Posts Tagged ‘program’

Ovarian Cancer: Know your body, know your risk

“There is no effective surveillance technique for the detection of early stage ovarian cancer, so the only effective way to prevent it and save lives is to identify women at risk,” said David A. Fishman, MD, Director of the Mount Sinai Ovarian Cancer Risk Assessment Program and Professor and Fellowship Director in the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Medicine at the Icahn School of Medicine at Mount Sinai.

He recommends that women with a family history of ovarian and breast cancers get a formal genetic evaluation by a board-certified genetic counselor. For women who have tested positive for a BRCA mutation or are identified to be at a high risk for developing ovarian cancer, preventive surgery should be considered to remove the ovaries and fallopian tubes before ovarian cancer can develop.

Facts About Ovarian Cancer

• About 75 percent of women with ovarian cancer are diagnosed with late-stage disease. Only 15-40 percent of women survive for five years after initial aggressive cytoreductive surgery that is performed to remove cancerous tissue from the abdominal cavity in combination with chemotherapy.

• Almost 90 percent of women who are diagnosed while the disease is still confined to the ovary (stage I) survive for five years. They also require less surgical intervention, may not require chemotherapy and have a better quality of life.

• After removal of the ovaries and fallopian tubes, the risk of developing ovarian cancer is close to zero and the incidence of peritoneal cancer is about 1 percent.

Tips for Ovarian Cancer Prevention

• Family and personal history is important to identify women at increased risk: At least 10 percent of ovarian cancers are attributed to the inheritance of genetic mutations (such as BRCA, HNPCC) that increase the risk of certain cancers (breast, colon, endometrial, thyroid, and melanoma). If you have a history of these cancers in your family (either in men or women), get your risk assessed for ovarian cancer by a board certified genetic counselor.

• Take oral contraceptives: Long term use of oral contraceptives reduces the risk of developing ovarian cancer by approximately 50 percent.

• Pay attention to symptoms: Swollen or bloated abdomen; pressure or pain in abdomen, pelvis, back or legs; difficulty eating or feeling full quickly; nausea, indigestion, gas constipation or diarrhea; feel tired; urinary symptoms; and unusual vaginal bleeding.

New Treatment

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is an innovative technique being used by Dr. David Fishman and other oncologists at The Mount Sinai Hospital to treat ovarian cancer in women undergoing cytoreductive surgery. The HIPEC treatment combines cytoreductive surgery with a chemotherapy “bath” that delivers heated chemo directly into the abdomen cavity for two hours. The chemo “bath” then penetrates the diseased tissue, directly killing any remaining cancer cells in the area, destroying undetected cancer cells and preventing them from forming into new tumor while having minimal exposure to the rest of the body.

source : http://www.sciencedaily.com/releases/2014/08/140825185323.htm

Women with severe, chronic health issues are screened for breast cancer less often

They are also screened less often than women with moderate disabilities or women with only one chronic condition, according to Dr. Sara Guilcher, an affiliate scientist with the Li Ka Shing Knowledge Institute of St. Michael’s Hospital.

Dr. Guilcher said women with disabilities often have other measures of social vulnerability, such as low income and low education levels.

Her research, published in the journal Preventive Medicine, is consistent with other studies showing that low income and education were also associated with lower breast cancer screening rates. Previous research has also shown that having a certain level of disability is associated with higher breast cancer screening rates, perhaps because those women have more frequent contact with the health care system.

However, in contrast to previous research, this study identified higher screening rates for women with moderate disabilities compared to those with severe disabilities — who also have greater contact with physicians than other women with no disabilities.

“Despite the presence of a universal health insurance system in Ontario, our research highlights the persistence of significant health disparities in breast cancer screening, particularly for women who are more vulnerable due to severe disability, multiple chronic conditions, low income and lower education,” said Dr. Guilcher, who has a PhD in Clinical Epidemiology at the Institute of Health Policy, Management and Evaluation, University of Toronto.

The highest rate of screening was 75 per cent, which was among women with moderate level of disability and one chronic condition. Women with severe disability, across levels of chronic conditions, had the lowest rate of breast cancer screening at 61 per cent. Women with two or more chronic conditions were screened particularly less often.

