Two Critical Matters in Colorectal Cancer Early Detection

By Hui Xie-Zukauskas

Time for cancer screening_Clipart library & CPDAccording to the American Cancer Society (ACS), an estimated 135,430 cases of colorectal cancer (CRC) will be diagnosed and an estimated 50,260 CRC deaths will occur in 2017 in the United States.

Zeroing in on the numbers: within the predicted colorectal cancer incidence, 71,420 will be men and 64,010 will be women, and deaths will be 27,150 among men and 23,110 among women. Consequently in cancer deaths, CRC is the second leading cause in men and the third leading cause in women among Americans. Worldwide, CRC is the third most common cancer.

These numbers make clear that CRC affects both men and women, in contrast to a myth that CRC is primarily a man’s cancer.

The good news is that most colon cancers are preventable! YES!

Yet, why are the statistics so large? Here are two areas many people often ignore or miss:

  •  Lack of adherence to the screening recommendation
  •  Delay in presenting symptoms to a physician/oncologist

Let me weigh in a bit more on each of these issues.

Adherence to screening and the value of colonoscopy

Let’s start with ACS screening guidelines: “Starting at age 50, men and women at average risk for developing colorectal cancer should use one of the screening tests…” This is because about more than 90% of this disease is diagnosed after age 50. For individuals who have a 1st degree family member or relative with colon cancer, exams should start at an earlier age (e.g. ages 40).

One recommended screening test is colonoscopy, because it can not only detect cancers at their earliest, most treatable stages; it can also detect pre-cancerous polyps that can be removed during the exam before they become cancerous.

In reality, 50-60 percent of Americans who are recommended to get screened comply with the guidance. The lower screening rate might partially explain why only about 40 percent of colon cancers are diagnosed at an early stage (i.e. localized in colon or rectum).

Why should you go for a colonoscopy screening?

  1. You gain significant value. Your anxiety, fear, or even feelings of embarrassment may be understandable. However, consider this: Individuals undergo this exam of high quality under a comfortable, sedated condition, during which the entire colon and rectum are visualized by a qualified gastroenterologist. Pre-cancerous polyps can be found and removed safely. Can you see that this is a very valuable package of diagnosis and therapeutics for your colon health care? 
  2. You acquire rigorous clarity concerning your colon health. We want rigorous clarity in science, and surely, everyone wants thorough clarity when purchasing a house or insurance policy. It makes sense to seek rigorous clarity about a matter so critical to your health. If the result is normal, the colonoscopy should be repeated every 10 years up to the age of 75. If the test detects pre-cancerous polyps, the physician will recommend repeating the exam more frequently.
  3. You benefit from one of the most effective cancer prevention methods, and it is often covered by insurance.

Help your physician to help you by presenting any indications

In some cases, especially at an early stage, colon cancer may present no symptoms. Again, that’s why screening is vital to identify cancer early when prognosis and cure are optimistic.

Nevertheless, other folks may experience symptoms such as:

-          Blood in the stool or rectal bleeding

-          Abdominal pain or discomfort

-          Feeling the bowel incompletely empty, or bloating

-          Sudden changes in bowel habits (diarrhea, constipation, or oddly narrow stools)

-          Unexplained fatigue or weakness

-          Unexplained weight loss

Remember, nobody can read what’s on your mind or what’s going on in your life. If you don’t visit or communicate with your doctor, it’s likely he or she won’t know about your cramps or unexplained changes in your bowel movements.

So, devoting yourself to meeting screening guidelines is a key preventive measure, but another critical area is to counsel with your physician about possible warning signs.

In addition, an important step to preventing colorectal cancer is to know its risk factors. These factors can be categorized as:

-          Uncontrolled: age, colon polyps, family or personal history of cancer, esp. CRC

-          Pathological: obesity, diabetes, inflammatory bowel diseases

-          Controllable or Preventable: sedentary lifestyle, tobacco smoking, heavy alcohol consumption, diet with low-fiber but high-fat (esp. animal fats)

To conclude, for colorectal cancer early detection, as for all cancer risks:

#1 Cancer screening is your first crucial preventive step.

#2 Recognizing risk factors and warning signs is your second vital protective weapon.

