Is skin cancer on the rise?

The incidence of skin cancer is increasing. And this increase is not only due to better screening and diagnostic techniques. The threat is real and not just an artefact of better technology, according to researchers at the Stanford University Medical Center in California.

This rise of skin cancer incidence has been reported both in the US and Europe. In the US, the increase is on average, 3.1% each year, from 1992 to 2004.

The Stanford researchers argue that improved screening methods will detect more skin tumors which are thinner and most likely to be benign, the kind that were easily missed before the new methods were introduced. However,

“after assessing 70,596 previously documented cases of cancer diagnosed between 1992 and 2004 in the United States, they found that there were significantly more cases of tumours of all thicknesses”.

Another indication of skin cancer increase is the fact that the rise is evident in all socioeconomic groups, not only among those who belong to higher income groups in the US and therefore have better access to health care and insurance coverage.

The findings of the two studies indicate that skin cancer is indeed on the rise.

Skin cancer incidence reports are quite controversial, because the disease is closely associated to exposure to the sun. In recent years, there is a rapid increase in vitamin D deficiency the world over because people tend to avoid sun exposure for fear of skin cancer. However, vitamin D deficiency has been linked to a variety to chronic conditions, including cardiovascular problems, osteoporosis, neurodegenerative disorders, as well as pregnancy complications.

According to lead researcher Eleni Linos

“Over the past 100 years, people are really changing the amount of time they spend in the sun, the clothes they wear, and whether their hobbies and work are indoor or outdoor.” This has been confounded by the thinning of the ozone layer which led to “increased exposure to ultraviolet light or a longer-term increase in the genetic susceptibility to cancer.”

According to the Medline Medical Encyclopedia,

Skin cancer is the most common form of cancer in the United States. The two most common types are basal cell cancer and squamous cell cancer. They usually form on the head, face, neck, hands and arms. Another type of skin cancer, melanoma, is more dangerous but less common.

• skin cancer commonly occurs in people who
• have light-colored skin, hair and eyes
• are older than 50 years old
• family history of skin cancer
• spend a lot of time outdoors in the sun.

Photo credit: stock. xchng

               

Know your heart conditions: diastolic dysfunction

Resource post for January

About 80 million adult Americans suffer from at least one type of cardiovascular disorder. This is equivalent to 1 in every 3 adults. Diastolic dysfunction is a commonly used term nowadays in connection with diagnosis of heart disease. This term, however, is fairly new, and the dysfunction has only been identified with improved diagnostic techniques.

What is diastolic dysfunction?

Before we can understand this disorder, we first have to understand how our heart works.

“Lub-dub” This is the sound that our heart makes with each and every heartbeat. And with every beat, the heart contracts and relaxes. The contraction phase when the ventricles contract to pump blood out of the heart is called the systole. The relaxation phase when the ventricles relax and get filled with blood pumped from above by the atria is the called diastole. The “lub-dub” sound is actually made by the heart’s valves as they close and open during the contraction - relaxation cycle.

Our heart has 4 valves, namely:

• The tricuspid valve divides the right atrium from the right ventricle.
• The mitral valve divides the left atrium from the left ventricle.
• The pulmonary valve separates the right ventricle from the pulmonary artery, the big blood vessel that brings blood to the lungs.
• The aortic valve is separates the left ventricle from the aorta, the big artery that carries blood from the heart to the body.

The soft “lub” is the sound that the mitral and tricuspid valves make when they close at the start of the systole or contraction phase. The louder “dub” is the sound that the aortic and pulmonary valves make when they close at the start of the diastole or relaxation phase.

Diastolic dysfunction occurs when the relaxation or diastolic phase of the heart does not proceed normally. This has something to do with “stiff” heart muscles leading to the failure of the ventricle to relax normally. This inability of the ventricle to completely relax results in:

• the pressure in the ventricle to increase above normal.
• difficulty for the blood to enter the ventricle in the next heartbeat.

