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CT Scans & Cancer Risk

 

 

 

Weekly Health Update:


CT Scans & Cancer Risk

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS

  

Photo of Dr. Wascher

 

Updated:  12/20/2009

 


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

Welcome to Weekly Health Update

 


 

“A critical weekly review of important new research findings for health-conscious readers”

 

HAPPY HOLIDAYS FROM WEEKLY HEALTH UPDATE!

 

CT SCANS & CANCER RISK


CT (computed tomography) scanners have revolutionized the practice of medicine since they were first introduced into routine clinical practice in 1974.  CT scanners utilize a rotating x-ray device to create hundreds of individual images that can then be reconstructed into a complex three dimensional view of the body by computers.  Current generation CT scanners are able to image the entire human body within seconds, and these high definition images provide physicians with an incredibly detailed view of the organs and tissues deep within us. 

CT scanners have become an indispensible diagnostic tool within virtually every medical and surgical specialty, and an estimated 75 million CT scans are now performed annually in the United States, alone.  As the popularity of these complex and powerful diagnostic imaging machines has continued to grow, so has their use for clinically dubious reasons.  For example, routine scans of the heart, and its coronary arteries, have, increasingly, been used for “screening purposes” in patients without any clinical evidence of heart disease.  Likewise, there has been an explosion in the number of private radiology imaging centers offering fee-based “body scans” for clinically healthy people who are interested in having their internal organs examined for any early signs of diseases that can be detected by CT scans.  Another area of concern regarding the use of CT scanners is that physicians have become so dependent on these machines, and the exquisite images of the human body that they provide, that many (if not most) doctors have a very low threshold to order CT scans as a routine part of their diagnostic work-up of patients.  (For example, in my own specialty of Surgery, the diagnosis of appendicitis is now routinely made with a CT scanner, rather than by the traditional method of the surgeon’s clinical evaluation of the patient.) 

While CT scanners have become essential diagnostic tools, they also expose patients to much higher doses of radiation than most conventional x-ray examinations.    It has long been known that exposure to radiation increases the risk of developing cancer, and that the risk of developing cancer is proportional to the dose of radiation received by patients.  (Based upon recent estimates, it has been estimated that at least 2 percent of all cancer cases may be caused by prior exposure to medical x-rays.)  Moreover, there is no known “safe” dose of radiation in terms of radiation-induced cancer risk.  As if this was not already bad enough, there has been a growing concern regarding the actual dose of radiation that is being delivered to patients from CT scanners across the country, as there is a great deal of variability in the radiation dose settings being used among different CT scan imaging facilities.  (This alarming point was recently brought to the public’s attention when it was revealed that Cedars Sinai Medical Center, a prestigious private hospital in the Beverly Hills area, was being investigated after multiple patients who had undergone CT scans of their brain there began to notice that their hair was falling out.  Authorities subsequently determined that these patients had received grossly excessive radiation doses during their scans.)

Two very important public health studies have just been published in the Archives of Internal Medicine, and the findings of these two related studies have significantly raised the level of concern regarding the current use of CT scanners among public health experts. 

The first of these two studies quantified the amount of radiation dose delivered to 1,119 patients for 11 common types of CT scan examinations that were performed at 4 different hospitals in the San Francisco area.  In addition to calculating the radiation doses received by these patients, the authors also estimated the probable lifetime cancer risk associated with these CT scans.  As the Cedars Sinai case has already shown, there appears to be considerable variability in the amount of radiation used at different institutions to conduct the same exact type of CT scan.  However, the sheer magnitude of this variability in radiation doses, as measured by these researchers, is both mind-boggling and disturbing.  Not only was there an enormous difference in radiation doses associated with performing the same exact type of CT scan between the 4 different institutions that were studied, but significant radiation exposure differences were also present within each individual institution when performing the same type of CT scan examination on different patients.  When the researchers had finished their calculations, they noted an almost unbelievable 13-fold difference, on average, in radiation exposure for the same type of CT scan between the highest and lowest observed radiation doses for each individual type of CT examination. 

Based largely upon cancer incidence data collected after the Hiroshima and Nagasaki atomic bombings, this clinical study’s researchers calculated that an estimated 1 in 270 women who underwent a CT scans of their coronary arteries at age 40 will eventually develop cancer as a direct result of these CT scans (versus 1 in 600 men), while 1 in 8,100 women who underwent CT scans of the brain at age 40 will develop cancer from these scans (versus 1 in 11,080 men).  For men and women who underwent CT scans at age 20 (instead of age 40), the projected lifetime risk of CT scan-associated cancer was nearly double the projected risk of the 40 year-old patients. 

The findings of this study indicate that the variability in radiation exposure between hospitals for the same type of CT scan examination is much greater than was previously believed.  Perhaps even more surprising was the finding that identical CT scan examinations performed within a single hospital also subjected patients to significantly different amounts of radiation exposure.  Finally, the calculated range of radiation exposure for CT scans revealed that, in general, patients are receiving far higher doses of radiation from routine CT scans than has generally been appreciated.  (For example, a single CT coronary artery angiogram delivers the same amount of radiation as 310 chest x-rays!)

The second research study used public health data to estimate the average number of radiation-induced cancers caused by CT scans in the United States.  Based upon current CT scan use, these researchers predicted that approximately 29,000 future cases of cancer could be expected to arise from CT scans performed in 2007 in the United States, resulting in approximately 15,000 deaths due to cancers caused directly by CT scans!

These two studies are eye-openers that should cause all of us, physicians and patients alike, to reconsider the benefits versus the risks of each and every CT scan that is considered before such scans are performed.  Although most CT scans are performed because they offer vitally important clinical information on patients that could only otherwise be obtained by surgical exploration, too many CT scans are still being ordered and performed for far less compelling reasons (one of them being, unquestionably, the tendency of many physicians to order multiple unnecessary tests on patients as part of their practice of “defensive medicine,” in the absence of tort reform throughout most areas of the United States…).  Moreover, the striking variation in CT-associated radiation doses, and the unexpectedly high level of these radiation doses in general, points to the need to improve standardization and compliance at every one of the thousands of institutions in the United States that operates a CT scanner.

As a dedicated cancer specialist, I am already well aware of the potential for radiation-induced cancers, and I have, for many years, tried to be very selective in ordering CT scans on my patients.  In cases where I can gather the necessary clinical information without resorting to radiographic imaging, then I try to avoid obtaining any form of x-ray examination (including CT scans).  In other cases, where I must obtain some sort of imaging examination, then I will often initially use ultrasound or MRI studies in place of CT scans, when appropriate.  Even so, the dramatic findings of these two studies suggest to me that all physicians need to further decrease their routine use of CT scans whenever possible. 

 

Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)



Bookmark and Share
   



Send your feedback to Dr. Wascher at:  

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


Copyright 2007 - 2010

Robert A. Wascher, MD, FACS

All rights reserved


Dr. Wascher's Archives:

12-13-2009:  Soy Isoflavones Decrease Breast Cancer Recurrence Risk

12-6-2009:   Salt (Sodium) Intake, Stroke & Cardiovascular Disease

11-29-2009:  Exercise & Prostate Cancer Risk

11-22-2009:  Genistein (Soy Isoflavone) & Prostate Cancer

11-15-2009:  Breast Cancer Treatment & Chronic Pain

1-8-2009:     Vitamin D & Breast Cancer Risk

11-1-2009:   Exercise & Prostate Cancer Risk

10-25-2009:  HPV Virus & Risk of Breast Cancer

10-18-2009:  Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:   Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:    Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:    Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:     Prostate Cancer & Green Tea

6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:     Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009:  Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009:  Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009:  Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009:  Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009:  Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008:  Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008:  Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008:  Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer;  Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008:  A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:     Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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Salt (Sodium) Intake, Stroke & Cardiovascular Disease


 


Weekly Health Update:

Soy Isoflavones Decrease Breast Cancer Recurrence Risk

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS


Photo of Dr. Wascher


Updated:  12/13/2009


 

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


  

Welcome to Weekly Health Update

 


 

“A critical weekly review of important new research findings for health-conscious readers”

 

SOY ISOFLAVONES REDUCE BREAST CANCER RECURRENCE RISK

 

Regular readers of this column are already aware of the controversy surrounding soy isoflavone intake and breast cancer risk.  As happens frequently in clinical research (unfortunately), contradictory research findings have made it difficult to understand the true relationship between dietary soy intake and breast cancer risk (if one exists).  There is, for example, both laboratory and clinical data suggesting that a diet rich in soybean-derived products may be associated with a lower risk of developing breast cancer.  At the same time, because genistein and other dietary isoflavones are known to weakly mimic the effects of estrogen, there has been some concern that a diet rich in isoflavone “phytoestrogens” may increase both the risk of developing a new breast cancer and the risk of developing a recurrence of a previous breast cancer.  (In fact, there is data from laboratory research studies showing that genistein can indeed fuel the growth of human breast cancer cells growing in culture dishes, when exposed to high concentrations of this soy-derived isoflavone.)

 

A growing body of public health research, primarily from Asian countries where tofu and other soy-based foods are frequently consumed, appears to link increased soy consumption with a decreased lifetime breast cancer risk, particularly when soy-based foods are consumed during adolescence, during the time when development of the female breast is most active (Soy & Breast Cancer Risk).  (Interestingly, there is also recent research suggesting that soy products might also reduce the risk of prostate cancer, which is another hormonally driven cancer:   Genistein & Prostate Cancer Cells, Dietary Soy & Prostate Cancer Risk.)

 

Although epidemiological research is, increasingly, suggesting that a diet rich in soybean-derived foods might lower a woman’s lifetime risk of developing breast cancer, many breast cancer experts have remained apprehensive regarding dietary isoflavone intake in women with a prior history of breast cancer, in view of the estrogen-like effects of these “phytoestrogens.”  As I have already noted, there is considerable research data available to suggest that soy-derived isoflavones can, at least under certain laboratory conditions, stimulate estrogen-sensitive breast cancer cells to grow and divide.  These research findings have left many oncologists feeling uncomfortable in recommending soy-based foods to their breast cancer patients.  Now, a newly publish public health study in the Journal of the American Medical Association suggests that soy-based foods may actually reduce the risk of breast cancer recurrence, and death due to any cause, in women who have previously been diagnosed with this very common form of cancer.

 

In this study, which was performed in Shanghai, China, 5,042 female breast cancer survivors (ages 20 to 75 years) were followed for an average of almost 4 years.  All of these patient volunteers underwent detailed surveys regarding their lifestyle habits, including their diets.  These patients, who were originally diagnosed with breast cancer between 2002 and 2006, were surveyed at 6, 18, 36 and 60 months following their original diagnosis with breast cancer.  

