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January 31st, 2011

How to reduce your risk of bowel cancer

For obvious reasons, no one likes to discuss or even think about bowel cancer, but the uncomfortable reality is that colo-rectal cancer (a “nicer” sounding label, I guess) is the overall 2nd leading cause of death from cancer in North America, so whether you like it or not, you have to think about it, especially as you get older since advancing age is the leading risk factor for bowel cancer in most people.

And the good thing you have to keep telling yourself is that bowel cancer doesn’t have to take nearly as many lives as it does.

First, of course, bowel cancer is – luckily – easily detectable in most cases at an early stage in individuals who get appropriate and regular bowel cancer screening tests, such as stool tests for occult bleeding or colonoscopies, and everyone should – must - familiarize themselves with the recommendations about when to start getting those tests and how often to get them, especially as you head north (or is that south) of 50.

But just as important, and this is what should get the attention of younger readers, bowel cancer seems to be highly preventable.

For example, according to a large study from Denmark which followed over 55000 men and women for over 10 years and which was published online in the BMJ, the researchers concluded that roughly 25 % of bowel cancers could be prevented if people followed a healthier lifestyle, meaning – yes, you guessed right, the same-old, same-old, namely, not smoking, not drinking too much alcohol, eating a good diet, maintaining a healthy weight, and doing some regular exercise (roughly 30 minutes a day for most days of the week).

It’s easy to do if you set your mind to doing it, and hey, it has a good chance of saving your life.

I’m Dr Art Hister

January 27th, 2011

Money can cause cancer

If you’re really worried about the latest trendy health concern, the chemical BPA, which is found ubiquitously in plastic products, even (gulp!) drinking cups and which has been accused of causing cancer and many other bad things, there’s a new worry for you to take into account, and I do mean account.

According to a group called the Washington Toxics Coalition (WTC), BPA can wipe onto your hands from receipts used by “95 % of stores” and BPA can even yikes! wash onto your hands from that holy of holies, the American dollar bill.

In fact, this group tested both cash receipts and money from varying retailers and found BPA on nearly all money and receipts in “very large quantities”, and here`s the part to make you really nervous: the BPA-slathered receipts and especially the BPA-covered money transferred BPA very easily to the hands of the people holding those products.

In other words, like my socialist friends have long said, money can cause cancer, folks, so as a humanitarian gesture, hey, I`m willing to take all your cash off your hands.

And best of all, I won’t even send you a receipt for the funds.

I’m Dr Art Hister

January 24th, 2011

The Potential Benefits of Taking ASA Regularly

In a review from the University of Oxford which was published in the online edition of the Lancet, the researchers claim that after looking at 5 studies that have stretched over 20 years now, they’re able to conclude that people who take ASA regularly have a 24 % lower risk of ending up with colon cancer.

Even better, they also concluded that people who use ASA regularly have a 35 % lower risk of dying from colon cancer than people who don’t use ASA regularly.

In other words, regular use of ASA not only lowers the risk of cancer, but even more important, seems to lower the risk of aggressive cancers, which are, after all, the ones you most want to prevent.

That doesn’t detract, however, from the potential risks of taking ASA, which are substantial, although for many people, especially those at highest risk of bowel cancer, the benefits of taking ASA regularly probably out-weigh the risks, and it’s certainly something that most people should discuss with their family doctor.

I’m Dr Art Hister

January 21st, 2011

Emerging therapies for a serious infection

The problem of Chlostridium difficile infection is very worrying to public health experts (and to anyone who monitors disease trends, not to mention to those who have to actually treat real patients) because this very serious infection is increasing quite dramatically, especially in some high-risk populations (the elderly, patients hospitalized with serious health problems, but even “normal” people in the community) for whom these infections can be deadly.

And we don’t really have great treatments for this problem.

So, it’s interesting to make note of two poster presentations at the 2010 annual meeting of the American College of Gastroenterology.

In one presentation, the researchers claim that curcumin, the active ingredient in the spice turmeric, "inhibited the growth of various strains of C.difficile" in the lab, meaning perhaps that if hospitals – or even individuals – prepared more meals with curry, we might be able to lower our risk of serious infection, especially at periods of high-risk, such as when we have to take powerful antibiotics.

Even if hospitals don’t adopt this strategy, it’s certainly something that individuals can do for themselves.

The self-treatment that you don’t want to try on your own involved (according to 3 studies presented at that meeting) the transplantation of feces from a healthy donor to one infected with C. difficile, a tactic that presumably leads to healthy bacterial growth in the new host, which all the studies agreed, was a useful therapeutic tactic.

I’m Dr Art Hister

January 20th, 2011

Compelling evidence for mandatory PE classes

A study from Sweden presented at the 2010 annual meeting of the American Society for Bone and Mineral Research showed pretty clearly why kids need to jump and play, and why schools are the perfect places to provide relief from study, study, study, study - especially via the easy route of mandatory PE classes.

In this compelling study comparing one school where kids (ages 7-8) got a mandatory 200 minutes a week of "playing" activities – jumping, skipping, running, etc – to a school where it was left to individual teachers to do as they pleased, when the kids were evaluated some years later, the “mandatory PE” kids had better bone density and had had significantly fewer fractures, a benefit that would undoubtedly follow them well into their adult years, although that certainly needs to be followed up with another study.