Image credit: Clipart library & CPD

22 Proactive Things You Can Do on World Cancer Day and Beyond

By Hui Xie-Zukauskas

Mid_Blue Globe Bkg. Red Ribbon for WCDFebruary 4th each year is designated as World Cancer Day. This day is significant because it

  • kicks off a drive to expand awareness of cancer and its prevention;
  • offers a chance to discover risk factors for cancer and take protective measures;
  • provides a time to reflect on what you can do to make a difference in the fight against cancer;
  • embraces people around the globe to fulfill whatever needs to be done to control this deadly disease; and
  • presents an opportunity to spread a message – We Can Save Millions of People from Preventable Deaths Each Year!

Lifestyle-centered cancer prevention is evidence-based and it’s science. It’s no longer a theory or hypothesis, or breaking news. Healthy lifestyle measures provide powerful ways to lower the risk for many types of cancer.

The theme of World Cancer Day for the current three years (2016-2018) is “We Can. I Can.” Surely, each of us can do something, no matter how small. So, I have compiled a list of actions you can take for World Cancer Day and every day after:

  1. Set a “Cancer Patients First” agenda: Whether from a note, gift, prayer, or—best of all—a visit, let your friend battling cancer know you are with him or her in this fight.
  2. Pack a tool kit for cancer awareness or a thoughtful kit for cancer care.
  3. Remind your loved one to get a cancer screening. Early detection saves lives.
  4. Change one unhealthy behavior, e.g., harmful sun exposure, intentional tanning, alcohol abuse, or tobacco smoking (smokeless tobacco causes cancer too). Importantly, stay on the right course.
  5. Do something about early childhood weight management, especially control obesity in childhood cancer survivors.  Unhealthy behaviors and overweight that develop early in life and persist over time can increase not only the risk for some types of cancer but also cancer-related mortality.
  6. Host a Veggies/Vegetarian party or gathering (the size doesn’t matter).  Alternatively, go on a Mediterranean diet. The point is to replace Western diet components, which are rich in refined grains, animal fats, excessive sugar, and processed meat but poor in fruits, vegetables, legumes, and whole wheat or whole grains. A substantial body of evidence has linked the Mediterranean diet to increased cardiovascular benefits and prevention of some chronic diseases.
  7. Make a “Cancer Prevention” family dinner, or make a “Cancer Prevention Salad.”  Family meals can be a cost-effective intervention for weight management. Evidence suggests that regular family meals protect against unhealthy eating and obesity in children. If time or schedule is challenging, get your teens and/or other family members involved.
  8. Start or improve your weight management plan and actions. Make sure to have a balanced diet and exercise regime.
  9. Enjoy an “Exercise Day” or “Move Day,” and at least, consider taking a 30-minute walk.
  10. Take a “NO JUNK FOOD Day,” and limit red meats. Then do it often.
  11. Drink filtered tap water at home. Drink plenty of filtered water away from home too.
  12. Drink tea to replace sugar-rich beverages.
  13. Better: Have a “Triple Combat” day, by combining three intensive but joyful actions together.
  14. Give your unexplained pain some TLC by paying attention to it, tracking its duration, frequency or pattern, and scheduling a visit to your doctor.
  15. Give cancer caregivers a token of love to honor their labor of love.
  16. Write or speak to your local/national legislator or lawmaker about a policy idea to make food systems safer or make the environment safer.
  17. Speak out or stand up against any external source that potentially promotes cancer.
  18. Volunteer for a cancer fundraising or a cancer care center.
  19. Support the great cause of fighting cancer in any form you can.
  20. Parents and teachers: Advise your girls and boys to vaccinate against HPV. Recommended vaccination starts at age 11 or 12.
  21. Go along with proven strategies to prevent cardiovascular disease (CVD). Why?  Because doing whatever is practical or plausible to lower your risk of CVD will enhance your potential to reduce the risk of cancer. For instance, research findings indicate that proven preventive measures for CVD are identical to preventive actions for prostate cancer.
  22. Take pancreatic cancer seriously. Based on the proposed “pancreatic injury−inflammation−cancer” pathway, it’s critical to avoid risk factors such as smoking, chronic pancreatitis, diabetes, and obesity.   Pancreatic cancer remains a complex, lethal malignancy with the worst prognosis, and a lack of early diagnostic symptoms. It’s also resistant to conventional chemo- and radiation therapies. The rate of its incidence is slowly increasing.

The list can go on and on…

By now, you likely see a clearly centered theme—prevention, which is the most cost-effective implement to fight cancer.

Remember: Cancer doesn’t develop overnight. It’s vitally essential to stick to a healthy lifestyle. Take protective measures such as enjoying a balanced diet, regular physical activity, and a healthy weight now and far beyond World Cancer Day.