 

The results of this study indicate that the breast cancer survivors who consumed the greatest amount of soy-based foods in their daily diets were 32 percent less likely to experience a recurrence of their breast cancer when compared to the women who consumed the least amount of soy-based isoflavones.  Moreover, the women who consumed the greatest amount of soy were also 29 percent less likely to die, from any cause, when compared to the women who consumed the least amount of soy-derived foods.

 

A particularly interesting and unexpected finding of this study was that both women with estrogen sensitive breast cancers and women with tumors that were not sensitive to estrogen appeared to experience a significantly decreased risk of breast cancer recurrence if they frequently consumed soy products.  Another important finding of this study was that women who were taking the estrogen-blocking cancer treatment drug tamoxifen also appeared to enjoy a reduced risk of breast cancer recurrence with higher levels of dietary soy intake.  Additionally, the researchers noted that high levels of soy intake appeared to be about as effective in reducing the risk of breast cancer recurrence as the breast cancer prevention drug tamoxifen, alone.

 

The results of this very important study mirror the findings of the only other prospective clinical study that has looked at the impact of soy-based foods on breast cancer recurrence (the “Life After Cancer Epidemiology,” or “LACE,” study).  The LACE study, which was performed in the United States, followed nearly 2,000 breast cancer survivors for, on average, more than 6 years.  In the LACE study, women who were taking tamoxifen, and who also consumed the highest amount of soy-based dietary isoflavones, were 50 percent less likely to develop a recurrence of their breast cancer when compared to women who reported the lowest consumption of soy-derived foods.

 

As I have pointed out previously, epidemiological research studies based upon dietary surveys are susceptible to several types of bias which, in turn, can cause researchers to draw the wrong conclusions.  In this case, however, there are now two large prospective cohort studies that have reached essentially the same conclusions (albeit with a rather limited duration of patient follow-up).  Both studies strongly suggest that high levels of soy-based isoflavones in the diet may be able to significantly reduce the risk of breast cancer recurrence.  Based upon the findings of this large Chinese study, the apparent cancer risk reduction effect associated with high levels of soy intake also appears to benefit premenopausal and postmenopausal women, as well as women who are taking the estrogen-blocking drug tamoxifen, women with estrogen-sensitive tumors, and women with (counter-intuitively) estrogen-resistant tumors.

 

In view of the limited duration of patient follow-up in both of these clinical breast cancer studies, as well as the limitations of survey-based epidemiological research in general, I would like to see updated data from both of these studies after at least 10 years of patient observation before I would be willing to tell my breast cancer patients that they should significantly increase their dietary soy intake.  On the other hand, the rather compelling data presented by both of these clinical research studies will also make me less anxious when any of my breast cancer patients decide, of their own accord, to increase their intake of soy-derived isoflavones.

  


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


 

  

"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)

 


 


Bookmark and Share



Send your feedback to Dr. Wascher at
:
 

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2010

  

Robert A. Wascher, MD, FACS

  

All rights reserved

 


 

Dr. Wascher's Archives:

 

12-6-2009:   Salt (Sodium) Intake, Stroke & Cardiovascular Disease

11-29-2009:  Exercise & Prostate Cancer Risk

11-22-2009:  Genistein (Soy Isoflavone) & Prostate Cancer

11-15-2009:  Breast Cancer Treatment & Chronic Pain

1-8-2009:     Vitamin D & Breast Cancer Risk

11-1-2009:   Exercise & Prostate Cancer Risk

10-25-2009:  HPV Virus & Risk of Breast Cancer

10-18-2009:  Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:   Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:    Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:    Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:     Prostate Cancer & Green Tea

6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:     Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009:  Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009:  Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009:  Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009:  Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009:  Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008:  Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008:  Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008:  Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer;  Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008:  A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:     Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 

 


Dr. Wascher's Home Page


 

 

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Exercise & Prostate Cancer Risk

 
 
 
 

Weekly Health Update:


Exercise & Prostate Cancer Risk

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS

 

Photo of Dr. Wascher
 
 

Updated:  11/29/2009


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

EXERCISE & PROSTATE CANCER RISK
 
 
There is an increasing body of research evidence to suggest that many cases of cancer can be prevented through lifestyle and diet modifications. Indeed, even conservative estimates suggest that more than 60 percent of new cancer cases could be prevented simply by abstaining from unhealthy lifestyle and dietary habits. (More enthusiastic cancer prevention experts have suggested that 80 percent of cancer cases, or more, might be preventable with rigorous lifestyle and diet changes.)   Given that, in the best case, modern cancer treatment results in the long-term survival of only about 60 percent of all cancer patients, and that the survival rate for many of the most lethal cancers still remains far more dismal, an ounce of cancer prevention is certainly worth much more than a pound of cancer cure. (This simple yet profound realization is the central theme of my new book, “A Cancer Prevention Guide for the Human Race,” which will be published in the spring of 2010.) 
 
 
As a practicing comprehensive Surgical Oncologist, I routinely treat patients with highly lethal cancers, many of which are, sadly, incurable by the time they are diagnosed. While not every case of cancer can be prevented through lifestyle and diet modification, many of the terrible, and ultimately fatal, cancer cases that I routinely see might have been prevented with reasonably moderate alterations in the way that people choose to live their daily lives.
 
 
Prostate cancer is the most common non-skin cancer that occurs in men, and the second most common cause of cancer death in men.  In 2009, an estimated 192,000 new cases of prostate cancer will be diagnosed, and approximately 27,000 men will die of this disease.  Prostate cancer currently afflicts 1 out of every 6 American men during their lifetimes, and accounts for 25 percent of all cancer diagnoses in men (similar, I might add, to the percentage of breast cancer cases among all cancer cases diagnosed in women).  Most prostate cancers are stimulated to grow and spread by testosterone and other androgens produced by the testes, and by other tissues in the body. 
 
 
The relationship between prostate cancer risk and exercise has not been entirely clear, thus far, as various clinical studies have produced contradictory findings. Some of these studies have suggested that high levels of daily physical activity may reduce the risk of prostate cancer, while other studies have not confirmed a link between prostate cancer risk and physical activity levels.
 
 
A new prospective public health study, just published in the British Journal of Cancer, adds further important evidence that increased levels of physical activity may indeed reduce the risk of developing prostate cancer. In this newly published study, nearly 46,000 men between the ages of 45 and 70 years were prospectively followed between 1998 and 2007. All of these male volunteers completed extensive questionnaires regarding their daily levels of physical activities at 30 years of age and at 50 years of age, as well as at the time or their entry into this clinical study. These questionnaires specifically included questions regarding walking or bicycling; current waist, hip and height measurements; education level; cigarette smoking; alcohol consumption; diabetes; family history of prostate cancer; and other lifestyle factors. Six predefined activity levels for occupational activity (from “mostly sitting down” to “heavy manual labor”), and additional predefined categories for time spent on different activities, were specifically included in the questionnaire, such as walking or bicycling (“hardly ever” to “more than 90 min per day”), home or household work (“less than 1 hour per day” to “more than 8 hours per day”), inactive leisure time (“from 2 hours per day or less” to “5 hours per day or more”), and active leisure-time exercising (“from less than 1 hour per week” to “more than 5 hours per week”). The patient volunteers were also queried regarding the average number of hours per day they spent sleeping. 
 
 
Importantly, the researchers conducting this study took the extra step of conducting 7-day physical activity evaluations to verify that the study’s participants actually engaged in the levels of physically activity that they claimed on the questionnaires. (This additional validation step confirmed the accuracy of the questionnaire information supplied by the study’s volunteers.) The incidence of prostate cancer, and the death rate associated with prostate cancer, among these 45,887 middle-aged and elderly men were then analyzed at the conclusion of this very large prospective epidemiological study. 
 
 
When the men who engaged in physical activity at the highest levels were compared with those at the lowest levels, some very important differences in prostate cancer risk emerged. Overall, very high levels of physical activity were associated with a 16 percent reduction in the risk of developing prostate cancer. Additionally, among the men who spent at least half of their work days being physically active, the risk of prostate cancer was 20 percent lower when compared to men who spent most of their work day sitting down. Specifically, and very importantly, there appeared to be a linear and progressive decrease in prostate cancer risk with each additional 30 minutes of walking or bicycling per day over the course of the adult lifetimes of these men (this linear relationship was noted within a range of 30 to 120 minutes of walking or bicycling per day). Additionally, the risk of developing advanced prostate cancer appeared to be further lessened by regular daily physical activity. 
 
 
The results of this study mirror those of other high-quality cancer prevention studies for other types of cancer (including, most notably, breast cancer). While clinical research studies such as this one are prone to various forms of bias, and in particular, biases that arise from patients “self-reporting” their personal health and lifestyle information on study questionnaires, the authors of this study appear to have taken very significant and effective steps to reduce the risk of including such biases in the data that they collected from these nearly 46,000 men. Therefore, although a small degree of residual error cannot be completely excluded from the results of this impressive epidemiological study, its findings that progressively higher levels of daily physical activity (and, it must be stressed, throughout one’s lifetime) are associated with a decreasing level of prostate cancer risk are very likely to be valid even in the presence of small errors in the study’s data (if they exist).
 
 
Cardiovascular disease remains the most common cause of premature death in most societies. Cancer is the number two cause of premature death when including people of all ages, and the number one cause of premature death below the age of 80 in the United States. Regular exercise, including relatively moderate activities such as brisk walking or bicycling, have been shown to significantly reduce the risk of death due to cardiovascular disease, as well as, increasingly, the risk of developing or dying from multiple different types of cancer. Based upon the results of this well designed and well executed prospective clinical research study, it would appear that prostate cancer can be added to the list of life-threatening illnesses for which the risk can be decreased through regular and frequent physical activity (and both at work and at home).
 
 

Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


 

     

"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 
 

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Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

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Dr. Wascher's Archives:

11-15-2009: Breast Cancer Treatment & Chronic Pain

1-8-2009:     Vitamin D & Breast Cancer Risk

11-1-2009:  Exercise & Prostate Cancer Risk

10-25-2009: HPV Virus & Risk of Breast Cancer

10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:  Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:    Prostate Cancer & Green Tea

6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:    Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:    Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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Genistein (Soy Isoflavone) & Prostate Cancer

 

 

 
 
 

Health Report:


 

Genistein (Soy Isoflavone) & Prostate Cancer

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS

 

Photo of Dr. Wascher
 

Updated:  11/22/2009

 

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

GENISTEIN (SOY ISOFLAVONE) & PROSTATE CANCER
 
 
While the normal healthy cells within our body are destined to die after a predetermined number of cell divisions (senescence), cancer cells are, essentially, immortal. They divide endlessly, until enough cancer cells have formed to cause a tumor.  Similarly the normal cells that line your colon (as well as all of the other estimated 75 trillion cells that make up the human body) never decide to leave the colon and spread to, say, your liver or your lungs. However, colon cancer cells seem to have an overwhelming compulsion to move into blood vessels and lymphatic vessels, and from there, to spread to other distant organs of the body. Once these nefarious pioneers arrive in the liver, the lungs, or in other organs outside of the colon, these metastatic tumor cells then resume their growth cycle, eventually causing metastatic tumors to form. Other types of cancer exhibit the same malignant biology, beginning with invasion through normal tissues, followed by invasion into blood vessels or lymphatic vessels, and ending with the establishment of metastatic colonies of tumors in distant organs and tissues.
 