According to the American Heart Association (AHA), when not managed properly, diastolic dysfunction leads to inefficient pumping of the heart and “can cause increased pressure and fluid in the blood vessels of the lungs (pulmonary congestion). It can also cause increased pressure and fluid in the blood vessels coming back to the heart (systemic congestion).” This can eventually lead to diastolic heart failure.

According to this article in the American Academy of Family Physicians (AAFP) site

“diastolic heart failure is defined as a condition caused by increased resistance to the filling of one or both ventricles; this leads to symptoms of congestion from the inappropriate upward shift of the diastolic pressure-volume relation.”

A condition called systolic dysfunction also exists.

What causes diastolic dysfunction?

The disorder seems to be especially common in elderly women, even among those not previously diagnosed with heart disease. The following cardiovascular conditions can lead to the stiffening of the ventricles and thus diastolic dysfunction:

• aortic stenosis
• chronic hypertension
• coronary artery disease
• some forms of cardiomyopathy, e.g. hypertrophic and restrictive cardiomyopathy

How is diastolic dysfunction detected and diagnosed?

In its early stages, diastolic dysfunction does not manifest in obvious symptoms. Perhaps the earliest noticeable symptom would be dyspnea or shortness of breath. However, since this is a very common symptom for many kinds of diseases and disorders, diastolic dysfunction is often “missed” during routine medical check ups. Thus, “diastolic dysfunction may be present for several years before it is clinically evident.”

It its advanced stage, when diastolic dysfunction has progressed to the point of causing diastolic heart failure, the following symptoms and related conditions may be evident:

• Abnormal heart rhythms such as atrial fibrillation
• Periodic increase in blood pressure
• Decreased tolerance to physical exercise
• Severe breathlessness even without exertion
• Edema or accumulation of fluids in the feet and ankles
• Acute pulmonary congestion

A standard electrocardiogram or ECG unfortunately cannot easily distinguish between systolic and diastolic dysfunction. The most reliable but rather invasive diagnostic method is cardiac catheterization. As a less invasive alternative, a two-dimensional echocardiography with Doppler function can be used, although the physician must be well-trained in evaluating “the characteristics of diastolic transmitral and pulmonary venous flow pattern” in order to diagnose diastolic dysfunction.

How is diastolic dysfunction managed?

As in almost every disease, early diagnosis and treatment of diastolic dysfunction is important to prevent irreversible damage to the heart.

There is no easy way to treat diastolic dysfunction. However it can be effectively managed through treatment and management of the underlying conditions, namely:

High blood pressure. Management of hypertension is essential in the management of diastolic dysfunction. The AHA gives a comprehensive review of hypertension, including online tools to check for risk factors and blood pressure monitoring.

Coronary artery disease. CAD on its own requires aggressive management strategies to prevent heart attacks. This animation on the AHA site explains clearly how CAD develops.

Aortic valve stenosis. The aortic valve can also become stiff or is misformed at birth, resulting in aortic stenosis, a condition which puts a strain on the left ventricle. Usually, this condition is relieved by surgical interventions.

Arrhythmia. Abnormal heart rhythms such as atrial fibrillation need to be managed effectively to avoid further complications. The AHA site also gives a useful animation on atrial fibrillation. More information about arrhythmias can be found here.

Currently, there is a scarcity of conclusive data on therapies specifically for diastolic heart dysfunction and failure. However, the American College of Cardiology and the American Heart Association have jointly come up with guidelines which “recommend that physicians address blood pressure control, heart rate control, central blood volume reduction, and alleviation of myocardial ischemia when treating patients with diastolic heart failure. These guidelines target underlying causes and are likely to improve left ventricular function and optimize hemodynamics.” Medications used for the management of diastolic heart failure are summarized in this AAFP article (Table 4).

Can diastolic dysfunction be prevented?

Like many heart disorders, diastolic dysfunction and heart failure are preventable.