And yes, every single small step counts! It’s a life-course approach.

 

Image credit: Designer at <a href=”http://www.freepik.com/free-photos-vectors/medical”>Medical vector designed by Ibrandify – Freepik.com</a>

Rethink Powerful Strategies for Cancer Prevention in 2017

By Hui Xie-Zukauskas

LoveHope 2017_Std.The holiday season is over and the new year started. Many of you probably have set some exciting goals or resolutions already. In reality, early or later, some folks would probably fall “off the wagon”? How would you do differently?

CancerPreventionDaily has provided plenty of practical advice, resources, and useful links on powerful strategies for cancer prevention over the years. Instead of reiterating those strategies here, I’d like to highlight a tool of “RETHINK”.

First, let’s cherish HOPE by celebrating recent scientific and medical advances in cancer treatment! Cancer Immunotherapy has been put on the spotlight – a therapy based on the principle of unleashing the body’s immune system to attack cancer. In addition, remarkable advances in other therapies (e.g. chemotherapy, targeted therapy, surgery and radiation therapy) all improved clinical outcomes, especially lives of people battling cancers.

Equally significant is advance in cancer prevention, specifically, HPV vaccine. As the human papillomavirus (HPV) is the major cause of cervical cancer – infected by passing the virus during sex, and the disease is preventable.

Now let me dive in a bit deeper on “Rethink”.

Consider Uber or Zipcar. Whether through Uber (providing you with a car and a driver) or Zipcar (providing you with a car), you can reach your desired destinies – a different approach from using traditional or old fashion rental cars. Note: These are good examples of innovation or rethinking, not paid Ads! :)

Next, how to rethink with regard to health?

Take weight loss as an example. Maintaining a healthy weight is one of the top powerful strategies for cancer prevention, as scientific evidence clearly indicate that obesity is a risk factor for several types of cancer in both men and women, needless to say risk for diabetes and heart disease.

Many folks are struggling with losing weight for various reasons. If one lesson we can learn from “Santa” to apply here, it is to lighten our load.

So, get motivated, get rid of all unhealthy baggage in all possible ways – dispose of fats, throw away junk foods, abandon extra sugar and extra salt, dispense or burn off some calories, thereby getting rid of “unwanted” pounds, consequently you will reach your goal of weight management. Certainly, you can discover creative ways that work best for you along the journey.

Rethink about cancer and prevention: Instead of fearing “Big C”, treat it as a life or health project with “small pieces”. This is because cancer is the mass (of tissues) on the surface but a collection of complex and multiple diseases in the hub, therefore, you need to tackle it with multiple approaches from genetic medicine, lifestyle to environment and early detection.

So, you got the idea.

In summary –

Rethink, Re-envision, Re-tweet, Re-evaluate and/or Re-calibrate, whatever works for you, so that you gain new perspectives and new approaches, which will help your new year’s resolutions stick, and reap your health benefits in the long run.

May more happiness and better health be all of yours throughout the year 2017!

 

Image credit: mozakdesign.com and CancerPreventionDaily

A Year End Note: Let Bundle of Love and Ray of Hope Continue

By Hui Xie-Zukauskas

A Year End NoteAs we approach the New Year, thank you for your time, reading, likes, comments and feedback in this past year!

I reach out to you because many of you are healthy but fearful of getting cancer, some folks survive cancer, while some are struggling with cancer or other chronic illnesses now.

At the beginning of 2016, one New Year’s resolution from CancerPreventionDaily.com was to bring a theme of love and hope for cancer prevention and care. Throughout the year, the site delivered this theme by serving you with knowledge and solutions for cancer prevention. Here are highlighted areas of the posts:

  • Steered self-care and preventive measures in the ways that foster your well-being from the cells to the whole body and lifestyle choices, from kids to seniors and all ages.
  • Updated serious epidemic and environmental factors.
  • Facilitated clinical care, primarily patient safety and engagement.

Many cancers are preventable; and there are so many things we can do to prevent cancer. Start within.

Let bundle of love and ray of hope carry on in 2017 and future!

The Power of Participation in Patient Surveys

By Hui Xie-Zukauskas

Survey-Feedback_CPD w-otherAfter a trip to the doctor, you or a family member may be requested to fill in a “patient satisfaction survey” or “patient experience survey.” Many folks, questioning what difference it would make whether they complete the survey or not, simply ignore it, as if there were more urgent issues in life at the moment. Sound familiar?

