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Good news for the New Year: new drugs against breast cancer

Some news of hope for the new year.

Medical researchers are continuously working on the quest for a drug that can cure breast cancer. The last significant breakthrough was three decades ago when tamoxifen was found to reduce the risk of recurrence of breast cancer. At the CTRC-AACR San Antonio Breast Cancer Symposium in Texas this year, several drugs that show promise for curing this deadly disease have been presented.

Among these drugs, zoledronic acid (Zometa) was found to be the most promising one. Zoledronic acid is a drug used for treating osteoporosis. Recent studies, however, showed that this drug may potentially have direct anti-tumor properties and can also shrink breast tumors in patients who are undergoing chemotherapy. Zoledronic acid is already an approved drug for treating breast cancer that has spread to the bone. Aside from osteoporosis, however, they discovered that it can also lower the risk of breast cancer recurrence in pre-menopausal women with early estrogen- or progesterone-positive tumors. This was based on the study involving more than 200 women with breast cancer. Those patients who were treated with zoledronic acid in addition to chemotherapy have better results compared to those who were treated with chemotherapy alone. The “chemotherapy-alone” group had an average tumor size of 42.4 millimeters. This is significantly bigger compared to those patients with the zoledronic acid – chemotherapy combination where the average tumor size was only 28.2 millimeters.

Zoledronic acid is currently being evaluated against breast cancer in the clinical trial AZURE (Adjuvant Zoledronic Acid to Reduce Recurrence).

“This data suggests that zoledronic acid is doing something more than protecting bone,” said study senior author Dr. Robert Coleman, a professor of medical oncology at the University of Sheffield in England. “It’s not practice-changing. It’s hypothesis-generating, which will lead to the design of new trials to look at this in detail. But this is the first patient-related evidence.”

The other promising drugs presented in the symposium include the following:

• Aromatase inhibitor exemestane (Aromasin) reduced cancer by 15% and reduced the risk of distant metastasis by 19% in postmenopausal women with breast cancer.
• Herceptin (trastuzumab) which is a drug used to treat HER2-positive breast cancer plus chemotherapy before surgery resulted in 70% of women surviving for 3 years without cancer recurrence.
• Lapatinib (Tykerb) which is another HER2 inhibitor if combined with another aromatase inhibitor can extend progression-free survival by 5 months on patients with HER2-positive metastatic breast cancer.
• Aromatase inhibitors show promise as potential replacement of tamoxifen as standard treatment to prevent recurrence of breast cancer in women who have already undergone conventional therapy.

HAPPY NEW YEAR!!!

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Acupuncture and cardiovascular health

Millions of Americans are into some of complementary and alternative medicine (CAM), according to the 2007 National Health Interview Survey (NHIS). In total 38% of adults and 12% of children in the US are “doing” CAM. One of the most common forms of CAM is acupuncture.

Acupuncture is a well-known form of traditional Chinese medicine although there are actually other forms which include (aside from classical Chinese style), Korean, Japanese, Tibetan, and Vietnamese acupuncture.

Acupuncture utilizes the principle of stimulation of certain key body points. Traditionally, stimulation is done manually using thin, metallic needles penetrating the skin. However, the practice has evolved to include the use of modern technology for stimulation – including electrical impulses, lasers, moxibustion, and heat.

The practice of acupuncture used to be dismissed as “quack medicine”. However, the health benefits of acupuncture have slowly been recognized by medical experts. In a consensus statement in 1997, the National Institute of Health (NIH) stated

“Acupuncture as a therapeutic intervention is widely practiced in the United States. While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.”

In recent years, acupuncture has gained popularity as an alternative and complementary treatment of various ailments and symptoms. The main reason for this is the non-pharmacologic nature of acupuncture, thus avoiding the side effects and complications that many drugs can cause.

Acupuncture has been recommended in the control and management of hypertension and other cardiovascular disorders. In a meta-analysis study, Korean researchers conducted systematic review of clinical studies to evaluate the effect of acupuncture on blood pressure (BP) in hypertensive patients. The results showed that there is actually a paucity of good and reliable data on this topic.

The meta-analysis concluded that “…evidence to date does not support acupuncture treatment to reduce BP…controlled trials found no difference between acupuncture alone and active medication, small numbers and poor reporting should be carefully considered before jumping into a promising conclusion…”

In other words, the results are inconclusive. The authors further recommend that more studies with “rigorous methodology” are needed to find out the truth between acupuncture and BP.

However, this doesn’t mean to say that acupuncture and other CAM are worthless. As NIH observed that

“…the scientific basis of some of the key traditional Eastern medical concepts … are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture.“

HAPPY NEW YEAR!!!

Photo credit: wikipedia

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Prostate cancer screening and marital status

As in most diseases, early detection of prostate cancer can greatly improve the chances of treatment and survival. According to the Mayo Clinic, about 40% of prostate cancer cases are not detected until they have spread beyond the prostate gland. A lot of cases are asymptomatic in its early stages so that screening by a medical professional is sometimes the only way to diagnose the disease. However, some men are wont to avoid the issue. That is why it is important to understand psychosocial factors that influence men from having or not having prostate cancer screening.

Screening for prostate cancer can be done in many ways but the two most commonly recommended diagnostic tests are:

• The prostate-specific antigen (PSA) test, which looks at the levels of the biomarker PSA in the blood. High PSA levels can indicate inflammation or enlargement or cancer of the prostate
• The digital rectal examination (DRE) is done by a medical professional by manual examination of the rectum. About 70% of prostate tumors develop on the outer part of the gland, which can then be felt by a finger inserted in the rectum.

