On Ovarian Cancer

October 10, 2011

Reports indicate that approximately two million women develop breast or cervical cancer each year, and these rates continue to increase. Though not as common, ovarian cancer – the fifth most common cancer in women – causes more deaths than any other type of female reproductive cancer. According to the National Cancer Institute, to date in 2011 there have been an estimated 21,990 new cases of ovarian cancer, and 15,460 deaths due to the disease. Making women aware of the possible symptoms of ovarian cancer and encouraging them to have routine gynecological appointments may help to improve rates of diagnosis of the condition.

While nearly one in three women will develop breast cancer in their lifetime, one in seven will develop ovarian cancer, but detection and diagnosis is significantly more difficult in ovarian cancer. The symptoms associated with ovarian cancer are often vague, and are commonly associated with other common conditions. According to experts, women should see their doctor if they experience bloating, difficulty eating or feeling full quickly, and pelvic or abdominal pain on a daily basis for more than a few weeks. Because of the difficulty detecting ovarian cancer, it is frequently not detected until it has spread within the pelvis and abdomen. In its late stages it is often fatal, but if diagnosis is made early and treatment is received before the cancer spreads outside of the ovary, the 5-year survival rate is very high. In order to combat difficulties diagnosing ovarian cancer, researchers are working to develop new flureoscence-guided techniques that may make it possible to identify very small tumors that may have been missed using traditional detection methods.

All women are at risk of developing ovarian cancer, but approximately 90 percent of women who get the disease are 40 years of age or older, with the greatest number of cases occurring in women aged 60 and older. Women who have children earlier in life have a decreased risk of developing ovarian cancer, while those who have a personal history of breast cancer or a family history of breast or ovarian cancer have an increased risk. Once ovarian cancer has been positively diagnosed, as with other cancers, it is most often treated surgically. This frequently involves the removal of the uterus, both ovaries and fallopian tubes, and/or removal of the lymph nodes. In addition to the surgical removal of tumors, individuals with ovarian cancer may undergo chemotherapy, however radiation therapy is seldom used in the United States to treat ovarian cancer.

Though difficult to diagnose, if treated quickly ovarian cancer can be beaten. By encouraging women to monitor their health and communicate any concerns to their physician, it may be possible to identify cases more quickly and improve treatment outcomes.

 

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On Breast Cancer Worldwide

September 20, 2010

This October marks the 25th annual celebration of Breast Cancer Awareness Month, during which organizations in the U.S. and worldwide will hold events aimed at raising awareness and providing education about breast cancer. In spite of ongoing efforts to inform the public about breast cancer, it continues to be a major health concern worldwide. According to the National Cancer Institute (NCI), in 2010, there will be 209,060 new cases of breast cancer in the United States. Reports from the World Health Organization (WHO) indicate that incidence rates vary worldwide, however as the adoption of “western lifestyles” increase in the developing world, breast cancer has become more common. Due to the lack of adequate diagnosis and treatment facilities in these regions, survival rates are often also significantly lower. In 2004 an estimated 519,000 women died worldwide due to breast cancer, with 69 percent of these deaths occurring in developing nations. By ensuring that information about breast cancer and early detection programs are available, treatment outcomes worldwide can be greatly improved.

Like other types of cancer, breast cancer develops when abnormal cells divide in an uncontrolled fashion and spread to surrounding tissue (metastasize). Breast cancer is a malignant form of tumor growth which can develop in both men and women, but is approximately 100 times less common in men. An estimated one in every eight women will be diagnosed with breast cancer during their lifetime, making it the second most commonly diagnosed cancer after skin cancer in women in the United States. There are many types of breast cancer, but two of the most common are ductal carcinoma, which begins in the cells that line the milk ducts of the breast; and lobular carcinoma, which begins in the lobes or lobules of the breast. Unlike less common forms of breast cancer, including inflammatory breast cancer which is marked by heat, redness, and swelling of the breast, these common types of breast cancer tend to manifest similarly.

The first signs of breast cancer may include a lump in the breast or thickening of breast tissue, change in shape of the breast, changes in the breast or nipple skin, or bloody discharge from the nipple. Tumors in the breasts may be detected during clinical breast exams, mammograms and other imaging tests, or self breast exams. A mammogram is a black-and-white image of the breast similar to an X-ray. Though some recommendations differ, the American Cancer Society suggests that women undergo yearly mammograms beginning at age 40. Though mammography has proven to be an effective screening method and can help ensure early diagnosis of breast cancer, the Centers for Disease Control and Prevention (CDC) indicates that more than 7 million women in the United States have not had a recent mammogram.

