Lifestyle Risks for Breast Cancer

The Institute of Medicine’s Committee on Breast Cancer and the Environment issued a report discussing the scientific evidence that documents various risks for breast cancer. The strongest evidence for risk is combined synthetic hormone therapy (especially progestins, not natural progesterone), exposure to X-rays, excessive weight after menopause, and alcohol consumption. Mixed evidence implemented smoking, use of hair dyes, lack of exercise, and exposure to microwaves and other electrical devices. Next in line were second hand smoke, nightshift work, and exposure to various chemicals. The latter has not been well studied. Genetics obviously plays some role as well. Do the best you can to live environmentally safe. IOM Committee on Breast Cancer and the Environment(click here).

For Women, To Drink or not to Drink, That is the Question

The Nurses Health Study out of Harvard has shown that two drinks a day, regardless of whether they are beer, wine or other alcohol, increase the risk of breast cancer. However, the same intake of alcohol reduces the risk of cardiovascular disease. The mechanism is unknown, but the authors speculate that the cancer risk has something to do with circulating levels of estrogens. The CV benefit might be due to stress reduction. Look at your family history to see which of the risks predominates, and perhaps act accordingly. See JAMA (click here)2011;306:1884-90.

Screening Mammography’s Role in Saving Lives

A study in the Archives of Internal Medicine showed that the benefit of screening mammography has declined over time. Only 5-10% of women who find a cancer by getting a mammogram will have their life saved by early detection. The authors speculate that the benefit has declined because women present to a physician earlier if they self-detect a lump and because treatment of self-detected cancers has improved. One advantage of using thermography for breast screening is that tendencies toward the development of cancer show up before a cancer starts to grow. Interventions to try to modify that risk can then be implemented. Another advantage of thermography is that it can better evaluate dense breasts. Efforts by the group, Are You Dense, to inform patients with this finding and require additional screening are causing several states to introduce legislation this year. See Welch and Frankel, Arch. Intern. Med 2011, Oct 24. For thermography see ThermaScan.com (click here) or my website, healthcelebration.com (click here)

Misguided Concerns about Overdosing with Vitamin D

The popular press recently reported on a study that supposedly warned about a slight increase in the incidence of atrial fibrillation for patients with very high levels of vitamin D. The Alliance for Natural Health-USA has clarified this minor concern. In fact the study just confirmed what we have known for a long time. Levels of 25 [OH] vitamin D3 of less than 30 mg/ml are clearly deficient, optimal levels are 60-100 ng/ml, and possible side effects are of concern the more above 100 ng/ml the blood levels go. Yes, it is a good idea to get a blood test. To achieve toxicity, however, according to the Vitamin D Council, most reports suggest that a consistent level of at least 40,000iu a day over time has been required. The benefits of vitamin D include treatment of viruses and osteoporosis and prevention of heart disease, cancer, autoimmunity, and other illnesses. Please do not let the gullible press response to anti-supplement campaigns distract you from the multiple benefits you can achieve from optimal nutrition. See www.anh-usa,org/truth-about-vit-d-study/(click here)

PSA Screening—One Man at a Time

The U.S. Preventive Task Force released a new draft recommendation that PSA screening for prostate cancer is no longer appropriate. The concern was that the risk of complications and unnecessary surgery outweigh the potential benefit of catching a cancer early. Large studies showed no significant benefit in reducing mortality. An editorial in the New England journal disputed the action, and I agree with the authors. A PSA for screening should not be a required test, but serial measurements for individual men should be an option, along with digital rectal exams, after a careful discussion with the doctor about the potential risks and slight benefits. Individualized medicine addresses the needs of every person. Statistics are a guide but they should not direct us to throw the baby out with the bathwater if there is a reasonable chance of benefit for an individual patient. See New England Journal of Medicine (click here) subscription required. 2011;365:1951-1953.

Zinc Lozenges for the Common Cold

An analysis of 13 placebo-controlled studies showed that zinc lozenges can shorten the duration and decrease the symptoms of the common cold, including pharyngitis. A 40% reduction in the duration of symptoms was noted by combining the studies. The key is to take adequate doses. 75 mg of zinc acetate was needed for maximum effect. Occasionally, the zinc had to be discontinued due to constipation or a bad taste, but other side effects for short-term use were uncommon. Long-term use is not recommended. A deficiency in copper can result. See Open Respiratory Medicine Journal(click here), 2011;5:51-58.

Obama Saves Lives by Regulating Mercury

In December, President Obama and the EPA enacted the first national controls on mercury and other toxic chemicals released by coal-fired power plants. True, there will be a cost to these regulations, but the EPA estimates that we will save $9 in health benefits for every dollar spent to reduce this highly toxic metal. It is estimated that reducing mercury in the air will prevent 11,000 premature deaths each year, 4700 heart attacks, 130,000 cases of childhood asthma, 6300 episodes of acute bronchitis, and who knows how many cases of autism (my addition on autism)? Next we have to deal with the American Dental Association. See Editorial in the Toledo Blade, December 23, 2011, section A, p. 10.

Parents are Creating New Vaccine Schedules

Researchers in Ann Arbor, Michigan have determined that one out of seven sets of parents is following a vaccine schedule that is contrary to the standard procedure. Half of these are refusing some vaccines and another half are getting the vaccines when the child is older. DPT and polio vaccines are least likely to be skipped and flu vaccines most likely. Doctors need to be flexible when arranging for vaccines with parents. The latter’s concerns are real. The risk to your child is a different issue than the overall benefit to society. See Pediatrics 2011-0400)