Be Careful Not Fearful - How Cancer Grows - Dr Pawan Gupta

Definitve Answers to18 of Your Biggest Health Questions

The Definitive Answers To 18 Of Your Biggest Health Questions

1. Does olive oil prevent heart disease?

Short answer: Yes 

The health benefits of olive oil come from the presence of polyphenols, antioxidants that reduce the risk of heart diseases and cancers. But to get these healthy compounds, consumers should buy good-quality, fresh "extra-virgin" olive oil, which has the highest polyphenol content. Most commercially available olive oils have low levels of polyphenols associated with poor harvesting methods, improper storage, and heavy processing.

2. Do cough syrups work?

Short answer: No 

In 2006, the nation's chest physicians agreed that the majority of over-the-counter cough medicines don't actually work. These colorful syrups typically contain doses of codeine and dextromethorphan that are too small to be effective. Only cough suppressants that contain older antihistamines seem to relieve coughs. That includes brompheniramine, an active ingredient in Dimetapp. 

3 Do sugary soft drinks lead to diabetes?

Short answer: Yes 

The majority of health research is stacked against sugar-sweetened soda. A large 2004 study in the Journal of the American Medical Association found that women who drank one or more sugary drinks per day increased their risk of developing type 2 diabetes by 83% compared to those who consumed less than one of these beverages per month. 

4 Do I need sunscreen with more than 30 SPF?

Short answer: No 

Sunscreens with an SPF (sun protection factor) of 30 block about 97% of ultraviolet rays, while sunscreens with an SPF of higher than 30 block 97%-98%. It's more important that you choose "broad-spectrum" sunscreen, meaning it protects against both UVB and UVA rays. Sunbathers also need to apply a generous amount of sunscreen in order to get the full benefit of the SPF.

5. Is the MSG in Chinese likely to give you a headache?

Short answer: No 

A review of 40 years of clinical trials, published in the journal of the American Academy of Nurse Practitioners in 2006, found that all previous research "failed to identify a consistent relationship between the consumption of MSG and the constellation of symptoms that comprise the syndrome," including headaches and asthma attacks. The misconception spawned from several poorly-done small studies in the 1960s that seemed to connect MSG with a variety of maladies that people experienced after eating at Chinese restaurants. 

6. Do nuts make you fat?

Short answer: No 

As much as 75% of a nut is fat. But eating fat doesn't necessarily make you fat. The bigger factor leading to weight gain is portion-size. Luckily, nuts are loaded with healthy fats that keep you full. They're also a good source of protein and fiber. One study even found that whole almonds have 20% less calories than previously thought because a lot of the fat is excreted from the body. 

7. Is walking as effective as running?

Short answer: Yes 

Studies have shown that how long you exercise — and thus how many calories you burn — is more important than how hard you exercise. Running is a more efficient form of exercise, but not necessarily better for you. A six-year study published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology in April found that walking at a moderate pace and running produced similar health benefits, so long as the same amount of energy was expended. 

8. Is drinking fruit juice as good for you as eating fruit?

Short answer: No 

Calorie for calorie, whole fruit provides more nutritional benefits than drinking the pure juice of that fruit. That's because when you liquefy fruit, stripping away the peel and dumping the pulp, many ingredients like fiber, calcium, vitamin C, and other antioxidants are lost. For comparison, a five-ounce glass of orange juice that contains 69 calories has .3 grams of dietary fiber and 16 milligrams of calcium, whereas an orange with the same number of calories packs 3.1 grams of fiber and 60 milligrams of calcium. 

9. Are all wheat breads better for you than white bread?

Short answer: No 

Not all wheat breads are created equal. Wheat breads that contain all parts of the grain kernel, including the nutrient-rich germ and fiber-dense bran, must be labeled "whole grain" or "whole wheat." Some wheat breads are just white bread with a little bit of caramel coloring to make the bread appear healthier, according to Reader's Digest. 

