Archive for the 'Women's Health' Category

Women Over 50 Need to Exercise An Hour a Day to Keep the Weight Off

Daily exercise on a treadmill is an excellent way to stay fitFor normal-weight women, middle-aged and older, sixty minutes of moderate-intensity physical activity a day is needed to prevent weight gain, according to researchers from Brigham and Women’s Hospital and Harvard Medical School.

Weight tends to gradually increase with age, even among those who have maintained a normal weight in their younger years. After the age of 25 our body naturally gains 1 pound per year, if nothing else changes.

What is moderate-intensity exercise? Experts usually consider it to be strenuous enough to cause a slight but noticeable increase in breathing and heart rate. Hard enough to break a sweat, but not so hard that you can’t comfortably carry on a conversation.   In the above study, moderate-intensity exercise was considered the equivalent of one hour a day of brisk walking or 30 minutes a day of jogging or running.

Note: Check with your health care provider before beginning an exercise program. If you have chest pain, feel faint or light-headed, or become extremely out of breath while exercising, stop the activity at once and tell your doctor as soon as possible.

More Information: Exercise

Source: Lee IM, et al “Physical activity and weight gain prevention” JAMA 2010; 303(12): 1173-79.
Source: “Cardiovascular Exercise” from Harvard.edu

Does A Drink a Day Really Help with Weight Control?

Women drinking wineLight to moderate drinking may keep women from gaining too much weight, according to the researchers from the Brigham & Women’s Hospital in Boston.

In their recent 13-year study of normal-weight women younger than 50, those who drank light to moderate amounts of alcohol daily, gained less weight and had a lower risk of becoming overweight or obese than either teetotalers or those who drank too much.

These findings and conclusions are highly controversial for a number of reasons. Experts do agree that further research is needed to confirm these conclusions, but certainly the findings should not be used as a license to drink. 

The fact remains that alcohol is well known to increase the risk of cancers of the mouth, pharynx, larynx, esophagus, liver, and breast.  Regular consumption of even a few drinks per week is associated with an increased risk of breast cancer in women. In fact, the American Cancer Society warns that those at high risk of breast cancer may want to consider not drinking any alcohol at all.

Source reference:
Wang L, et al “Alcohol consumption, weight gain, and risk of becoming overweight in middle-aged and older women” Arch Intern Med 2010; 170(5): 453-61.

Source: “Cheers! A Drink a Day May Keep the Pounds Away”, MedPage Today, March 8, 2010

Source: “Common Questions about Diet and Cancer” from the American Cancer Society

Breast Cancer Drop Linked to Decreased Use of HRT

2 womenThe decline in breast cancer rates among women over age 50 is linked to less use of hormone replacement therapy (HRT), according to Harvard Researchers. In their study of more than 350,000 women, the decline was most significant for cases of estrogen receptor-positive cancer and among affluent, white women who were most likely to have used HRT.

Source: American Journal of Public Health, February 2010

Aspirin May Reduce the Spread of Breast Cancer

AspirinAn aspirin at least two days a week significantly reduced the risk of death from breast cancer by 64% to 71% in a recently published study from Harvard and Brigham and Women’s Hospital in Boston. 

This study included 4,164 female registered nurses diagnosed with early stage breast cancer. The use of aspirin in the first year after breast cancer diagnosis was excluded in this study since the drug is discouraged during chemotherapy.

 The dose of aspirin was not specified in the study as methodology was limited by self-reporting for aspirin intake. The researchers speculated that most regular use of aspirin is for heart disease prevention at the 81 mg/day level. 

“These are promising findings, and if they are confirmed in additional clinical trials, physicians may be able to regularly recommend aspirin to their breast cancer patients to reduce risk of cancer spread and mortality,”  wrote Lori Pierce, MD, of the University of Michigan in Ann Arbor, on behalf of the American Society of Clinical Oncology, in a prepared statement.

Previous studies have also found benefits of aspirin in relation to breast cancer. In September of 2009 the American Cancer Society wrote, “some studies have found that women who take aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen seem to have a lower risk of breast cancer. These, as well as several other drugs and dietary supplements, are being studied to see if they can lower breast cancer risk, although none are approved for reducing breast cancer risk at this time.”