Following the identification of a tumor within the breast, a determination must be made regarding how advanced the spread of the cancer is so that it can be effectively treated. The “Stages” into which breast cancer are categorized – from Stage 0, defined by abnormal cells that are not invasive cancer, to Stage IV, defined by cancer which has spread throughout the tissues of the body. The Stages indicate how aggressively the cancer is spreading within the breast, to the surrounding tissue and lymph nodes, and throughout the rest of the body. Depending on the progression of the cancer, treatment options may include chemotherapy and surgery. Chemotherapy is a drug treatment that uses powerful chemicals to slow the growth of cancer in the body or kill off the cancer cells. Though it is effective, chemotherapy, which can produce a number of side effects, including nausea, vomiting, hair loss, and fatigue, is often used in combination with surgical interventions. Breast-sparing surgeries, which aim to remove cancer from the breast while preserving the surrounding tissue; and mastectomies, in which the entire breast is removed, are often employed.

Though breast cancer treatment can be physically and emotionally painful, there are currently over 2.5 million breast cancer survivors in the U.S. and many more around the world. Breast cancer can occur at any age, but the risk of its development increases as an individual gets older. While the cause is still unknown, there are a number of factors linked to an increased risk of developing breast cancer including the presence of certain “breast cancer genes,” a woman’s age, family history, and age at the onset of menstruation and menopause can increase their risk of developing breast cancer. While little can be done about some of these factors, some women with a genetic predisposition to developing cancer have opted to undergo preventative mastectomies to reduce their risk. Individuals can also help to reduce their risk by maintaining a healthy lifestyle.

By ensuring that individuals are made aware of the importance of regular clinical and self breast evaluations and that early detection and diagnosis programs are made available, treatment outcomes can be greatly improved.

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On Sunscreen and Skin Cancer

July 12, 2010

In 1903, Dr. Auguste Rollier opened the world’s first sun clinic at Leysin offering a place where sunlight was seen as a treatment for disease. Well into the 20th century, tanned skin was not only an indicator of health, but was fashionable as well. In recent years, outdoor tanning as well as the use of tanning beds have drawn attention for their potentially harmful effects. Skin cancer is the most common form of cancer in the United States with nearly one million cases diagnosed each year. Though other risk factors can contribute to the development of skin cancer, one’s exposure to ultraviolet (UV) radiation can speed their progression. By making sure to apply sunscreen, wear protective clothing, and limit time spent in direct sun, individuals can decrease their likelihood of developing skin cancer.

UV rays are a type of invisible radiation that comes from the sun, tanning beds, and sunlamps. There are three kinds of UV light: UVA rays are present year round and penetrate deep into the surface of the skin, damaging the cells beneath and causing signs of aging. Though UVA radiation can contribute to skin cancer, UVB rays, which cause sunburn and tanning of the skin and are more prevalent during the summer months, are also most often responsible for the development of skin cancer. UVC rays, are blocked by the ozone layer, but would cause sunburn with only brief exposure, while prolonged exposure would be fatal. Tanning beds primarily emit UVA radiation, which is the least harmful, but a 2006 study indicated that the use of tanning beds before an individual is 30 years old is associated with a 75 percent increase in melanoma risk.

Excessive UV exposure frequently leads to erythema, or sunburn, as well as causing a darkening and thickening of the outermost layers of the skin, which differs from a sun tan. Chronic exposure to any UV radiation can cause degeneration of the cells, fibrous tissue, and blood vessels of the skin, and may eventually contribute to the development some types of skin cancer. The primary symptom of skin cancer is a mole or other growth on the skin. The “ABCD system” is frequently used to help individuals understand what to look for when determining if a skin growth is cancerous. Asymmetry, when one half of the area is different from the other; Borders, irregular edges to the growth; Color, changes in color from one area to another; and Diameter, when the growth is larger than a pencil eraser; are all indicators that a lesion should be examined by a dermatologist. Some experts also make note of the “E factor” associated with skin cancer development – the Evolution or changing of the lesion.

The two most common types of skin cancer, basal cell and squamous cell carcinomas, also called non-melanoma skin cancers, can be caused by exposure to ultraviolet (UV) light. Though they are often curable, the process of surgical removal can be painful and disfiguring. According to a survey from the American Society for Dermatological Surgery (ASDS), there was a 10 percent increase in the number of surgical procedures related to skin cancer between 2007 and 2009. Melanomas are often malignant and are a more dangerous form of cancer, and 65 to 90 percent of them are caused by UV exposure.