Dr. Lauren Wallner of University of Michigan, Ann Arbor and her colleagues investigated the factors that influenced men to get tested for this deadly disease. Medical data of 2447 men from the Olmsted County Study on Urinary Symptoms and Health Status were collected and used for this specific study. These men were randomly selected in 1990 and information on family history of prostate cancer, prostate cancer concerns, marital status and medical and laboratory records was analyzed.

The patients who were included in the study have an age median of 51.9 years, 85% of which were married or living with someone. Approximately 9% of them have history of prostate cancer in the family while about 10% have shown concern or worry about the disease.

Statistical analysis showed that men with prostate cancer history in the family do have prostate cancer screening more frequently that those without history. Men who also showed more concern or worry more about the disease are more likely to have frequent screening that those who don’t. Married men or those with live-in partners are also found to have frequent prostate cancer screening compared to their single, unattached counterparts.

“Among men with a family history of prostate cancer, those who were married or living with someone were more likely to get screened compared with men who were not, suggesting a role for marital status in influencing screening behaviour,” the researchers concludes.

Could it be that emotional attachments make men more conscious of their health?

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It’s not the weather, it’s your lifestyle

Winter time is a difficult time for many people. It’s cold, dark, and gloomy. No wonder winter is associated with high incidence of depression.

Currently available data indicate that depressed individuals have a 50% higher risk for cardiovascular disease than those without psychological problems. Guidelines issued by American Heart Association (AHA) and endorsed by the American Psychiatric Association recommend that cardiac patients be routinely screened for depression. In addition, treatment of depression is commonly addressed during cardiac rehabilitation. In related previous posts, depression among heart patients were shown to be best tackled with a combination of psychotherapy and physical exercise.

But – we cannot blame the weather for everything. Researchers at the University of College London report that the wrong lifestyle leads to psychological distress, which in turn result in increased risk for cardiovascular disorders. In addition, the findings of the current study “suggest that treating psychological stress on its own might not be the best approach to reducing the risk of cardiovascular disease.”

The study used data from the Scottish Health Survey (SHS) which followed up 6576 adults aged 30 years and above fo7 seven years (on the average). The researchers measured psychological distress as well as behavioral and pathophysiological risk factors. The measurements were based on the General Health Questionnaire (GHQ-12), an assessment tool which basically looked at general levels of happiness, depression and anxiety, and sleep disturbances.

The results showed that

“…behavioral factors, including smoking, physical activity, and alcohol consumption, accounted for 65% of the relationship between psychological distress and cardiovascular disease risk. An additional 19% of the association was explained by pathophysiological risk factors, such as hypertension and C-reactive protein (CRP).”

The role of smoking and physical activity seems especially significant. People who were stressed of psychologically distressed tended to be smokers who little or no exercise at all. “These two factors alone explain well over 50% of the association between distress and cardiovascular risk.” Surprisingly, alcohol explained only a small part of the psychological distress – cardiovascular risk link.

The study results indicate the association between psychological distress and cardiovascular risk can be largely explained by behaviour and lifestyle factors, in this case, cigarette smoking and physical activity.

If your goal is to treat mental illness for the purposes of reducing cardiovascular risk, you need to take a fairly broad approach and not just look at the psychological components,” lead investigator Dr Mark Hamer (University College London, UK) told heartwire. “You need to also look at the behavioral risk factors as well, with a particular emphasis on physical activity and smoking cessation.”

Now that we are about to enter the New Year, maybe it’s time to reflect on our lifestyle. Is there anything we can change for the better? For better mental and physical health?

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Online health chats at Cleveland Clinic in January

Once again, I bring you information on the upcoming heart(y) topics at the Cleveland Clinic Online Health Chats. Ask questions about your heart health and get answers from experts – for free! Here are some upcoming events on heart disease and stroke for January:

Mitral Valve and Aortic Valve Surgery – Minimally Invasive Approaches at the Cutting Edge
Wednesday, January 7, 2009 – 12 noon (EST)
Ask questions on how to battle the heart disease monster. This live web chat is hosted by Dr. Marc Gillinov, a heart surgeon who holds the position of Surgical Director of the Center for Atrial Fibrillation at Cleveland Clinic.
Dr. Gillinov has special expertise in minimally invasive mitral valve, aortic valve, and tricuspid valve surgery; robotic valve surgery; mitral valve repair; aortic valve replacement; surgical treatment and minimally invasive surgery for atrial fibrillation; off-pump coronary artery bypass surgery and high-risk mitral valve surgery.

Treatment Options in Acute Ischemic Stroke
Friday, January 9, 2009, 12:00 p.m. – 1:00 p.m. (EST)
Ask questions on how to battle the stroke monster. In this chat session, your questions will be answered by Dr. Rishi Gupta, who is a member of the Cerebrovascular Center in the Department of Neurology and Neurosurgery, as well as of the Department of Diagnostic Radiology at the Cleveland Clinic.
Dr. Gupta specializes in the management and treatment of ischemic stroke, hemorrhagic stroke, cerebral aneurysms, arteriovenous malformations (AVMs), dural fistulas, carotid artery stenosis, intracranial stenosis, spinal AVMs, epistaxis and preoperative tumor embolization.

Latest Innovations in Heart Care: Stem Cell, Percutaneous Advances, New Stents
The safety of drugs, stents, heart implants, and other therapies has been a big issue in recent years. Dr. Stephen G. Ellis, an interventional cardiologist, will answer your questions on the latest interventional treatments and innovations.
Dr. Ellis is the Head of Invasive/Interventional Cardiology and Director of the Sones Cardiac Catheterization Laboratory in the Department of Cardiovascular Medicine at Cleveland Clinic Heart and Vascular Institute. His principal clinical interests are complex coronary interventions, novel treatments for inoperable patients and studies to better understand the basis of disease.