In a recent post, I talked about the issue of improving patient safety and quality of care. Well, participating in a patient experience survey is a key part of that issue. Here, I’m going to dive in a little deeper.

First, let’s start with difference between a “patient satisfaction survey” and a “patient experience survey”

Though wordings of the two are similar, a careful assessment reveals striking differences. Understanding these differences can help you collaborate with your providers effectively.

The essential difference between the two is that a patient satisfaction survey concentrates on making patients happy, while a patient experience survey focuses on making people well – beyond making them happy!

A patient satisfaction survey reflects perceptions or preferences of quality of care received, so it’s more subjective. In contrast, a patient experience survey exposes what happened during the care, so is more objective.

Experience reporting is a more reliable instrument because it tells about the patient’s actual experience of a specific service, clinician, or hospital incident. Questions are designed to be more meaningful to patients and more measurable for providers’ care, and the answers can be transformed into actions.

On the other hand, a satisfaction rating is merely a judgment on meeting one’s expectations. As you can understand, people’s expectations vary, and what matters to one person is different for another.

Take a particular example of waiting time:

When asked “How satisfied are you with the waiting time for your appointment” (e.g. setting up time for your visit, finally seeing your doctor), the results from a satisfaction survey could range from excellent through good, fair, and finally poor.

But in a patient experience survey, when asked “How long did you wait for an appointment when you needed care”, the choices are more concrete (e.g., 1 day, 2-3 days, 4-7 days, or longer than 7 days). To the question “How long did you wait to see your doctor”, the answers are specific (e.g., 15 minutes, 15-30 minutes, 30 minutes or longer).

In sum, to steer towards patient-centered care, it is better to ask patients to report their real experience rather than to put down their satisfaction ratings.

Next, how do patients benefit from patient experience surveys?

Patient experience is important because it not only stimulates a strong patient-provider relationship but also is a critical step toward improving quality of care.

In particular,

  1. Patient experience surveys communicate the best way to improve quality of care. Research indicates that improving patient satisfaction has not been linked to improving quality of care.
  2. Emphasizing patient experience means putting patients first, with healthcare providers being concerned more about “what matters to you” rather than “how are we doing”.
  3. Patient experience surveys value patients’ voices. With your voice, an actionable change can begin because your input reveals key indicators for delivering quality of care.

Eventually, greater patient experience will lead to greater quality of care, which will translate into greater patient satisfaction.

Good news for cancer patients ! – CAHPS for Cancer Care

The Agency for Healthcare Research and Quality (AHRQ) has advanced Consumer Assessment of Healthcare Providers and Systems (CAHPS®) to assess quality of care from the patient’s point of view in various healthcare settings.

CAHPS for Cancer Care has been developed by AHRQ to consistently measure and compare cancer care delivered by different providers and ultimately to provide information for quality improvement. CAHPS for Cancer Care includes three separate sets of questionnaires for surgical, radiation, and medical oncology respectively.

Although CAHPS® is the best tool for healthcare providers, patient engagement and participation are important parts of the process. More reasons for this survey, according to Dr. Caren Ginsberg, director of CAHPS® at AHRQ are:

  • CAHPS surveys are featured to capture information about patient experience rather than patient satisfaction;
  • The surveys are scientifically and statistically sound, thus the results are valid and reliable;
  • CAHPS is flexible to use and easily incorporated into any hospital existing surveys. 

Overall, CAHPS® also serves as a massive database that offer measurable and actionable information, as the surveys have been implemented for over 20 years.

How can you participate and cooperate?

As a final point, remember: one survey cannot change health care or save a life, but it represents one voice and constitutes a worthy part of a large set of valuable data. So, when requested next time, please complete the survey (via innovative technology, direct mail, or telephone), because your voice will be heard, and you can help improve healthcare and save lives!

 

Image credit: http://earlylearningwa.org/ and http://knswb.org.au/

Work Together to Reduce Errors in Cancer Diagnosis

By Hui Xie-Zukauskas

Patient engage comm._CPDHave you or your family member ever gotten a wrong diagnosis from your doctor? Have you heard that a doctor treated your friend for a disease or disorder that he/she actually didn’t have? “It is likely that most of us will experience at least one diagnostic error in our lifetime, sometimes with devastating consequences,” according to the experts on diagnostic safety.

Imagine you were diagnosed with breast cancer and went through cancer treatment, then found out the diagnosis was wrong and the treatment should never have happened. That could spell enormous damage from one diagnostic error!

