Category Archives: Cancer Prevention

Beyond Colon Cancer: The Hidden Cancers Threatening Young Lives

By Hui Xie-Zukauskas

Lower Cancer Risk_Sm_for LIIn recent years, there has been a concerning rise in cancer incidence and mortality among individuals aged 15–39. Notably, colorectal cancer (CRC) has shown an uptick in cases among those under 50, both in the US and globally. This underscores the urgent need for preventive measures to mitigate cancer risks and elevate awareness.

While it might be perplexing to see the unexpected rise in cancer among the younger population, considering that traditionally cancer primarily affects older adults, the reasons behind this trend are complex and fascinating. Let’s delve into this in simpler terms.

Cancer is caused by mutation, i.e., a permanent change in the DNA sequence of an organism. Mutations can result from damage to DNA and errors in DNA repair.

Imagine DNA as a blueprint for building a magnificent LEGO castle. Each LEGO brick represents a specific unit of DNA called a “base pair”. DNA damage is like the LEGO bricks get chipped or break due to various factors, DNA repair by enzymes works as repair crews identify damaged bricks and replace them with new ones. When the damage is too severe or the repair crew is overwhelmed, the building plan (DNA) can be disrupted and structural crises in the castle (cell malfunctions) take place.

We know that most of cancer risk in aging adults can be attributed to randomly acquired mutations in proliferating tissues or susceptible cell types. In contrast, cancers in younger individuals result from the presence of genetic predisposition or the exposure to carcinogens (cancer-causing agents) or both, which all impact DNA damage and repair, genomic integrity, and then accelerate cancer growth in a young body.

To illustrate further, its origins have three key elements: inherited genetic predisposition, environmental carcinogens (including cancer-causing viruses), and developmental mutations—the latter can vary greatly depending on mutational rates in various cell types. Importantly, the interplay between each element and among these factors can also contribute to the variation in cancer risk among different cells, tissues and age groups.

Colon cancer is not the only type of cancer with a high prevalence in young people. Other cancers include:

  • oropharyngeal cancers (more in adolescent and young cancer survivors),
  • breast cancer,
  • cervical cancer,
  • skin cancer, melanoma and
  • pancreatic cancer – its genomic feature distinctly involves the well-known tumor genes (including breast cancer’s BRCA1 and BRCA2).

I’d like to highlight some harmful environmental factors more relevant to young people, and mostly also apply to a broader population.

  • Traumatic brain injury (resulting from car accidents, sports, falls, bast injuries but leading to long-term chronic neuro-inflammation in the brain and link to CNS tumors)
  • Oncogenic pathogens or carcinogenic viruses – such as Infections by the human papilloma virus (HPV), causing cervical and oropharynx cancers; Infections by the Epstein-Barr virus (EBV), causing lymphomas and nasopharyngeal cancer; Merkel cell polyomavirus, causing Merkel cell carcinomas; Human T-cell lymphotropic virus, causing leukemias; and Fusobacterium, associated with colorectal cancer.
  • Hazard environmental exposures – Sunlight/UV damage, causing skin cancer; air-borne radon or tobacco smoke, or air-borne asbestos, causing lung cancer.
  • E-cigarettes – potential risk for oral cancer
  • Food-borne pre-carcinogens and/or carcinogens: generated by chemical or physical food processing, including N-nitroso compounds (NOCs), polycyclic aromatic hydrocarbons (PAHs), heterocyclic aromatic amines (HCAs), and acrylamide. Moreover, some fungi- and plant-derived substances pose a cancerous potential. Their mechanisms of action and relevance to human biology can be classified as either genotoxic (DNA-reactive) or epigenetic (effects other than DNA reactivity).

It’s essential to remember that adolescents and young adults diagnosed with cancer face a risk for early death. This risk, influenced by factors such as age at diagnosis, race, ethnicity, lower socioeconomic status and cancer type, is multifaced and requires adequate healthcare with careful monitoring.

Next, let’s move to colon cancer, especially early-onset CRC, with an emphasis on risk factors.

Modifiable risk factors

These include obesity, type-2 diabetes, heavy sugar and red meat diet, physical inactivity, smoking, high alcohol consumption, inflammatory bowel disease (IBD), and frequent antibiotic use.

Non-modifiable risk factors

Particularly for early-onset CRC, being male, black or Asian, having IBD, or a family history of CRC are among non-modifiable risks.

Based on recent scientific evidence, early-onset CRC is associated with a genetic predisposition, mainly attributed to sporadic mutations in some genes (e.g., APC, KRAS, BRAF, TP53) that trigger uncontrolled cell growth and subsequent tumor formation.

However, one overlooked group is individuals younger than 50 years (<50 years) who do not usually undergo screening if they are at average-risk (defined as those without a personal or family history of CRC, without a personal history of IBD). Currently, there are little data regarding risk factors for CRC at average-risk young adults who are also asymptomatic.

Act to lower cancer risk

Armed with a comprehensive awareness and an inner-warrior mindset, act swiftly in the specific domains to impede or prevent cancer development within your young body.

  1. Live a healthy lifestyle. Eat a plant-based diet, stay active, avoid smoking, limit alcohol, and practice sun-safety.
  2. Maintain a healthy weight.
  3. Get screened for early detection.
  4. Get cancer risk assessment and genetic counseling. (for high-risk individuals)
  5. Get the HPV vaccination. Protect yourself from sexually transmitted infections.

Finally, cancer in young people disrupt crucial life stages such as education, career development and family planning. Early diagnoses can have long-term consequences in every aspect of individual’s well-being. Furthermore, the rising cancer burden in young people poses a significant public health challenge. Thus, the unexpected vulnerability in young people demands our attention and dedication to this troubling shift.

 

Image credit: Matt Cole, Mis wanto at Vecteezy

Walking Matters

By Hui Xie-Zukauskas

People Walking_SmSometimes, ordinary acts can be the solutions to challenging and complex problems.