10. Can a hot tub make me sick?

Short answer: Yes 

Hot tubs — especially ones in spas, hotels, and gyms — are perfect breeding grounds for germs. The water is not hot enough to kill bacteria, but is just the right temperature to make microbes grow even faster. Even though hot tubs are treated with chlorine, the heat causes the disinfectant to break down faster than it would in regular pools. The most common hot tub infection is pseudomonas folliculitis, which causes red, itchy bumps. A more dangerous side-effect of soaking in a dirty Jacuzzi is a form of pneumonia known as Legionnaire's disease. This is what reportedly sickened more than 100 people at the Playboy Mansion back in 2011. 

11. Does coffee cause cancer?

Short answer: No 

Coffee got a bad rap in the 1980s when a study linked drinking coffee to pancreatic cancer. The preliminary report was later debunked. More recently, health studies have swung in favor of the caffeinated beverage. Coffee has been linked to a lower risk of type 2 diabetes, Parkinson's disease, liver cancer, and even suicide. 

12. Do eggs raise cholesterol levels?

Short answer: No 

Although egg yolks are a major source of cholesterol — a waxy substance that resembles fat — researchers have learned that saturated fat has more of an impact on cholesterol in your blood than eating foods that contain cholesterol. "Healthy individuals with normal blood cholesterol levels should now feel free to enjoy foods like eggs in their diet every day," the lead researcher from a 25-year University of Arizona study on cholesterol concluded. 

13. Can you drink too much water?

Short answer: Yes 

It is very rare for someone to die from drinking too much water, but it can happen. 

Overhydrating is most common among elite athletes. Drinking an excess of water, called water intoxication, dilutes the concentration of sodium in the blood leading to a condition known as hyponatremia. The symptoms of hyponatremia can range from nausea and confusion to seizures and even death in severe cases. To avoid this, drink fluids with electrolytes during extreme exercise events. 

14. Can yogurt ease digestive problems?

Short answer: Yes 

Our digestive tract is filled with microorganisms — some good and some bad. Yogurt contains beneficial bacteria, generically called probiotics, that helps maintain a healthy balance. Probiotics can relieve several gastrointestinal problems, including constipation and diarrhea. Certain brands of yogurts, like Activa by Dannon, are marketed exclusively to treat tummy issues. 

15. Do whitening toothpastes whiten teeth more than regular toothpastes?

Short answer: No 

Whitening toothpastes usually contain peroxides and other strong abrasives that might make your teeth appear whiter by removing stains. Unlike at-home whitening strips and gels that contain bleach, these toothpastes do not actually change the color of your teeth. 

16. Is it safe to microwave food in plastic containers?

Short answer: Yes 

But the plastic container should display the words "microwave safe." This means that the Food and Drug Administration has tested the container to make sure no chemicals used to make the plastic leech into foods during microwaving. If chemicals do seep out into food, the amounts are tiny and not dangerous to our health. As a general guideline, plastic grocery bags as well as most plastic tubs that hold margarine, yogurt, cream cheese, and condiments are not microwave safe. 

17. Can watching TV ruin your eyesight?

Short answer: No 

Watching TV will not destroy your rods and cones as the outdated myth suggests. Before the 1950s, TVs emitted radiation that could increase an individual's risk of eye problems after excessive TV viewing. Modern TVs have special shielding that blocks these harmful emissions. 

18. Is bottled water better for you than tap water?

Short answer: No 

Bottled water is no safer or purer than tap water, although it is substantially more expensive. A recent study by Glasgow University in the U.K. found that bottled water is actually more likely to be contaminated than water from your faucet because it is less well-regulated. Bottled water and tap water typically come from the same sources — natural springs, lakes, and aquifers. While public water supplies are tested for contaminants every day, makers of bottled water are only required to test for specific contaminants every week, month, or year.

 (The above have been collected from a email I received from a friend as trail mail) 

Dr Pawan Gupta M.Ch.(Onco-surgeon)

Please give your feedback

It’s never your ill fate, till it’s not too late!!

It’s never your ill fate, till it’s not too late!!

Every cancer patient...a story untold...

Few days back I was treating a gentleman that I doubt I would ever forget...just felt like sharing what I’ve been through.

