chemotherapy?
Most Chemotherapy given after or before surgery for breast cancer does cause hair loss. There is a cold cap available but does not work if one of the drugs is adriamycin. READ MORE
My mother is 72 years with a history of breast cancer. What are the chances of her getting the disease again?
Difficult to calculate without additional information. If she was hormone positive, then there remains a (low) risk of relapse forever. Hormone-positive breast cancer has a consistent late relapse rate. If she had hormone-negative disease, then the likelihood or relapse is nil. READ MORE
I want to get pregnant but I have undergone chemotherapy 2 years back. Is it advisable to conceive?
If you are having regular periods and chemotherapy is this far out, then there should not be a problem. There is no evidence that remote chemotherapy negatively impacts fetal health. Getting pregnant might be a little harder. READ MORE
Can breast can spread even after breast removal surgery?
Everything you did was to prevent cancer from coming back but it is not a guarantee. While the tumor was in your breast, it had a chance to send cells to other places like bone and lung. The chemotherapy you did was to kill these cells, but some may be dormant and escape the treatment. So there is a chance it could come back. How much risk depends on factors such as the size of the tumor and whether lymph nodes were involved. You are at a slightly higher risk to get cancer in the other breast. If this occurred, it would not be a spread from the first cancer, but a new tumor that you would approach like this one biopsy, surgery, maybe chemo, etc. Hope this helps. READ MORE
Expert Publications
Data provided by the National Library of Medicine- Palliative management of dyspnea in advanced cancer.
- Communication in advanced disease.
- Symptom control in the pregnant cancer patient.
- The business of palliative medicine: management metrics for an acute-care inpatient unit.
- A phase II study of methylphenidate for depression in advanced cancer.
- Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions.
- Hydrocodone for cough in advanced cancer.
- The business of palliative medicine--Part 2: The economics of acute inpatient palliative medicine.
- The impact of a palliative medicine consultation service in medical oncology.
- Cancer fatigue--more data, less information?
- Dyspnea: the continuing challenge of palliative management.
- Physicians and patient spirituality.
- Normal-release and controlled-release oxycodone: pharmacokinetics, pharmacodynamics, and controversy.
- End-of-Life care: the death of palliative medicine?
- Randomized clinical trial of an implantable drug delivery system.
Areas of expertise and specialization
Faculty Titles & Positions
- Local Public Speaking -
- Regional Public Speaking -
- National Public Speaking -
- International Public Speaking -
Awards
- Fellow of the American College of Physicians
- Fellow of the American Academy of Hospice and Palliative Medicine
Internships
- University of Texas 1986
Fellowships
- University of Arizona Cancer Center- Oncology
Professional Society Memberships
- American Society of Clinical Oncology
Articles and Publications
- Yes
What do you attribute your success to?
- Her Training and What She Has Learned From Patients. Staying Up To Date and Caring For The Whole Patient Physically and Emotionally.
Hobbies / Sports
- Reading, Computer Games
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