“Women who are at a lower socioeconomic position may be less likely to be assertive and to be strong advocates for their health care management,” said Dr. Guilcher.

Dr. Guilcher noted that in Ontario, women can refer themselves to the Ontario Breast Screening Program, which sends them reminders of when they are due for mammograms and can provide results at the same time the test is done. Further research could explore the demographics of the women who enrol in this program, she said.

Dr. Guilcher said that worldwide, breast cancer is the most prevalent cancer among women and the second leading cause of cancer-related deaths. Deaths have significantly dropped due to advances in prevention and treatment. In Ontario, mortality rates fell 37 per cent for women between the ages of 50 and 74 between 1990 and 2009.

source : http://www.sciencedaily.com/releases/2014/08/140822124641.htm

Should you add enzyme supplements to your shopping list? Expert explains pros, cons

What’s the issue?

Dr. Bauer: “They’ve become so popular. Like so many dietary supplements, patients are looking for something to help their health, so they’re reading about over-the-counter enzymes as one of those many dietary supplements, and all of a sudden we’re seeing sales go through the roof. A huge challenge with dietary supplements is that most haven’t been tested as most drugs are. We have a lot of information, but we don’t have definitive information. So our patients hear a lot of positive things, but they do not always hear the negatives or the side effects. So we’re trying to be very evidence-based. We don’t want to say no, there’s no reason to ever take an over-the-counter enzyme. By the same token, we don’t want to just rush out and buy it because we heard somebody say something positive on TV.”

What are some of the reasons people take enzyme supplements?

Dr. Bauer: “We have a lot of natural enzymes in our bodies. They help us digest food. There are clearly medical reasons to use enzymes. If a patient’s pancreas isn’t working, for example, that patient may need to take a medically prescribed enzyme supplement. That’s a little different story from a healthy person who wants to use over-the-counter bromelain, or papain — the enzymes that come from the pineapple and the papaya — or trypsin, or chymotrypsin. The reasons people might use those center around digestion: Maybe they’re getting older, they’re having more gas and bloating, so they think if they take an enzyme it will help their digestion. There are also some anti-inflammatory effects, so some people will use those enzymes to try to reduce inflammation, maybe help with osteoarthritis. And there’s a long history of these being used as anti-cancer agents. The challenge from a physician standpoint is that the evidence for each of those is pretty limited. We just don’t have the data to say, `No, it doesn’t work. Yes, it does work.’ We’re stuck.”

What if I want to try over-the-counter enzymes? Are there any side effects?

Dr. Bauer: “Fortunately, for most over-the-counter enzymes, unless you’re taking super-high doses, the risks are pretty minimal. Some people get gastrointestinal upset or some irritation. So I’ll have that conversation with my patients: If they want to try enzymes, I want them to understand the risks, the potential benefits, the limited amount of evidence. And then if we’re going to use it, I try to do it in a short trial period, use it for two or three weeks. If you notice a big improvement, it doesn’t mean it works, but it means maybe for you it’s something you might want to continue with. If it’s not working, don’t just keep taking more and hoping for something magical to happen.”

Is there anyone who shouldn’t take these?

Dr. Bauer: “Bromelain, the enzyme from the pineapple, may have anti-platelet activity. So for people taking blood thinners or who have anti-platelet activity, theoretically there could be increased risk of bleeding. For children with cystic fibrosis, there have been a couple of bad adverse reactions where those taking prescription enzymes can get a bad colon disorder called fibrosing colonopathy.”

How can consumers judge advertising claims?

“If you look at some of the bold headlines on dietary supplements — ‘Use our enzymes, we can help prevent cancer’ — there’s probably a grain of truth in a lot of the advertising, but it’s hyped and it’s made to sound unbelievably good. As soon as you hear that type of hype, those types of overblown promises, it’s time to step back and say `Wait a minute, what am I investing my money in?’ And then it’s a good time to do a little research, then it’s even a better time to go and talk to your physician and ask whether there are any risks and any interactions with the medications you are taking.”

source : http://www.sciencedaily.com/releases/2014/08/140804095748.htm