 
This unique, and potentially deadly, biology of cancer cells arises from hundreds, if not thousands, of genetic mutations and other transforming events that occur within cancer cells. As we are still in the infancy of our understanding of the complex biology of cancer cells, we are only beginning to understand the interplay between these hundreds, if not thousands, of aberrations in cancer cell biology.
 
 
In most cancer cells, genes that play important roles in normal cell growth and division become corrupted, either due to genetic mutations that cause these “tumor suppressor genes” to become inactivated, or through other so-called “epigenetic” alterations that can also inactivate tumor suppressor genes. One such epigenetic mechanism whereby tumor suppressor genes are commonly inactivated is through “hypermethylation” of the promoter region of the gene. The promoter region of genes can be thought of as a switch that turns on the activation of a gene to produce its specific protein product. Hypermethylation is a process whereby the promoter region of a gene is essentially locked into the “off position.” (When gene hypermethylation occurs, the affected gene is said to be “silenced.”)  
 
 
Tumor suppressor genes produce proteins that reduce the risk of normal cells becoming cancer cells. Therefore, when key tumor suppressor genes are silenced by hypermethylation, normal (benign) cells may become transformed into malignant cells. This very basic review of the molecular biology of tumor suppressor genes and carcinogenesis is important in order to understand this week’s featured research study.
 
 
A tumor suppressor gene known as BTG3 is known to be commonly silenced, by hypermethylation of its promoter region, in cancers of the prostate, breast and kidney. There also is experimental evidence showing that genistein, which is a dietary nutrient found in soybeans and soybean products, can reverse the hypermethylation of multiple different tumor suppressor genes, including BTG3. (Once hypermethylation is reversed, the gene is once again able to produce its cancer-preventing protein.)
 
 
A new research study, just published in the journal Cancer, evaluated the effects of genistein on hypermethylated human prostate cancer cells. In this elegant laboratory study, prostate cancer cells were grown in culture dishes, and were tested for hypermethylation of the BTG3 tumor suppressor gene. Once the scientists confirmed that the BTG3 gene was indeed silenced by hypermethylation in these prostate cancer cells, the cells were then treated with genistein. Following additional experiments, the scientists were able to confirm that genistein effectively reversed hypermethylation of the BTG3 tumor suppressor gene. Additionally, a new experimental prostate cancer drug which is being evaluated in ongoing clinical research trials, 5Aza-C, was also tested on the hypermethylated prostate cancer cells, and was found to reverse hypermethylation of the BTG3 tumor suppressor gene, as well.
 
 
While it is still a big stretch to assume that the reactivation of the BTG3 tumor suppressor gene in prostate cancer cells growing in a culture dish will translate into clinically meaningful results in human beings, the results of this interesting little study are both intriguing and encouraging. Given that genistein is a natural and generally non-toxic dietary nutrient, it may have certain advantages over the novel prostate cancer drug 5Aza-C (assuming, of course, that ongoing clinical research trials identify a clinical benefit in prostate cancer patients undergoing treatment with 5Aza-C).
 
 
The true role of genistein in the prevention and treatment of certain cancers, if any, is not clear at this time. However, the results of this laboratory study add to the growing body of research suggesting that genistein may have clinically significant anti-cancer effects in at least some human cancers.
 


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity
 

Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


 

"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)
 



Bookmark and Share
  


Send your feedback to Dr. Wascher at:  

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved

 


Dr. Wascher's Archives:

11-15-2009: Breast Cancer Treatment & Chronic Pain

1-8-2009:   Vitamin D & Breast Cancer Risk

11-1-2009:  Exercise & Prostate Cancer Risk

10-25-2009: HPV Virus & Risk of Breast Cancer

10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:  Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:    Prostate Cancer & Green Tea

6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:    Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:    Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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Breast Cancer Treatment & Chronic Pain

 

 

 

Health Report:


 

Breast Cancer Treatment & Chronic Pain

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS

 

Photo of Dr. Wascher
 

Updated:  11/15/2009

 

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

BREAST CANCER TREATMENT & CHRONIC PAIN

 

Chronic pain following breast cancer treatment is, unfortunately, relatively common, and is a subject that I have previously extensively studied and written about. Most of the clinical data that has been published, thus far, about chronic pain following breast cancer therapy is from the “mastectomy era,” when every patient with breast cancer routinely underwent complete dissection (removal) of the breast and armpit lymph nodes (also known as modified radical mastectomy). 
 
Chronic pain following breast cancer treatment has been estimated to occur, on average, in approximately 25 to 30 percent of patients undergoing axillary (armpit) lymph node dissection, with or without mastectomy, and appears to correlate with the extent of axillary lymph node surgery.  Important additional non-surgery factors that have been linked to breast cancer treatment-associated chronic pain syndromes include neuropathic pain caused by chemotherapy and radiation therapy, both of which may be additive to the neurological impairments associated with surgery. As occurs with many other types of chronic pain syndromes, affected breast cancer patients frequently experience some degree of disability that interferes with their ability to lead productive and comfortable lives.  Moreover, the added overlay of the emotional stress and anxiety that commonly follows the diagnosis of breast cancer further adds to the impact of chronic pain on the daily lives of patients who have undergone breast cancer treatment.
 
A newly published public health study of chronic pain following breast cancer treatment appears in this week’s Journal of the American Medical Association. In this large Danish epidemiological study, a nationwide cohort of 3,253 breast cancer survivors, ages 18 to 70 years, was extensively surveyed regarding their breast cancer treatment history and outcomes two to three years following completion of their breast cancer treatment. (It is important to note that all of the women who participated in this study underwent current standard-of-care breast cancer surgery in 2005 or 2006.) The results of this large nationwide Danish breast cancer study were very instructive.
 
Among these more than 3,000 patients, nearly half (47 percent) reported ongoing pain issues two to three years after completing their breast cancer therapy. Among these 1,543 patients with chronic pain symptoms, 13 percent reported severe pain (or, about 6 percent of all patients participating in this study). Another 39 percent of these 1,543 patients reported moderate pain (18 percent of all study patients). Finally, 48 percent of these 1,543 patients reported mild chronic pain symptoms (23 percent of all study patients). Among this group of patients with chronic pain following completion of breast cancer therapy, 20 percent were sufficiently bothered by their symptoms to seek out medical evaluation and treatment.
 
Following statistical analysis of the data, several important clinical factors were found to be significantly associated with chronic pain following breast cancer treatment, some of which have also been confirmed by previous studies. Young age was a particularly important risk factor for chronic pain following breast cancer treatment. Patients between the ages of 18 and 39 in this study were almost four times more likely to report chronic post-treatment pain than older women. Radiation therapy was also a significant risk factor (nearly all women who undergo breast-conserving “lumpectomy” will be advised to undergo radiation therapy to reduce the risk of local recurrence of their breast cancer). Women who underwent radiation therapy following breast cancer surgery were almost twice as likely to report chronic pain when compared to the women who did not receive radiation treatment. (Chemotherapy, on the other hand, did not appear to be associated with chronic pain in this large group of breast cancer survivors.) The extent of axillary lymph node surgery was also a predictive factor for chronic pain, as has been shown by previous research (including my own research). Women who had undergone complete removal of their axillary lymph nodes were nearly twice as likely to report chronic pain when compared to patients who had undergone the more limited sentinel lymph node biopsy of their axillary lymph nodes.
 
A separate risk factor for chronic pain following breast cancer treatment was the presence of chronic pain in other areas of the body prior to undergoing breast cancer treatment, suggesting that women who have preexisting chronic pain symptoms are more likely to develop a new chronic pain syndrome following breast cancer treatment.
 
In addition to chronic pain, decreased or abnormal sensation of the skin of the chest wall, axilla, and upper arm are well known side effects of breast cancer treatment. In this study, abnormal sensation was also more common among younger patients (5 times more likely than for older women), and following complete axillary lymph node dissection (5 times more likely than for women who did not undergo complete axillary lymph node dissection).
 
This study adds to an important and growing body of clinical research regarding the prolonged effects modern breast cancer therapy on patients. When contrasted to the rather high incidence of chronic pain syndromes associated with modified radical mastectomy, the recent data on chronic pain and sensory abnormalities in the “modern era” of breast-conserving surgery is much more favorable, although, clearly, there is still a substantial proportion of women who will go on to experience significant long-term symptoms following completion of their breast-conserving treatment. 
 

The links below provide additional information for patients who are interested in this important topic:
 
 
 

Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


 

 

  

"A Cancer Prevention Guide for the Human Race"


(Anticipated Publication Date:  March 2010)
 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)

 


Bookmark and Share



 
 
 
 
 


Send your feedback to Dr. Wascher at:
 

rwascher@doctorwascher.net



Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved



Dr. Wascher's Archives:

11-8-2009:   Vitamin D & Breast Cancer Risk

11-1-2009:  Exercise & Prostate Cancer Risk

10-25-2009: HPV Virus & Risk of Breast Cancer

10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:  Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:    Prostate Cancer & Green Tea

6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:    Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:    Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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Vitamin D & Breast Cancer Risk

 

 

 

Health Report:


 

Vitamin D & Breast Cancer Risk

 



"A critical weekly review of important new research findings for health-conscious readers..."

  

Photo of Dr. Wascher

By, Robert A. Wascher, MD, FACS



Updated:  11/08/2009
 

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

VITAMIN D & BREAST CANCER RISK

 

As regular readers of this column already know, Vitamin D is a very hot molecule in the world of cancer prevention research. While there have been contradictory results among various clinical research studies regarding the proper role of Vitamin D in the prevention of cancer, there is a growing tally of clinical and laboratory research studies suggesting that higher levels of Vitamin D in the blood may be associated with a lower risk of developing certain cancers. Now, another clinical research trial, just published in the journal Cancer Epidemiology, Biomarkers & Prevention, adds further weight to the theory that Vitamin D may, in fact, significantly reduce the risk of developing certain cancers.

This study involved 2,465 women who were scheduled for diagnostic mammograms. Blood levels of Vitamin D were measured in these women prior to performing their mammograms. Of these nearly 2,500 women, 142 were subsequently confirmed to have a breast cancer. An additional 420 women participating in this study were matched with the newly diagnosed breast cancer patients in terms of age, menopausal status, and other factors known to play a role in breast cancer risk. (This group of 420 women turned out not to have breast cancer, following their mammograms, and so they served as a “control group” for this prospective clinical research study.)