As the lead researcher said, and this should be underlined for all parents, teachers, school administrators, some of whom dismiss the importance of physical exercise during school hours, "there is no downside to physical activity".

On the other hand, there is clearly a terrific potential upside to more PE classes, even for the teachers who lead the classes as they would also benefit by doing PE activities with the kids.

I’m Dr Art Hister

January 18th, 2011

A cautionary study about anti-inflammatory drugs

A study out today in the BMJ, in which researchers analyzed 31 other studies involving the regular use of non-steroidal anti-inflammatory drugs (NSAIDs), those ubiquitous products like naproxen and ibuprofen (but lots of others, too, including some available only by prescription such as Celebrex), concluded that anyone using these drugs regularly for a long time has an increased risk of heart attack and stroke.

In fact, equally alarmingly, the regular long-term use of these drugs was also linked to a higher overall risk of death.

The overall raised risk of heart attack and stroke (and death) on these drugs is slight, but still, the bottom line is that, anyone using an NSAID long-term, even a so-called safer 2nd generation one like Celebrex is at slightly higher risk of suffering a major adverse event.

Now, there are lots of good reasons to use these drugs long-term – some people can’t seem to manage their pain without them.

But lots of people use these drugs in situations where there is scant evidence they do much or in which there are better alternatives – long-term osteoarthritis is a good example – and such people need to ask themselves if this raised risk of adverse events, small though it is, is worth the price of taking these drugs.

I’m Dr Art Hister

January 14th, 2011

Teens consume a terrific amount of sugar

According to a survey just published in the journal, Circulation, teens in the US (and presumably it’s the same here in Canada) consume an amazing 28 teaspoons of sugar per day, and since that’s just an average, we can figure out that lots of teens eat way more sugar than that.

This sugar high adds, the researchers say, 476 calories per day to the average teen’s diet and accounts for over 21 % of the average teen’s daily caloric intake, and again, since those are just averages, clearly lots of teens get hundreds more calories a day from sugar sources (and this is not just plain old sugar – the kind of stuff we add to coffee, etc. - but these days, a lot of that sugar intake is from those ubiquitous and unavoidable “corn” solids that seems to be added to everything to sweeten the products.

That’s bad enough but alarmingly, the teens with the highest sugar intake also had the lowest HDL and highest LDL levels (something that last year the same researchers showed in another study was true in adults, too) , and although there was no way in this study to determine if sugar intake alone was enough to adversely influence cholesterol levels (in other words, sugar intake may just be a marker for other unhealthy habits which are the ones directly responsible for lowering HDL and raising LDL), it’s still safe to say that we were never designed to consume that amount of sweetener so it couldn’t be doing us – and our teens – any good.

And most worrisome, the negative influence of sugar intake was worst in the heaviest kids, and given that our kids are gaining weight at a rapid rate, this bodes very poorly for those teens health as they hit their adult years.

I’m Dr Art Hister

January 13th, 2011

Testosterone levels and what they mean for the average Joe

It’s long been believed that high testosterone levels predispose men to premature mortality, which is one of the major concerns about using testosterone replacement therapy in men, but according to a study published in the journal, Heart, the opposite may be true as well, namely that testosterone levels that are “too low” may also lead to an earlier death.

In this study of 930 men with pre-existing heart disease who were followed for 7 subsequent years, one-quarter of the men started out with “low testosterone levels”, and of those men, roughly 20 % died over the next 7 years, as opposed to only 12 % of the men with “normal testosterone levels”, ergo, low testosterone may predispose to an earlier death.

Does that mean that men with low levels of testosterone would very likely benefit from some testosterone replacement?

As usual, the definitive answer is “maybe”.

For a start, we just don’t know nearly as much as we need to know about what “normal” and “low” means when it comes to testosterone measurement, and there are a host of ever-changeable factors – and probably a host that we don’t yet know – that can throw those levels off, so I’m always leery about studies that involve “low” testosterone levels.

It’s also very possible that “low” testosterone levels may just be a marker for something else going on in that guy that predisposed him to an earlier death, so treating only the testosterone level wouldn’t do any good.

I’m Dr Art Hister

January 12th, 2011

Cash for Calories

Here’s a really easy way to get people to eat more healthy diets: don’t allow them to pay for their food with credit cards or debit cards, but make them use cash instead.

In a study of 1000 American households that were monitored for over 6 months (and which was published in the Journal of Consumer Research), the authors found that when the householders were using only cash to pay for their purchases, they were much less likely to make impulse buys, and everyone knows what happens when we let our impulses go at the check-out counter: it’s not tofu and tuna that make it into our carts but rather, toffee and Twinkies.

In other words, a good part of the solution to our obesity woes may lie in simply restricting the manner in which we’re allowed to pay for what we want, but given that in a free society (and even one that’s not-so-free) that kind of restriction will never come into being, an easier thing to do is to carry only cash when visiting the food market.

Or the restaurant. Or the bar.

Chances are you will make much better choices at all those locales.