Cancer diagnostic errors can be the most harmful and costly type of diagnostic errors in various ways. As many cancers are complex and multifaceted, a timely and accurate diagnosis for cancer is still often challenging. That adds weight to preventing cancer altogether and urgency to detecting cancer early.

That’s why I bring your attention to this issue: A diagnosis is something that’s done for a patient (you) and the patient (you) needs to be a part of the team in that process.

1.      Basics and facts

What is a “diagnostic error”?

The Institute of Medicine (IOM) defines a diagnostic error as the failure to:

a. Establish an accurate and timely explanation of the patient’s health problem(s); or

b. Communicate that explanation to the patient. 

What is the reality?

40,000 – 80,000 deaths each year are due to diagnostic errors, as reports vary. However, national diagnostic safety experts, Drs. Graber and Schiff, emphasize that the frequency of diagnostic error is in the range of 10%.

Does it sound like misdiagnosis happens far more frequently than you thought?

2.      When does diagnostic error occur and who may be involved?

No doubt, human factors contribute to diagnosis errors. Studies have reported that communication problems are the most frequent root cause of serious events threatening patient safety. Today’s health-care systems are transforming toward not only integrated care practice but also enhanced patient engagement, to this end, everyone is involved.

Let me bring cancer diagnosis to the forefront. A delayed cancer diagnosis may occur at various stages of the journey to fight cancer. It could be a delay in:

  • symptom recognition or interpretation,
  • decision or action to seek medical attention (e.g., putting off making an appointment due to fear or feeling embarrassed),
  • a care system’s scheduling (e.g., not being seen by a doctor in a timely fashion),
  • clinical tests or subsequent consultations, or
  • receiving cancer treatment.

In addition, putting off doing anything might simply be due to lack of insurance coverage.

Here is the key point: Delayed cancer diagnosis at an early stage may leave the cancer to progress or spread, leading to limited treatment options. Thus, a delay in cancer diagnosis can have devastating consequences, including poor clinical outcomes and a lower chance of survival.

3.      How can you help reduce or prevent diagnostic errors?

Here are 15 things you can do to enhance your communication with your doctor, medical care team, and health care system.

1)      Prepare for your visit: know or collect your medical records, medications, and family history.

2)      Remember your screenings and, importantly, follow up. Having a separate calendar can assist your memory.

3)      Always bring a list of questions or at least your top three questions when visiting your physician.

In case you don’t know where to start, Agency for Healthcare Research & Quality provides a list of questions to ask your doctor. You can also generate your own list using their Question Builder. It’s a fantastic tool!

4)      Bring your spouse or a family member to your doctor visit to facilitate communication and/or fill in missing information that might help with diagnosis or treatment.

5)      Use technology (e.g., a smartphone) to record the conversation or instructions.

6)      Feel free to ask the doctor to clarify terminology or procedure. If you don’t understand why a particular question is relevant to your situation, ask about it or let a family member do so.

7)      If you have a limited English proficiency, make sure you have a family member or a friend act as a translator.

8)      Participate in a patient experience survey to improve patient safety and care.

9)      Get involved in facilitating the chain of communication—e.g., in scheduling appointments, visits, follow-ups, and even questioning an insurance billing if you don’t understand it.

10)  Don’t self-diagnose, especially based on online information from an unreliable source.

11)  Do keep a diary or inventory of your symptoms for better recollections when needed.

12)  Seek a second opinion or multiple consultations on cancer diagnosis when in doubt or if necessary. The second opinion must be an expert’s one. Be proactive.

For example, if you have a lump in your breast but get a normal mammogram—after all, mammograms pick up only 80-90% of breast cancer. So, for your safety, you should ask for further screening, e.g., a breast ultrasound (sonogram) or even a test with a higher sensitivity like magnetic resonance image (MRI) to ensure accuracy if your physician doesn’t order such tests.

13)  If diagnosed with cancer, follow up vigorously and treat any referrals to specialists, tests, or care with urgency.

14)  Further the discussion about potentially discrepant diagnosis or different finding.

15)  When you have unintentional weight loss or unexplained pain, take it seriously and see your doctor.

One more point – Misdiagnosis may not be discovered for years if ever in some cases. That’s why I cannot emphasize enough how prevention and early diagnosis of cancer offer clear and significant benefits, especially concerning common cancers (the breast, prostate, colon, lung, and skin cancer).

Although I talked more about cancer, these principles can be applied to any other illnesses. And I’ll elaborate with more details in near the future. Stay tuned.

Finally, your take-home message: Actively engage in your health care!