“Primary prevention of diastolic heart failure includes smoking cessation and aggressive control of hypertension, hypercholesterolemia, and coronary artery disease. Lifestyle modifications such as weight loss, smoking cessation, dietary changes, limiting alcohol intake, and exercise are equally effective in preventing diastolic and systolic heart failure.”

Photo credits: stock.xchng

               

Do you know your risk for heart disease?

Do you have an undiagnosed risk for developing cardiovascular disease (CVD)? You think it’s highly unlikely? Well, think again.

According to a British study, one in three people with high cardiovascular risk over the next years are unaware of their risk, and neither are their health care providers. In other words, it is very often that the risk remains undiagnosed until it manifests in overt symptoms. This oversight in risk assessment is especially strongest in middle-aged men.

The study conducted by Oxford University researchers in a mobile clinic looked at 71,037 men and women aged 18 and older all over England, Wales and Scotland. Tests were performed and questionnaires were filled in. The results do not look good.

• 20% of all male study participants and 6% of female participants have high likelihood of developing CVD in the next 10 years.
• CVD risk is highest in the 50 plus age group compared to others. 75% of men and 45% of women in this age group have CVD, diabetes, and are taking anti-cholesterol or anti-hypertension drugs.

Based on the results, the participants were classified as having high, medium, or low risk profiles.

People were defined as high risk if they had more than a 20 per cent chance of developing CVD over the next 10 years. This criterion is in line with the Joint British Societies Guidelines on Prevention of Cardiovascular Disease in Clinical Practice, which were issued in 2005 and endorsed by the UK’s National Institute of Health and Clinical Excellence in 2006.  

Based on their risk profiles, the participants were then given appropriate medical advice. High risk individuals were advised to see their doctor, together with their tests. Those with medium risk profiles were given verbal as well as written advice as to how to reduce the risk.

In the UK alone, almost 8 million people have been diagnosed with CVD or have recognized high risk for CVD. However, it is estimated that there are almost 4 million people out there whose risk are undiagnosed and are therefore unaware of this risk. Because of this, they do not concern about preventive measures, lifestyle changes, professional advice or early treatment. Of these, 2.8 million are male and 900,000 are females. If these figures were to be extrapolated on a global scale, the numbers are staggeringly big. There is clearly a need for more awareness of CVD risks and risk factors on the part of patients and health care providers alike.

The most common risk factors for CVD are:

• Obesity
• Lack of exercise
• Bad nutrition
• Smoking
• Genetics

So don’t think you are exempt from CVD risk. Check your lifestyle. Check with your doctor. Remember: early detection means early prevention.

Photo credit: fishmonk at stock.xchng

               

CVD News Watch for the Weekend 29 August

CVD treatment watch

New hope for stroke patients

3 hours max. That’s how long a stroke patient has before major brain damage and death occur. If treated within 3 hours, the patient has very high chances of survival and full recovery. After 3 hours, the brain becomes irreversibly damaged.

Anti-nogo, a new experimental approach can give new hope to patients with high risk for stroke. It can potentially restore brain function weeks or even months after the stroke has occurred. The technique disables the nogo protein which inhibits the growth of nerve fibers. In doing so, Anti-nogo stimulates the growth of nerve fibers, thereby compensating for those damaged by stroke.

 

CVD test watch

Hearts a flutter as exam includes audio portion for first time

It’s something every medical student in the US has to go through - the 3-part medical test. However, this autumn brings new angle (and sound) to the test - cardiac auscultation or listening to the heart. However, the students will not listen to a real patient’s heart beats but audios specially develop for this test. According to one medical professor, many medical students lack the skills to identify heart conditions using a stethoscope and instead depend mostly on very expensive tests for diagnosis. With the audio tests, it hoped that the students get proper training to know the difference between a healthy and a diseased heart by simply listening.

CVD weight watch

Not all fat is created equal

If you are obese, chances are your fat cells are “sick. Researchers at Temple University in Philadelphia report differences in fat cells between obese and non-obese individuals.