As with several previous Vitamin D cancer prevention studies that I have previously reviewed, the results of this study were quite interesting. After analyzing their data, this study’s authors determined that the women with the highest levels of Vitamin D in their blood experienced a 48 percent reduction in the relative risk of being diagnosed with breast cancer when compared to the women with the lowest levels of Vitamin D.

The evidence for a potential protective effect of Vitamin D against cancer is, arguably, strongest for colon and rectal cancer. However, there is a growing body of research hinting at a potential protective effect for Vitamin D against breast cancer, as well. (As is virtually always the case for disease prevention research, however, there have been several research studies that have failed to identify a cancer prevention benefit for Vitamin D.)

Clearly, additional research is necessary to ferret out the appropriate role of Vitamin D in cancer prevention, and large prospective, randomized, placebo-controlled clinical research (with long term follow-up of patients) will be necessary to resolve the conflicting cancer prevention research data with respect to Vitamin D. Meanwhile, given the stronger data for Vitamin D and colorectal cancer prevention (and for cardiovascular disease prevention, as well), Vitamin D remains, essentially, the only vitamin for which there is at least moderate clinical evidence supporting a potential cancer prevention benefit.

As always, before starting a new vitamin supplement, or other nutritional supplement, I encourage patients to see their personal physician first.

Below are links to previous Vitamin D and breast cancer columns that I have recently published:

Breast Cancer Recurrence, Death & Vitamin D

Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California


 

"A Cancer Prevention Guide for the Human Race"


(Anticipated Publication Date:  March 2010)

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)

 



Bookmark and Share

 



Send your feedback to Dr. Wascher at:
 

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved


Dr. Wascher's Archives:

11-1-2009: Exercise & Prostate Cancer Risk

10-25-2009: HPV Virus & Risk of Breast Cancer

10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:  Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:    Prostate Cancer & Green Tea

6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:    Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:    Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


Email ItEmail It | Print ItPrint It | CommentsComments (0) | TrackbacksTrackbacks (0) | Flag as offensiveFlag as Offensive

Exercise & Prostate Cancer Risk

 

 

 

Health Report:


 

Exercise & Prostate Cancer Risk

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS

 

Photo of Dr. Wascher
 

Updated:  11/01/2009
 

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

EXERCISE & PROSTATE CANCER RISK


Prostate cancer is the most commonly diagnosed cancer in men, and the second most common cause of cancer-associated death in men. In 2009, an estimated 192,000 men will be diagnosed with prostate cancer, and more than 28,000 will die from this disease. Based upon current trends, 1 in 6 males will go on to be diagnosed with prostate cancer during their lifetimes.

While several different risk factors have been implicated in the development of prostate cancer, male gender, increasing age, and being an African-American male are the three most important known risk factors for this disease. As none of these major risk factors can be eliminated, it is unlikely that prostate cancer can be completely eliminated, either. However, there is some clinical evidence to suggest that specific lifestyle and dietary modifications may reduce the risk of developing prostate cancer. One lifestyle factor that has previously been proposed to potentially reduce prostate cancer risk is exercise. However, the results of previous clinical research studies have provided contradictory evidence regarding the role of exercise in prostate cancer prevention.

An intriguing new clinical research study, just published in the Journal of Urology, raises the possibility that regular aerobic exercise may, indeed, be associated with a decreased risk of developing prostate cancer. In this study, 190 men who were undergoing prostate gland needle biopsy completed a validated lifestyle and exercise history questionnaire. Statistical adjustments were then made for known prostate cancer risk factors, including age, ethnic race, body weight, prostate specific antigen (PSA) levels, family history, and digital rectal examination (DRE) findings. 

The authors of this study found that the men who exercised regularly (at least 9 METS, or metabolic-equivalent task hours, per week), when compared to the men who did not regularly exercise, had a markedly lower risk of prostate cancer. In fact, the men who vigorously and regularly exercised had a whopping 65 percent lower risk of prostate cancer when compared to the men who lived sedentary lives. Additionally, even moderate levels of exercise (3 to 8.9 METS per week) were associated with a lower risk of aggressive high-grade prostate tumors among the men who were diagnosed with prostate cancer (86 percent risk reduction for high-grade tumors).

While this rather small clinical study raises the possibility that high levels of aerobic exercise throughout the week may significantly decrease the risk of prostate cancer (and may decrease the likelihood of high-grade tumors in men who are diagnosed with prostate cancer), a larger prospective, randomized clinical research trial, with long-term follow-up, will be necessary to confirm the results of this small study. Small studies, such as this one, may come to erroneous conclusions due to their small sample size, and their limited follow-up of patients. Moreover, all survey-based research studies, such as this one, are susceptible to potential biases. Finally, this study’s finding that exercise reduces prostate cancer risk may only be indirectly true, as other dietary or lifestyle factors that are more common among men who exercise regularly may actually be responsible for the decreased prostate cancer risk observed in this clinical study.  Having listed all of these disclaimers, we know, without a doubt, that regular aerobic exercise improves overall health and decreases the risk of premature death. Thus, there are many good reasons to engage in regular exercise, including the possibility that doing so might reduce your risk of developing prostate cancer.            
 

Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California


 

 

"A Cancer Prevention Guide for the Human Race"



















(Anticipated Publication Date:  March 2010)
 
 
 

Link to TV36 Interview with Dr. Wascher


(Click above image for TV36 interview of Dr. Wascher)
 



Bookmark and Share

 



Send your feedback to Dr. Wascher at:
 

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved


Dr. Wascher's Archives:

10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:  Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:    Prostate Cancer & Green Tea

6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:    Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:    Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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HPV Virus & Risk of Breast Cancer

 

 

Health Report:


 

HPV Virus & Risk of Breast Cancer

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS

Photo of Dr. Wascher
 

Updated:  10/25/2009


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 HPV VIRUS & RISK OF BREAST CANCER


The human papilloma virus, or HPV, is already known to directly cause more than 90 percent of all cases of cervical cancer, and this knowledge has been used to develop several HPV vaccines that can dramatically reduce the risk of developing cervical cancer if given to girls and young women before they are exposed to this sexually transmitted virus.   HPV has recently also been linked to an increasing number of cases of oral cancer in patients without the usual risk factors for this cancer (i.e., smoking and increased alcohol intake).

Recently, there has been some research evidence suggesting that human papilloma virus (HPV) may also play a role in the development of at least some cases of breast cancer. However, the data linking breast cancer with chronic HPV infection has been rather contradictory thus far, resulting in a lack of consensus about whether or not HPV actually plays any significant role in breast cancer development. Now, a newly published research study in the British Journal of Cancer adds more weight to the theory that this cancer-causing (oncogenic) virus may also lead to the development of at least some cases of breast cancer.

The authors of this study used two different and complementary tests to evaluate breast tissue specimens for HPV infection. The researchers tested normal breast tissue from breast biopsies, as well as non-invasive breast cancer (ductal carcinoma in situ, or DCIS) tumors and invasive breast cancer (ductal carcinoma) tumors. Prior studies looking for evidence of HPV infection within breast cancer cells have relied mostly upon a highly sensitive and sophisticated laboratory test known as reverse transcriptase-polymerase chain reaction (RT-PCR) to identify snippets of HPV DNA. In these prior studies, HPV DNA has been found to be present, variably, in 25 to 80 percent of tested breast cancer tumors. However, some experts have questioned the findings of many of these RT-PCR studies, and have suggested that RT-PCR’s notorious susceptibility towards false-positive results (due to contamination) may explain the findings of apparent HPV infection within breast cancer cells.

In this new study, the authors not only used RT-PCR, but also microscopic examination of these same breast tissue and breast tumor specimens as well. As with several other prior studies, this study once again confirmed the presence of cancer-causing (oncogenic) strains of HPV within invasive breast cancer cells, DCIS cells, and normal breast cells. The authors also tested breast cancer cells growing in cell cultures and, once again, were able to demonstrate HPV DNA in many of these breast cancer cells, using RT-PCR. 

In view of the known limitations of RT-PCR, the researchers in this study also evaluated benign and malignant breast cells under a microscope.  To their surprise, they were able to identify the classic changes in these same cells that occur with chronic HPV infection. (These altered cells, called koilocytes, are considered precancerous when they are identified on Pap smears in women who have chronic HPV infection of the cervix.) Finally, using antibodies against HPV proteins known to play a role in causing HPV-associated cancers, these researchers were also able to identify traces of this HPV oncoprotein in breast tumor cells and breast tissue as well.   

Taken together, the results of this very elegant and complex study appear to show rather convincing evidence of chronic HPV infection in both normal and malignant breast tissue, as well as the characteristic oncogenic HPV-associated changes in the appearance of these cells. More work still needs to be done to understand the precise role of HPV in breast cancer development, and the incidence of HPV infection within both normal breast tissue and in breast cancer cells. Although these important questions must first be answered, the findings of this study suggest a potential role for currently available HPV vaccines in the fight against breast cancer. 
 

Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California


 

"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)




Bookmark and Share



Send your feedback to Dr. Wascher at:
 

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved


Dr. Wascher's Archives:

10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:  Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:    Prostate Cancer & Green Tea

6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:    Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:    Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

 

 

 

Health Report:


 

Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS
 
Photo of Dr. Wascher
 

Updated:  10/18/2009


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


  

 

POST-CHOLECYSTECTOMY SYNDROME (SYMPTOMS AFTER GALLBLADDER SURGERY)

 

An estimated 20 million Americans have gallstones (cholelithiasis), and about 30 percent of these patients will ultimately develop symptoms of their gallstone disease. The most common symptoms specifically related to gallstone disease include upper abdominal pain (often, but not always, following a heavy or greasy meal), nausea, and vomiting. (The upper abdominal pain often radiates around towards the right side of the back or shoulder.) 


Patients with complications of untreated cholelithiasis may experience other symptoms as well, in addition to an increased risk of severe illness, or even death. These complications of gallstone disease include:

Severe inflammation or infection of the gallbladder (cholecystitis)

Blockage of the main bile duct with gallstones (choledocholithiasis), which can cause jaundice or/and bile duct infection (cholangitis), as well as pancreatitis


More than 500,000 patients undergo removal of their gallstones and gallbladders every year in the United States, making cholecystectomy one of the most commonly performed major abdominal surgical operations. In 85 to 90 percent of cholecystectomies, the operation can be performed laparoscopically, using multiple small “band-aid” incisions instead of the traditional large (and more painful) upper abdominal incision.

