Category Archives: Cancer

The things we already know–but don’t often do

There is the old Middle Eastern story of the one who journeyed East in search of wisdom. He came upon a stone where he read, “Turn me over.”
He picked up the stone and read on the underside: Why do you seek new knowledge when you do not use that which you already have?

A recently reported Swedish study that followed 71,000 individuals over a 13-year period found that consuming less than five daily servings of fruits and vegetables was associated with higher mortality and shorter survival periods. Those eating one serving of fruit daily lived 19 months longer on average, while those eating 3 servings of vegetables lived 32 months longer.

Now by itself, this is not very surprising. We know that heavy meat consumption is linked to colorectal cancer, particularly in combination with genetic mutations, as described in a recent issue of Smithsonian Magazine. So, the possibility that a different diet would be protective, even by contrast, makes some sense.

Fornaciari subsequently analyzed bone collagen of King Ferrante and other Aragonese nobles, revealing a diet extremely reliant on red meat; this finding may correlate with Ferrante’s cancer. Red meat is widely recognized as an agent that increases risk for mutation of the K-ras gene and subsequent colorectal cancer. (As an example of Ferrante’s carnivorous preferences, a wedding banquet held at his court in 1487 featured, among 15 courses, beef and veal heads covered in their skins, roast ram in a sour cherry broth, roast piglet in vinegar broth and a range of salami, hams, livers, giblets and offal.)

In a similar vein, one out of three Americans suffers from hypertension (high blood pressure), a major risk factor for serious cardiovascular events such as stroke and heart attack. A recent study in JAMA showed that 18 months after the beginning of a study in which the experimental group did home blood pressure monitoring along with pharmacist case management, 71.8 percent had controlled blood pressure compared to the control group with usual care at 57.1 percent.

It would be easier if we had pills that would lower our body weight or a vaccination against high blood pressure. We don’t. But we have knowledge that we are not using: walk more, eat less processed foods and more whole grains, vegetables, and fruits, monitor blood pressure and pulse regularly. No, it is not magic–just the best that we can do.

The latest in DME: an umbrella

When my wife moved to the States from Singapore, she was amazed to find that the umbrellas sold did not list their UV protection. Singapore is 137 km or 85 miles from the equator, and light skin is valued in Chinese culture. So protection from the aging and darkening effect of the sun’s rays has strong cultural underpinnings–unlike the US where there seems to be a tanning salon in every strip mall.

Normally we don’t think of an umbrella as DME (Durable Medical Equipment). However, if DME is home medical equipment you need for your health, then using an umbrella to prevent melanoma seems to qualify. As reported in JAMA Dermatology The researchers Josette R. McMichael, MD, Emir Veledar, PhD, and Suephy C. Chen, MD, MS of Emory University performed a simple, but well-designed experiment: they invited friends to join them in a parking lot, took 3 ultra-violet radiation (UVR) readings, and then opened umbrellas the friends had brought, taking two UVR readings, 1 cm from the individual, and 1 cm from the edge of the umbrella as shown:

Umbrella_uvr_measurement_20130304

There was wide variety in protection among the 22 umbrellas tested, ranging from a white totes® (77%) to a silver Coolibar® (99%). Fourteen were black in color.

Some of the numbers: Umbrella_findings_20130314

As is apparent in the account, the two readings (close and far) were highly correlated. The following scatterplot shows that as the values of each of the two readings are on the axes. The lowest reading shows the greatest protection, so umbrella 6 is the Coolibar®.

Umbrella_uvr_emory_20130304

As the earth warms, we can expect disturbances in the atmosphere that increase our exposure to UVR. Borrowing the style of the 19th century, carrying umbrellas, especially those designed to screen UVR, may be the best we can do.

What’s a woman to do? Or a man? Dairy and weight and bones and stuff.

In many ways women’s health is more challenging than men’s.

Women over age 50 are much more likely to get breast cancer, or its precursors, such as fibrocystic breast disease.

Women get cervical and ovarian cancer–men don’t need pap smears or the equivalent.

Women are five times more prone to osteoporosis.

Many medical studies have disproportionately targeted men, although that is changing.

But let’s just consider osteoporosis for a moment. Some risk factors are:

  1. Unchangeable
    • Sex
    • Age
    • Race
    • Family History
    • Frame Size
  2. Hormone Levels
    • Sex Hormones
    • Thyroid
    • Other Glands
  3. Dietary
    • Low Calcium Intake
    • Eating Disorders
    • Weight Loss Surgery
  4. Steroid Prescriptions and Others
  5. Lifestyle
    • Sedentary Lifestyle
    • Excessive Alcohol Consumption
    • Tobacco Use
  6. Too little estrogen

This is but one ailment, but threading the needle is difficult. Consider that sedentary lifestyle and inadequate weight are opposites. If someone exercises and loses weight, the risk is increased. If someone does not exercise, the risk is increased. And the task is even more complicated. A recent study found that consumption of high-fat dairy is associated with increased mortality from breast cancer–so your doctor will probably tell you to stick to low-fat dairy to get additional calcium–be sure to ask.

Very often we hear that someone fell and broke their hip; less often we realize that someone’s hip broke, and they fell.

The International Osteoporosis Foundation estimates that 1 in 3 women and 1 in 5 men will experience a fracture from osteoporosis.

Osteoporosis affects more than 10 million Americans, accounting for 1.5 million fractures annually.