I’m Dr Art Hister

January 11th, 2011

Spare brain capacity

It’s a very medical maxim that if you don’t use it, you lose it, and that applies to every area of the body, from the southerly parts in both genders, albeit more obviously in men than in women, but also perhaps most tellingly, in the most northerly parts, that is, the brain so that the more brain function you set up and develop, the more likely it is that you will suffer less from dementia and Alzheimer’s disease than someone who hasn’t used their brain as much, such as politicians, of course.

So it should be no surprise to many of you that according to a recent Canadian study published in the journal Neurology, people who are bilingual tend to get Alzheimer’s later in life than do people who do not develop a facility with une autre langue.

Using a 2nd language means that you build up, these researchers believe, what is called cognitive reserve, sort of spare brain capacity, so that even though your brain may be deteriorating, when you have extra capacity, you don`t show the signs of cognitive decline as quickly.

In other words, like what good make-up does for bad skin, excess brain capacity does for a failing brain so you can hide your failing brain for a longer time than someone who doesn’t have that spare capacity.

I’m Dr Art Hister

January 10th, 2011

Sports injuries are rising in kids

According to several surveys, more and more kids are suffering significant sports injuries, and although the vast majority of those mishaps are not serious, according to a report from the National (US) Athletic Trainers’ Association, 48 kids died in the US last year as a direct result of a sports injury, and 63,000 kids suffer a brain injury every year from playing sports.

Happily, most of those brain injuries don’t produce a long-term consequence but the problem is that some of them do, and unfortunately, there are simply no very good and easy-to-learn guidelines about which “minor” injuries may result in long-term problems.

This is an especially important consideration for coaches and parents to take into account so the bottom line is that any child who suffers a head injury should not be allowed to return to that sport until he or she has been given the all-clear by an objective third party, which should be a health professional.

Simply asking a kid to tell you how he or she feels is not a good enough guideline to follow.

I’m Dr Art Hister

January 7th, 2011

A pretty controversial study about lung cancer screening

A provocative study about lung cancer screening was terminated before its end date because the expert panel overseeing the study concluded that the results were clear cut: screening for lung cancer can reduce the risk of dying from that malignancy.

In this study, over 50,000 heavy smokers who’d been smoking for many years were screened 3 years in a row with a spiral CT examination, and then they and the un-screened placebo group were followed or another 5 years.

Results were impressive: screened people had a 20 % lower risk of dying from lung cancer in that time compared to those who weren’t screened, presumably because the spiral CTs picked up small and more readily treated cancers, and they were also 7 % less likely to die from any cause (that one is hard to explain). Spiral CT screening clearly saves smokers’ lives. So where’s the controversy?

Where to start?

Although it involves less radiation than a normal CT scan, a spiral CT scan still involves SOME radiation. Second, at what age do you start screening smokers?

Ad how much do they have to be smoking, and for how long should they have been smoking, for the benefits of this test to set in?

These are very important considerations since this is an expensive screening test, and given the number of smokers out there, it’s going to cost everyone a ton of money is this screening method becomes widely used.

Also, some people worry that if there’s a screening test that seems to offer a lower risk of dying from lung cancer, some smokers may use that as an excuse to avoid quitting smoking.

There’s also this: as with all screening tests, spiral CT scans also produce false positives (and in this instance, that rate seems to be substantial), a change, something, that resembles cancer on the CT scan but which turns out to be non-malignant, which not only necessitates further investigation (biopsies, for example, which can result in infections and other complications) and of course, needless worry until the results are in.

All in all, then, still lots to work out on this one.

I’m Dr Art Hister

January 6th, 2011

Male Siblings

In a study from the University of Western Australia, researchers studied nearly 300 people between the ages of 18 and 75, and concluded that women who had an older brother tended to start menstruating a lot later – about a year later on average – than women who did not have an older brother.

Not only that, but girls whose only sibling was a younger brother were a stunning 2 years older on average when they had their first sexual experience than girls who didn’t have younger male siblings.

So how do you explain this rather large difference in these two standards of sexual maturation between girls who have brothers and girls who don’t?

Pretty easy, if you ask me: clearly, any young girl who has had to live with a male sibling – whether he’s older or, especially if he’s a younger sib – will do anything she can not to have anything more to do with any other members of the male gender for as long as possible.

I’m Dr Art Hister

January 5th, 2011

Hope is not always helpful

You know how everyone always tells you that you gotta hope, if you give up hope, you’re going to do worse than if you keep hoping things will turn out.

Well, according to a study from the University of Michigan, having hope isn’t always a good thing.

In fact, in this study of people undergoing colostomies – surgery that creates an opening in the colon and the abdomen to collect stool - those people who accepted that the colostomy was final and irreversible did better than those who were told that they might be able to get the colostomy reversed, presumably because the former were able to accept their condition and move on, while the latter kept hoping – without much reason in most cases - that things weren’t as final as they turned out to be.

Sometimes, it seems, you just gotta face reality and move on, which is why, after 40 years of hoping and hoping and hoping, you might consider abandoning the Canucks and rooting for the Red Wings instead.

I’m Dr Art Hister