Daily aspirin therapy is also thought to help lower the risk of heart attack and stroke in certain people, but it isn’t appropriate for everyone. Doctors often recommend daily aspirin therapy in some people who’ve had a heart attack or stroke, or who are at high risk of either.

It’s important to note that breast cancer patients should always consult their oncologist or general physician before taking aspirin, especially during the chemotherapy, as it is often discouraged.

Anyone who wishes to start on aspirin should always consult with their physician as there are several potentially dangerous side-effects of this drug:

  1. The anticoagulant effect of aspirin may increase the chance of serious bleeding in some people. Therefore, aspirin should be used for its preventive anticoagulant effects only when your doctor decides, after studying your medical condition and history, that the danger of blood clots is greater than the risk of bleeding.
  2. Aspirin can irritate the stomach or cause GI bleeding. Aspirin should always be taken with food, preferably after a meal due to its potential for stomach irritation and GI bleeding.
  3. Aspirin is also contraindicated in: people with allergy to aspirin or NSAIDs (Advil, Motrin, Alleve, etc), 3rd trimester pregnancy. Precautions: History of asthma or peptic ulcer, severe hepatic (liver) or renal (kidney) dysfunction, bleeding disorders, diabetes, gout, pregnancy or nursing mothers. Aspirin interacts with many medicines. For more contraindications and a list of drugs that interact with aspirin, click here
  4. Children and teen-agers suffering from flu-like symptoms, chickenpox and other viral illnesses shouldn’t take aspirin or aspirin products (acetylsalicylic acid / salicylates) because of the possibility of a deadly disease called Reye’s syndrome.

Source: “Aspirin Benefit Seen in Established Breast Cancer”, MedPage Today, February 16, 2010

Source: Holmes MD, et al “Aspirin intake and survival after breast cancer” J Clin Oncol 2010; DOI: 10.1200/JCO.2009.22.7918. 

Important Breast Cancer Highlights 2004-2008

A measuring tape is a good tool for monitoring weight controlObesity linked to increased risk for six cancers
According to a recent report, excess body fat is on course to overtake tobacco as the leading risk factor for cancer in America. Furthermore, the cancer risk increases with only modest weight gain. In this analysis, excess body fat was found to be associated with an increased incidence of cancers of the colon, kidney, and pancreas, adenocarcinoma of the esophagus and endometrium, and breast cancer in postmenopausal women.There are two main types of phytoestrogens — isoflavones and lignans. Isoflavones are found in soybeans, chickpeas and other legumes. Lignans occur in flaxseeds, whole grains and some fruits and vegetables. Source: World Cancer Research Fund, American Institute for Cancer Research, October 2007

The American Cancer Society recommends MRI screening for women with lifetime breast cancer risk of 20%
Calculate your Lifetime Risk with this tool. Note: There are different risk models. Each one is imperfect and provides only an approximate estimate of risk. The tool should not be used to calculate breast cancer risk for women who have already had a diagnosis of breast cancer or for women known to have breast cancer-producing mutations in the BRCA1 or BRCA2 genes.
Always discuss these results with your doctor.)

Further recommendations from the American Cancer Society include:

  • Screening should begin at age 30 for most high-risk women
  • Annual MRI screening is recommended for patients with BRCA mutations and for patients whose lifetime risk for breast cancer is at least 20%,
  • MRI screening is not recommended for women with lifetime risk below 15%.
  • Annual MRI screening is recommended for patients who received chest radiation (e.g., for Hodgkin disease) between ages 10 and 30 and for patients with several unusual genetic syndromes;
  • The evidence is insufficient to recommend for or against MRI screening for women with dense breasts; women with personal histories of breast cancer, atypical ductal hyperplasia, ductal carcinoma in situ, atypical lobular hyperplasia or lobular carcinoma in situ; or women with lifetime risk of 15% to 20%.

