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 Malaria Worldwide

May 3, 2010

Nearly half the world’s population – roughly 3.3 billion people – are at risk of contracting malaria. Though individuals in Latin America, the Middle East, and Europe are among those most often affected by the disease, the Centers for Disease Control and Prevention reports that 98 percent of global malaria deaths occur in 35 countries – 30 of them in sub-Saharan Africa and five in Asia. Every year there are nearly 250 million cases and an average of one million deaths due to malaria. Reports show that in 2008, an estimated 863,000 people died from malaria infection, indicating some improvement in diagnosis and treatment outcomes. Transmission is possible to any individual, however some groups are at an increased risk. These include young children who have not yet developed full immunity, pregnant women whose immunity has been decreased by pregnancy, international travelers who lack immunity, and  individuals with HIV/AIDS or others with compromised immune systems.

Malaria is a preventable and curable acute febrile illness caused by the bite of Anopheles mosquitoes which have been infected with Plasmodium parasites. The long lifespan of the Anopheles species found in Africa contributes to the disease’s prevalence in the region, and experts note that more than 85 percent of the world’s malaria deaths occur in Africa. Symptoms are usually seen seven days after the infective mosquito bite, and include fever, headache, chills, and vomiting. If diagnosed quickly, malaria can be treated using artemisinin-based combination therapy (ACT), however if treatment is not initiated, malaria can progress and lead to severe anemia, respiratory distress, or death.

In countries where malaria is endemic, access to diagnostic tools and medications may be limited. Less than 15 percent of these individuals are able to begin treatment within 24 hours of the onset of fever, which is when treatment must be started. Malaria diagnosis relies on either microscopy or rapid test procedures to allow healthcare providers to quickly determine if patients have the disease and require treatment. The Malaria Product Testing Evaluation Programme recently completed an assessment of 29 rapid diagnostic tests and found that 16 of them met the minimum performance criteria set by the WHO. According to Robert Newman, the director of the WHO’s Global Malaria Programme, using rapid tests allows healthcare providers to “test people who cannot access diagnosis based on microscopy in remote, rural areas where the majority of malaria occurs” and thus improves treatment outcomes.

In addition to improved testing, global efforts are underway to control malaria by eliminating the mosquitoes that transmit the disease. During the past decade, the distribution of treated bed nets has increased rapidly in 11 African nations, helping to reduce infection rates. Reports indicate that in 2008, 31 percent of African homes had insecticide-treated nets (ITNs), compared with 17 percent in 2006. Through the use of ITNs, as well as spraying of homes with insecticide chemicals, 10 African nations reduced the number of cases of malaria by at least 50 percent between 2000 and 2008.

Though there is no vaccine for malaria, more effective prevention measures, diagnostic tests, and medications can help to improve treatment outcomes for those affected. Government agencies, including the World Bank, and other groups, such as Roll Back Malaria global partnership, have made efforts to increase global awareness about malaria. By utilizing social media and online tools it has been possible to improve the effectiveness of outreach and fundraising for efforts which may help to eradicate malaria worldwide.

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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”

Medical Social Networking

May 12, 2009

Social networking websites have become increasingly popular in recent years. Kerri Breen of the CBC News reports that YouTube has become the third most popular website in the world, Facebook now has over 200 million users, and Twitter has grown 2,565 percent in the past year. Through the new channels offered by these social networking websites and tools, users can discuss anything from cat toys to a bothersome rash on their arms.

Fighting a Cold Online
The ever-increasing popularity of these Web 2.0 sites offers new opportunities for their application to improve health and medical care. The New York Times reports that during the last week of April, “Swine Flu” was the most searched term on Yahoo, the Wikipedia page on “Swine influenza” received 1.3 million page views, and an estimated 125,000 tweets a day on Twitter mentioned the illness. Despite this increase in discussion about the virus, Alessio Signorini, a PhD candidate in Computer Science at the University of Iowa, told the NYT that this “noise” does not indicate actual trends in the spread of the virus. Dr. Philip Polgreen further explained that by tracking indicators within popular search terms, such as symptoms of a condition or virus, it is possible to better track its spread and plan more effectively for inoculations.

Growth in Internet use has also led to a rise in self-diagnosis and/or self-prescription. Through tools like Twitter or Facebook, individuals can simply state that they do not feel well, and are much more likely to do so than to visit a doctor. While this could potentially lead to their not getting necessary treatment, other forms of web use may help to ease discomfort, physical and/or psychological, caused by certain conditions. A number of websites have been introduced which allow patients with specific conditions (e.g., MS, diabetes, eczema) to form a community. ABC Health and Wellbeing reports that research indicates that patients with psoriasis indicated their perceived quality of life had improved following the use of these online support websites. Center for Connected Health and Boston’s Massachusetts General Hospital researchers have also found that these online networks provide a valuable base of information and support to patients, and that health outcomes can be further improved through physician involvement.

A number of social networking websites have also been developed to allow physicians, clinicians, researchers, and medical specialists to link to one another and discuss various areas of their practice. In addition to sites which allow doctors to create social connections, others, like iCons in Medicine, provide the opportunity for healthcare providers in remote or medically underserved areas to request assistance on difficult cases from physicians in 30 medical specialties. Through these teleconsultations and the social networking tools provided by programs like iCons in Medicine, doctors can collaborate on difficult cases and improve patient health at the point of care.

Find out more about iCons in Medicine

CBC NewsNew York TimesABC Health and Wellbeing

Using Telemedicine to Treat Chronic Disease

April 13, 2009

Chronic diseases pose a threat worldwide, particularly in the developing world. Heart disease, cancer, diabetes, and other chronic diseases account for over half of all deaths each year – double the number of deaths caused by infectious diseases, maternal and perinatal conditions, and nutritional deficiencies combined.  Developing nations are facing an epidemic of non-communicable chronic diseases as risk factors such as obesity, lack of physical activity, and tobacco use continue to increase.  Contrary to the popularly held belief that infectious diseases are the leading cause of death in the developing world, 80 percent of chronic disease deaths occur in low and middle income countries.

International attention and funding has primarily focused on communicable disease, and as a result the healthcare systems of developing nations are not well equipped to manage chronic conditions.  For example, the World Health Organization spends only 50 cents per person on chronic disease (excluding mental health) per year, compared with $7.50 for the major infectious diseases.  Regular doctor visits are necessary for proper treatment and management of chronic diseases, but most low- and middle-income countries have not developed the necessary infrastructure or network of specialty physicians to provide this type of care.

Telemedicine and teleconsultation programs offer a cost-effective solution to this problem. Through initiatives like iConsult, healthcare providers in remote or medically underserved areas can consult with specialty physicians over the Internet to gain access to their clinical expertise. By utilizing iConsult, an Endrocrinologist in New York City or Cardiologist in Portland would be able to offer assistance to a provider in a clinic in Chad, and ensure that a patient with diabetes or high blood pressure receives the highest quality of care.

Find out more about the iConsult program

Reports indicate a nutritious diet, physical activity, avoiding alcohol and tobacco use, and regular medical exams help decrease the risk of developing a chronic disease.

CDC Report on Chronic DiseaseWHO Report on Chronic DiseaseReport from SciDev Net

See also:
Nugent, R. (2008). Chronic diseases: a growing problem in developing countries. DiabetesVoice, 53, 17-20.