For the vast majority of patients with cholelithiasis, cholecystectomy effectively relieves the symptoms of gallstones. In 10 to 15 percent of patients undergoing cholecystectomy, however, persistent or new abdominal or GI symptoms may arise after gallbladder surgery. Although there are many individual causes of chronic post-cholecystectomy abdominal or GI symptoms, the presence of such symptoms following gallbladder surgery are collectively referred to as “post-cholecystectomy” syndrome (PCS) by many experts.

I routinely receive inquiries from patients who have previously undergone cholecystectomy, and who report troubling abdominal or GI symptoms following their surgery. In many cases, these patients have already undergone rather extensive evaluations, but without any specific findings. Understandably, such patients are troubled and frustrated, both by their chronic symptoms and the ongoing uncertainty as to the cause (or causes) of these symptoms. 

The most common symptoms attributed to PCS include chronic abdominal pain, nausea, vomiting, bloating, excessive intestinal gas, and diarrhea. Fever and jaundice, which most commonly arise from complications of gallbladder surgery, are much less common, fortunately. While the precise cause, or causes, of PCS symptoms can eventually be identified in about 90 percent of patients following a thorough evaluation, even the most comprehensive work-up can fail to identify a specific ailment as the cause of symptoms in some patients. It is important to stress that there is no universal consensus on the topic of PCS among the experts, although most agree that there are multiple and diverse causes of chronic post-cholecystectomy symptoms. Thus, it can be very difficult to counsel the small minority of patients with chronic symptoms after surgery when a comprehensive work-up fails to identify specific causes for their suffering.

Because PCS is, in effect, a non-specific clinical diagnosis assigned to patients with chronic symptoms following cholecystectomy, it is critically important that an appropriate work-up be performed in all cases of chronic PCS, so that an accurate diagnosis can be identified, and appropriate treatment can be initiated. As the known causes of PCS are numerous, however, physicians caring for such patients need to tailor their evaluations of patients with PCS based upon clinical findings, as well as prudent laboratory, ultrasound, and radiographic screening exams. This logical clinical approach to the assessment of PCS symptoms will identify or eliminate the most common diagnoses associated with PCS in the majority of such patients, sparing them the need for further unnecessary and invasive testing.

In reviewing the etiologies of PCS that have been described so far, both patients and physicians can gain a better understanding of how complex this clinical problem is:

Irritable bowel syndrome (IBS)

Bile gastritis (inflammation of the stomach)

Gastroesophageal reflux (GERD)

Hypersensitivity of the nervous system of the GI tract

Abnormal flow of bile into the GI tract after removal of the gallbladder

Excessive consumption of fatty and greasy foods

Painful surgical scars or incisional (scar) hernias

Adhesions (internal scars) following surgery

 

Retained gallstones within the bile ducts or pancreatic duct

Stricture (narrowing) of the bile ducts

Bile leaks following surgery

Injury to bile ducts during surgery

Infection of the bile ducts (cholangitis), incisions, or abdomen

Residual gallbladder or cystic duct remnant following surgery

Fatty changes of the liver or other liver diseases

Chronic pancreatitis or pancreatic insufficiency

Abnormal function or anatomy of the main bile duct sphincter muscle (the “Sphincter of Oddi”)

Peptic ulcer disease

Diverticulitis

Crohn’s disease or ulcerative colitis

Stress

Psychiatric illnesses

Tumors of the liver, bile ducts, pancreas, stomach, small intestine, colon, or rectum

         


In reviewing the extensive list of potential causes of PCS, it is evident that some causes of PCS are directly attributable to cholecystectomy, while many other etiologies are due to unrelated conditions that arise either prior to surgery or after surgery.

While it is impossible to predict which patients will go on to develop PCS following cholecystectomy, there are some factors that are known to increase the risk of PCS following surgery. These factors include cholecystectomy performed for causes other than confirmed gallstone disease, cholecystectomy performed on an urgent or emergent basis, patients with a long history of gallstone symptoms prior to undergoing surgery, patients with a prior history of irritable bowel syndrome or other chronic intestinal disorders, and patients with a history of certain psychiatric illnesses.

In my own practice, the initial assessment of patients with PCS must, of course, begin with a thorough and accurate history and physical examination of the patient. If this initial assessment is concerning for one of the many known physical causes of PCS, then I will usually ask the patient undergo several preliminary screening tests, which typically include blood tests to assess liver and pancreas function, a complete blood count, and an abdominal ultrasound. Based upon the results of these initial screening tests, some patients may then be advised to undergo additional and more sophisticated tests, including endoscopic ultrasound (EUS), upper or/and lower GI endoscopy (including, in some cases, ERCP, or endoscopic retrograde cholangiopancreatography), bile duct manometry, or CT or MRI scans, for example. (The decision to order any of these more invasive and more costly tests must, of course, be dictated by each individual patient’s clinical scenario.)

Fortunately, as I indicated at the beginning of this column, a thoughtful and logical approach to each individual patient’s presentation will lead to a specific diagnosis in more than 90 percent of all cases of PCS. Therefore, if you (or someone you know) are experiencing symptoms consistent with PCS, then referral to a physician with expertise in evaluating and treating the various causes of PCS is essential (such physicians can include family physicians, internists, GI specialists, and surgeons). Once a specific cause for your PCS symptoms is identified, then an appropriate treatment plan can be initiated.
 



Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California


 

 

"A Cancer Prevention Guide for the Human Race"



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(Anticipated Publication Date:  March 2010)
 
 
 
 
Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)




Bookmark and Share



 


Send your feedback to Dr. Wascher at:
 

rwascher@doctorwascher.net



Dr. Wascher's Biography



Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved


Dr. Wascher's Archives:

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:  Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:    Prostate Cancer & Green Tea

6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:    Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:    Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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Surgery, NSQIP, Complications & Death

 

 

 

Health Report:


 

Surgery, NSQIP, Complications & Death

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS

Photo of Dr. Wascher
 

Updated:  10/04/2009

 

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

 

SURGERY, NSQIP, COMPLICATIONS & DEATH

 

As a practicing cancer surgeon, complications following surgery (including death, which can be considered the “ultimate” complication of surgery) are of great concern to me. As federal and state government officials continue to grapple with the tremendously complex and seemingly insoluble deficiencies in our current health care system here in the United States, one area that has been receiving increased attention, lately, has been patient outcomes following surgery. 
 
Traditionally, surgeons have reviewed and analyzed their complications during regular morbidity and mortality (“M&M”) conferences. Each surgical complication is presented by the operating surgeon during such conferences, and the surgeon, and his or her peers, then analyze the patient’s clinical course. A consensus is then, hopefully, reached as to the proximate causes of the patient’s complications. Therefore, the goal of M&M conferences is to retrospectively identify patient risk factors for complications, as well as to examine the quality of care that patients have received, in an effort to identify areas where patient care can potentially be improved, and complications, perhaps, prevented. 
 
Unfortunately, there are several obvious weaknesses associated with this approach to quality improvement in patient care. The first and perhaps greatest weakness of M&M conferences is their retrospective nature. A great deal of subjectivity is injected into the analysis of specific patient care factors when the operating surgeon reviews his or her own patient complications, in hindsight, and then presents selected patients to other surgeons participating in the M&M conference. Whether by accident or by intention, important lapses in diagnosis and/or treatment are commonly withheld during such conferences, which often leads to an incomplete picture of the events leading up to patient complications and deaths. 
 
Another pitfall of M&M conferences is directly related to the interpersonal and professional dynamics between surgeons participating in such conferences. Some medical centers’ M&M conferences have a justly earned reputation for being ruthlessly aggressive in holding individual surgeons accountable for their complications, in an effort to improve the quality of patient care. At the same time, in many other medical centers, M&M conferences are relatively benign and quasi-social affairs among collegial groups of surgeons, and a critical evaluation of surgeons’ care of their patients is, instead, substituted with an affable and superficial review of patient complications and deaths that, too often, fails to drill down to specific potential patient care deficiencies. Both extremes in approaches to surgeon morbidity and mortality conferences tend to obscure the true causes and events associated with patient complications and unexpected deaths following surgery, due to the many biases that are injected into purely retrospective M&M conferences. 
 
In an attempt to overcome the intrinsic biases and limitations associated with a purely retrospective assessment of surgical complications, most surgeons at morbidity and mortality conferences present clinical research studies, published in peer-reviewed medical journals, in an effort to inject some scientific objectivity into the discussion. However, once again, personal biases still often arise despite attempts to present published clinical data relevant to the complication being discussed, as it is almost always possible to find a couple of published papers that appear to support the decisions that were made by the operating surgeon.
 
In response to growing concerns regarding the quality of surgical care at Veterans Administration hospitals in the United States, a paradigm-shifting approach to the analysis of surgical complications was initiated by the Veterans Administration (VA) in 1991. Out of an abundance of concern over the high rate of postoperative complications and deaths at several VA medical centers, the National Surgical Quality Improvement Program (NSQIP) was born. Between 1991 and 2001, VA medical centers prospectively collected data encompassing multiple patient risk factors, as well as data related to 30-day postoperative morbidity (complications) rates, and 30-day postoperative mortality (death) rates. Using this prospectively collected data to improve surgical care at all of the VA’s 132 medical centers that perform surgery, the VA was able to subsequently demonstrate some striking improvements in patient outcomes. Specifically, between 1991 and 2001, 30-day death rates following surgery decreased by 27 percent, while postoperative complications occurring within 30 days of surgery were decreased by a whopping 45 percent. The average length of stay after surgery also declined by a rather incredible 50 percent (from an average of 9 days, to 4 days). Needless to say, if the NSQIP results from these 132 VA hospitals were to be universally replicated in all of the nearly 6,000 hospitals in the United States, the potential for improvement in patient morbidity and mortality, and consequently in the cost of delivering high quality surgical care in the United States, would be enormous (currently, only 243 civilian hospitals are listed as voluntary NSQIP participants by the program’s steward, the American College of Surgeons).
 
As surgeons finally begin to move from their long tradition of well-intentioned but seriously flawed retrospective analysis of postoperative complications, and into the dawning era of prospective data collection and analysis, a detailed evaluation of the data from programs such as NSQIP will continue to yield important new insights into the causes of preventable surgical complications and deaths. Indeed, a newly published study in the prestigious New England Journal of Medicine, from the University of Michigan, evaluated NSQIP data collected on 84,730 surgical patients between 2005 and 2007. Unlike most prior studies that have used NSQIP data to assess the potential causes of preventable surgical complications and mortality, the authors of this research study were particularly interested in the role of patient management in preventing postoperative deaths once complications had, in fact, already occurred.
 
The authors of this important clinical study ranked the NSQIP-participating hospitals according to their overall death rates for patients undergoing inpatient surgery, and divided them into five different groups, based upon their mortality rankings. The researchers then evaluated and compared the extensive NSQIP data in each of these five groups of hospitals. The results of this analysis were both intriguing and, seemingly, rather counterintuitive.
 