About Cleveland Clinic
Cleveland Clinic is located in Cleveland, Ohio. It is a not-for-profit multispecialty academic hospital that integrates hospital care with research and education. It is one of the US’ top hospitals. It has been ranked no.1 in heart care by the U.S. News & World Report survey – for the 14^th year in a row! It was also ranked as 4^th best American hospital overall this year. The survey evaluated 5,453 hospitals across the US.

How to participate
Go to the Cleveland Clinic Chats site and create an account.

You can start submitting your questions the day before.

On the day of the scheduled event, log in well in time. You can also ask questions on that same day.

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“Benign” breast cancer is not necessarily harmless

Breast cancer is the leading cancer disease that causes death in women in the age range 25 to 49 years old. It has also been observed that younger patients have lower survival rate and higher chances of cancer recurring back compared to older women. Thus, it is important to understand how the cancer develops and the ways to prevent it.

Breast cancer may be malignant or benign. Although benign breast cancer may not seem to be clinically important, it can actually present significant risks not previously known.

There are 3 types of benign breast disease, namely:

• the non-proliferative disease
• the proliferative disease without atypia
• the atypical hyperplasia

Atypical hyperplasia is characterized by a high number of abnormal-looking cells lining the milk duct. These cells, however, are not cancerous. In proliferative disease without atypia, a large number of cells line the milk duct but they look normal. Non-proliferative disease, on the other hand, is characterized by fibrocystic changes but has no increase in cell numbers. 

A recent study at the well-known Mayo Clinic investigated which of the benign disease can become cancerous. The study was based on 4,460 women with benign breast cancer with an average age of 39 years old. Among the group, 2% have been diagnosed with atypical hyperplasia, 72% had non-proliferative disease while 26% have proliferative disease without atypia. The scientists tracked the progress of these women for several years and found out that, within the group, 326 eventually developed breast cancer several years later.

The result showed that atypical hyperplasia can increase a young woman’s chance of getting breast cancer even if there was no history of breast cancer in her family. In fact, women with atypical hyperplasia are three times more likely to develop breast cancer compared to those diagnosed with the other two benign types. However, history of breast cancer in the family may slightly increase the risk of breast cancer in those women diagnosed with these two benign forms. Another interesting finding was that the risk for cancer is reduced in women with benign cancer if the “milk-producing lobular duct glands” where the cancer usually develops shut down. This process is known as lobular regression or involution.

“The impact of lobular involution on risk, even in young women with benign breast disease, is an interesting finding,” Dr. Ghosh, lead investigator says. “It suggests that future research could potentially think about ways of promoting lobular involution as a means to reduce breast cancer risk.”

The take home message is: a diagnosis of benign breast cancer shouldn’t just be taken for granted!

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CVD News Watch December 26

Happy Boxing Day.

Plus some heart news for you this weekend.

CVD drug watch

FDA warns consumers about tainted weight loss pills
More than two dozen different products for weight loss have been flagged by the US FDA for consumer warning. These products are said to have undeclared yet active ingredients which may cause health problems. The ingredients which are of health risks include:

• sibutramine (a controlled substance)
• rimonabant (a drug not approved for marketing in the United States)
• phenytoin (an anti-seizure medication)
• phenolphthalein (a solution used in chemical experiments and a suspected cancer causing agent)

A previous report has estimated that we spend billions of dollar each year on weight loss products which tunr out to quack or even dangerous.

CVD health supplements watch

Evidence for protective effect of fish oil not conclusive
Fish oil, which contains a lot of omega-3 fats, has always been thought to be beneficial to health, especially on cardiovascular health. That is why fish oil supplements are routinely recommended for heart patients. This recent meta-analysis study indicates that fish oil is not necessarily effective against all heart problems. “Fish oil was found to be effective at reducing deaths from heart problems, but showed no strong evidence of a beneficial effect on arrhythmias or deaths from all causes.”

CVD fat watch

L.A. liposuction doc investigated for alleged use of patients’ fat to fuel SUV

What a way to recycle. It may be innovative and environmentally friendly but it is nevertheless against the law. Beverly Hills liposuction specialist Dr. Alan Bittner has been accused of using fat waste from liposuction procedures to produce biodiesel that could then make his SUV run. He is currently facing charges since it is also illegal in the state of California “to use human medical waste to power vehicles.”

CVD health drink watch

FDA says diet coke plus claims violate regulations

Problems with the Diet Coke Plus, Coca-Cola Co’s attempt to turn soda into a health drink. The US FDA declared that the drink’s claims about vitamins and minerals content violate federal regulations, as reported by Bloomberg. According to FDA letter dated December 10, 2008 to the company, the regulatory body objects to the use of the word “Plus” in the product’s name and the term “Diet Coke with Vitamins & Minerals” on its label. In addition, “FDA does not consider it appropriate to fortify snack foods such as carbonated beverages.” The company is ordered to correct the violations within 15 days of receipt of the letter.

 Photo credit: stock.xchng

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News from the cancer side, December 26

Happy Boxing Day. Be sure to reuse or recycle those boxes!