“Doctor Saab you know when I was young, I used to be a very handsome man”...the man said in a very weird voice, as I was removing the thick pad of dressing around his neck...and of what was remaining in his face...it seemed to be quite true. The smell was terrible and the sight just unbearable!!

This was a almost 6 ft tall gentleman...sparkling blue eyes and very fair complexion...the reason why he was here is...he had lost his face…Yes his face to oral cancer!!!

Pt: “I started smoking very early...was more for fun, sometimes just to show how cool I was...never realised when it became my habit...”

Me: “why did you not quit”...

Pt:  “I did...and it was very easy to quit”. He laughed...”I would do that often! Only to get back!!”

Me: why did you wait till it became so bad, was money an issue!?

Pt:  Sir frankly I have lots of money. I dealt in properties, so money wasn’t an issue. I was a very successful man. Each deal I mediated would close well and so was the money I earned. With money came long hours, the stress and the smoking. I was very confident man, to the point of being rude and arrogant, so when this cancer thing happened, I just couldn’t believe it was happening and it was happening to me! It all started as a small ulcer like thing in the inner cheek, it caused lot of burning while having food but I simply ignored it for pain was never an issue I was very strong & could bear any amount of pain ”

Me: Then what happened?

Pt:  My wife died few years ago and with her I lost the most precious thing I ever had! To ease my mood and to tackle with the loss of my wife my smoking frequency increased and so did this cancer. The pain had increased too. And by then there was this very foul smelling wound in my mouth, I would feel so ashamed that by then I stopped going out of house. I wouldn’t even accept any relatives to meet. It was only when this pain and this wound became big my son has got me out of my home to the hospital”

Medically this patient had advanced oral cancer that had eaten away his lower half of face...including the bone (mandible), entire inner structures were visible and the sight was truly ghastly.

So what got him to this state...the deadly cancer, the kick tobacco gave, the ignorance towards his disease, the grief of losing his wife, loss of will to live....probably all!!

The cancer didn’t just destroy his face...but his confidence, his identity and probably soon...his existence!!!

I doubt if I would ever forget this man...his face...rather lack of it....I guess even if a single soul gets the correct lesson out of this story, his suffering would probably would for once be useful to someone else.

We may ban tobacco, show video clips, paste horrible photos on the packet itself but it’s a natural human tendency to default...not falling for these things isn’t a momentary act...but a continued one. As a doctor I know this disease, I diagnose it, I treat it but with each patient I see, this new-age Ravaan keeps raising its ugly head...one after another!! For now, this has ceased to be a fight...it’s a battle. A battle that one will have to fight from within...

We at I CAN WIN are continuously behind this devil...and we won’t stop till we hammer the last nail in its coffin.

Remember it’s never your ill fate

Till it’s not too late!!

(Contributed by – Dr Vishal Soni)

30.12.2013

"जब भी देखो छोटा दाना, उसकी पहचान जल्द ही कराना 

कैंसर को बनने न दो नासूर, शीग्र करो इसे दूर!"

Young Rashmi could brave the treatment of cancer, but can she brave the social stigma of cancer?

The greatest hurdles to “WIN OVER CANCER” is the myths, phobia surrounding cancer and this has built over years of ignorance.

The greatest challenge to win over cancer is to change the mindset of the people about cancer.

Travelling across villages and cities I have come across number of such challenges.

Once I visited a patient in East Delhi. Rashmi (name changed) was a young patient of breast cancer 33 years old with two kids aged 9 and 2 years. Husband was employed with a private firm in Noida.  Rashmi was an educated girl and now a house keeper. She noticed a lump in her breast and took the necessary treatment. She braved all the complications, side effects associated with the treatment. But she was failing to face the social stigma associated with cancer. Whenever she visited, I would try to keep her positive telling her that now she is a cancer winner, but I would notice something missing. One day, I decided to visit her.

The truth of her negativity was not cancer but the situation prevailing in her house. Rashmi was being treated at home as an untouchable – she was given a separate room at the corner of the house, the utensils, clothes everything was kept separate. The children and husband were not allowed to be with her, because they would be “infected” with cancer!!!!