Source: American Cancer Society, June 2007

Women at high risk of breast cancer should get an annual MRI scan plus mammogram
Women who have an especially high risk of developing breast cancer should get magnetic resonance imaging (MRI) scans along with their yearly mammogram, according to a new American Cancer Society guideline released today. This recommendation applies only to the 1% to 2% of women who have at least a 20% risk of developing breast cancer due to their family history. Performing both a mammogram and MRI together improves the chances of finding breast cancer early, when the cancer is easier to treat. In a related study also being released today, the researchers found that, in 969 women newly diagnosed with cancer in one breast, MRI found 30 additional tumors in the opposite breast that had been missed by mammograms and physical exams.

MRI scans are not recommended for women with an average risk of breast cancer. Although the scans are more sensitive than mammograms, they are more likely to result in false-positives, or false alarms in other words. This creates a great deal of prolonged anxiety, and an additional costly and invasive biopsy or procedure to adequately investigate a questionable area in a woman who is not likely to have breast cancer. Another significant drawback of the MRI scan is that its cost is about 10-times that of a mammogram. Thus the American Cancer Society only recommends the additional MRI scan in those with the highest risk. Source: American Cancer Society, March 3, 2007

Breast Reconstruction Referrals Not Always Offered by Surgeons
Women’s Health and Cancer Rights Act of 1998 mandates that insurance companies cover breast reconstruction for patients who undergo breast cancer surgery. Source: MedPage Today, March 2007

Radiation patients greatly benefit from nutrition counseling
Periodic nutrition counseling significantly improved the nutritional status of cancer patients were undergoing radiation therapy. Those patients who received dietary counseling, not only avoided malnutrition, and also experienced a significantly smaller decrease in overall quality of life, and had a faster recovery with regard to physical function, compared to those who did not receive counseling. Source: Journal of the American Dietetic Association, March 2007

Weighing yourself daily is recommended for weight controlObesity appears to increase risk of breast cancer
Another recent study strengthens the current theory that adult weight gain increases the risk of breast cancer. In a recent study of 44,000 post-menopausal women not taking hormone therapy, researchers compared women who gained only 20 pounds or less after the age of 18, with those who gained 60 or more pounds. The women in the higher weight gain group had an elevated risk of every type, stage, and grade of estrogen receptor-positive tumor. The most likely explanation offered by the American Cancer Society researchers is that fat tissue increases the level of estrogen circulating in the body, thereby increasing the risk of estrogen-positive tumors. Source:  MedPageToday, May 23, 2006
  

Reduced levels of fat in the diet may decrease the risk of breast cancer recurrence
In a recent, large-scale clinical study, postmenopausal women who had undergone treatment for early-stage breast cancer and then subsequently reduced the fat in their diet, appeared to reduce their chances for breast cancer recurrence or a second breast cancer.

At the start of the study, women in both control and intervention groups consumed on average 57 grams of fat per day. Both groups decreased their fat intake and maintained this decrease during the five years of the study. The intervention group decreased the fat in their diet by an average of 24 grams per day, while the control group only decreased it by an average of 5 grams per day. By the fifth year of the trial the women in the intervention group not only weighed an average of 6 pounds less than the women in the control group, but had a decreased incidence of recurrent breast cancer. Source: National Cancer Institute, December 2006

Weight gain of 21 pounds or more, after age 18, increases the risk of breast cancer
A recent American Cancer Society Study found that women who gained 21-30 pounds since age 18 were 40% more likely to develop breast cancer than women who had not gained more than 5 pounds, and women who gained 70 pounds doubled their risk. Furthermore, women who gained more than 60 pounds since age 18 were 3 times more likely to have metastatic breast cancer than women who gained less than 20 pounds as an adult. Source:  American Cancer Society

Computer factory workers may have increased cancer risk
Brain, kidney and breast cancer and non-Hodgkin’s lymphoma were more common causes of death for IBM computer employees than the rest of the population from 1969 to 2001, according to a recent analysis of a large mortality database. This data was released by the company involuntarily during litigation. No information was available to link these deaths to any specific chemicals or other toxic exposures.