“The fat cells we found in our obese patients were deficient in several areas…They showed significant stress on the endoplasmic reticulum, and the tissue itself was more inflamed than in our lean patients.“, according to one study author.

 

CVD treatment watch

Olive leaf extract may help reduce blood pressure

An article in Phythotherapy Research reported that olive leaf extract at a dose of 1000 mg per day can lower blood pressure in humans. However, large-scale tests are needed to confirm these results.

 

CVD diagnostics watch

FDA Clears Test to Help Doctors Manage Heart Transplant Patients

The US FDA has approved the marketing of AlloMap, an in vitro diagnostic assay that can determine potential organ rejection among heart transplant patients.

“AlloMap measures genetic information contained in the white blood cells (cells of the immune system that defend the body against invading viruses, bacteria or other foreign material) from a patient’s blood sample.”

AlloMap has been developed by the California biotech company XDx Inc.

               

New Prostate Cancer Screening Recommendations

Yesterday the U.S. Preventative Services Task Force (USPSTF) released its recommendations regarding prostate cancer screening.

Summary of Recommendations:

• USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 years.
• The USPSTF recommends against screening for prostate cancer in men age 75 years or older.

What is the USPSTF?

“The U.S. Preventive Services Task Force (USPSTF) , first convened by the U.S. Public Health Service in 1984, and since 1998 sponsored by the Agency for Healthcare Research and Quality (AHRQ), is the leading independent panel of private-sector experts in prevention and primary care. The USPSTF conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications. Its recommendations are considered the “gold standard” for clinical preventive services.”

More on Prostate Cancer:

Prostate cancer is the most common cancer in men after lung cancer, affecting one in six men in the U.S.

Prostate cancer rarely affects men under the age of 40. Diagnosis is usually over made after 50 and in fact two-thirds of all cases are diagnosed in men over 65.

60 to 61% of the time it is diagnosed in an African American male.

A male is twice as likely to be diagnosed with prostate cancer if he has/had a father or brother with the disease. There is also an inherited gene for prostate cancer, affecting 5 to 10 % of all diagnosed cases. While research into genetic testing is promising, it is not yet available.

Current American Cancer Society Guidelines recommendations for screening:

Both the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE) should be offered annually, beginning at age 50, to men who have at least a 10-year life expectancy.

Screening will begin with:

• Digital Rectal Exam-part of a regular yearly physical to exam the gland for changes.
• PSA-Prostate Specific Antigen blood test-higher than normal levels may indicate a problem.

And may proceed to the following if your DRE and PSA indicate the need.

• Ultrasound-A small probe inserted into the rectum will take pictures of the gland using sound waves.
• Biopsy-Tissue samples examined by a pathologist to determine the staging of a cancer diagnosis.

Prevention:

The Mayo Clinic recommends a diet low in fat and rich in lycopene and regular exercise.

Treatment:

Treatment may include surgery, radiation, chemotherapy and hormone therapy.

The Prostate Calculator offers disease forecasts based on real patients and artificial intelligence

More articles on the screening recommendations of the U.S. Preventative Services Task Force (USPSTF):

The Wall Street Journal: Prostate Cancer Screening: Making Decisions Without Evidence

Forbes . Com: Do You Need a Prostate Cancer Screening?

               

Carcinoid Cancer

Carcinoid Cancer as defined by the American Cancer Society: “carcinoid tumors or carcinoids: tumors that develop from neuroendocrine cells, usually in the digestive tract, lung, or ovary. The cancer cells from these tumors release certain hormones into the bloodstream. In about 10% of people, the hormone levels are high enough to cause facial flushing, wheezing, diarrhea, a fast heartbeat, and other symptoms throughout the body.” These symptoms are referred to as Carcinoid Syndrome.

The causes of carcinoid cancer are unclear. This type of cancer is very slow growing and has no early signs or symptoms. It is often detected while evaluating other unrelated symptoms.

Risk Factors per the Mayo Clinic:

Sex: Affect women more often than men.