It took me sometime to understand the whole situation, tried to explain the elders of the house that cancer is not infection and she should be allowed into the house. Nothing worked. And then I decided on a method, I would visit her now more frequently and would share food with her in her ‘room’. The people around were surprised and astonished. But the change happened.

Rashmi took training and is now employed as a teacher in a government school.

To make a cancer winner it is not just the treatment but we have to take care of the social stigma associated. 

Have you come across such challenges associated with cancer, I would request you to share the same. We can bring the change with awareness.

Let us join to “WIN OVER CANCER”

Most common Regrets of the Dying

Subject: Most Common Regrets of the Dying

Priorities become crystal clear when people are about to die. This has been the observation of nursing staff while working with terminally ill patients. Bronnie Ware spent several years caring for dying people in their homes. She shares the five most common regrets the dying have. For many years I worked in palliative care. Some incredibly special times were shared. I was with most of them for the last three to twelve weeks of their lives. People grow a lot when they are faced with their own mortality. Each experienced a variety of emotions, as expected, of denial, fear, anger, remorse, more denial and eventually acceptance. Though, every single patient found their peace before they departed. When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five: 1. I wish I’d had the courage to live a life true to myself, not the life others expected of me. This was the most common regret of all. When you are on your deathbed, what others think of you is a long distance away from your mind. Most people had not honoured even a half of their dreams and died knowing that it was due to choices they did not make , invariably due to influence of others. When people realise that their life is almost over and look back, it is easy to see how many dreams have gone unfulfilled. It is very important to try and honour at least some of your dreams along the way, till your health is intact. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it. 2. I wish I didn’t work so hard. This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence. By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle. 3. I wish I’d had the courage to express my feelings. Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result. We cannot control the reactions of others. However, although people may initially react when you change the way you are, by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Alternately, it releases the unhealthy relationship from your life. Either way, you win. 4. I wish I had stayed in touch with my friends. Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying. It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks…. love and relationships. 5. I wish that I had let myself be happier. This is a surprisingly common one. Many did not realise until the end that hapiness is a choice. They had stayed stuck in old patterns and habits. The so called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. Deep within, they longed to laugh properly and have silliness in their life again. Bottomline: How wonderful would it be, not to have any of these five regrets , just as you are about to depart. Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.

Webinar on Breast Cancer Awareness

Want to know more about Breast Cancer? Check this out.


Join Jiyo Befikar Women as they take you through what you must know about Breast Cancer, rebut the myths and share some hard hitting survivor stories.

Date: 27th October, 2012
Time: 12:00 p.m

http://www.jiyobefikarwomen.com/webinar-on-breast-cancer-awareness/#cf2_field_2

Be Positive

LATEST CANCER INFORMATION.AFTER YEARS OF TELLING PEOPLE CHEMOTHERAPY IS THE ONLY WAY TO TRY AND ELIMINATE CANCER, JOHNS HOPKINS IS FINALLY STARTING TO TELL YOU THERE IS AN ALTERNATIVE WAY …[Cancer Update from Johns Hopkins ]


1. Every person has cancer cells in the body. These cancer cells do not show up in the standard tests until they have multiplied to a few billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size.

2. Cancer cells occur between 6 to more than 10 times in a person's lifetime.

3. When the person's immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumors.

4. When a person has cancer it indicates the person has multiple nutritional deficiencies. These could be due to genetic, environmental, food and lifestyle factors.

5. To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.

6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastro-intestinal tract etc, and can cause organ damage, like liver, kidneys, heart, lungs etc.

7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.

8. Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction.

9. When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.

10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.


11. An effective way to battle cancer is to STARVE the cancer cells by not feeding it with foods it needs to multiple.

What cancer cells feed on:

a. Sugar is a cancer-feeder. By cutting off sugar it cuts off one important food supply to the cancer cells. Note: Sugar substitutes like NutraSweet, Equal, Spoonful, etc are made with Aspartame and it is harmful. A better natural substitute would be Manuka honey or molasses but only in very small amounts. Table salt has a chemical added to make it white in colour. Better alternative is Bragg's aminos or sea salt.


b. Milk causes the body to produce mucus, especially in the gastro-intestinal tract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soy milk, cancer cells will starved.

c. Cancer cells thrive in an acid environment. A meat-based diet is acidic and it is best to eat fish, and a little chicken rather than beef or pork. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.

d. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment. About 20% can be from cooked food including beans. Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes t o nourish and enhance growth of healthy cells.