Computer manufacturing and semiconductor fabrication have been known to expose workers to a variety of potentially carcinogenic chemicals, metals (especially arsenic, nickel and chromium), and electromagnetic fields (especially ultraviolet light, radiofrequency, and, in one process, x-ray radiation). These manufacturing processes have changed over time in the industry, and exposures have changed as well. Environmental Health October 2006

The link between soy protein, heart health and breast cancer risk…
Based on a recent review of 22 studies on the effects of soy protein with isoflavones and its association with heart health, the American Heart Association committee made the following recommendations: Taking soy or isoflavone supplements is unlikely to reduce your risk of heart disease. Eating foods that contain soy protein to replace food high in animal fats may prove beneficial to heart health. Circulation/American Heart Association, April 2006

Phytoestrogens are a weak form of estrogen that occurs naturally in certain foods.
Some studies suggest that high isoflavone levels might increase the risk of cancer, particularly breast cancer. On the other hand, some studies show just the opposite–that under some conditions, soy may help prevent breast cancer. It is this scientific controversy that is causing many researchers to urge caution until further clinical evidence is available.

The specific concerns about soy focus on components of soy, such as the soy isoflavones daidzein and genistein, not the whole food or intact soy protein, such as tofu. These chemicals, available over the counter in pills and powders, are often advertised as dietary supplements for use by women to help lessen menopausal symptoms such as hot flashes. (FDA) The bottom line, women who have concerns about breast cancer should not take soy dietary supplements (pills) without first consulting with their health care provider.

Large studies are currently underway and should offer better information regarding soy and breast cancer risk.

The medicine in your spice cabinet Turmeric, the main ingredient in curry powder appears to have potent anti-inflammatory and anticancer activity. Turmeric is a yellow powder made from the roots of a plant in the ginger family and is widely used in Indian and Southeast Asian cooking. For thousands of years, many cultures have used turmeric for medicinal purposes to treat everything from heartburn to arthritis.

A number of clinical studies have focused on curcumin, the most active compound in turmeric, and have found that curcumin can indeed slow inflammation. It also appears to slow the spread of cancer (metastasis), slow down the growth of new tumor blood vessels (angiogenesis), and cause cancer cells to die the way normal cells do (apoptosis). A word of caution, however, at least one study has shown that curcumin may inhibit the action of certain chemotherapy drugs.

Researchers have recently launched a number of new human trials to find out more about curcumin’s anticancer effects. Source: American Cancer Society

Postmenopausal women with more body fat are more likely to develop breast cancer than those with less body fat.
Researchers have found that increased body fat may contribute to breast cancer. Fat cells produce a type of estrogen, the “female hormone,” which can stimulate certain types of breast cancer tumors to grow. Researchers studied more than 7,500 women and found that women who weighed more, who had gained a lot of weight since age 25, had a high BMI, a wide waist, or who had a high percentage of body fat were somewhat more likely to have developed breast cancer. Source: Journal of the American Geriatrics Society, January 2006

Raw cabbage is thought to improve breast cancer riskStudy: A Diet High In raw and short-cooked cabbage may help prevent breast cancer
Cabbage contains anti-carcinogenic glucosinolates and myrosinase enzymes and it may be at the reason why the breast cancer risk of Polish women triples after they immigrate to the United States. The study found the protective effect to be only for raw and short-cooked cabbage, not long-cooked. Source: American Association for Cancer Research

Blood Test Better Predicts Cancer Treatment Outcomes
A new technology that counts cancer cells in the blood helps predict the success of breast cancer treatments more quickly and more reliably than traditional methods. A study published in a recent edition of The New England Journal of Medicine said the new technique allows doctors to determine within weeks, not months, whether a breast cancer patient’s treatment is working. This could help physicians, at the start of treatment, determine more accurately which patients need more aggressive therapy and which patients need less aggressive therapy. This would spare some women from the most potent chemotherapy. Source: New England Journal of Medicine August 19, 2004

Study: Breast MRIs may find nearly twice as many breast cancer tumors as mammograms
Although breast MRIs are not routinely being performed, the procedure is emerging as a recommended screening test for women at high risk for developing breast cancer. It is also being used to further evaluate an abnormality that has already been detected. Unfortunately, MRI may produce a greater number of false alarms than mammography.  Source: The New England Journal of Medicine, July 2004