A professor, a man in his late 60s, walked down the farmers’ market every day, whether on freezing winter days or hot, humid summer ones. He would stop at a few booths and buy some vegetables, fruits, nuts, or meat. He would also pass by other sellers, smiling and greeting them as friendly acquaintances. This was a daily stop for the elderly man on his way from work to home (an extra 20–30-minutes added to his 20-minute walk each way). He stayed with this routine for decades and in doing so, outlived many of his colleagues and friends. He lived into his 80s even though he had a family history of cancer and had poor health during his youth and middle age.

A tiny lady walked around local department stores virtually every day after she finished her accounting job that demanded sitting for long hours. Sometimes she bought clothing or necessities for her children, whereas at other times she was just window shopping or walking along. Her relatives were always puzzled about what attracted her to those stores where they had the same merchandise almost every day. They didn’t realize that her “go shopping” was simply her daily “relaxation activity routine.” A result of her spending decades in that home-workplace-department store route was that the lady has lived well up into her 90s.

I witnessed these real-life anecdotes because this man and woman are my parents.

These stories reflect at least one simple thread – Walking matters. Daily walking can bring substantial health benefits!

Cancer touches each of us so much, so deep, and there is no cure for it currently despite medical and technological advances, as is the case for some other debilitating chronic diseases.

Of course, the best cure would be prevention! As everybody knows, “An ounce of prevention is worth a pound of cure.”  Of various risk factors, physical inactivity is a major one. However, it is increasingly common in our modern life. As the saying goes, “sitting is the new smoking.”

To prevent cancer, heart disease and improve one’s overall health, the American Heart Association recommends that all adults to get at least 150 minutes exercise per week with moderate intensity. The American Cancer Society has also advised on being physically active: particularly, adults should get 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity activity each week (or a combination of these).

I’ve seen that a majority of people don’t meet these guidelines based on my experience in public health. I also understand how difficult it is for many busy folks to fulfill this goal due to the demands of their work and family life. Accordingly, for years, I’ve shared some practical ways for daily exercises.

Today, I would make it even simpler—if time is a problem—by suggesting to start small in terms of walking and its feasibility. If it’s really challenging for you to exercise 30 minutes a day and 5 days a week, how about walking ~20 minutes a day and 7 days a week? Or alternatively, any combination that may fit your schedule? Cumulativeness counts too and is better than nothing. You may divide 30 minutes into a 10- or 15-minute walk first thing in the morning, and 10 minutes of walking-oriented activities during the day (for examples, running up stairs, parking farther away from a destination, or walking to a local store). Then ideally, add 5-10 minutes more of activity (say dancing, jumping, gardening, or playing with the kids).

There is no need to reiterate the well-documented, numerous health benefits of walking at this time. While I’m stressing not to underestimate the power of walking, it’s important to engage in various physical activities, along with a balanced diet, weight control, adequate sleep, and living a healthy lifestyle for your overall well-being.

Doing nothing is like waiting for a miracle that much likely won’t happen soon. So, simply getting up from your chair to get moving is your best regime and the first step in disease prevention.

Happy walking!

 

How Your Sleep Quality Affects Your Health and Your Quality of Life

By Hui Xie-Zukauskas

Sleep & QoL_Pixabay & CPDGetting adequate sleep is a critical part of the daily cycle of renewing bodily functions. Yet, many folks experience sleep deprivation; and those that do often tend to brush off its signs. Such signs include tossing around on the bed or staring at the ceiling at night, still feeling exhausted after sleep and having frequent mood swings, and undergoing reduced alertness and concentration during daytime.

Poor sleep quality is not a minor issue. In fact, it’s an alarming one due to its being a possible underlying contributor to serious health problems and its adverse effects on your overall quality of life.

So, I’d like to zero into the topic of sleep disorders, particularly obstructive sleep apnea (OSA) and how common and serious it is.

First, let’s glance at OSA prevalence.

Sleep apnea is a serious sleep disorder, often underdiagnosed and undertreated. Obstructive sleep apnea (OSA) happens when there is intermittently reduced or stopped airflow despite ongoing ventilatory effort. This is caused by the blockage or collapse of the upper airway during sleep. In other words, your breathing stops and starts repeatedly.

About one billion people suffer from OSA worldwide. The overall prevalence in the US population amounts to 20 to 30 percent in men and 10 to 15 percent in women.

Second, what are risk factors of OSA? 

  • Old age
  • Obesity
  • Men (more commonly affected than women)
  • Large tonsils (potentially narrow the airway)
  • Certain populations (e.g., individuals with hypertension or atrial fibrillation)
  • Changes in body hormone levels (women after menopause)

Also consider that sleep trouble could be reflective of lifestyle or behavior issues. A healthy lifestyle and sleep hygiene can assist you with a good night’s sleep. I’ve highlighted some practical tips previously.

Third, what are the possible severe consequences of OSA?

Poor quality of sleep, especially OSA, can negatively impact your well-being—not only your daily behaviors (e.g., fatigue, slow or suboptimal performance, being easily irritated, and increased caffeine or alcohol intake) but also various health problems. OSA is a respiratory condition. However, it is more and more accepted as a systemic disease. Let me briefly emphasize OSA’s possible, detrimental long-term effects on health.

1. Cardiovascular diseases

OSA can sneakily contribute to numerous cardiovascular disorders, including coronary artery disease, myocardial infarction or heart attack, stroke, arrhythmias, heart failure, diabetes, and hypertension. About 80 percent of individuals with drug-resistant hypertension also have OSA, which shows how complex OSA’s causes are and how chronic illnesses can be intertwined with OSA. So, be aware that unscreened and untreated OSA may potentially trigger preventable cardiovascular disease.