To obtain live enzymes for building healthy cells try and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees C).

e. Avoid coffee, tea, and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties. Water--best to drink purified water, or filtered, to avoid known toxins and heavy metals in tap water. Distilled water is acidic, avoid it.

12. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines will become putrified and leads to more toxic buildup.

13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body's killer cells to destroy the cancer cells.

14. Some supplements build up the immune system (IP6, Flor-ssence, Essiac, anti-oxidants, vitamins, minerals, EFAs etc.) to enable the body's own killer cells to destroy cancer cells. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body's normal method of disposing of damaged, unwanted, or unneeded cells.

15. Cancer is a disease of the mind, body, and spirit. A proactive and positive spirit will help the cancer warrior be a survivor.

Anger, unforgiving and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life.

16. Cancer cells cannot thrive in an oxygenated environment. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells.


(PLEASE SHARE IT WITH PEOPLE YOU CARE ABOUT)
The above material has been sent by Dr B C Gupta by Email.

Aware When Young: Tobacco and Lifestyle Awareness Lecture for Engineering College Students

On March 4, 2011, the Ghaziabad Chapter of I CAN WIN conducted an Aware When Young workshop for students of ABES Engineering College, Ghaziabad. The speakers on the occasion were:
ul>

Shri Suresh Prakash Agarwal: An Introduction to Indian Cancer Winners Association and its key activities

Dr Pawan Gupta: A Healthy Lifestyle for Prevention of Cancer

Dr Natasha Das: Tobacco & Your Health: Make an Informed Choice

Dr Rudra P Acharya: Oral Cancer: How to Detect Early Changes and Prevent Oral Cancer

Mr. Rajesh Dube: I CAN WIN Creative Club

<

Myths about breast cancer

This afternoon, Dr Pawan and I were discussing about the myths people have about breast cancer. That's when I remembered an article I once wrote on the topic. Here's a link to the article.

Ten things you have heard about breast cancer: Myths or facts?

Chemotherapy and Hair Loss

Chemotherapy and hair loss: What to expect during treatment
Find out what to expect when it comes to chemotherapy and hair loss. Plan to use your energy staying healthy rather than worrying about how you look.

You might not think about how important your hair is until you face losing it. And if you have cancer and are about to undergo chemotherapy, the chance of hair loss is very real. Both men and women report hair loss as one of the side effects they fear most after being diagnosed with cancer.

Whether or not you have hair loss from your chemotherapy depends mostly on the type and dose of medication you receive. But whether you can maintain a healthy body image after hair loss depends a lot on your attitude and the support of your friends and family. Read more..

Chemotherapy and hair loss: What to expect during treatment

Screening-Mammography Benefits and Harms in Spotlight Again

Screening-Mammography Benefits and Harms in Spotlight Again

Nick Mulcahy

Medscape Medical News 2009. © 2009 Medscape

April 2, 2009 — A new study adds to the debate about how the benefits and harms of screening mammography are presented to the public and provides new estimates of the absolute numbers of breast cancer deaths prevented by the screening.

The authors argue that the public is not currently presented with a balanced view of the screening, with potential benefits overemphasized and potential harms rarely discussed.

The study was published April 2 in the open-access online journal BMC Medical Informatics and Decision-Making.

Repeated screening mammography starting at age 50 saves about 1.8 lives over 15 years for every 1000 women screened, according the study authors.

They calculated that the absolute death risk from breast cancer without any screening is about 1% over those 15 years. "This means the survival percentage among women aged 50 to 60 who are not screened is 99%," said lead author John D. Keen, MD, senior attending radiologist at the John H. Stroger Hospital of Cook County, in Chicago, Illinois.

The survival percentage among women aged 50 to 60 who are not screened is 99%.