The first important finding of this study was that the actual incidence of complications following surgery did not significantly vary among the hospitals studied. The second illuminating finding of this study is that, unlike complication rates, death rates following surgery did significantly vary among these same hospitals (from 3.5 percent among the best performing hospitals, to 6.9 percent among the poorest performing hospitals). 
 
A comprehensive review of the NSQIP data for these nearly 85,000 surgical patients confirmed that the two-fold difference in death rates that was observed between the best performing and worst performing hospitals appeared to be directly related to the way that patients with major complications were managed once the complications occurred, and not due to any underlying difference in the actual incidence of complications among the various hospitals. Thus, the authors concluded that our attention must not only continue to focus on preventing complications, but that we should also more aggressively concentrate on our actual management of complications following surgery, once they occur, in our ongoing efforts to reduce the incidence of preventable postoperative deaths.
 
In view of the landmark Veterans Administration NSQIP findings linking the prevention of complications with a decrease in postoperative death rates, it may seem counterintuitive that the two-fold difference in postoperative death rates observed in this new study appeared to be unrelated to the actual incidence of complications among the hospitals studied. However, it is important to remember that these same hospitals had already previously demonstrated their strong commitment to reducing preventable postoperative complications through their voluntary participation in the NSQIP program. Therefore, the finding of this study that complication rates did not vary considerably among these particular hospitals may not be applicable to the vast majority of hospitals that have not yet adopted NSQIP guidelines (or other comparable, prospective surgical quality improvement programs).
 
The results of this study clearly show that, while the implementation of the NSQIP program is helping participating hospitals to make significant progress in reducing the incidence of complications following surgery, we still have much work to do in devising and implementing evidence-based clinical pathways for managing those complications that, despite our best efforts, still continue to occur. Based upon the results of this important clinical research study, it appears that  we can further and dramatically reduce the incidence of unnecessary deaths following surgery while, at the same time, significantly reducing the already excessive cost of delivering quality health care in the United States.  
 

Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California



 

"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)

 



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Send your feedback to Dr. Wascher at:  

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved

 

Dr. Wascher's Archives:

9-27-2009   Stress, Heart Disease, Exercise & Death

9-20-2009: Vitamin D & Colorectal Cancer Survival

9-13-2009: H1N1 Swine Flu Update

9-7-2009:   Green Tea, Aging & Lifespan

8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009: Update on Prostate Cancer and Cryotherapy

8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009: Coronary Artery CT Scans & Cancer Risk

7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009: Breast Cancer & Metformin (Glucophage)

7-5-2009:   Prostate Cancer & Green Tea

6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009: Red Yeast Rice, Statins & Cholesterol

6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:   Diet, Soy & Breast Cancer Risk

5-31-2009: Diet and Prostate Cancer Risk

5-24-2009: Diabetes, Glucose Control & Death

5-17-2009: Drug Company Marketing & Physician Prescribing Bias

5-10-2009: Hemorrhoids & Surgery

5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009: Are We Really Losing the War on Cancer?

4-19-2009:   Exercise in Middle Age & Risk of Death

4-12-2009: Can Chronic Stress Harm Your Heart?

4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009: Depression, Stress, Anger & Heart Disease

3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008:   A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:  Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:  Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:  Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:  Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:  Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:   Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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Stress, Heart Disease, Exercise & Death

 

 

 

Health Report:


 

Stress, Heart Disease, Exercise & Death

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS
 

 
Photo of Dr. Wascher
 

Updated:  09/27/2009


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

STRESS, HEART DISEASE, EXERCISE & DEATH

 

Multiple prior clinical research studies have identified a link between high levels of stress and the risk of death in patients with coronary artery disease (CAD). 
 
 
Aerobic exercise training is a standard component of rehabilitation programs for patients with CAD. A properly supervised exercise training program for patients with CAD, including patients who have suffered a heart attack, has been shown to reduce the risk of CAD-related death. At the same time, it is also well known that regular aerobic exercise can also help patients to better cope with high levels of personal stress, and also improves the symptoms of depression and other mental health disorders, as well. 


An intriguing clinical research study, newly published in the American Journal of Medicine, evaluated the impact of exercise training on the risk of death in patients with CAD. The two “experimental” groups of patients included 53 patients with CAD who reported high levels of stress in their lives, and 369 patients with CAD who reported low stress levels in their personal lives. These two groups of patients participated in a cardiac rehabilitation program that included formal aerobic exercise training. A “control” group of 27 patients with CAD was also included in this research study, and these control patients also reported high levels of stress in their lives. However, unlike the experimental group patients, this control group of patients did not undergo cardiac rehabilitation, or any other form of supervised exercise training. The subsequent findings of this clinical research study were rather dramatic.
 
 
Overall, the risk of death among the patients with CAD who reported high levels of stress was a whopping 4 times greater than the mortality rate of the patients with low levels of stress in their lives (22 percent vs. 5 percent, respectively).   
 
 
As has been shown in previous clinical studies, regular aerobic exercise appears to decrease self-reported stress levels. In this study, the percentage of patients reporting severe levels of stress declined from 10 percent, at the beginning of the study, to 4 percent, by the end of the study, among patients who underwent formal exercise training. 
 
 
Perhaps the most interesting finding from this study was that patients who increased their total exercise capacity by at least 10 percent also lowered their risk of death by a rather amazing 60 percent when compared to patients who achieved a less than 10 percent improvement in exercise capacity. Moreover, among the patients who reported high levels of stress in their lives, the risk of dying during the course of this clinical study was dramatically reduced in the group of patients who were able to increase their prior exercise capacity by at least 10 percent. In fact, while 19 percent of the “highly stressed” patients who achieved little or no improvement in their exercise capacity died during the course of this study, none of the “stressed” CAD patients who managed to increase their exercise capacity by at least 10 percent died. On the other hand, CAD patients reporting low levels of personal stress did not appear to experience any significant improvement in mortality risk whether they achieved a high level of exercise capacity improvement or a low level of exercise capacity improvement. 
 
 
The results of this study suggest that (as has previously been shown) a high level of personal stress is independently associated with an increased risk of dying from preexisting CAD. A second finding of this study, which has also been confirmed by other studies, is that self-perceived levels of stress can be significantly reduced with regular aerobic exercise. The most interesting and novel finding of this study, however, is that exercising at a level that increases one’s exercise capacity by at least 10 percent appears to be a potentially powerful way of reducing the increased mortality risk that is associated with chronically elevated levels of personal stress in patients with CAD.
 
 
One potential limitation of this clinical study is that it is not entirely clear how well the patients in each group were matched in terms of the severity of their CAD (as well as other chronic illnesses, including mental health and personality disorders). For example, at least some of the experimental group patients who were unable to improve their exercise capacity by at least 10 percent may have been unable to do so due to the presence of serious illnesses (including more severe heart disease) that limited their ability to exercise. In such cases, the increased risk of mortality observed in this study may have been directly caused by the presence of more serious illnesses in these patients, when compared to the patients who were able to more dramatically improve their exercise capacity. However, as most of the findings of this clinical research study are consistent with larger and better controlled previous studies, it is very likely that there is some validity in its more novel conclusions (and, most notably, that vigorous and regular aerobic exercise may directly reduce stress-related physiological factors that increase the risk of dying from CAD).
 
 
Prior to embarking on a new or more vigorous exercise program, I advise that you first be evaluated by your personal physician, especially if you have CAD or other serious illnesses. (For an in-depth overview of the benefits of exercise on cancer prevention, look for the publication of my new book, “A Cancer Prevention Guide for the Human Race,” in the spring of 2010.)
 



Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California 


 

 

"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)




Send your feedback to Dr. Wascher at:
 

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved


Dr. Wascher's Archives:

9-20-2009: Vitamin D & Colorectal Cancer Survival

9-13-2009: H1N1 Swine Flu Update

9-7-2009:   Green Tea, Aging & Lifespan

8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009: Update on Prostate Cancer and Cryotherapy

8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009: Coronary Artery CT Scans & Cancer Risk

7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009: Breast Cancer & Metformin (Glucophage)

7-5-2009:   Prostate Cancer & Green Tea

6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009: Red Yeast Rice, Statins & Cholesterol

6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:   Diet, Soy & Breast Cancer Risk

5-31-2009: Diet and Prostate Cancer Risk

5-24-2009: Diabetes, Glucose Control & Death

5-17-2009: Drug Company Marketing & Physician Prescribing Bias

5-10-2009: Hemorrhoids & Surgery

5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009: Are We Really Losing the War on Cancer?

4-19-2009:   Exercise in Middle Age & Risk of Death

4-12-2009: Can Chronic Stress Harm Your Heart?

4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009: Depression, Stress, Anger & Heart Disease

3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008:   A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:  Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:  Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:  Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:  Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:  Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:   Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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Vitamin D & Colorectal Cancer Survival

 

  

Health Report:


 

Vitamin D & Colorectal Cancer Survival

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS

Photo of Dr. Wascher

Updated:  09/20/2009

 

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

VITAMIN D & COLORECTAL CANCER SURVIVAL
 
 
Vitamin D is increasingly being looked at as a cancer prevention nutrient, as multiple prior clinical research studies have linked higher blood levels of this hormone-like vitamin, and calcium (which is regulated by Vitamin D), with a decreased risk of colon and rectal cancer, as well as other cancers.Less well understood is the role of Vitamin D as a survival factor in patients who have already been diagnosed with colorectal cancer. Now, a newly updated clinical research study from Harvard University, just published in the British Journal of Cancer, suggests that higher Vitamin D levels in colorectal cancer survivors may be associated with a significantly greater likelihood of surviving the third most common cause of cancer death in the United States.
 

The authors of this clinical research study analyzed volunteers within the massive Nurses’ Health Study. A total of 1,107 volunteers were diagnosed with colon or rectal cancer, between 1986 and 2004, after joining this long-term prospective public health study. Using a previously validated scoring system that accurately predicts Vitamin D levels in the blood, the researchers assessed the survival rates of these colorectal cancer patients as a function of their Vitamin D scores. (It is important to note that Vitamin D scores were calculated prior to the diagnosis of colorectal cancer in these patient volunteers.) The results were rather profound.
 
 
The Vitamin D scores for these 1,017 colorectal cancer patients were broken up into a five different ranges, and the patients with the highest Vitamin D scores were then compared with those in the lowest “quintile” with respect to cancer-related mortality and overall mortality. This analysis revealed that patients with the highest Vitamin D scores were 50 percent less likely to die of colorectal cancer during the course of this study, and 38 percent less likely to die from all causes, when compared to the patients with the lowest Vitamin D scores.
 