2. Cancer

Growing evidence shows that OSA is significantly associated with a higher cancer incidence and with mortality in various types of cancer. Individuals with OSA are more likely to develop cancer, and the severity of OSA results in a higher risk.

It’s not clear how OSA potentially promotes tumor malignancy; however, hypoxia, hypoxia-reoxygenation cycles—as the hallmark of OSA—can have an impact on tumor biology at least through systemic inflammation and subsequent activation of diverse cellular pathways to advance tumor progression. I’ve explained how poor sleep quality and OSA may contribute to cancer development in the book Key Strategies for Cancer Prevention.           

3. Other chronic and systemic illnesses

Though a sleeping body is at rest, that body is still carrying on dynamic processes and integral functions. Poor sleep reduces circulating monocytes and natural killer cells, resulting in a weakened immune system. Patients with OSA are at higher risk for depression, mood swings, and cognitive delay. Moreover, OSA is also linked to disrupted hormonal balance and periodontal disease, etc..

I hope that by this point, you’ve gained new insight into the very important health issue of getting quality sleep and have gotten ready for action. Next time, don’t stop at an answer of “Yes” or “No” to the question of whether you had a good night’s sleep? Examine the question further (for yourself and your loved ones): How good or efficient is your sleep? What is the time it takes for you to fall asleep after turning off the lights? How long is your estimated sleep duration? How often or how long are you waking up at night? Do you have any gasping or breathing difficulty?

If you have trouble with these answers or wonder if you have a sleep disorder, it’s time to consult your doctor.

Key Take-home Message:

Improving your sleep quality is closely linked not only to improved health outcomes, but also to improved quality of your life.

 

Image Credit: Pixabay, CPD

Artificial Sweeteners: What Helps and What Hurts

By Hui Xie-Zukauskas

Past-Present-Future on AS & CancerWhen it comes to artificial sweeteners, do you have mixed feelings? Are you confused about its link to cancer risk or not? Well, you’re not alone.

All over scientific literature, this topic remains intensely controversial. I summarized where we are on an association between consumption of artificial sweeteners and risk of cancer in a flowchart illustration here.

Briefly, little or no evidence from past decades shows common artificial sweeteners have a cancer-causing (i.e., carcinogenic) potential, except a link to bladder cancer in animals but inconsistent results in humans. The US FDA also approved the safety of several artificial sweeteners as food additives.

However, this view has shifted in recent publications. Especially, a large epidemiological study (102,865 adults, follow-up nearly 8 years) found that participants who heavily consumed artificial sweeteners—aspartame and acesulfame-K—showed a 13-15% higher risk of cancer (e.g., breast, obesity-related cancer), compared with non-consumers (Debras et al. PLoS Med. 2022). Keep in mind that obesity is linked to more than ten types of cancer. Meanwhile, the International Agency of Research on Cancer (IARC) would place a high priority in the near future to evaluate the possible carcinogenic effect of aspartame on humans, as recommended by its advisory group.

So, what do you do? How the renewed awareness influences your choice on a healthy and palatable diet?

Artificial sweeteners exist in a wide variety of food (especially those packaged or processed), drinks, drugs, and hygiene products. Therefore, virtually everybody uses or ingests artificial sweeteners, knowingly or not.

An immediate concern is about unanticipated or undesirable consequences from its regular consumption, along with confusion, or worse, disinformation.

But this is more complex than what one may think.

To help clarify it, let’s examine what helps and what hurts in critical areas, so that you can strike a balance between benefits and risks, and make wise choices.

What helps –

Artificial Sweeteners packs_SmWe all have a sweet tooth, and often add a little amount of sugar to enhance our food’s flavors and pleasure.

Artificial sweeteners—as sugar substitutes—are calorie-free and nutrient-free. With their sweet taste or perception, these food additives may affect certain health outcomes. For instance, they are used as a strategy to reduce calorie intake in weight loss programs, though controversies exist. Furthermore, as for whether these sweet alternatives are advantageous, there is little evidence based on long-term studies to demonstrate that.

What hurts – 

Aspartame Structure_SmAfter all, artificial sweeteners are synthetic chemicals hidden in packaged foods and soft drinks, which are different from natural sugar contained in fruits and vegetables.

Excessive sugar intake can negatively impact human metabolism and health. Likewise, excessive consumption of artificial sweeteners is undoubtedly risky.

Of potentially grave concern is those pregnant women and young children who consume aspartame-containing foods and beverages in a large quantity, because research reveals that offspring of rodents exhibit increased incidence of leukemia and lymphoma after fetal or prenatal exposure to aspartame. And there is a clear dose-response correlation between aspartame exposure and occurrence of blood or lymphatic malignancies. Obviously, aspartame is a carcinogen in rodents.

Paradoxically in dietary intervention to counter weight gain, artificial sweeteners might not be as efficient as expected, or at least need to be considered cautiously.

First, we know that sugar is a driver of inflammation and weight gain, and artificial sweeteners are also inflammatory foods. After reviewing more than 100 studies that investigated aspartame in both higher (>40 mg/kg/d) and safe (<40 mg/kg/d) dosages, and ascertaining its harmful effects on various cells, tissues and organs, the authors concluded “aspartame use could not only exacerbate existing systemic inflammation but also cause inflammation if healthy individuals ingest it on a regular basis” (Choudhary & Pretorius. Nutr Rev. 2017).

Chronic, low-grade inflammation is a significant risk factor for the development of many diseases including cardiovascular diseases, diabetes, cancer, neurological disorders (e.g., Alzheimer’s), and arthritis, right? So is malnutrition (or micronutrient deficiency). Malnutrition is associated with not only lower body weight but also obesity.

Taken together, it’s important to understand adverse effects of artificial sweeteners and their metabolites. For individuals with or susceptible to inflammatory bowel disease, it’s critical to avoid or at least limit artificial sweeteners, processed foods, and sugar-sweetened beverages.