These statistical facts about mammography are in sharp contrast with what is most publicized about this screening, which is "mammography saves lives," suggested Dr. Keen.

"From a consumer perspective, the screening-mammography discussion in the United States is rather paternalistic and 1-sided," said Dr. Keen in an interview with Medscape Oncology.

What's needed is a balanced presentation of the facts to patients, which should include mention of the absolute benefits associated with screening and a discussion of potential harms, such as false positives, anxiety, unnecessary biopsies, and overdiagnosis, emphasized Dr. Keen. "This is not occurring now," he added.

However, a critic of the study says that its statistical methods are questionable and its findings debatable. Furthermore, the paper "labors an obvious point" about preventive medicine, says the critic.

"One has to apply an intervention to large numbers of healthy subjects in order to benefit the few who are unlucky enough to develop the disease," writes Stephen W. Duffy, MD, from the Cancer Research Center, in London, the United Kingdom, in an editorial that accompanies the study.

Dr. Keen's response to that criticism was that the "public has a right to know what the statistics are regarding mammography screening so that individuals can make informed decisions about participating."

Another cancer-screening expert approached by Medscape Oncology joined the study authors in calling for a better presentation of the facts about screening mammography. "We all have to do a better job to best inform the public about the benefits and harms of screening mammography," said Bob Smith, PhD, director of cancer screening at the American Cancer Society, in Atlanta, Georgia.

We all have to do a better job to best inform the public about the benefits and harms of screening mammography.

The new study appears at a time of increased public scrutiny of screening mammography. The New York Times recently covered the story of a public-health leaflet on screening mammography in the United Kingdom and the public outcry that resulted because the leaflet failed to mention the potential harms of screening. The controversy had been reported a month earlier by Medscape Oncology.

Findings Disputed and Supported

In their new paper, Dr. John Keen and his brother and coauthor James E. Keen, DVM, PhD, associate professor of epidemiology at the University of Nebraska, in Lincoln, analyzed the claim that "mammography saves lives" by calculating the life-saving absolute benefit of screening mammography in reducing breast cancer mortality in women aged 40 to 65.

To make this estimate, the authors used a variety of existing data sources, including randomized trials and SEER data on breast cancer mortality.

Dr. Duffy points out in his editorial that this study is one of modeled results and not empirical observation. "The accuracy of the figures arrived at is questionable," he writes.

Dr. Duffy notes that empirical data from 2 different randomized trials indicate that 3 or 2.1 breast cancer deaths, respectively, are prevented by repeatedly screening 1000 women. So the figure of 1.8 prevented deaths used in the current study is low, he says.

However, in a second editorial that accompanies the new study, Michael Retsky, PhD, from Harvard Medical School, in Boston, Massachusetts, says that the 1.8 deaths prevented by screening are consistent with other results.

"The crux of the problem is that early detection from screening only benefits approximately 1 in 1000 participants. That ratio appears in many trials and in the Keen and Keen paper," he told Medscape Oncology. The numerical results of the new study "are consistent with my knowledge and experience," he writes.

The crux of the problem is that early detection from screening only benefits approximately 1 in 1000 participants.

Dr. Duffy also disputes the new study's estimate that only 4.3% of screen-detected breast cancer cases have their lives saved as a result of screening. "This is clearly at odds with the experimental evidence. In the Swedish Two-County Trial, 141 breast cancer deaths were prevented — 15% of the 928 screen-detected cancers," he writes.

However, Dr. Keen countered this criticism by pointing out that a recent review of Swedish screening trials had turned up "multiple problems" and that his study findings predicted the results from the most recent AGE trial in England. He also said that the new study's data are derived from American sources and are "therefore more likely accurate for women in the United States."

Challenging a Popular Perception; A Question About Patient Knowledge

The finding that so few (only 4.3%) screen-detected breast cancer cases have their lives saved as a result of screening seems counterintuitive, write the authors. There is a widely held view that breast cancer is a uniformly progressive disease and that it is rarely curable unless caught early, they write. But in reality, breast cancer is a heterogenous disease, and it may be systemic from the start or it may never metastasize, they say.