News from the regulators

FDA approves Gleevec to prevent recurrence of rare gastrointestinal cancer.
Gleevec or imatinib mesylate, an anti-tumor product of Novartis has been approved for a new indication by the US FDA. The new indication is for gastrointestinal stromal tumor or GIST, a rare type of cancer that originates in the interstitial cells of Cajal, which are found in the gastrointestinal tract. Gleevec can now be used to patients with GIST after tumor removal surgery to prevent recurrence.

News from the celebrities

Gabrielle Union helps fight breast cancer in Ghana
Actress Gabriel Union travelled top Ghana to promote breast cancer awareness as part of her role as a Global Ambassador with the Susan G. Komen for the Cure and the Circle of Promise program. Gabriel stars in the movie Cadillac Records. Check out the audio interview at Nationla Public Radio (NPR).

News from the global health front

Melamine and the global implications of food contamination
In this perspective article in this week’s issue of the New England Journal of Medicine, Dr. Julie Ingelfinger writes about the global implication of food contamination, a concern largely triggered by the recent melamine scandal. Although the melamine problem seems to have now been contained (at least for now), the long-term effects of the contaminant, a potential carcinogen, remain unknown.

Dr. Ingelfinger writes

“In today’s world, it is crucial to understand and deal with the global implications of foodborne diseases if problems like the melamine epidemic are to be prevented. In 2006, the WHO launched an ambitious project to estimate and understand the global burden of foodborne disease, and the Foodborne Disease Burden Epidemiology Reference Group appears to be well on its way to achievement of its initial goals. In addition, the group will be developing much-needed user-friendly tools so that outbreaks, be they due to organisms or chemical substances, can be studied more rapidly and the causes identified, reported, and eliminated.“

News from the health care side

Clinical pharmacists can reduce drug costs
Researchers at the University of Chicago may have found a way to reduce drug costs. They report that clinical pharmacy services provided in hospitals, community pharmacies, nursing homes, and other medical facilities may be the answer to the ever increasing cost of drugs in the US. “Clinical pharmacy services, defined as services that involve direct patient care by a clinical pharmacist. Unlike traditional pharmacy services, in which a pharmacist dispenses medications, clinical pharmacists make recommendations to physicians regarding drug therapy or sometimes even help write the prescription.”

Photo credit: stock.xchng

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Christmas Greetings!

It’s almost two months since I took over this blog and I enjoyed every minute of it.

But during the holiday season, I can not help but think about the loved ones, the friends, and even the casual acquaintances we’ve lost to cancer and many others still fighting the battle. Let’s hope that the next year will bring hope and healing to those battling the monster cancer.

For this occasion, I would like to share my thoughts to everyone, young and old, big and small, healthy and sick: TAKE TIME.

• Take time for your love ones.
• Take time to smell the flowers.
• Take time to look at the stars.
• Take time to breathe the fresh air.
• Take time for yourself.

Some of us have lots of time on our hands. Some don’t. Some of us have years, decades ahead of us. Some of us have only days, weeks, months to look forward to. It’s not the length/amount of time you have. It’s what you do with time that counts.

Time is so precious. Use it well.

I would like to wish all readers of Battling Cancer a very happy Christmas, a wonderful New Year and a relaxing holiday season.

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Merry Christmas!

The presents have been unwrapped, the Christmas lunch has been eaten. Now is the time to relax and reflect.

Thank you for being with me here at Battling Heart and Stroke during the last months. It’s been a pleasure to write on this blog for you.

Thank you for all those who have commented, contributed, and linked to this site.

I wish you all a very Merry Christmas and a most relaxing holiday season. And while you are at it, give yourself the best Christmas gift of all – take good care of your heart.

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Your lingerie and your health

Lingerie is probably on almost every woman’s Christmas wish list. Next to jewellery, it’s a popular (and affordable) gift from men to the women they love. The brassiere or short for bra is especially an important part of a woman’s lingerie collection. In recent years, there have been rumors floating around about health risks associated with bras. Let’s see the latest updates.

Chemicals

Certain chemicals are sometimes added to textiles for a number of reasons, including protection from moths, mildew and color loss. In November this year, the lingerie company Victoria’s Secret was sued by several women who developed rashes and other skin problems upon wearing a certain model of bra. The litigants claim that lab tests detected trace amounts of formaldehyde in the bras, a chemical used in fabrics to make them crease-resistant. It is well-known that some people are allergic to formaldehyde. Formaldehyde is also classified as a probable carcinogen.

Wrong fit

Some experts claim that ill-fitting bras can cause breast cancer. The book Dressed to Kill: The Link Between Breast Cancer and Bras was written by 2 medical anthropologists and mentions a study showing that women who do not wear bras have a reduced risk of having breast cancer. Others claim that wrongly fitting bras can cause breast lumps that are benign but may nevertheless be painful

Metal wires

There are also medical professionals who believe that metal wires in the bra “can form an antenna attracting electromagnetic fields, which can also increase your risk of breast cancer.”

Facts or Myths?

I searched through the PubMed database for medical studies that linked bras and their use to breast cancer but I couldn’t find anything.

I found however a statement from the National Research Center for Women & Families about this issue. Here is what they have to say:

“It is not clear how the story about bras causing breast cancer got started. One piece of ‘evidence’ that is often mentioned is the fact that breast cancer is more common in Western cultures – where women started wearing bras in the 1920’s – than in parts of the world where bras are not typically worn. While it is true that there are geographic variations in breast cancer rates, there are many, many factors – including diet, exercise, lifestyle, childbearing practices, and others – that are more plausible explanations for these differences than bras. In places where people have less access to medical care, breast cancer will not be diagnosed as often, even though it might be present. And because the risk of breast cancer increases as women get older, breast cancer rates will be lower in parts of the world where people die of other causes at younger ages, whether they have worn bras or not.”