Family history: Children who have a parent with carcinoid tumors or a family history of multiple endocrine neoplasia type 1 (MEN 1) syndrome.

Smoking: Linked to some atypical lung carcinoids.

Other medical conditions. Those that affect the stomach’s ability to produce acid may be linked to some gastrointestinal carcinoids.

Diagnosis can be difficult and is usually done through:

• A blood test evaluating for high levels of the protein chromogranin A.
• A urine test for the presence of 5-HIAA.
• A CT scan
• A fine needle biopsy

Treatment is truly individualized depending on the location and staging. If the tumor has not metastasized, surgery may be the treatment option.

Other treatment options:

• Chemotherapy
• Radiofrequency Ablation
• Injections of Sandostatin to slow tumor growth
• Hepatic Artery Embolization-cutting off the blood supply to the tumor

Resources:

The Carcinoid Cancer Foundation offers not only information on carcinoid cancer but online discussion groups and seek to increase awareness.

Together We Make a Difference

Carcinoid. com is the Novartis website which offers information on carcinoid cancer and managment of the symptoms of Carcinoid Syndrome.

Carcinoid Cancer Awareness Network: CCAN.: A non-profit organization whose mission is to intensify awareness of carcinoid cancer and to assist support groups around the world in providing patients and caregivers access to important information about carcinoid disease.

Battling Books:

Carcinoid Cancer, Zebras and Stardust: My Sister’s Cancer Battle by Mary Girsch-Bock

(May 2008)

               

Thyroid Cancer Basics

Thyroid cancer is the single most common endocrine cancer and the most curable. If diagnosed before it spreads, thyroid cancer has a 97 % five year survival rate.

Per The American Cancer Society: 2008 about 37,340 new cases of thyroid cancer will be diagnosed in the United States. Of those, about 28,410 will occur in women, and 8,930 in men. A three to one ratio. AND…nearly 2 out of 3 cases are found in people between the ages of 20 and 55.

Read more

               

Pancreatic Cancer

The pancreas is considered a glandular organ. It is about 7 inches by 1.5 inches in size. It lies under the stomach and at the beginning of the small intestine, and functions as an exocrine organ by producing fluids for digesting food. It functions as an endocrine organ as it releases hormones. When released into the blood stream, these hormones regulate our glucose levels (insulin and glucagon).

Pancreatic cancer is a cancerous tumor that occurs in the tissues of this gland/organ.

Estimated new cases and deaths from pancreatic cancer in the United States in 2008 per the National Cancer Institute: New cases, 37,680 and deaths, 34,290.

This type of cancer typically spreads fast and is often not diagnosed in the early stages.

Per the Mayo Clinic, signs and symptoms of pancreatic cancer, which may not occur until the cancer is in the advanced stages:

• Upper abdominal pain that may radiate to your back
• Yellowing of your skin and the whites of your eyes
• Loss of appetite
• Weight loss
• Depression

There are two types of pancreatic cancer: exocrine and endocrine. Endocrine cancers are very rare. The American Cancer Society states that exocrine cancers are the most common and 95% of those diagnosed are adenocarcinomas.

Risk Factors for Exocrine (Pancreatic) Cancers:

• Smoking
• Obesity
• Gender-men have a slightly increased rate of occurrence
• Race-occurs more often in blacks than Caucasians
• Age-most people diagnosed are in their 70’s and 80’s
• Personal or family history of pancreatic cancer
• History of chronic pancreatitis
• Diabetes-occurs more often in diagnosed diabetics

The American Cancer Society site discusses risk factors that are uncertain or under research.

Diagnosis:

While there is no screening for pancreatic cancer you may undergo a CT, Ultrasound, and/or MRI if your physician suspects this disease.

Other diagnostic tests:

• Endoscopic retrograde cholangiopancreatography-ERCP-a dye is injected into your bile ducts and they are examined with a scope as air is blown into the ducts.
• Endoscopic Ultrasound-EUS-a scope with an ultrasound device is passed through the stomach into the duodenum to take pictures. It may also collect biopsy specimens.