Improving diagnosis for patient safety and for better health care is a responsibility of each of us. Doing that can alone save many lives.

 

Never Miss a Chance to Protect Children from Cancer

By Hui Xie-Zukauskas

Cancer Boy w-Ribbon_uthscsa.eduImagine that a tiny, precious life with a bright future was taken away by cancer, the “big C”… Nothing is more devastating than that.

That’s why I’m going to focus on what we can do about childhood cancers, so to prevent the worst loss by all means.

First, what exactly causes childhood cancers remains unclear. Risk factors of childhood cancers are different from those in adult cancers. For instance, lifestyle-related risk factors (such as tobacco smoking, alcohol intake, unhealthy diet, and sun overexposure) do not play a significant role in childhood cancers. Environmental factors have little influence, largely due to the lack of direct exposure of the fetus. Most childhood cancers result from genetic mutations, i.e. genetic errors occur randomly and unpredictably whether it’s inherited or acquired.

So, am I suggesting that there is nothing we can do to prevent childhood cancers or protect our children? No.

If you are not well-informed, you may miss a chance to prevent the unthinkable. Here is an example. Human papillomavirus (HPV) infection is linked to cancers of cervix, oropharynx, rectum, or at other body locations. Nearly 93% cancer due to HPV-infection could have been prevented with recommended HPV vaccine as routine immunization for adolescent girls and boys starting at ages 11 to 12 years, following specific guidelines.

Can you see how one could miss the chance by doing nothing? Let me expand a little more on preventative measures.

1.      Childhood cancer prevention can start before conception in young women.

The mother-to-be’s well-being has an impact on the babies. For example, a pregnant, smoking mom can affect the offspring’s health in a hazardous way. To say the least, alcohol consumption and drug abuse fall into the same category. To minimize a child’s risk of cancer, young women should stay healthy and fit, and avoid or limit the exposure to toxic chemicals and environmental pollutants in daily life. Detect cancer early by genetic testing or genetic consulting, especially when you have a history of familial cancers.

2.      Cancer prevention with a healthy lifestyle should begin early in childhood.

A lifestyle cannot be developed overnight. Lifestyle factors also take years or decades to influence a cancer risk. Fostering a lifestyle with nutrition-rich diet, regular exercises, and healthy weight from a young age forward can greatly lower the risk of several cancers in adults, as accumulating evidence shows. Childhood obesity prevention can produce considerable health benefits. Also, postpone the time for kids to use cell phone or mobile devices to prevent brain tumor, the leading cancer death in children. Growing studies reveal an association of radiation with pediatric brain tumors, especially when young kids have the thinner skulls, with still developing nervous system and brain.

3.      A long-term protection: prevent secondary cancer after childhood cancer.

Cancer treatment like radiation can harm young kids’ organs or tissues because of their vulnerability and developmental stages. Radiation or chemo therapies for childhood cancers increase a risk for secondary cancer as one ages. Particularly common are tumors of the brain, breast, skin or spine, and bones. The higher doses of radiation, the greater risk these individuals have. So, it’s important to detect cancer early in the population of childhood cancer survivors, and make sure they have regular visits or check-ups, in addition to living a healthy lifestyle.

Let me conclude with the Quote from Elizabeth Barrett Browning: Light tomorrow with today.All said and done, apply these outlined approaches today to protect every child, so that each child has a healthier, happier, and brighter life tomorrow.

 

Image credit: uthscsa.edu and CPD

5 Reasons for a Higher Awareness of Zika

By Hui Xie-Zukauskas

Zika_Pt.2_CPDZika virus continuously poses a public health threat in the U.S.. Since my last post “Zika Virus Infection and Cancer Care Indication”, as of August 24th, 29 people in Florida have been infected with Zika virus through local mosquito transmission, along with 2,487 travel-related cases across the country, according to the CDC.

This is a more alarming reality than that presented three months ago when all 544 Zika cases in the U.S. were travel-related. Regions along the Gulf Coast are at an elevated risk for Zika outbreak, especially Louisiana, because of recent devastating flooding.

Pregnant women are particularly vulnerable to the Zika crisis. Of importance is to avoid traveling to Zika outbreak areas and stay self-protected to prevent mosquito bites. I won’t get into details here because plenty of information or guidance is available elsewhere.