Therapeutic benefits of bra

There are however, documented health benefits from wearing properly fitting bras, namely:

• Wearing a properly fitting bra reduced the need for breast reduction surgery, according to UK’s Royal Free Hospital in Hampstead. A bra of the correct size helps in the management of large breasts and reduces the back pain that comes with them.

“To date, 100% of those fitted have been wearing the wrong size, overestimating the width of their back and underestimating cup size.  This results in the weight of the breasts being carried by the shoulders rather than supported around the chest, and contributes to back pain.”

• Firm supporting bras are recommended in managing painful but non-cancerous breast complaints such as fibrocystic breast disease, mastodynia and mastalgia.

To conclude, there isn’t enough evidence to support the bra use – breast cancer link. Whether a woman wants to wear a bra or not is her prerogative.

Photo credit: stock. xchng

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Film feature: The Meaning of Tea

Documentary films might not be your cup of tea but you have to try this one. The Meaning of Tea, a film by Tea Dragon Films, is a 74-minute documentary on – well, tea. Now, you may ask, what is so special about a film about – of all things – tea? What on earth is so exciting about tea? Well, check out this press release:

“The Meaning of Tea is an engaging documentary film that explores the romance and complexities surrounding tea, a universally beloved and widely consumed beverage. The film travels through eight countries, unveiling many reasons behind tea’s mysterious appeal. From afternoon tea in the Midwestern United States to tea estates in India, from the traditional tea ceremony of Japan to modern tea life in Morocco, the film explores the rituals and ceremonies of tea celebrated and enjoyed by a myriad of unique cultures. With an exciting mix of interviews, archival footage and music, the film sheds light on tea’s many varieties, whose value, use, practices, and traditions are sometimes misunderstood, neglected, and even threatened by today’s marketplace. The common thread weaving together these individual stories is the question of whether there is any inherent “meaning” to be found in tea, particularly in an era increasingly dominated by mass-marketing, fast food and corporate coffee. The film also examines the role certain modern forces pay in threatening the survival of tea and its cultural significance. By visiting places where tea is still revered and by investigating its role in these societies, The Meaning of Tea suggests the profoundly positive role tea may play in the future of humanity.“

Tea is supposedly the most popular drink in the world after water. However, experts may argue that it has been overtaken by soda and other sweetened drinks among the younger generation. We know, however, the adverse health effects that soda has brought about. Tea, on the other, has been shown to have beneficial effects on our health as I’ve written in previous posts:

• Green tea can help prevent cardiovascular diseases.
• Tea (black or green) can also help prevent some types of cancer.
• Black tea consumption can potentially lower risk for type 2 diabetes.
• Tea may potentially have therapeutic use in the elderly.

The Meaning of Tea was directed and produced by Scott Chamberlin Hoyt, together with Michaela Mckee and Keir Moreano. The film may just be “the beginning of a movement to reduce the stresses of our “amped-up high-tech world by encouraging people to have a cup of tea.” Now, that’s what I call a relaxing idea!

Photo credit: 2008 Tea Dragon Films

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AHA report update 2009

As the year comes to a close, reports from health authorities and advocacy groups are slowly coming. The American Heart Association’s Heart Disease and Stroke Statistics 2009 Update has just been released – with data from 2005 to 2006. The report gives some good and not-so-good news. On the one hand, US mortalities due to heart disease and stroke are down On the other hand, the risk factors for cardiovascular disease are still on the rise.

Some figures to think about:

• Mortalities due to CHD have gone down by 30.7%.
• Deaths by stroke have gone down by 29.2%.
• One out of 2.9 deaths in the US was due to cardiovascular disease.
• Coronary heart disease (CHD) was responsible for one out of five deaths in the year 2005
• Stroke accounted for about one out of ever 18 deaths.
• Heart failure was a factor in one out of 8 deaths in 2005.

“It’s really gratifying to see that coronary heart disease and stroke deaths are continuing to decline, and they have been declining since 1968,” first author on the report, Dr Donald Lloyd-Jones of Northwestern University, told heartwire. “Since 1999, our most recent benchmark, we have seen essentially a 30% reduction in those death rates, which from AHA’s perspective is particularly nice to see because we’ve already exceeded the goal set for 2010. So that’s fantastic, and it comes from a number of different things. But there’s also an important asterisk beside those figures, and that is, if you really drill down in the data, there are some concerning trends to suggest that among younger adults-and we see this best in women ages 35 to 54-there actually appears to be a slight uptick in CVD and stroke death rates, which may well be attributable to the obesity epidemic and subsequent increases in diabetes finally working their way through. So there is cause for celebration, but real cause for concern that we’re going to give back some of the substantial gains that we’ve made, because obesity and the aftereffects are going to start to come to the fore, and we’re going to be paying the price.”

The risks factors that triggered these concerns are as follows:

• Mean serums levels of total cholesterol were declining in older people (men 40 and above, women 60 and above) but not in younger adults.
• More that 66% of adults surveyed lacked exercise and did not meet the minimum 10 minute daily recommended vigorous exercise.
• Incidence of childhood obesity was up by 4% (children aged 6 to 11 years old) in 2003 to 2006.

Although the figures showed some improvement, it seems that AHA and other heart health groups have so much more to do before we can beat the monsters heart disease and stroke.

Photo credit: stock.xchng

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Tea and cancer

There are teas and there are teas. But the original one and only tea is from the plant Camelia sinensis.