 
While the exact mechanisms whereby Vitamin D and calcium may decrease the risk of colorectal cancer, and the risk of death following a diagnosis of colorectal cancer, are still being studied, there is already intriguing data showing that Vitamin D supplementation can “up-regulate” the activity of genes in both premalignant and malignant colon and rectal tumors that, in turn, increase the death rate of the abnormal cells that make up such tumors (through a pathway known as apoptosis).
 
 
While no nutrient or medication has been shown to prevent all colorectal cancers, or to cure all colon and rectal cancers once they develop, there is an increasing amount of high-quality clinical data suggesting that higher levels of Vitamin D in the blood are associated with a decreased risk of both premalignant and malignant colon and rectal tumors. Now, based upon this new study’s results, it appears that higher Vitamin D levels may also be associated with improved survival following the diagnosis of colorectal cancer as well. The impact of Vitamin D levels on colorectal cancer survival also mirror similar findings that I have recently reported on with respect to breast cancer (Breast Cancer Recurrence, Death & Vitamin D).
 
 
Look for a much more detailed discussion of the role of Vitamin D, and other dietary and nutritional factors, in cancer prevention in my forthcoming book, “A Cancer Prevention Guide for the Human Race.”
 


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California



 

"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 
 
Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)

 


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Copyright 2007 - 2009

Robert A. Wascher, MD, FACS

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Dr. Wascher's Archives:

9-13-2009: H1N1 Swine Flu Update

9-7-2009:   Green Tea, Aging & Lifespan

8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009: Update on Prostate Cancer and Cryotherapy

8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009: Coronary Artery CT Scans & Cancer Risk

7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009: Breast Cancer & Metformin (Glucophage)

7-5-2009:   Prostate Cancer & Green Tea

6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009: Red Yeast Rice, Statins & Cholesterol

6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:   Diet, Soy & Breast Cancer Risk

5-31-2009: Diet and Prostate Cancer Risk

5-24-2009: Diabetes, Glucose Control & Death

5-17-2009: Drug Company Marketing & Physician Prescribing Bias

5-10-2009: Hemorrhoids & Surgery

5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009: Are We Really Losing the War on Cancer?

4-19-2009:   Exercise in Middle Age & Risk of Death

4-12-2009: Can Chronic Stress Harm Your Heart?

4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009: Depression, Stress, Anger & Heart Disease

3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008:   A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:  Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:  Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:  Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:  Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:  Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:   Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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H1N1 Swine Flu Update

 

 

 

Health Report:


 

H1N1 Swine Flu Update

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS


Photo of Dr. Wascher


Updated:  09/13/2009

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


  

H1N1 SWINE FLU UPDATE


Influenza is a viral disease that has vexed mankind, and other animals, for thousands of years. The earliest definitive recorded observation of influenza in humans is contained in the writings of the renowned ancient Greek physician, Hippocrates, nearly 2,500 years ago. 

Various strains of the influenza virus cause regular seasonal epidemics, or global outbreaks, which arise primarily during the fall and winter months. Because of this seasonal cycle of flu epidemics, there are generally two separate influenza epidemics each year (one in the northern hemisphere and one in the southern hemisphere). 

Periodically, “super epidemics” of influenza, called pandemics, occur, resulting in very large numbers of flu cases. Unlike the regular seasonal flu epidemics, which reliably occur every winter, influenza pandemics are often associated with especially contagious and severe strains of influenza virus, resulting in large numbers of flu-associated deaths, particularly in more vulnerable victims (i.e., the very young, the very old, and people with serious preexisting illnesses). The worst recorded influenza pandemic in recent times was the 1918 “Spanish flu pandemic,” which resulted in the death of millions of flu victims around the world. Estimates of the number of deaths associated with the 1918 flu pandemic vary widely, as many deaths associated with influenza during this pandemic, doubtless, included deaths due to causes other than influenza. Nonetheless, between 20 and 100 million people are thought to have succumbed to influenza between 1918 and 1919, which approaches the number of deaths associated the Black Death plague pandemic (1348-1350), one of the deadliest pandemics in recorded human history. While typical seasonal influenza epidemics result in several hundred thousand deaths, globally, each year, pandemic flu outbreaks are often associated with millions of deaths (although, as with seasonal flu outbreaks, the lethality of individual pandemic-associated influenza outbreaks varies from one pandemic to the next).

Annual seasonal outbreaks of influenza are characterized by dominant strains of common human flu viruses, which tend to change from one year to the next.   Influenza pandemics, however, frequently arise following the migration of new or uncommon strains of influenza viruses from animals to humans, or from human influenza viruses that acquire additional genetic material from animal strains of flu viruses.

Generally speaking, influenza is transmitted in the same manner as with other common viral respiratory infections. Viral particles adherent to respiratory secretions are primarily spread by coughing and sneezing, although flu viruses can also be spread through direct physical contact with infected secretions present on other people or on contaminated surfaces. As influenza viruses also afflict both birds and mammals, infected secretions (including feces and urine) from animals can also transmit flu viruses.  

The symptoms of influenza are well known to most of us, and typically include fever, chills, muscle aches (myalgias), fatigue, headache, coughing, sore throat, nasal congestion and drainage, loss of appetite and, less commonly, abdominal pain, nausea and vomiting. Altogether, an estimated 150 different viruses are known to cause respiratory infections and flu-like syndromes in humans. However, infection with true influenza viruses commonly leads to more severe bouts of illness than is seen with most non-influenza viral infections.

Each year, public health experts try to predict which strains of flu virus will most likely predominate during the following year’s flu season, and three or more strains of influenza virus are selected to be included in the following year’s influenza vaccination. Occasionally, these educated guesses turn out to be inaccurate, and the resulting flu vaccine may therefore be relatively ineffective in a given year. However, annual influenza vaccinations are generally credited with dramatically reducing the incidence and severity of flu outbreaks in heavily vaccinated populations. (Since different strains of influenza predominate every year, seasonal flu vaccines must be updated every single year.) 

Although antibiotics are ineffective against viruses, including influenza, there are several antiviral agents that are available as treatment for severe cases of influenza infection, particularly in patients with other serious and chronic health conditions or risk factors. However, while these antiviral agents can reduce the severity and duration of infections with influenza viruses, they are not able to complete eradicate the flu virus, as antibiotics do with bacterial infections. Importantly, most antiviral medications have to be given very early in the course of influenza infection (typically, within the first 48 hours after the onset of symptoms) in order to be maximally effective. In some selected cases, physicians may also recommend the use of antiviral medications in very high-risk patients as a flu prevention measure.

In April of 2009, a new strain of influenza first appeared in rural areas of Mexico. Because this particular strain of flu virus contains genetic material found in strains of influenza that commonly infect pigs, this new H1N1 influenza virus quickly became known as the “swine flu.” By June of 2009, the World Health Organization had already declared the H1N1 swine flu virus to be a pandemic virus, based upon its very rapid spread throughout the world. 

According to the Centers for Disease Control’s (CDC) latest weekly flu update, more than 98 percent of current active influenza infections in the United States are being caused by the H1N1 swine flu virus. While most public health authorities are predicting a surge in the incidence of H1N1 swine flu infections during the upcoming fall and winter months, it is very important to note that, based upon clinical data acquired since the initial outbreak of this strain of influenza in Mexico, the health effects of the swine flu virus appear to be very similar to those observed with typical seasonal influenza viral infections. Just as with typical seasonal influenza epidemics, approximately 70 percent H1N1 swine flu patients who require hospitalization, due to severe flu infections, have one or more of the following associated high-risk medical conditions: age less than 5 years or greater than 64 years, pregnancy, chronic lung disease (including asthma and emphysema), heart disease, kidney disease, certain blood disorders (including sickle cell anemia), diabetes, immune system suppression (including HIV infection), certain neurologic or muscular disorders, and morbid obesity.   Additionally, it should be noted that children and teens who are taking aspirin are at increased risk of acquiring a life-threatening complication of influenza infection known as Reye’s syndrome. (Once again, these same risk factors apply to typical seasonal flu outbreaks, as well.)

At the present time, a vaccine against H1N1 swine flu is in production. Although the release date for this vaccine (which will be given in addition to the usual annual flu season vaccine) has not yet been announced, public health experts hope to have the new vaccine available at about the same time as for the annual flu season vaccine. Meanwhile, the CDC recommends several simple but important steps to reduce your risk of infection: (1) cover your nose and mouth with a tissue whenever you cough or sneeze; (2) wash your hands with soap and warm water frequently, especially after coughing or sneezing; (3) avoid touching your eyes, nose, or mouth with your fingers; and (4) stay home from school or work if you develop flu-like symptoms.

Finally, I want to stress, once again, that the available clinical evidence, thus far, suggests that the H1N1 swine flu behaves, basically, like the more typical seasonal flu viruses that occur each and every year throughout the world. Be sure to take prudent measures to reduce your risk of contracting or spreading the H1N1 influenza virus, as I have outlined above. If you believe that you, or someone in your family, might have contracted the flu, then please do not delay seeing your physician, especially if any high-risk health factors are also present. When the H1N1 and annual flu season influenza vaccines become available, please also make sure that you receive both of these vaccines promptly.
 


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity



Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California


"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)


Send your feedback to Dr. Wascher at:  

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved



Dr. Wascher's Archives:

9-7-2009: Green Tea, Aging & Lifespan

8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009: Update on Prostate Cancer and Cryotherapy

8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009: Coronary Artery CT Scans & Cancer Risk

7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009: Breast Cancer & Metformin (Glucophage)

7-5-2009:   Prostate Cancer & Green Tea

6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009: Red Yeast Rice, Statins & Cholesterol

6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:   Diet, Soy & Breast Cancer Risk

5-31-2009: Diet and Prostate Cancer Risk

5-24-2009: Diabetes, Glucose Control & Death

5-17-2009: Drug Company Marketing & Physician Prescribing Bias

5-10-2009: Hemorrhoids & Surgery

5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009: Are We Really Losing the War on Cancer?

4-19-2009:   Exercise in Middle Age & Risk of Death

4-12-2009: Can Chronic Stress Harm Your Heart?

4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009: Depression, Stress, Anger & Heart Disease

3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008:   A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:  Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:  Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:  Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:  Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:  Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:   Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


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Green Tea, Aging & Lifespan

 

 

 

Health Report:


 

Green Tea, Aging & Lifespan

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS
 
Photo of Dr. Wascher

Updated:  09/07/2009


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

 

 

GREEN TEA, AGING & LIFESPAN


Many health claims have been made for green tea, and as with the vast majority of over-hyped fad foods and nutritional supplements, the majority of such claims will, inevitably, turn out to be overstated or false. However, recent and ongoing clinical research continues to suggest that, at least in the laboratory environment, key chemical components of green tea (catechins) may indeed have potentially beneficial health properties. Specifically, research in the areas of cardiovascular health and cancer prevention have suggested that green tea catechins might actually be able to decrease the risk of these two top killers, although, in the interest of remaining objective, not all research in these areas has been uniformly favorable.