Based on some new research and clinical findings, I’d like to emphasize FIVE reasons why we need a higher alert and responsiveness to Zika infection. Here goes:

1.      There are various ways for Zika virus transmission.

A person who has acquired the Zika infection could pass virus along through mosquito bites, maternal-fetal and/or sexual transmission. Unmistakably, blood transfusion also becomes a major concern as Zika-positive blood donation is evident. That’s why the FDA recently recommended nationwide screening of blood donations for Zika virus. Thank about it – why is it necessary to run such a costly and time-consuming testing for a massive blood donation system? Remember that people infected with Zika virus could be symptomless.

2.      Zika virus can damage not only a baby’s brain but also an adult’s brain cells.

Painful scan images have shown that Zika infects a fetus, causes brain calcification, and destroys a baby’s brain. Severe brain damage may bring about long-term developmental problems or neurological complications affecting vision, movement and epilepsy. On the other hand, new research reveals that Zika virus impacts a different area of adult mice’s brain, such as a specific neural cell, and it could affect long-term memory in some adults.

3.      Zika virus affects the immune response, particularly in those whose immune system has been compromised due to a chronic disease or cancer therapy.

Infections by viruses can suppress the immune system. Moreover, a person’s inflammatory response to mosquito bites may augment the severity of arbovirus infection (e.g. Zika). Studies suggest that mosquito bites, especially in individuals hypersensitive to mosquito bites, may be linked to cancer development through activating cancer cellular pathways by mosquito-feeding, and/or through influencing human metabolic pathways leading to the initiation of cancer.

4.      It’s challenging to control mosquitoes.

Mosquito population is measured in the millions, and usually in the hundreds of millions. There is no way to distinguish Zika-infected mosquitoes from the rest uninfected. It’s virtually impossible to eradicate them all. But it doesn’t mean we should give up our effort.

Aerial spraying and backpack fogging carried out by the professionals can help reduce mosquito populations in epidemic areas. There are also effect measures that individual citizens can take right at home or the backyard with little or no cost. For instance, the best ways to control local mosquito population is to eliminate the places where mosquitoes breed, such as water-filled buckets, flowerpots, containers, puddles or pools of standing water outdoors.

Using pesticides to kill mosquitoes is delicate. Be cautious about unintended consequence, because pesticides often contain some toxic chemicals that can be harmful to human health if inhaled or ingested. 

5.      Finally, keep in mind those young women whose newborns suffering from microcephaly, neurological abnormalities and birth defects. What would their hardship be? – raising their ill babies, caring for the infants with various disabilities, and likely dealing with their own stress, anxiety, depression or quality of life.

 

Image credit: physio-pedia.com and CPD

How Can Climate Change Impact Cancer Risk

By Hui Xie-Zukauskas

Climate change & Cancer_CPD comboMuch of the talk lately is about a heat wave. “Are you cooked?” “Are you baked?”

Yes, massive, harsh and dangerous heat waves that hit most regions of the country are certainly unwelcomed, and unexpected in its increasing intensity, frequency and duration. Sure, mother nature is something to blame, but climate change and consequential global warming cannot be ignored. Particularly, I’m going to weigh in an issue seemingly less visible yet closely related.

Global warming is no longer a theory or myth, rather a reality. Just look around – those extreme weather cases, more wildfires, more rainfalls and floods, especially the worst, deadly flooding in West Virginia in 1,000 years. A warming planet undoubtedly plays a role.

As an alarming and disturbing note, climate change posts the biggest threat to public health in the 21st century (Castello et al., Lancet 2009). Solid science has told us so. Now, a more specific question should be addressed – Is there a connection between climate change and cancer development? If so, how? My focus here is to explain how climate change affects a risk for cancer, directly and indirectly, in FIVE ways.

  1. Increased our exposure to toxic chemicals by heavy and long-lasting rainfalls or floods: Global warming followed by excessive rainfalls wash toxic chemicals into water and surrounding communities. Then what? Think about smoking. A cigarette releases plentiful chemicals (>7000); out of them about 70 are carcinogens (i.e. cancer-causing substances). These harmful agents damage almost every organ in the body by causing genetic or DNA mutation, leading to the development of cancer.
  2. More intensified exposure to toxins by higher temperature: Heat itself can make toxic chemicals either more poisonous or unstable with unpredictable fallouts.
  3. More bacterial growth driven by a warmer or higher temperature: Bacteria have been attributing to cancer through inducing chronic inflammation and generating bacterial metabolites as carcinogenic end-products.
  4. Increased diffusion of UV radiation by depleting stratospheric ozone (i.e. “good ozone”): As you know, the overexposure to UV radiation causes skin cancer. Noticeably, UV radiation also suppresses some aspects of immunity, as a result, weakening your defense against cancer.
  5. Reduced air quality we breathe by producing ground-level ozone (i.e. “bad ozone”): Increasing evidence suggests considerable or long-term exposure to air pollutants may lead to lung diseases, such as lung cancer and chronic obstructive pulmonary disease (COPD), though it’s not conclusive.