Again, lifestyle with a healthy diet is an integrative, effective solution. If you eat more veggies, fruits and less processed foods, you easily curb added sugar or artificial sweeteners without loss of nutrients. For example, you may sprinkle fresh fruits (such as pineapples, oranges, or watermelon, etc.) or dried fruits (such as raisins or dates) onto your salad (or other dish) as a sweet addition—not only making it palatable but also supplying antioxidants (i.e., a bonus). Alternatively, use a tiny amount of honey or maple syrup, when necessary, which is relatively healthier than artificial sweeteners.

So, take-home points:

Enjoy nutrients-dense foods and reduce sugar intake overall. Specifically, eat plenty of fruits and veggies for natural sweetness, and engage in more physical activity to prevent inflammation.

 

Image Credits: CancerPreventionDaily, Pixabay

Key References: click here

4 Takeaways for Colon Cancer Smart plus Prevention Tips

By Hui Xie-Zukauskas

Colon Cancer Prevention_Cleveland Clinic HealthImagine your colon functions fairly well for years. Unaware was that healthy cells in the inner lining of your colon developed changes in their DNA (i.e., mutation), and formed polyps that may start cancer, a couple of which reside on the left side of your colon. You are either asymptomatic or unchecked by mistaking cautionary signs as normal. Fortunately, one day these polyps (varying 0.4 to 10 mm in size) showed up on your colonoscopy and the surgeon successfully removed them, thus stopping the cancerous growth.

Unfortunately, millions of people had their polyps growing in size from tiny (about a match head) to giant (≥25 mm or almost 1 inch), from benign lumps progressed to malignant tumors that invade adjacent tissues or distant organs. Then we all know the sad ending.

How should you be aware that you need a colon cancer screening (when or based on what)? What’s new about colon cancer pertinent to you and your loved ones?

I summarized 4 takeaways from updated research findings here. In addition, I’m highlighting proven preventive measures in a memorable poetry style.

So, let’s dive in the takeaways.

1.      Risk factor you might have overlooked

Primary risk factors for colorectal cancer can be categorized as:

-          non-modifiable ones that you can’t control, such as age, taller height, family history, personal history of inflammatory bowel diseases or polyps (pre-cancerous growth), etc., and

-          modifiable ones that are more lifestyle or diet behaviors related, including tobacco smoke, heavy intake of alcoholic beverages, obesity/overweight, high consumption of red or processed meats and dairy fats, and physical inactivity.

A recent, large study (based on 47 observational studies involving 280,644 colorectal cancer and 14,139 colorectal adenoma cases) indicated that taller individuals had a 14% higher risk of colon cancer and 6% higher odds of adenomas (a type of benign tumor). Note that taller stature has been linked to an increased risk of several other cancers.

The findings are intriguing and supported from other perspectives. For example, Laron syndrome (LS) is a rare genetic condition, characterized with congenital deficiency of insulin-like growth factor-1 and dwarfism. Patients with LS do not develop cancer.

This is significant yet overlooked because current cancer screening guidelines do not define height as a risk factor or relevant specifics that one should get screened. So, it’s up to doctors’ recommendations or an individual’s choice.

2.      Age for colon cancer trending younger (under age 50)

In contrast to falling or steady rates of colorectal cancer incidence in older adults, a concerning trend is the rising occurrence of young people (< 50 years old) with colorectal cancer. Simply blaming obesity and diabetes in this population might be too early, because new studies shed a light from various angles. Gut microbiome may play a role in carcinogenesis as bacteria alter inflammatory and immune environment. High consumption of sugar-sweetened beverages in adolescence and young adulthood may also contribute to an increased risk of early-onset colorectal cancer.

In addition to reinforcing awareness, an immediate outcome improvement can be done by early screening. Multiple societies and the United States Preventive Services Task Force have updated their recommendation—individuals should initiate screening for colorectal cancer at age 45, instead of age 50.

3.      Obesity as a strong and sustained risk

Obesity and/or being overweight is a well-known, independent risk factor for more than ten cancers, and with obesity comes a worse prognosis. We also know that gut microbiota imbalance can influence cancer, and there are identified colon cancer-promoting bacteria. Recent studies showed that changes in gut microbiota composition occur in patients with colon cancer, particularly among those having a BMI >25 kg/m2.

Cumulative history or effects of excess weight is another issue, as an investigation newly published on JAMA Oncology (online March 17, 2022) emphasized a greater role of cumulative lifetime excess weight in colon cancer risk. The researchers defined “cumulative lifetime exposure” as the subjective numbers of years lived with an overweight condition or obesity, and found that excess weight effect at all ages (between 20 and 70 years) studied is clearly associated with an increased colon cancer risk. In other words, the longer one is carrying excess body weight, the more likely he/she will develop colon cancer.

4.      Polyps’ vulnerability and risk critical to screening methods

Although not all polyps will become cancer, many cancers, especially in colon, start from polyps. Vulnerability and/or risk of polyps turning to cancer depend on their size, shape, number, and microscopic characteristics or pathology.  The larger in size and the more in number the polyps, the greater likelihood they are on the road to cancer. The good news is that polyps can be safely and successfully removed during the colonoscopy.

That’s why colon cancer screening is critical. There are several screening tests with variable specificity and sensitivity—from at-home, stool-based kits (e.g., fecal immunochemical test or FIT, Cologuard DNA test), a new blood-based biomarker test to sigmoidoscopy and colonoscopy. Of all, colonoscopy is still the gold standard, and a preferred test strategy.

However, consider as an early intervention, even starting with at-home kits, is better than doing nothing. Understandably, the cost associated with different preferences may be involved in the decision-making, that’s why your voice to ensure life-saving screening should be raised loudly.

At the end, colon cancer is a most common but preventable cancer!