In effect, this finding about lives saved by mammography challenges "the popular perception that earlier detection through mammography helps most patients with screen-detected breast cancer," write the authors.

In his editorial, Dr. Retsky agrees that the new study findings "defy" some "well-established viewpoints." He also believes that screening has considerable limitations.

"Personally, I am doubtful that imaging-based early detection will ever make dramatic improvements in breast cancer mortality. Rather, I think improved therapies are needed," Dr. Retsky commented to Medscape Oncology.

The limitations of mammography screening make the discussion of the harms all the more important, suggested Dr. Keen.

"Authorities acknowledge that screening-mammography harms include a 30% increase in overdiagnosis and overtreatment, delayed diagnosis, and radiation-induced cancers," write the authors. They also cite a survey that showed that physicians discuss these potential harms only 7% of the time when talking to women before a baseline mammogram (Health Expect. 2008;11:366-375).

However, the American Cancer Society's Dr. Smith believes that women are not uninformed about most of the potential harms of screening mammography.

"The authors imply that women are naive about these harms. They aren't. A study by Schwartz [et al. BMJ. 2000;320:1635-1640] observed that 90% of women said they were fully aware of false-positive mammograms and biopsies, and this awareness remained just as high when women who had experienced a false positive were compared with those who had not," he told Medscape Oncology.

The new study authors suggest that substantial business concerns influence the likelihood that consumers will receive "professional even-handed advice" about the harms and benefits of mammography. "Fundamentally, cancer testing is a business," they write.

Breast radiologists, equipment manufacturers, and advocacy groups all have conflicts of interest arising from financial incentives. "These incentives create the temptation to exaggerate the benefits and dismiss the harms of screening for breast cancer when advertising to the public," the authors write.

The study authors have disclosed no relevant financial relationships. Dr. Retsky disclosed that he has a patent application for a therapy for early-stage breast cancer.

BMC Med Inform Decis Mak. 2009;9:18, 19, 20.

For details go to - http://www.medscape.com/viewarticle/590535

Exercise for Cancer Patients

http://www.seacoastonline.com/articles/20090402-LIFE-904020335
Exercise for cancer patients
n Elisa Fraser 'Dream Time' gets a workout in York
By Rachel M. Collins
April 02, 2009 6:00 AM

Physical therapist Elisa Fraser knows first-hand that rest does not make cancer-related fatigue go away.

Having been diagnosed in 2003 with breast cancer herself, Fraser recounts vividly that year in which she had five surgeries, four months of chemotherapy and six weeks of radiation.

"You don't feel like doing anything," she said. "And the longer you rest the less you feel like doing something."

That is a sentiment well-known by the 14 cancer patients, or cancer survivors, who can be found twice a week doing stretching and strengthening exercises in the Next Step class led by Fraser at York Hospital's Heart Health Institute in York, Maine.

"I call them my 'Dream Team,'" she said. "If ever there was a group of people who have every right to complain ...; none of them ever complain ...; ever ...; They are just awesome."

The group exercise class actually is designed to combat cancer-related fatigue — which is being recognized today with Cancer-Related Fatigue Awareness Day — by focusing on improving a person's flexibility, strength, cardiovascular endurance and balance.

After all, studies have shown exercise not only can reduce fatigue, it can improve well-being, functionality, bone density, assist an immune system and enhance mental function, Fraser noted.

But the proof is in the amazing stories told around the classroom by Fraser's "Dream Team."

For instance, when Don Simard first was diagnosed with multiple mylenoma he was at times bedridden.

But then he decided he would begin the journey to get in better shape so that he could be a viable candidate for a stem cell transplant.

Now in Fraser's class, he alternates between stretching exercises and some strength training, such as balancing on an exercise ball while doing bicep curls with small weights.

"This has changed me in a lot of ways," Simard said of the class, which he is supplementing with walking and physical therapy. "Coming into this class was like coming into one big family where we all have the same problems and are coming from the same place."

Phyllis Bachi, whose uterine cancer has required surgery and 24 chemotherapy treatments over an eight-month period, agreed.