In addition, chronic exposure to air pollutants associated with global warming causes an increase in oxidative stress and inflammation that contribute to cancer. Research findings also reveal that sensitive individuals and vulnerable populations such as children and the elderly are more susceptible to air pollution related illness because of potential genetic predisposition.

So, collectively, climate change can impact cancer risk, cancer development, and for sure, cancer care. Any misconception of global warming is relatively naïve and potentially dangerous.

Climate change is largely man-made, which is beyond the scope of this article. However, it is clear that we must take responsibility to safeguard a healthy environment, because a healthy environment supports healthy living for each and every one of us.

 

Image credits: www.freeimages.com/; www.medicinenet.com/

Men’s Health Month Ends BUT Men’s Health Challenges Persist

By Hui Xie-Zukauskas

Happy father and son isolated on white backgroundA lot of men are “pull yourself up by your bootstraps” kind of guys and believe they can fix anything by themselves. This is true many times in life. But when it comes to health conditions, it could be a dangerous misconception.

Today, I’m going to highlight how men’s masculinity or “toughness” and emotional restraint may impede them from seeking medical or professional help, consequently having a negative or even grave effect on their health.

The Cover-Ups & Attitude

Sometimes, those “annoying” symptoms (e.g., snoring, bad breath, enlarged prostate, and unexplained weight gain or loss) show up and even persist; but a lot of guys would rather tough it out or put off a visit to the doctor with various excuses. I get that. But do you know – a quiet health crisis may be underway?

How about in the workplace? Masculinity may influence workplace health and safety particularly in male-dominated skilled trades as injured workers return to work too early and “tough” workers then reinforce dominant masculine norms. Results of a joint study from the University of Toronto showed, “A desire to be viewed as a strong, responsible, resilient worker may intersect with concerns about job loss, to influence participants’ decisions to not report safety issues and workplace accidents, to not disclose post-injury work challenges, and to not request workplace supports” (Stergiou-Kita et al., Work; 2016). Certainly, institutional identification and practices play a role too.

How about social or psychosocial beliefs? Some folks believe that cancer will inevitably lead to death (so-called cancer fatalism). A study by Mitchell et al. (Res. Aging; 2016) reported that among 1,666 African American males enrolled in Medicare, 76.5% felt helpless, 44.2% confused, and 40.7% pessimistic about the ability to prevent cancer. Despite a couple of limitations, the study reveals a challenging factor for cancer prevention and screening detection. Important to note, although African American males remain at greatest risk for dying from prostate, colorectal, and lung cancers compared to men of other races, early detection and treatment save lives.

The Facts & Evidence

Men are more vulnerable to various disorders at all ages across the lifespan. Also, men’s average life expectancy stays largely behind that of women’s. Primary physical health risks that are leading causes of death or are burdens for men include cardiovascular diseases (heart disease and stroke), cancer (especially prostate and lung cancer), diabetes, depression, and suicide. Fortunately, many of the top causes of death are preventable and can be treated, if found early.

Finally, here is a list of Strategic Actions you or your loved ones can take for men’s health:

  • Check out critical numbers such as blood pressure, blood cholesterol, and blood sugar; keep them in normal ranges.
  • Schedule recommended screenings for prostate and colon cancer, and a routine testicle exam.
  • Schedule a routine medical care or physical examination.
  • Ladies, accompany your man to his doctor visit. This can be a great help with eliminating potential communication barrier(s) to disclosing a real problem or filling in a missing note.
  • Keep mentally active; for example, take new classes, play brain games, or learn something new.
  • Forge a close relationship with a circle of friends.
  • Never ignore some seemingly common symptoms such as snoring, bad breath, and enlarged prostate. Take note of it. If the problem persists, consult your physician to rule out any medical conditions.
  • Consult professional help if you (or your man) have symptoms of depression.

In summary, to prevent a quiet health crisis in men, we all need to step in by advancing men’s mental health, strengthening men’s workplace safety, and caring about men’s overall well-being, in addition to monitoring men’s physical health.

Saving His life—men’s lives—is one of the best things to do throughout the year!

Image credit: www.communitycarechemist.com.au/category/mens-health