I draw your attention to the effective, preventative strategies below in a poetry style.

Title: Reminder of Colon Cancer Prevention

Imagine your colon cool and smooth,

With a regular bowel move;

To steer away from cancer growth,

Your brain and action are your tools.

 

Rainbow dish stands a golden rule,

More water, veggies and fruits,

Less red and processed meats,

No smoke, alcohol, and junk foods;

Stay lean and burn fat,

Walk, run, or yoga, whatever you choose.

 

Let your motion get annoying pounds removed,

Let your screening discard any malign root;

Enlighten your disease prevention and a long life,

Keep a good, positive mood!

 

Image Credit: Cleveland Clinic Health Essentials

Facing Challenges with Change or Chance

By Hui Xie-Zukauskas

New opportunity with Change 2022_PixabayIn a nutshell, cancer has no cure-all or magic bullet. There are still many unanswered questions. We—not just oncologists and cancer researchers—everyone and the society, have a lot of challenges on the road ahead, despite remarkable progresses in cancer breakthroughs and medical technologies.

Starting off 2022, I’d like to emphasize a couple of challenging areas where we all can contribute to saving lives.

Cancer landscape is changing. Cancer cases in age are getting young (such as colon cancer), rare or malignant cancers show upticks (such as pancreatic cancer). Cancer itself is a disease of changing; the changes taking place inside the body dynamically. Our human practices are connected to our health outcomes.

One of the key attentions in fighting cancer is the influence of one’s daily habits or culture and the environment (both physical and social). So, can we all relate to this? Based on multiple cancer risk factors in our daily life that I previously described, how about starting with just one unhealthy behavior to change for this New Year’s Resolution and doing it consistently? As for environment in our home, workplace and community, get rid of as many cancer-causing substances or toxins as you possibly can.

Then look at a bigger picture: climate change can significantly impact public health, specifically one area is through affecting food security, which involves our dietary behavior. A smart approach is to increase consumption of plant-based foods—that in turn, not only to reduce the human impact on the environment but also to reduce the incidents of chronic diseases from cardiovascular conditions to cancers.

Furthermore, let’s provide more support for cancer patients. Recent studies in breast cancer survivors revealed that social environment contributes to a huge difference in an individual’s prognosis. This is because social environment can alter basic physiological processes that may modulate cancer growth, and social isolation enables this physical setting to promote cancer.

One current twist is the challenge of COVID pandemic. Many people skipped early screening or testing, and healthcare systems were overwhelmed by care for severely sick patients with COVID. Fundamentally, the concern is that delayed detection or diagnosis will lead to promoting cancer growth, bringing about a poor projection in years or a decade later, as cancer is not formed overnight. With advanced medicine and technology nowadays, the earlier you detect a cancer or precancerous cells, the sooner you can get effective treatment, and the better outcome or prognosis you will achieve.

So, if you have reservation to a hospital visit or preventive screen, you can always take advantage of virtual appointment/visit or available home-testing kit. Those genetically vulnerable individuals need to take more stringent risk-reducing measures.

One immediate action is HPV vaccination. Why?
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Human papilloma virus (HPV) is a family of more than 150 related viruses. According to CDC, “HPV is so common that nearly all sexually active men and women get the virus at some point of their lives.” To help you understand more, I’m highlighting some new research updates:

  1. HPV does not just cause female cancers, though being responsible for 99% of cervical cancer and 65% of vaginal cancer. Evidence shows HPV to be the cause of estimated 90% anal cancer, ~60% penile cancer, and 50% or higher of mouth and throat cancers.
  2. Although sexual transmission is a well-known route to get infected by HPV, the route of HPV transmission is beyond penetrative sex, can occur through skin-to-mucosa or skin-to-skin contact.
  3. Routine screening test may not detect all types of HPV viruses. HPV can also survive well outside its host, thereby potentially being transmitted through non-sexual modes. For instance, the high-risk type HPV16 is highly resistant to disinfection.

Therefore, HPV vaccination is crucial; it’s safe and effective, with proven efficacy in preventing cervical cancer. Youths and young adults should follow the recommended guidelines to get vaccinated, and parents should support and protect the children.

Last but not the least, believe the power and facts/evidence of science, go to your trusted doctors for advice. Disregard those spreading vaccine disinformation that continue the reckless indifference to both science and human lives.

At the end –

Each new day is a gift and/or opportunity, and each new year opens a new chapter.

We can do more and add more, don’t let your desire for life and for your health wane!

Image credit: Pixabay and CPD

Unique and Reflective Angles to Breast Cancer

By Hui Xie-Zukauskas

Unique View on Breast Cancer_pixabay & CPDAre you scared or terrified when hearing a breast cancer diagnosis (whether it happens to yourself or your loved ones)? I can fully understand it. Many lives lost to breast cancer (young, old, ordinary folks or celebrities) are so sad and alarming!

What I’ll share with you here is my hope that you may think and approach breast cancer differently.

Have you thought about how the liver and liveliness (or vigor) related to breast cancer? If you have an open mind, read on for different perspectives.

First, let me briefly underscore the genetics of this disease (as I’ve addressed it previously), but many folks still believe or blame the genes. That’s understandable too.

But the genes do not tell the full story.

We all have BRCA1 and BRCA2 genes, both women and men, because BRCA is not a sex-linked gene. The gene mutation can be inherited from either parent. For women with a BRCA mutation, the lifetime risk of breast cancer is approximately 80 percent, and the chance of ovarian cancer is 54 percent. Men may carry the BRCA mutation, but they have a lower risk.

The fact is—Of more than 200,000 breast cancer cases newly diagnosed each year, BRCA gene mutation accounts for about 10 percent of them. Furthermore, about 85 percent of women diagnosed with breast cancer have no family history of the disease. So, there are more promising areas for treatment and prevention.