"She (Fraser) has been able to make us each feel equal, even though we all have had different types of cancers and surgeries, we all feel equal," Bachi said. "It has helped me greatly."

During the class, while working out to tunes such as Louis Armstrong's "What a Wonderful World," participants do exercises with exercise balls and small weights, but they also take time to joke with each other and socialize.

"This class is incredible," said Bobbie Stephenson, who was diagnosed with breast cancer four months ago. "It's really been life-changing. It gives you a lot more energy and it makes you feel you can do some things."

It is clear, Fraser said, through the research and her experience personally and in this class, that exercise is a key to battling cancer-related fatigue.

Certainly she seems to be right. Not only is there a long waiting list for the class, but when Fraser announced that she was beginning a "Step Up" class for those who no longer were qualified by their insurance to stay in the beginner's class, immediately it had its minimum of nine students. Fraser said she also is considering adding a second section to the beginner's class, if possible.

"After you've had surgery and treatment you know exercise will help you heal, but you don't want to do it alone," said Ann McHugh, who had her cancer surgeries and radiation beginning last November. "You know you're all starting with limitations you have to overcome, but this way you do it with someone who has professional knowledge."

Fraser, with her boundless enthusiasm, is also someone who easily motivates the class participants not only to exercise, but to bond with each other.

"Psychologically it's a little bit difficult to recover from this," said George Schumacher, who was diagnosed with cancer a year ago last December. "You can't do things you did before. This is a big help to get you back on track."

Certainly Fraser said the class includes "people on all parts of the cancer journey."

"When you get a cancer diagnosis it seems like people always want to relate with someone who has had exactly what they had and they're still here," she said.

Think you or your group should be profiled in Get off the Couch? Contact Rachel Collins at Rcollinsme@aol.com.

Benefits of Mammogram Under Debate in Britain

Benefits of Mammogram Under Debate in Britain
New York Times - United States
By RONI CARYN RABIN The conventional wisdom about breast cancer screening is coming under sharp attack in Britain, and health officials there are taking ...

http://www.nytimes.com/2009/03/31/health/31mamm.html?ref=science

Why booze is bad for women

Why booze is bad for women

Times Online - UK

A new research study told us that just one small glass of wine a day was enough to significantly raise a woman's risk of breast cancer. ...

Go to the link below to read more on this topic.

http://www.timesonline.co.uk/tol/life_and_style/health/features/article5940695.ece

Quick Cancer Facts

Cancer affects everyone – the young and old, the rich and poor, men, women and children – and represents a tremendous burden on patients, families and societies. Cancer is one of the leading causes of death in the world, particularly in developing countries.

Yet, many of these deaths can be avoided. Over 30% of all cancers can be prevented. Others can be detected early, treated and cured. Even with late stage cancer, the suffering of patients can be relieved with good palliative care.

* Cancer is a leading cause of death worldwide: it accounted for 7.9 million deaths (around 13% of all deaths) in 2007.
* Lung, stomach, liver, colon and breast cancer cause the most cancer deaths each year.
* The most frequent types of cancer differ between men and women.
* About 30% of cancer deaths can be prevented.
* Tobacco use is the single most important risk factor for cancer.
* Cancer arises from a change in one single cell. The change may be started by external agents and inherited genetic factors.
* About 72% of all cancer deaths in 2007 occurred in low- and middle-income countries.
* Deaths from cancer worldwide are projected to continue rising, with an estimated 12 million deaths in 2030.

There are more than 100 types of cancers; any part of the body can be affected.

Worldwide, the 5 most common types of cancer that kill men are (in order of frequency): lung, stomach, liver, colorectal and oesophagus.

Worldwide, the 5 most common types of cancer that kill women are (in the order of frequency): breast, lung, stomach, colorectal and cervical.

All patients in need of pain relief could be helped if current knowledge about pain control and palliative care were applied.

More than 30% of cancer could be prevented, mainly by not using tobacco, having a healthy diet, being physically active and preventing infections that may cause cancer.

Ref:http://www.who.int/features/factfiles/cancer/en/index.html downloaded on 19.3.09