Tomatoes, citrus fruits, cabbage and broccoli lower your risk of cancerLower your risk of cancer through food by the National Foundation for Cancer Research
Research findings indicate the following foods help protect the body against cancer. Tomatoes, ketchup, tomato sauce, real teas (green, black and oolong), foods rich in Vitamin C (citrus fruits), and cruciferous vegetables (cabbage, broccoli, brussel sprouts and turnips). Source: National Foundation for Cancer Research, www.nfcr.org

Study: Exercise improves survival chances in breast cancer patients
In a study of 2,987 breast cancer patients, Harvard researchers found physically active women to have a greater chance of survival from the disease than those with sedentary lifestyles. This large study of U.S. nurses found that patients who walk or do other types of moderate exercise for three to five hours per week are about 50% less likely to die from the disease as sedentary women. Source:  Journal of American Medical Association, 2005

Combining an MRI scan and a mammogram is the most effective way to detect breast cancer in women with a high risk of the disease
In a study of 650 women at high risk of breast cancer, researchers found that MRI was nearly twice as effective as mammograms in finding signs of the disease. Mammograms picked up 40 percent of tumors in the women but MRI detected 77 percent. When the two methods were combined, 94 percent of tumors were identified.  Source: The Lancet, May 2005

Huge Government Changes in Breast Cancer Screening

A woman and her familyHuge changes in breast cancer screening have recently been announced by a government appointed task force, the U.S. Preventive Services Task Force (USPSTF). But the American Cancer society is highly critical of the new guidelines.

The USPSTF now says average-risk women between the ages of 40 and 50 don’t need a mammogram, and those between the ages of 50 and 74 should only have a mammogram every two years instead of every year. Routine screening is not recommended for women older than 74, whereas previously it was recommended every one to two years.

According the to USPSTF, the changes have been made because the benefits of earlier testing are minimal compared to the risk of false alarms and unneeded biopsies.

But this appears to be nothing more than a cost-cutting measure by the federal government. According to the Chief Medical Officer of the American Cancer Society, this recommendation is based on the conclusion  “that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save a life is not”.  This ”is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them.”  

Source: AP, November 2009

 

 

Drinking Alcohol Linked with Cancer

Drinking alcohol is an enjoyable drink in the U.S.The cardiovascular benefits of alcohol consumption have been touted for several years.  This has been welcome news for those who enjoy drinking, but there may be a huge price to pay in the long run.  

The good news about alcohol has been well publicized, but the bad news has usually been absent from the  news story.   People have grown accustomed to their nightly glass, or two, of wine and are totally surprised to hear that drinking alcohol increases cancer risk.  For years the American Cancer Society (ACS) has been warning of the cancer risks of alcohol, but the ACS has a small voice compared to the nightly news.  Unfortunately, many have now grown accustomed, and yes addicted, to their daily alcohol and don’t want to give it up. 

Recently, a large new study from the University of Oxford further emphasizes the link of regular alcohol consumption with cancer.  The British researchers studied 1.3 million women and found that as little as one drink or more per day increased the risk of a half dozen types of cancer. The increased risk was similar in women who drank wine exclusively and in those who consumed other types of alcohol.

Leading authorities contend that no level of alcohol consumption should be considered safe when it comes to cancer.  The American Cancer Society summarizes the research to date and publishes the following recommendations on its website: “Alcohol raises the risk of cancers of the mouth, pharynx (throat), larynx (voice box), esophagus, liver, and breast, and probably of the colon and rectum. People who drink alcohol should limit their intake to no more than 2 drinks per day for men and 1 drink per day for women. A drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. The combination of alcohol and tobacco increases the risk of some cancers far more than the effect of either drinking or smoking alone. Regular intake of even a few drinks per week is linked to a higher risk of breast cancer in women, especially in women who do not get enough folate. Women at high risk of breast cancer may want to consider not drinking any alcohol.”

The Oxford researchers acknowledge that studies have shown some cardiovascular benefits associated with moderate alcohol consumption, but they say the cancer risk may outweigh those benefits.  There are many other well known health problems associated with alcohol such as hypertension, stroke, cardiac arrhythmias, mental decline and dementia, cirrhosis of the liver, dilated cardiomyopathy, and fetal alcohol syndrome. Also, the disasterous consequences of acute intoxication such as fatal motor vehicle accidents and chronic destructive addiction are just a few of the many social hazards of alcohol.