Next, let me dive a little deeper into an alternative therapy, without replacing any proven successful treatments by surgery, chemotherapy and advanced immunotherapy.

Foundation of traditional Chinese medicine (TCM) on breast cancer therapy

I’m going to elaborate this in the following ways:

First, TCM view on breast cancer

In TCM, breast cancer refers to “mild rock”. The condition belongs to syndromes related to anger from the liver and depression from the spleen, loss of qi and blood. In clinical practice, patients with liver sluggishness and qi stagnation often have breast lumps, characterized by hard texture, unclear boundary, and mostly the same skin color. It can also be accompanied by chest tightness, rib area swelling or dilation, and impatience.

Then a variety of therapies are available—in combination with internal treatment, external treatments, and other ways such as psychological counseling in order to restore a physical state harmony—overall individualized, comprehensive treatments for a patient. The key is the TCM holistic view and differentially diagnostic approach through indications of the tongue and pulse, ultimately determining a prescriptive formula with a mixture of several Chinese medicinal herbs.

Second, the role of Qi in cancer development

As I discussed before, qi is the vital energy that moves with blood throughout the body at all times. It is everywhere in the body and interconnected with the organs (TCM often refers to the visceral), which keeps our wholeness in balance. One famous belief is that flow of qi makes blood circulate; stagnation of qi causes blood stasis. Therefore, the stagnation of flowing qi and blood over time leads to mass, lump or tumor.

Now the next question should be addressed is – What can cause qi stagnation?

In TCM’s view, one of causes for qi stagnation is attributed to emotional imbalance. Specifically, when intensive, persistent emotions dominate (e.g., uncontrolled anger, depression, stress, or lasting grief), not only can they interrupt normal harmony of organ functions, but also they impair the immune system. So, one of diseases for which there is a great concern about the adverse effect of emotional distress or disturbance is cancer.

In essence, this notion is comparable with Western medicine on psychological or psychosocial factors played in some diseases. Research has revealed that psychological stress may impact breast cancer onset and progression. To be clear, emotions do not automatically modify the genes, but they do trigger a surge of cellular changes that affect the immunity and alter the genes associated with stress.
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Third, of guiding philosophies of TCM, it urges one to prevent diseases rather treat them.

A treasured remedy for cancer prevention is to safeguard against a holistic imbalance resulting from poor diet, unhealthy lifestyle, harmful stressors or environmental pollutions, and to strengthen your inner qi.

One extra point: TCM has its unique advantage in breast cancer therapy. Unlike adverse or toxic effects from chemo- or radiotherapy, TCM treatment does not cause further damage to physical body or strength in general, but may facilitate restoring qi.

How can we harness vital energy to prevent cancer? - Eight Tips:

 1.      Make your immune system strong. Our immune system is our powerhouse to fight cancer. That’s why scientific innovations tap into the body’s immune system to destroy cancer cells. So, cultivate healing energy and sustaining qi or vitality through strong immunity.

 2.      Control your emotions to keep qi flow. Maintaining a positive outlook on life helps boost your positive energy. Anger, fear, sadness, and anxiety can adversely affect your qi. Have you noticed that stress can drain your energy? Another key to flowing qi is to share your feeling, let it out and let it go.

 3.      Foster gratitude. Devote time daily to appreciate what you have, even the small things. Keep content, cheerful, and compassionate. Doing so will channel your enlightened spirit and vital energy!

 4.      Go for a nutrient-packed diet. Various factors influence qi, thus be aware of them. Nutrition supports both the level and the quality of your energy. A balanced, healthy diet can prevent qi deficiency.

 5.      Exercise regularly and purposely. Be physically active because it keeps qi moving and blood circulating! Intentionally practice the moves that you love, and practice deep breathing or meditation to elevate your inner awareness.

 6.      Maintain a healthy weight. Obesity is a state of energy imbalance and a noteworthy risk factor of breast cancer. It is partly related to sluggish qi and metabolic dysfunction.

7.      Rest and relax well. Sufficient sleep can restore vibrant qi, cultivate healing qi, and maintain the holistic harmony.

 8.      Be vigilant about early detection! Get a genetic screening to identify the BRCA gene mutation, and start effective measures or therapy early. Treat any illness early. Doing so will help protect your vital qi.

Breast cancer prevention is for both women and men, especially based on our shared genetics. We cannot control our genes, gender, age, race, or family history. However, each of us can strengthen our qi and foster a healthy lifestyle, all is vital to keeping cancer at bay.

The bottom line is –

With TCM in mind, you can act with knowledge, self-care, vitality and prevention, rather than let fear cloud your thinking or paralyze your function.

Happy flowing Qi!

 

Image credit: Pixabay and CPD

Shining Clarity on Coffee and Cancer

By Hui Xie-Zukauskas

Coffee with Love_pixabaySteve and Karen, friends of mine, each has drunk more than five cups a day of black coffee—no sugar, no cream—for decades. I’m amazed always because I cannot drink coffee black.

Ari came in work every day with his morning coffee, whether it was Starbucks or a regular one to “stimulate his mind and brain”.

Sound familiar? Obviously, coffee drinking is a popular pleasure around the world.

On top of this, scientists have discovered numerous health effects of coffee. However, lingering confusions about coffee drinking seem to hardly disappear. Even market trends flow with controversies.

Here I’m going to provide renewed clarity on some controversies, misunderstandings or uncertainty and explain why, based on accumulated research, recent literature and knowledge.

One persistent myth or confusion surrounds the link between coffee consumption and cancer risk. You can be comfortably assured that coffee itself doesn’t increase cancer risk. To be even more clear, no evidence up to date concludes that coffee consumption causes cancer.

So, how does this certainty come?