Now, a newly published public health study of elderly Chinese adults suggests that increased green tea intake, at least in elderly Chinese men, may be associated with a potential increase in lifespan. In this epidemiological study, just published in the British Journal of Nutrition, a total of 976 men and 1,030 women aged 65 and older were initially evaluated in 2006. In addition to daily food intake questionnaires, the blood of these research volunteers was tested for telomere length, in an effort to identify any dietary or other lifestyle factors that might be associated with lifespan-lengthening preservation of telomere length.


Telomeres can be thought of as protective “caps” at the ends of every chromosome in our body. With every division of the cells of our body, small pieces of our telomeres are lost.  After a certain number of cell divisions, our cells lose their protective telomeres and die. This cumulative process of telomere loss and cell death (senescence), over the course of our lives, is thought to directly determine the potential lifespan of humans and other creatures, and has also been implicated in the process whereby many cancer cells become “immortalized.” In addition to aging (due to cumulative telomere loss with each cell division), inflammation and other biochemical stresses (including increased dietary fat intake) on our bodies can also prematurely shorten the length of telomeres in our cells, resulting in a shortened lifespan and an increased risk of developing cancer (and, perhaps, an increased risk of cardiovascular disease as well). Interestingly, the rate of telomere loss appears to be more rapid in men, and this is thought to be one of the most important biological factors underlying the generally shorter lifespan of men, compared to women.


Scientists can actually roughly estimate a person’s age by measuring the length of telomeres in their blood cells. Moreover, variations in telomere length between individuals can also be used as a rough guide to potential differences in lifespan between such individuals. In this innovative public health study, differences in telomere length among the 2,006 elderly research volunteers participating in this study were then matched to variations in the diets and lifestyles of these Chinese patients.


After adjusting for other health, lifestyle, and nutritional factors known to be associated with telomere length, the scientists conducting this study determined that a high level of green tea consumption was associated with longer telomeres in elderly Chinese men. After measuring the average difference in telomere length between men who consumed the most green tea and those who consumed the least, the researchers calculated a potential lifespan difference of 5 year between these two groups of men (the effects of green tea length on telomere length in the elderly Chinese women was less significant in this study, however). The researchers also determined that increased dietary fat and oil intake was also associated with a decrease in the length of telomeres in women (as has been noted in both men and women in previous studies, particularly in association with meat intake).


Therefore, in summary, the frequent consumption of green tea appears to be linked with longer telomere length, at least in elderly Chinese men. This finding suggests that, on average, such men may be approximately 5 years “younger,” physiologically speaking, than their same-aged counterparts who rarely drink green tea! 


This study, unfortunately, did not identify the same telomere protective effect for green tea in elderly Chinese women, although this finding does not exclude the possibility that women may also derive similar benefit from regular green tea consumption.  As it is already known that males lose telomere length more rapidly than females over the course of their lives, the gender-based differences in telomere length preservation observed in this study may arise from green tea catechins’ reversal of male-specific causes of increased telomere shortening, although this has not yet been scientifically confirmed. (I should also add that Vitamin D, which has recently gained a great deal of research attention in the areas of cardiovascular disease and cancer, as well, has also been associated with telomere length preservation.)


I will delve much more deeply into the potential cancer prevention roles of green tea catechins and Vitamin D in my new book, “A Cancer Prevention Guide for the Human Race,” which is due to be published in early 2010.
 
 

Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California


"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 
 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)

 

 



Send your feedback to Dr. Wascher at:
 

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


 

Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

All rights reserved


Dr. Wascher's Archives:

8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009: Update on Prostate Cancer and Cryotherapy

8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009: Coronary Artery CT Scans & Cancer Risk

7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009: Breast Cancer & Metformin (Glucophage)

7-5-2009:   Prostate Cancer & Green Tea

6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009: Red Yeast Rice, Statins & Cholesterol

6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:   Diet, Soy & Breast Cancer Risk

5-31-2009: Diet and Prostate Cancer Risk

5-24-2009: Diabetes, Glucose Control & Death

5-17-2009: Drug Company Marketing & Physician Prescribing Bias

5-10-2009: Hemorrhoids & Surgery

5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009: Are We Really Losing the War on Cancer?

4-19-2009:   Exercise in Middle Age & Risk of Death

4-12-2009: Can Chronic Stress Harm Your Heart?

4-5-2009:  Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009: Depression, Stress, Anger & Heart Disease

3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008:   A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:  Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:  Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:  Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:  Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:  Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:   Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Dr. Wascher's Home Page


Email ItEmail It | Print ItPrint It | CommentsComments (0) | TrackbacksTrackbacks (0) | Flag as offensiveFlag as Offensive

Irritable Bowel Syndrome (IBS), Diet & Fiber

 

 

 

 

Health Report:


 

Irritable Bowel Syndrome (IBS), Diet & Fiber

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS
 
Photo of Dr. Wascher
 

Updated:  08/30/2009


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


 

 

 

IRRITABLE BOWEL SYNDROME (IBS), DIET & FIBER

 

An estimated 10 to 20 percent of the population suffers from a complex of gastrointestinal symptoms that are collectively referred to as irritable bowel syndrome (IBS). Irritable bowel syndrome affects women three times more commonly than men, and has historically been considered a “wastebasket” diagnosis for patients with functional gastrointestinal (GI) complaints when no other specific diagnosis can be found. 
 
 
While the precise mechanisms underlying IBS are not well understood at this time, various theories have been proposed. These include abnormal responses to infections of the GI tract, abnormal hormonal and neurologic function of the intestines, hypersensitivity to certain types of foods, abnormal motility of the colon, a “hyper-awareness” of bodily functions, and certain psychiatric conditions, in addition to other hypotheses. (It is almost certain, however, that there is more than one cause for IBS.)
 
 
There are a variety of symptoms that have been associated with IBS, and the incidence, severity and frequency of each of these symptoms varies considerably from one IBS patient to another. Typically, however, IBS-associated symptoms include bloating, crampy abdominal pain, diarrhea alternating with periods of constipation, and the passage of clear or white mucus from the rectum. In many cases, IBS symptoms are more pronounced after eating, and patients with IBS often experience a powerful urge to move their bowels after meals. IBS symptoms are also more frequent and more severe during times of stress. In women with IBS, these distressing symptoms may become more intense around the time of patients’ menstrual periods. Other symptoms that have been commonly observed in patients with IBS include frequent heartburn, nausea and vomiting.
 
 
Because the true causes of IBS are poorly understood, there have been a wide range of treatments recommended for this syndrome. For example, exercise and other stress-reducing activities may be helpful for some IBS sufferers. Giving up tobacco, and reducing or eliminating alcohol consumption may also help to reduce IBS symptoms, while promoting improved overall health at the same time. Keeping a food diary can also help to identify foods that tend to provoke or worsen IBS symptoms in many patients. Finally, dietary fiber supplementation has been almost universally advocated by most IBS experts. Unfortunately, these and other recommended treatments for IBS are often ineffective in reducing the troubling GI symptoms of irritable bowel syndrome for many patients. Moreover, there have been only a handful of small, prospective, randomized clinical research studies, to date, looking at dietary interventions for IBS. Now, a newly published prospective, randomized, placebo-controlled fiber supplement study offers some helpful new clinical data regarding the treatment of IBS, and this data offers some hope for IBS sufferers. 
 
 
This new clinical study, just published in the British Medical Journal, enrolled 275 adult patients with IBS. Patients were then randomized to one of three different groups within this study. A control group was given rice flour, which is a starch and contains no significant fiber. A second group of patients were given supplements of indigestible (insoluble) fiber in the form of bran. The third group received digestible (soluble) supplementation with psyllium powder (Metamucil). The type of supplement received by each patient wasn’t revealed until the end of the study.
 
 
Following 12 weeks of fiber (or placebo) treatment, the participants in this study were reassessed for the severity of their symptoms. Among the three treatment groups in this IBS fiber supplementation study, only supplementation with psyllium significantly improved IBS-related symptoms. When compared to the placebo group, IBS patients who had been randomized to receive psyllium were 22 percent more likely to report improved IBS symptoms. In comparison, there was no statistically significant improvement in IBS symptoms with bran fiber supplementation when compared to placebo, and, in fact, many IBS patients in this group actually dropped out of this clinical study because their IBS symptoms worsened while taking bran fiber supplements.
 
 
It should be noted there were two significant limitations of this study. First of all, nearly 40 percent of the patients who volunteered for this trial dropped out prematurely. However, this is a rather common phenomenon in clinical studies where the treatments are unpleasant, or when the response to such treatments is not immediate or dramatic. A second limitation is that, despite the researchers’ efforts to “blind” the patients as to which supplement they were actually receiving, three-fourths of the patients were still able to accurately guess the supplement that they had been randomized to receive. This finding, of course, introduces the possibility of bias in the perceptions and responses of these patients at the conclusion of the study.  Moreover, to complicate matters further, and as prior studies have also shown, 35 percent of the control group of patients also reported an improvement in their IBS symptoms with a placebo supplement.
 
 
While there are significant limitations inherent in this study, it still represents one of only a very few existing prospective, randomized, placebo-controlled clinical research studies of fiber supplementation as a treatment for IBS. Based upon the findings of this study, despite its limitations, dietary supplementation with soluble (digestible) fiber appears to be a prudent and potentially helpful intervention for patients suffering from IBS-related symptoms; while insoluble (indigestible) fiber supplements, like bran, may actually worsen the symptoms of IBS.
 



Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California


 

"A Cancer Prevention Guide for the Human Race"

(Anticipated Publication Date:  March 2010)
 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)

 



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Dr. Wascher's Biography


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Copyright 2007 - 2009

  

Robert A. Wascher, MD, FACS

  

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Dr. Wascher's Archives:

8-23-2009: Update on Prostate Cancer and Cryotherapy

8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009: Coronary Artery CT Scans & Cancer Risk

7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009: Breast Cancer & Metformin (Glucophage)

7-5-2009:   Prostate Cancer & Green Tea

6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009: Red Yeast Rice, Statins & Cholesterol

6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:   Diet, Soy & Breast Cancer Risk

5-31-2009: Diet and Prostate Cancer Risk

5-24-2009: Diabetes, Glucose Control & Death

5-17-2009: Drug Company Marketing & Physician Prescribing Bias

5-10-2009: Hemorrhoids & Surgery

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4-26-2009: Are We Really Losing the War on Cancer?

4-19-2009:   Exercise in Middle Age & Risk of Death

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4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?

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3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008:   A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:  Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:  Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:  Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:  Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:  Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:   Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

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5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

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12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


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