To reduce an individual’s risk of developing skin cancer, experts recommend a number of measures that can be taken, including limiting the amount of time spent outdoors, particularly between 10AM and 4PM when UV exposure is highest in the continental United States. In addition, though it does not completely eliminate an individual’s risk of developing skin cancer, the use of sunscreen can help to decrease the risk. According to a U.S. sunscreen study conducted by Neutrogena, only 18 percent of American adults use sunscreen regularly, and only 48 percent of those reapply sunscreen when needed. Though the American Academy of Dermatology (AAD) suggests that consumers apply enough sunscreen to fill a shot glass, according to Jeffery Dover, president of the ASDS, consumers often do not apply enough for the products to be effective. The AAD reports that individuals frequently do not use enough sunscreen to adequately protect them from UV rays, and suggests the use of products with a sun protection factor (SPF) of at least 15 year round and 30 in the summer. SPF refers to the ability of a product to block UV radiation from reaching the skin, however the amount of protection does not increase proportionally with the SPF number and layering multiple SPFs does not result in protection equal to their sum. In order to ensure that sunscreens are most effective, they should be applied at least 20 minutes prior to sun exposure and only products stating that they provide UVA/UVB or “broad spectrum coverage” should be used.

In order to increase the use of sunscreen, public health officials have begun seeking new ways of increasing sun safety awareness. In one study, researchers found that using text messages to remind individuals to apply sunscreen when going outside, and reapply it following swimming or exercise increased its use. Sun protection has also advanced beyond the standard lotions, creams, and sprays, and now also includes clothing treated to provide UV protection. Most recently, a 10 percent tax was implemented on the use of indoor tanning services, underscoring the fact that even indoor tanning can be hazardous. With these new measures in place and continued improvements in sun protection technologies, researchers hope that it may be possible to prevent some skin cancers from developing.

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Tobacco Use Worldwide

December 23, 2009

Currently, approximately one third of the global population over the age of 15 – about 1.1 billion people – smoke cigarettes. Tobacco use continues to be the leading preventable cause of death worldwide, killing at least five million people each year. Trends from illness and death related to tobacco use indicate that by 2030, tobacco use will contribute to the deaths of more than 10 million people worldwide each year, 70 percent of whom live in the developing world. Though various strategies are in place, including bans on smoking in public areas, restrictions on advertisements for tobacco products, and increased taxes on cigarettes, the number of people who use tobacco has not significantly decreased. A recently released report from the World Health Organization (WHO) details cigarette and smokeless tobacco consumption and seeks to find an approach that may lessen the use of these products.

Global Tobacco Use

The WHO report indicates that though 22 of the world’s most populous 100 cities are now “smoke-free,” this only accounts for 5.4 percent of the world’s population. In 2008, the WHO established a set of guidelines aimed at helping nations to reduce smoking, which include:

  1. Monitoring tobacco use and the policies to prevent it,
  2. Protecting people from tobacco smoke,
  3. Offering people help to quit using tobacco,
  4. Warning people about the dangers of tobacco,
  5. Enforcing bans on tobacco advertising, promotion, and sponsorship, and
  6. Raising taxes on tobacco.

However, reports indicate that less than 10 percent of the world’s population is covered by any one of these measures. Additionally, only two percent of individuals live in nations that have comprehensive and widely-accepted smoke-free laws, and 94 percent are not protected by any laws against smoking.

Laws banning smoking – including the use of cigarettes, cigars, and hookahs – in public places will come into force in 2010 in many areas of the world. According the Syrian Society for Countering Cancer, 60 percent of adult men and 23 percent of women in Syria smoke, and 98 percent of Syrians are affected by second-hand smoke exposure. Other nations face similarly high rates of tobacco use and smoking-related illness and death. The high incidence of tobacco-related deaths in the Philippines (90,000 per year), Malaysia (10,000 per year), and Vietnam (40,000 per year) has caused concern in these regions, but fully effective smoking bans are not yet in place. Reports indicate that the majority of smokers in some Southeast Asian countries are men, and that as many as 75 percent of men smoke, compared to fewer than 20 percent of women who do. In Cambodia, for example, roughly half of the older women do use tobacco, but favor smokeless chewing tobacco, which many women begin during pregnancy to help lessen prenatal nausea.