According to the American Botanical Council

“…the tea plant is a small, evergreen shrub with white flowers that is native to mountainous regions of China, Japan, and India. It is cultivated around the world in countries with tropical and subtropical climates. While the plant can get as tall as 30 feet, it is usually pruned to 2-3 feet. The young leaves and the dried leaf bud are used and are considered to have a better quality than the older leaves. Tea types (green tea, black tea, oolong tea, etc.) vary based on the way the tea leaves are processed.”

Tea has been used over the ages as a beverage with medicinal use. Here are some recent clinical trials on the effects of tea on the risk for different kinds of cancer.

Prostate cancer

Japanese researchers conducted a study on the effect of green tea on the prevention of prostate cancer. They did not found an association between green tea consumption and localized prostate cancer. However, “consumption was associated with a dose-dependent decrease in the risk of advanced prostate cancer” This probably explains why the incidence of prostate cancer in Asian men is much lower than among Western men.

Bladder cancer

In another Japanese study, researchers evaluated the link between caffeine from tea and coffee on the incidence of bladder cancer. Results of this prospective study show that caffeine may be associated with increased risk of bladder cancer among smoking men. Cigarette smoking is a confirmed risk factor for bladder cancer.

Pancreatic cancer

Yet another Japanese study looked at the effect of green tea consumption on the risk of having pancreatic cancer. The study findings “do not support the hypothesis that green tea consumption is associated with decreased risk of pancreatic cancer in humans.”

Breast cancer

This prospective study conducted by Harvard researchers assessed the impact of caffeine consumption on breast cancer risk. The results show that there is “no overall association between caffeine consumption and breast cancer risk.” There is however, “a possibility of increased risk in women with benign breast disease or for tumors that are estrogen and progesterone receptor negative or larger than 2 cm” which requires more investigation.

In another long-term study on caffeine – breast cancer link, Harvard researchers followed women for 22 years. The results found no significant association between consumption of coffee (caffeinated and decaffeinated) and tea and risk of breast cancer. However, there is a weak inverse association between caffeinated drinks and risk of postmenopausal breast cancer.

Endometrial cancer

Another Japanese study investigated the effect of green tea consumption and the risk of endometrial cancer of endometrial endometrioid adenocarcinoma (EEA) type only. The researchers “observed a significant inverse association between green tea consumption and the risk of EEA with a dose-response relationship…This inverse association was consistently observed regardless of the presence or absence of factors such as obesity and menopause… Green tea consumption may be associated with a lower risk of EEA.”

The moral of these stories: It seems that tea might reduce risks for some cancers but not for others. However, it looks like it’s safe to give tea as a Christmas present!

Photo credit: stock.xchng

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Corn oil, canola oil, and breast cancer

The typical American diet includes a lot of omega 6 fats. And women of reproductive age who have high intake of these fats may be increasing their children’s risk of having breast cancer – at least at the genetic level. This is according to a study presented at the American Association for Cancer Research’s Seventh Annual International Conference on Frontiers in Cancer Prevention Research. The study was conducted using laboratory mice and still has to be confirmed in humans.

According to study leader  Dr. W. Elaine Hardman of the Marshall University School of Medicine

“We’re seeing changes in gene expression up to five months after the animals were exposed to a diet containing omega 6 fatty acids during gestation and lactation.The only explanation is that during gestation and lactation, the mother’s diet must be imprinting the genes of the baby.”

Corn oil, which is commonly used by Americans in food preparation, is especially rich in omega 6 fats. Canola oil – also known as rape seed oil, on the other hand, seems to have lower omega 6 fat content and may therefore be a better alternative.

In the study, two groups of mice were compared, one groups was fed with corn oil containing diet and the other group on canola oil containing diet. The incidence of breast cancer was then evaluated in the next generation of mice. The results show that offsprings of the corn oil group had higher incidence, and more and bigger tumors than offsprings of the canola group. The differences were also observed at the genetic level, specifically genes that are involved in fatty acid synthesis and cancer cell activation.

Americans consume high amounts of omega 6 fats. Polyunsaturated fats such as corn oil and soya oil were recommended by doctors 40 to 50 years ago because they were thought to prevent cardiovascular diseases. Dr. Hardman thinks there is a link between this increased polyunsaturated fat intake and the rise in the incidence of hormonally-influenced cancers such as prostate, breast, colon cancers.

“…50 percent of corn oil is made up of omega 6 polyunsaturated fats, which have previously been linked to increased rates of breast cancer. In comparison, canola oil has only 20 percent omega 6 fats. Omega 3 fats, which have been linked to lower cancer risk, vary as well. Corn oil has less than .5 percent omega 3 fats while canola oil has 10 percent.”

A shift from corn oil to canola oil is therefore recommended to protect the next generation from breast cancer.

 Photo credit: stock.xchng

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Lady, does your family stress you out?

How many people are in your household? How many generations are there?

Having grown up in Asia, I’m used to the tradition of extended families under one roof. There were advantages and disadvantage to this type of family structure. The advantage is the availability of help when help is needed. Grandmothers take care of grandchildren while the parents work. It also saves money on household costs. The disadvantage is that as the older generation age, they would need care and attention that would add to the financial burden to the younger generation. Another disadvantage is stress. When living within a closed setting in cramped quarters, tension and stress tend to build up.

This study on Japanese lifestyle showed that women living in multigenerational households with children and grandparents had to two to three times higher likelihood of having a heart disease.