The dangers of alcohol are well known, have been known for a long time, and it is far from the whole story to say that alcohol is good for you.  

Source: Allen NE, et al “Moderate alcohol intake and cancer incidence in women” J Natl Cancer Inst 2009; 101: 296-305.
Source: Lauer MS, Sorlie P “Alcohol, cardiovascular disease, and cancer: treat with caution” J Natl Cancer Inst 2009; 101: 282-283.  
Source: “Even a Few Drinks a Day Increases Cancer Risk in Women”, MedPage Today, February 24, 2009

Two Cans of Soda Per Day Linked with Kidney Damage in Women

Woman drinking a sodaWomen who drink two or more cans of regular soda a day may be increasing their risk of kidney damage, according to researchers at Loyola University Medical Center .  Diet soda intake was not associated with any signs of early kidney disease, and men who drank moderate amounts of regular soft drinks did not have any adverse effects. 

Source: Shoham D, et al “Sugary soda consumption and albuminuria: results from the National Health and Nutrition Examination Survey, 1999-2004″ PLoS ONE 2008; DOI: 10.1371/journal.pone.0003431.

Fosamax and Boniva linked to dental complications

Drawing of a toothOsteonecrosis of the jaw, as a complication of dental procedures, has occurred in 4% of patients taking oral alendronate (Fosamax), whereas none of those who didn’t take the drug experienced any complications.

Fosamax, as well as Boniva and Actonel, are oral bisphosphonates.   Fosamax is the most widely prescribed oral bisphosphonate, and in 2006 it was the 21st most prescribed drug overall. 

In an article in MedPage Today, the the researchers are quoted as saying, “…if patients are using bisphosphonates, dentists should consider alternate treatment options for non-necessary extractions and good oral hygiene should be achieved before extractions to minimize microbial load. Also, follow-up should be more vigilant and a chlorhexidine rinse pre- and post-operatively ‘can be effective’ in ensuring socket and wound healing and mucosal coverage of exposed bone…”

These findings are preliminary, but if you’re taking any one of the bisphosphonates, be sure to let your dentist know, especially before any dental procedures.

via MedPage Today, January 2009

Some women avoid active sports due to a weak bladder

Woman playing tennisSome women are missing out on healthy, active sports because of symptoms related to a weak bladder.  In a recent survey of 679 women of childbearing age, sports that involve repetitive bouncing, such as tennis, squash and basketball, were associated with the highest incidence of urinary stress incontinence episodes according to Italian researchers from University of Insubria, Del Ponte Hospital, Varese.

Stress incontinence is characterized by an involuntary loss of small amounts of urine in response to increased pressure on the bladder. This occurs during coughing, sneezing, lifting, bending or exercise. It is the most common type of urinary incontinence in women.  About half of all women suffer from this problem at some point, and it becomes more prevalent with age.   It is often caused by damage to the pelvic floor muscles and support system of the bladder as a result of pregnancy and childbirth, or possibly the effects of aging. In this study, the researchers found that obesity also increased the incidence of having the condition.  

In this study, 1 in 7 women were bothered by urinary stress incontinence and nearly half of those affected said the condition occurred during routine activities, while almost a third said they leaked urine only during sports activities. One in 10 women said the problem led them to give up their favorite sport, while one in five women said they limited the way they played the sport in an effort to decrease leakage episodes.

Although this condition was bothersome and disruptive to their lives, few of the women in the study had ever sought help. Only 5 percent of the women with episodes of stress incontinence said they regularly performed pelvic floor exercises (Kegals) which have been shown to be effective in alleviating the symptoms of this condition.  People are often reluctant to seek help for this troubling problem partly because it is an awkward and embarrassing subject, but also because there is a prevailing misconception that nothing can be done.  Ask your doctor or health care provider for help.  In most cases,  the symptoms can be controlled or cured. 

via British Journal of Sports Medicine, September 2008