Over the past four years, smoking rates have decreased in developed nations including the United States, Japan, and Western Europe as anti-smoking laws gain momentum. However, the World Lung Foundation (WLF) indicates that “More than 80 percent of those with premature deaths [from smoking] would occur in low- and middle-income countries.” Since 1960, according to the WLF, “the global production of tobacco has increased 300 percent in low- and middle-resource countries while dropping more than 50 percent in high-resource countries.” In China and India, over half a billion men consume tobacco, and other nations are facing similar problems of mass consumption of tobacco use. Tobacco is a contributing cause to heart attacks, strokes, diabetes, cancers and asthma worldwide, regardless of how it is consumed (smoked, chewed, etc.). According to Ala Alwan, the WHO non-communicable diseases expert, more than 80 percent of the WHO’s projected cancer deaths are likely to occur in the poorest regions of Africa. To increase awareness and provide education about the dangers of smoking, the WHO is planning to establish a regional hub there in 2010.

It remains to be seen how much impact the efforts of the WHO and other organizations will have with regard to decreasing the number of individuals who use tobacco. Through newly established laws, increased taxation, and outreach and education about the dangers of cigarettes and smokeless tobacco products, it may be possible to urge individuals to quit smoking or not to start at all.

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The Medicinal Life of Bees

August 31, 2009

Forms of apitherapy or bee venom therapy (BVT) have been in use for centuries in a number of cultures worldwide. As early as 800 BCE Charlemagne is said to have been treated with bee stings, and in 1888 Australian physician advocated the use of bee venom for rheumatism. Apitherapy is defined as the medicinal use of products derived from bees, including honey and royal jelly, as well as bee venom. While BVT has not been proven through clinical trials and testing, practitioners claim that bee stings contain an anti-inflammatory agent that relieves chronic pain and can be used to treat a number of diseases. BVT, which can involve either the application of live bees or the injection of bee venom, has been used to treat arthritis, multiple sclerosis, migraine headaches, psoriasis, and herpes. Raw honey and other ingested bee products are believed by some to contain B-complex vitamins, antifungal, and antibacterial properties.

Medicinal Bees

The use of BVT has gained some attention as a potential homeopathic remedy for the treatment of multiple sclerosis (MS) symptoms. Discovery Health reports that apitherapy can be used to lessen the pain, loss of coordination, and muscle weakness associated with MS. It is commonly held that compounds in bee venom, including melittin and adolapin, help to reduce inflammation and pain. Because of the lack of major studies to date regarding the effectiveness of BVT, only about 50 physicians in the United States use it as a treatment for MS and other diseases. Anecdotal evidence from patients with MS being treated with apitherapy is reassuring, however, and has prompted thousands of beekeepers, acupuncturists, and other alternative medicine providers to offer the treatment. Those who chose to use apitherapy methods based on the application of live bees may chose to raise their own colonies or rely on mail-order services.

Researchers at Georgetown University (Washington, D.C.) conducted a preliminary study to evaluate the safety of bee venom extract as a treatment for patients with progressive forms of MS. Although no serious adverse reactions were observed during the year-long study, four of the nine participants experienced a worsening of neurological symptoms, requiring termination of the study. It is important to note that this worsening could not be ascribed to side effects of the study, and three participants self-reported an improvement in their symptoms, and two demonstrated objective improvement. Larger scale studies would be needed in order to conclusively prove the effectiveness of BVT for patients with multiple sclerosis.

Delivery of melittin, the main component in bee venom, is also being studied by researchers at Washington University in St. Louis. By utilizing nanoparticles tipped with bee venom – so called “nanobees” – the researchers are seeking a cancer treatment with fewer side effects than conventional treatments. Nanobees work by delivering melittin, which destroys the cells around it by puncturing the cell membranes, directly to the cancer cells. However, unlike the melittin from bee stings, melittin attached to nanoparticles attacks only cells that have one particular protein on their surface, the protein that helps cancer cells to grow new blood vessels which is found only on tumor cells. After less than a week of treatment using nanobees, the growth of human breast cancer cells in mice had slowed by about 25 percent, and melanoma tumors in mice shrunk by 88 percent.

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On Apitherapy from cancer.orgAdditional information on ApitherapyDiscovery Health on BVT for MS –  Georgetown University Research on BVT –  Discovery on NanobeesCNN on NanobeesAdditional information on Ferris Apiaries, a Maryland-based bee supplierAdditional information on Pat Wagner, “the bee lady”