February 2014 Health Pearls

For years, heart disease has been the number one cause of death.  Very soon, cancer might take that position, as the incidence of cancer worldwide is estimated to skyrocket from 14 million cases in 2012 to 22 million within two decades.  The cancer deaths are predicted to increase from 8.3 to 13 million during that time.

The International Agency for Research on Cancer, part of the World Health Organization, estimated that the most common cancers are lung, followed by breast and large bowel, with the most common cancer deaths being those of the lung, followed by liver and stomach. 

Tobacco was found to be responsible for 33% of all U.S. cancers while obesity, poor diet and lack of physical activity account for 28%.

Much of cancer incidence can be prevented by reducing the risk factors such as tobacco use, obesity or by increasing physical activity.  Adequate legislation, according to WHO, is needed to reduce the risk exposure and to encourage healthier behaviors.

Globally, 60% of all cancer incidence occurs in Africa, Asia, Central and South America, accounting for about 70% of all world’s cancer deaths.  To reduce the death rate, early detection and access to affordable and effective treatments are needed in the developing countries.

New Cancer Cases Worldwide Expected to Skyrocket, by Nanci Hellmick, USA today 02/04/2014

Obesity rates have risen in the U.S. over the last decade, with more than 35.7% of adults in 2009-2010 being classified as obese by the Center of Disease Control and Prevention.  Obesity is defined as a BMI of more than 30 kg/m2. 

The endometrial cancer rate, or cancer of the uterus, has steadily risen along with the rate of obesity.  This is believed to be caused by a high level of estrogen released by the adipose tissue.  An increased BMI also was found to be associated with an increased risk of ovarian cancer. 

Obesity also increases the mortality rate in all gynecological cancers.  A BMI greater than 35 was found to increase the mortality rate in cancers of the ovaries, uterus, and cervical, as compared to those with normal weight.

The American Cancer Society recommends a healthy lifestyle for cancer survivors such as maintaining a healthy weight or weight loss for those who are overweight, 30 minutes or more of moderate activities 5 days weekly, a healthy diet of five servings of fruits and vegetables a day and limited processed foods and meat, as well as a low alcohol intake.

Obesity and Gynecologic Cancer, Ob.Gyn.News, Dr.Paola Gehrig,Professor of and Director of gynecologic oncology at the University of North Carolina at Chapel Hill.

On January 30, in the Opinion section of the NYTimes.com, Drs. Rita Redberg and Rebecca Smith-Bindman expressed their concern about the tremendous increase exposure to high dose radiation in medical diagnostic processes, especially from the use of CT scans.  The National Council on Radiation Protection & Measurement reported a six-fold increase in the use of CT scans between 1980 and 2006, with radiation doses from CT scans being 100 to 1000 times more than a typical XRay. 

Two large clinical studies in Britain and Australia found an increased risk of cancer with CT scan exposure.  The Institute of Medicine in 2011 concluded that radiation from medical imaging and hormone therapy were the leading environmental causes of breast cancer and women were advised not to expose themselves to unnecessary CT scans. The National Cancer Institute also estimated a projected 29,000 excess cancer cases and 14,500 excess deaths over a lifetime for those exposed to CT scans.

Drs Redberg and Smith-Bindman admitted that CT scans are overused and are not always performed in the safest ways.  Doses vary from different institutions and could be 50 times stronger from one hospital to another!

The authors advised patients to be careful of radiation exposure and informed them of a useful website called Choosing Wisely to learn about the most commonly overused tests.  Patients need to be proactive in their care by asking their physicians if they truly need a CT scan, or if it could be substituted with a non-radiating procedure such as a Sonogram or MRI.  

To reduce the risks of cancer, several strategies have to take place including a reduction in unnecessary CT studies, better guidelines and monitoring from a third party such as the FDA or Joint Commission, and the lowest dose possible for the appropriate studies.

We Are Giving Ourselves Cancer — January 30, 2014, NYTime.com . Dr. Rita F. Redberg, a cardiologist, and Dr. Rebecca Smith-Bindman, a radiologist, at the University of California, San Francisco Medical Center.