What might be confusing and problematic involves two factors. One is acrylamide—a byproduct derived when coffee beans are roasted; it is a “probable human carcinogen” (Group 2A) classified by the International Agency for Research on Cancer (IARC). However, its amount in coffee is insignificant, no cause for concern. Plus, acrylamide exposure via coffee is less than that from dietary source (French fries or fried foods) and tobacco (smoke or smokeless, a known carcinogen in Group 1).

The other factor is temperature (not the coffee itself), because IARC does classify drinking very hot beverages at or above 65oC (149oF) as “probably carcinogenic to humans” (Group 2A). Not just hot coffee. Drinking any hot liquids (tea, water or soup) have been linked to an increased esophageal cancer risk, which is conceivable as a result of the cell injury and recurring repair—leading to mutation and tumor growth over time. Put the two factors together, acrylamide becomes toxic only at high dose and at high temperature.

An additional fact came from the respected agency’s thorough evaluation. IARC actually took “coffee” out of their previous classification as a “probable human carcinogen” in 2016, owing to limited or inadequate evidence and inconsistent results in humans.

By contrast, strong evidence has revealed that coffee consumption may lower a risk of developing some types of cancer, but has no association with various cancers at all. Noticeably, coffee drinking reduced the liver and endometrial cancer cases, with support of a dose-dependent relationship. It also showed a decrease in the risk of postmenopausal breast cancer. As for cancer of many other organs such as lung, colon, pancreas, ovarian, prostate, mouth and pharyngeal, findings pointed to either a slight protective effect of coffee, or no association, or inconclusive results.

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Interestingly, most benefits of coffee are attributed to several key compounds, including caffeine, caffeic acid, chlorogenic acid, diterpenes (cafestol, kahweol), and polyphenols. Proposed mechanisms of their anti-cancer effects include a) help control cell growth and proliferation by blocking pro-carcinogenic proteins; b) defend against oxidative stress and DNA damage through antioxidant and anti-inflammatory properties; and c) stimulate enzymes or pathways leading to carcinogenic inactivation and cancer cell death.

It’s also worth mentioning, added calories from plentiful sugar, cream or whole milk with coffee consumption, just like drinking sugar-sweetened beverages excessively and frequently or ingesting unhealthy dietary fats, are potential health hazards—presenting a risk for chronic disorders such as cardiovascular diseases, diabetes and obesity.

Collectively, drinking coffee on a regular basis has a protective effect against some types of cancer, but no influence on other types, and no evidence of causing cancer. Because of its complex mixture of bioactive components, particularly containing a myriad of antioxidants, coffee acts not just as a mental stimulant but as a defensive agent for your health, which should come as no surprise.

Nevertheless, vegetables, fruits and whole grains are among the richest sources of antioxidants. And a healthy lifestyle goes well beyond coffee drinking.

Bonus ─ Wisdom for coffee delight:

  1. Stay moderate: It’s beneficial and healthy to have coffee no more than 5 cups/day (or 400 mg/day).
  2. Beware additions: Don’t drink coffee when it’s too hot, or with too much sugar and too much cream.
  3. Take precautions: If you have health issues such as GERD, bladder control, osteoporosis, etc., do limit the amount. If coffee triggers your anxiety, don’t drink it on an empty stomach. Some medications interact with coffee too, so follow your doctor’s directions.

Having cleared up certain confusion or “dispersed the confusion on coffee” in this post, I hope you find an inspiration or refreshed perspective that can add to your wellness tool kit.

Happy coffee drinking!

 

Image credit: Pixabay

Invisible But Critical Players: Focus on Cancer

By Hui Xie-Zukauskas

Microbiota & Cancer in Puzzle_PixabayOut of sight, out of mind is a familiar saying. What I’m going to share is something that is out of sight, but that we should always keep it in mind.

It’s about microbiota—the community of microorganisms (including bacteria, fungi, lower and higher eukaryotes, and viruses) that live within human beings.

They are fascinating creatures, so small that they are invisible, numbering in trillions, diverse in makeup, and importantly, exerting both local and distant effects on human health and diseases.

The microbiota exist as a part of the normal flora in our gastrointestinal tract, oral cavity and urinary-genital tissues. They can cause or promote various diseases, including wound infection, life-threatening conditions, and chronic diseases such as diabetes and cancer, by disrupting the human microenvironment and the immune system.

The interactions among microbiota affect human health too. For example, a respiratory virus infection may cause a perturbation in gut microbiota; conversely, gut microbiota may contribute to respiratory diseases. That’s why scientists have investigated the link between gut microbiota and COVID-19. We know that the composition of gut microbiota decreases as one ages, and we know that COVID-19 in elderly patients has been more severe and fatal, so gut microbiota may play a role in this disease.

Microbiota also have diverse activities with different consequences in your body. Take one bacterial species as an example. Bacteroides spp. are your friends that usually contribute to your nutritional status as well as mucosal and systemic immunity. In contrast, when the colon integrity is disrupted, they can be your foes (or at least acting as opportunistic pathogens) for causing potential infection.

Now we move to their impact on cancer, as microbial pathogens account for 15-20% of all cancers.

Growing evidence has linked the gut microbiota to gastrointestinal cancers (e.g., colon, pancreatic cancer), and vaginal microbiota to cervical cancer. As I’ve discussed previously, an imbalance of gut microbiota can influence breast cancer development.

Here, I want to emphasize microbiota’s impact on prostate cancer risk and development. So, what’s the connection?

First, the microbiota of men with prostate cancer can differ from those of healthy men. Various bacteria (species) are prevalent in prostate tissues from prostate cancer patients but not from healthy control subjects.

For example, of 14 studies, more than a dozen of bacterial species are most common in the prostate tissues and the adjacent tissues from men with prostate cancer, and these abundant species are significantly associated with prostate cancer. (Note: Their odd, multi-letter names are excluded here but attached at the end).