The study is based data from 90, 987 men and women (40 to 69 years old) followed up to 14 years. The participants were healthy and without serious health problems at the start of the study. By the time the study ended in 2004, 671 participants had coronary heart disease (CHD) and 339 had died of the condition. The incidence of CHD was much higher in multigenerational households. And the reason for this is probably stress. In Japan, women tend to go work outside the house but are still expected to perform household duties on a full-time basis.

The study reports:

“…women living in multi-generational households (living with spouse-children-parents; or spouse-parents) had 2.0 to 3.0-fold higher risk of coronary heart disease compared to women living with spouses only. Women living with spouses and children also had 2.1-fold higher risk of coronary heart disease incidence compared to married women living without children…Women in a multi-generational family had a higher risk of coronary heart disease incidence, probably due to stress from multiple family roles.”

Although the study was conducted in Japan on a Japanese study population, American health experts believe this trend is also slowly emerging in the US. According to Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City

“Women are becoming more educated and are more and more in the work force, yet culturally they still are the caretakers of the family… there is an enormous amount of stress and pressure required to do all these things.”

With the current economic situation, extended families are forced to live together in order to save on costs – cost for childcare and cost for old age care. In the end, it all falls on the women’s shoulders to juggle between job and extended family.

“…caring for others can increase the risk of heart disease… We should incorporate this potential risk factor into our screening, and refer women for support services when needed,” according to Dr. Lori Mosca, a physician scientist at New York Presbyterian Hospital.

This Christmas, families come together to celebrate. Let us take care that this season of cheer does not turn into a season of stress.

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News from the cancer side December 19

News for the policy makers

IOM Proposes 20 Optimal Indicators to Measure Nation’s Health
The Institute of Medicine (IOM) has spoken: “Policymakers, the media, and the public should focus on 20 specific health indicators as “yardsticks” to measure the overall health and well-being of Americans…By providing information that can be compared over time, these 20 indicators will also help Americans track the nation’s progress on improving our health and the effectiveness of public health and care systems,” according the IOM’s latest report. And these should be accessible for everybody – not only the experts – through the The State of the USA website.

News for the cancer survivors

Breast cancer incidence rising in female cancer survivors

Women who had had a previous cancer of any type seem to be likely to have breast cancer later in life, according to Dutch researchers. There has been a 20% increase of breast cancer incidence since 1975 in the general population. For women who have survived a previous cancer, however, it’s 30%. “Our findings suggest that there is ample room for improvement in follow-up strategies to detect breast cancer at an early stage in this group.“

News from the toxicologists

Experts set tolerable level for melamine intake
Earlier this month 21 toxicological experts met in Ottawa, Canada in early December to review the toxicology of melamine and cyanuric acid. The experts managed to set up a tolerable daily intake (TDI) of melamine at 0.2 mg/kg body weight. Cyanuric acid TDI is at 1.5 mg/kg body weight. The TDIs are for the chemicals as stand-alone contaminants. The combination of the two can have increased toxicity compared to the individual substances and a TDI for the combination still has to be set. The expert meeting was initiated by the World Health Organization (WHO). Check out a previous post on melamine.

News from the research side

15 January deadline for international cancer study grants
The deadline for the Yamagiwa-Yoshida Memorial International Cancer Study Grants is on January 15, 2009. The grant is for clinicians, investigators, epidemiologist, and pubic health professionals but not for clinical training fellowhip.

News from the regulators

FDA Approves Drug that Boosts Stem Cell Yield for Bone Marrow Transplants
Some good news before the end of the year. The US FDA has just approved this week the drug pleroxafor (Mozobil, manufactured by Genzyme Corp.). Pleroxafor helps boost the number of blood stem cells that can be used for bone marrow transplants to treat certain forms of blood cancer. It is indicated for the treatment of multiple myeloma or non-Hodgkin’s lymphomas in adults.

“Collecting the millions of cells needed for a bone marrow transplant can take hours or days,” said Richard Pazdur,director of the Office of Oncology Drug Products, Center for Drug Evaluation and Research, FDA. “Mobozil provides a new therapeutic option for patients with certain types of blood cancers by increasing the number of stem cells collected in a given time period to be reinfused after therapy.”

Photo credit: stock. xchng

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CVD News Watch December 19

CDC’s Winter Tip of the Week

Cold weather puts an extra strain on the heart. If you have heart disease or high blood pressure, follow your doctor’s advice about shoveling snow or performing other strenuous work in the cold. If you have to do heavy outdoor chores, dress warmly and work slowly.

CVD gender issues watch
Number of women cardiologists doubles, but still much room for improvement
It’s a man world out there. The good news is that the number of female heart doctors has doubled during the past decade. The sad news is that two thirds of them still feel discriminated against as a consequence of their gender and their other job – motherhood. “The new survey shows that only 73% of women cardiologists are married, and a smaller fraction have children (66%), compared with 91% of male cardiologists who are married and 92% who have children”, according to heartwire.

CVD lifestyle watch

Mayo opens Center for Tobacco-Free Living
The renowned Mayo Clinic helps those who want to quit. It opened the new Center for Tobacco-Free Living last month, a new addition to Mayo’s Nicotine Dependence Center. Aside from professional counselling, the center also offers self-help tools in the form of interactive media, illustrations, computer work stations. Smoking is major risk factor in cardiovascular disease and lung cancer.

CVD stem cell research watch

Stem cells drug testing predicted to boom under Obama
American scientists are hopeful and so are their European colleagues. Dr, Christine Mummery, Professor of Developmental Biology at Leiden University Medical Centre in The Netherlands who spoke at the British Pharmacological Society’s Winter Meeting in Brighton Wednesday predicts that stem cell drug testing will boon under the new US administration and in the process will benefit European research as well. President-elect Barack Obama is a well-known supporter of stem cell research.