• Percutaneous transhepatic cholangiography-PTC-a needle is inserted into the liver from outside the body and a tube is threaded into the bile ducts. Dye is injected into the ducts to detect blockages.

If a diagnosis confirms the cancer then further tests may be ordered to stage the disease and determine if it has spread. A CA19-19 blood test may be ordered to monitor your response to treatment.

Basic staging per the Mayo Clinic:

• Resectable. All the tumor nodules can be removed.
• Locally advanced. The tumor can no longer be removed with surgery because the cancer has spread to tissues around the pancreas or into the blood vessels.
• Metastatic. At this stage, the cancer has spread to distant organs, such as the lungs and liver.

For further staging information, including The American Joint Committee on Cancer TNM, numerical staging, see The American Cancer Society site.

Current Treatment for Exocrine (Pancreatic) Cancer:

• Surgery (resection)
• Chemotherapy
• Radiation therapy
• Targeted Gene Therapy

Battling Books:

100 Q & A About Pancreatic Cancer by Eileen O’Reilly M.D.

My Journey with Pancreatic Cancer by Calvin E. Rains Sr. (2006)

Pancreatic Cancer in the News:

ScienceDaily, January 9, 2008. Pancreatic Cancer: The smaller the tumor, the better your chances, study shows. “The odds of surviving cancer of the pancreas increase dramatically for patients whose tumors are smallest, according to a new study by researchers at Saint Louis University and the M.D. Anderson Cancer Center in Houston — the first study to specifically evaluate the link between tumor size and survival rates for one of the most common and deadly cancers.”

Resources:

The Pancreatica.org Clinical Trials Database is the largest resource of clinical trials for pancreatic cancer in the world.

PanCAN, the Pancreatic Cancer Action Network. “Working Together for a Cure”

The National Pancreas Foundation. Support, Education and Research.

               

CUPS

Cancer of Unknown Primary Site or CUP, Cancer of Unknown Primary is a tumor that is diagnosed at a metastatic site and the primary site is not known. Following additional testing many of these cancers are diagnosed with a primary site. Per the National Cancer Institute, 2% to 4% of these primary tumor site remain unknown.

The American Cancer institute ranks this as a “dangerous” cancer with an often poor prognosis due to these factors:

• Most are fast-spreading cancers.
• Because the exact type of cancer is not known, it is more difficult for doctors to know what treatment is most likely to help the patient.
• Because the cancer is usually widespread, it is rarely curable.

The next step in diagnosis is to classify the tumor in an effort to best treat the cancer.

As with any cancer, early diagnosis is the key. Have routine cancer related check-ups. See your doctor if you have symptoms that include:

• Shortness of breath
• Swollen lymph glands
• Abdominal tenderness and/or bloating
• Pain in the chest or abdomen
• Bone pain
• Skin tumors
• Weakness, fatigue, general malaise, weight loss

Diagnosis begins with:

• Physical exam, including a gynecological exam
• Blood tests, including tumor markers, tests for blood in stool and to evaluate kidney function
• Radiographic imaging, including, chest X-ray, mammogram, abdominal CT
• Biopsy and possible endoscopic exam

Special Lab Tests Used to Evaluate Biopsy Specimens:

• Immunohistochemistry, slices of tissue samples are treated with an antibody to rule out what type of cancer is not present
• Electron Microscopy, a microscope using beams of electrons to determine specific cell characteristics
• Polymerase Chain Reaction, this method may be able to detect abnormal DNA or RNA in a specimen
• Tissue Stains , specific stains such as Prostate-specific antigen, or Alpha-fetoprotien (for primary liver cancer).

Treatment is specific to the type of cancer that is suspected, or the subgroups of cancer that that is a probably diagnosis. Treatment is also determined according to staging and may include:

• Chemotherapy
• Radiation
• Surgery
• Hormone therapy

For more information on treatment options and staging please visit the American Cancer Institute site.