What’s intriguing is that one of these tiny creatures you may have heard of. Propionibacterium acnes (P. acnes) is the most abundant bacterial species on the human skin. But researchers found that it is one of predominant types in the prostate tissue samples, along with considerable tissue inflammation. This suggests that P. acnes infection is a contributing factor in prostate cancer development.

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Finally, although pathogenesis of prostate cancer is multifactorial, the microbiota can influence the risk and progression of prostate cancer by altering immune system, mediating inflammation, impacting tumor microenvironment, and damaging DNA (through increased pro-cancer agents or their metabolites).

Summary

The overall message here is that when it comes to your health, it’s worth caring about critical issues that may be out of sight.

The bottom line is that the microbiota—good or bad tiny creatures—are important players in our health and diseases, particularly in cancer development. We need to live with these microorganisms harmoniously.

So, what we do to achieve this goal? There are three areas for focused, fundamental strategies:

  1. Healthy diet. Healthy eating—particularly plentiful fiber intake—promotes a right balance of microbiota, which is also safter and more effective than supplements.
  2. Hygiene practice. Bacterial or viral infection-indued inflammation increases a risk for cancer, and hygiene is one of major factors affecting the makeup and functions of microbiota.
  3. Higher awareness of stressors. Smoking, poor diet, age, environmental pollutants or factors, and diseased conditions can cause microbial dysbiosis; because these stressors upset the balanced state of microbiota.

———————————————–

P. S. Types of microbiota in the studied prostate tissue samples that linked to prostate cancer: (alphabetical order)

Acinetobacter, Actinobacteria, Alphaproteobacteria, Bacteroidetes, Bacteroides spp, Enterobacteriaceae, (commonly, Escherichia coli.), Firmicutes, Lachnospiraceae, Propionibacterium acnes (P. acnes), Propionicimonas, Proteobacteria, Pseudomonas, Staphylococcus spp, Sphingomonas spp, Veillonella

 

Image credit: Pixabay

Amazing Five Breakthroughs on Cancer Treatment

By Hui Xie-Zukauskas

Niew in Fighting Cancer_CPD comboCancer is a leading cause of death globally according to the World Health Organization. In 2020, it accounts for nearly 10 million deaths worldwide. The sad reality is that some malignant cancers remain incurable despite remarkable progress achieved in cancer diagnosis and treatment.

The good news is that novel therapeutic breakthroughs are continuously being made to fight cancer!

I’m going to highlight a few of numerous advances, especially those tackling common malignant cancers.

1.      Precision oncology

Cancer differs from one individual to another. Precision oncology equips doctors to tailor cancer treatment specifically to a person’s cancer. Genes, proteins, or even blood vessels that promote cancer cells to grow and metastasize are targeted in these therapies. Leveraging biomarkers (genes, proteins, and different types of molecule) plays an essential role in personalized medicine and in fighting cancer. The validated biomarkers can improve risk stratification, cancer screening and differential diagnosis, evaluate cancer prognosis, and predict response to treatment. Along with the patient’s data, optimal therapy decision can be made. In other words, biomarkers facilitate the effort that can match the right patient with the right treatment at the right time. For instance, the innovation has been applied in diagnostic test for lung cancer and target treatment for metastatic breast cancer.

2.      Immunotherapy

Immunotherapy harnesses your own immune system to beat cancer. It uses the immune cells from a patient or a transplant donor to attack blood cancer cells (e.g., in leukemia, lymphoma, or myeloma), especially cancers that are resistant to chemotherapy or remain after chemotherapy. Immunotherapy with immune checkpoint inhibitors has been approved for the first-line therapy of advanced non-small-cell lung cancer (NSCLC). Immunotherapy through novel approaches used alone or in combination has substantially improved clinical outcomes of oncology and hematology, including in metastatic melanoma. Certainly, immunotherapy is intriguing and full of complexity, especially when some cancers don’t respond to it well.

3.      Controlled Nitric Oxide (NO) delivery

NO is a small, very reactive signaling molecule with a half-life less than 10 seconds. It regulates various key physiological functions, including blood vessel dilation, bronchial dilation, neuronal communication, and wound healing, etc. Underproduction of endogenous NO contributes to several chronic conditions from cardiovascular and lung diseases to cancer. Inhaled NO has been a valuable therapy for neonatal pulmonary hypertension, pulmonary inflammation control, and some heart and lung surgeries.

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4.      Virus-based treatment or engineered oncolytic viruses

Multidrug resistance is a big problem in cancer therapy, especially chemotherapy. Now oncolytic viruses are used to kill cancer cells by exploiting cancer cell-specific vulnerabilities and infecting them while sparing normal cells. Unlike vaccine-strain viruses failing to meet some critical safety and efficacy criteria, these genetically engineered viruses (such as oncolytic measles virus or adenovirus) enhance cancer therapy in clinical efficiency. Virus-based treatment has been used in glioblastoma, a malignant brain tumor; also, in breast cancer and lung cancer.

5.      Proton beam therapy (PBT) as advanced radiation therapy

Radiation therapy has been advancing rapidly in various ways. One way is proton therapy. Protons are positively charged particles of energy, a form of radiation that can send an intense burst of energy to a highly focused area, which means it kills cancer cells without damaging healthy tissues nearby. PBT therapy has been used for several common cancers including the lung, breast and prostate cancer as well as brain cancer.

 

Although many challenges remain to reach the full therapeutic potentials of these advanced biomedical technologies, future treatments for patients with cancer are very promising!

These exciting breakthroughs inspire us to prevent cancer by strengthening our body’s natural defense, so that the immune system can watch for and attack cancer cells effectively. We can also take advantage of new technologies for protection from common cancers (e.g., colon, breast, cervical, and prostate cancer), because they can be controlled if detected early and treated adequately.

 

Image credit: Pixabay, Clipart-Library, CancerPreventionDaily