CVD drug watch

FDA Announces New Recommendations on Evaluating Cardiovascular Risk in Drugs Intended to Treat Type 2 Diabetes
The lesson learned from Avandia! The US FDA is tightening the guidelines for drugs indicated for type 2 diaebetes. This week, the regulatory body “recommended … that manufacturers developing new drugs and biologics for type 2 diabetes provide evidence that the therapy will not increase the risk of such cardiovascular events as a heart attack. The recommendation is part of a new guidance for industry that applies to all diabetes drugs currently under development.”

 CVD statistics watch

AHA year-end report: Mortality declines as risk factors climb
The 2008 American Heart Association report gives some good news and not-so-good news. Death rates due to heart disease and stroke are down but the risk factors which are modifiable through lifestyle changes still continue to rise, a trend that might not be sustainable. Definitely there’s a need to step up on prevention.

 It’s the weekend before Christmas. Don’t stress yourself out with last-minute Christmas shopping!

Photo credit: stock. xchng

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Eating healthy during the holidays

‘Tis the season to be feasting. And we should. After all, Christmas only comes once a year.

Now, how do we enjoy the holidays without compromising our heart health? Here are some simple tips.

When cooking at home
Be creative. Substitute bad fats with good fats. And look at the total fats as well. There’s a whole load of cholesterol-free recipe books out there. Or download recipes from the Internet. The American Heart Association (AHA) recommends The Best Healthy Soul Food Recipes cookbook.

Go for the vegetable recipes. If you have to go for meat, then go for lean meat and slim down the gravy. Here’s a tip from the AHA:

With poultry, use the leaner light meat (breast) instead of the fattier dark meat (legs and thighs) and be sure to remove the skin. Use a rack in the pan so the meat or poultry doesn’t sit in its own fat drippings. Instead of basting with pan drippings, use fat-free liquids like wine, low-sodium tomato juice or lemon juice. When making gravy from the drippings, chill first, then use a gravy strainer or skim ladle to remove the fat.

When shopping for food
At the supermarket, check for the AHA heart-check mark. Product with this mark “has been screened and verified to meet the AHA’a certification criteria to be low in saturated fat and cholesterol for healthy people over age 2.”

And if the nutritional facts on the packaging challenge you, check out this resource from the US FDA – How to Understand and Use the Nutrition Facts Label. It can be downloaded free of charge from the FDA site in pdf and comes with a video.

When going to parties or eating out
Take care of what to take from the buffet or order from the menu. Avoid the wrap-type food, according to this webMD article. Go for something that you recognize. Sushi is usually low fat. Forget the cheese unless you are sure they are the reduced-fat kind. Go for the raw vegetable cuts but take it easy on the dips and the dressings. They can be loaded with fat as well. A little bit of nuts would also great as long as you are not allergic to them.

You don’t have to make do without the turkey. Just go for the lean part and avoid the skin. Take it easy on the on the rich gravy. The cranberry sauce is a healthier alternative.

Go for small portions with variety. It makes the food more interesting with being fattening.

When drinking
Water is the best choice but unsweetened fruit juices are also fine. Remember that alcohol is full of calories. But if you must imbibe, then go for red wine and drink in moderation.

Now, when partying this holiday season, don’t follow the “eat, drink, and be merry for tomorrow you shall die” principle. Instead, eat and drink wisely, be merry, and live a long life.

Photo credit: stock.xchng

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Fighting cancer during the holiday season

Christmas is the season to be jolly but when you are ill, the holiday season can be actually stressful rather than joyful. This is especially true among cancer patients and their families. How would they fit in Christmas shopping and baking between chemotherapy and radiotherapy sessions? The Dana-Farber Cancer Institute gives some tips for cancer patients and their families on how to cope with the holiday fever as described below.

FOR THE PATIENTS

Set realistic goals

Don’t even think of doing it all. Cut down on the decorating, shopping and baking. Pick one or two things that you want and can do. And know your limitations, physically, emotionally and financially.

Do not be afraid of asking or accepting help

Learn to ask for help and delegate.

Get plenty of rest and sleep

Overstressing yourself is counterproductive. Learn to say “no” to party invitations and visitors if you don’t feel like it. Don’t feel obligated to be festive.

Engage in some form of physical activity

Exercise is good for you even if the temptation of staying in bed the whole is strong. Take walks and breathe in fresh air. However, be sure to keep yourself warm and wrapped up. Check out winter walking tips from the American Heart Association.

Go cyber

Do your shopping online. Send e-Christmas greetings – and be comforted that they are more eco-friendly than paper Christmas cards.

Show emotion

You don’t need to put up a brave face all the time. Crying can be therapeutic. Do not bottle it all up. It’s OK to complain once in a while. Talk to your love ones.

Eat healthy food

Complete abstinence during the holidays is not asked of you. Do not deprive yourself but do not overindulge yourself either.

FOR THE CAREGIVERS

Although the coping tips above are meant for cancer patients, they may apply to the family member and caregivers as well. According to the American Cancer Society (ACS)

“As a caregiver, you may also be feeling overloaded during the holiday season. You likely have many new things on your to-do list on top of your normal responsibilities. Try to include your loved one in the holiday meal planning and preparation, decorating, gift buying and wrapping. Most importantly, be sure to take time for yourself and appreciate the little things that make life special.”

ACS gives some recommended do’s and don’ts to help caregivers handle the holidays. Their tips are basically similar to the list above, which only goes to show that the burden of cancer is felt both by the patient and the caregiver.

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