Resources and Support for CUP:

Cancer of Unknown Primary Foundation, “Making the Unknown Known.” A UK organization that provides support, information and advocacy.

CancerCare ,”a national nonprofit organization that provides free, professional support services for anyone affected by cancer. ”

Battling Books: The Following are Clinical Books on the Topic.

Metastatic Carcinomas of Unknown Origin by Mark R. Wick (2008)

Carcinomas of Unknown Primary Site by Karim Fizazi

               

To Tell or Not to Tell

This post discusses the merits of telling (or not telling) the affected person that he or she has Alzheimer’s disease.

Once Alzheimer’s disease is officially diagnosed, the primary caregiver and close family members have a decision to make.

Do you tell the affected person or not? There are valid arguments on both sides.  Let’s explore some of them.

Yes, tell the affected person what the diagnosis is and what it means.

Advantages of sharing the diagnosis

Knowing sometimes brings relief.  Although the person may not be able to articulate all that is going on, they know that something is awry.

Knowing takes away all need to lie and hide.  Often people in the earlier stages of Alzheimer’s disease make up excuses for their behavior and attempt to cover up mistakes.

Knowing may encourage the affected person to plan for the future.  Unfortunately, the prognosis for Alzheimer’s disease is quite certain.  The patient will know what is coming down the pike and can participate in long-term planning.

Knowing provides opportunity for cooperation on the affected person’s part–Eating a balanced diet, taking medications (which we’ll talk about in detail in an upcoming post), exercising the body and brain can possibly retard the progression of the disease.

Advantages of not sharing the diagnosis

Not knowing allows a sense of “normalcy.”  Denial is a coping mechanism that helps some people to make it through difficult times.

Not knowing may avoid some of the grief associated with reality of facing a terminal illness.

Not knowing may keep anxiety levels low.  For years, even doctors have advocated not causing further stress on already stressed individuals by not disclosing the diagnosis of Alzheimer’s disease.

Not knowing may enable the affected person to keep fighting instead of giving up.  Alzheimer’s is a cruel disease.  Sometimes knowing the future is just too much information for some individuals to handle.

What do the experts say?

According to an article in the March 2008 edition of the Journal of American Geriatrics Society, there may actually be many benefits to telling patients that they  have Alzheimer’s disease.  In addition, the study indicates, that at least in the short run, knowing brings a level of relief.

“Overall, patients told of their diagnosis did not experience an uncontrollable surge in depression or anxiety. Rather, most were relieved to have an explanation for their symptoms. They were also glad to have the opportunity to participate in planning for their futures, and relieved that help was at hand.”

“One reason an Alzheimer’s diagnosis can be comforting to both family members and patients, Dr. Carpenter suggests, is that it provides an explanation for what’s been going on with the patient. Caregivers, he notes, are often quick to attribute symptoms of dementia to the person, rather than the disease, and patients wonder if they are going “crazy.” This study confirms that most patients, regardless of their degree of impairment, tend to experience a sense of relief after getting their diagnosis.”  (see below)

In the end, to tell or not to tell is a very personal decision.  I did tell my mom she had Alzheimer’s disease, but it was long after we received the diagnosis.  I doubt that she understood.  She just looked at me with a blank stare.  I do wish that I had told  her earlier, like when I packed up her belongings and moved her 500 miles.  Maybe, it would have made the transition a little easier, but hindsight is always 20/20.

What’s do you think?  Did you tell?  Would you make the same decision again?

Note:  Kudos to the Fisher Center for Alzheimer’s Research Foundation and their great site, Alzinfo.org for access to this research.  Click here to read more of the article.

Source: Brian D. Carpenter, PhD, Chengjie Xiong, PhD, Emily K. Porensky, MA, et al: “Reaction to a Dementia Diagnosis in Individuals with Alzheimer’s Disease and Mild Cognitive Impairment,” Journal of the American Geriatrics Society, March 2008, pages 405–412.

               

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