Remember, we review the latest blogs related to drugs — medicinal, recreational, interactional, personal, professional, or any other aspect. If you were left out in this round, just leave a comment with your blog entry. You can check out the archives for every edition of this carnival.

For future editions, please remember to submit your blog entries using the online submission form. We will do our best to review and include your entry! Enjoy your readings…

A Dark and Sinister Force for Good writes Pseudo-poppycock:

Let’s take a look at the probable consequences of this action: A drug that anyone can now pick up at any grocery store or drug store for about six dollars will now only be available after paying a doctor upwards of fifty dollars for an office visit. Because the common, inexpensive drug must now be carried in the security of a drug store safe and only dispensed by licensed pharmacists, the cost per unit will have to be raised (to pay for the additional paperwork, among other things). Law-abiding citizens stricken with sinus headaches, allergies, or sinusitis will now have to wait until they can be seen by a doctor before getting any relief at all. The best part of the whole plan, of course, is that this will have almost no measurable effect on the production and sale of meth

Lab Rat writes Cell wall under attack – bacterial response to antibiotics:

The bacterial cell wall is made up of glycopeptide molecules (sugars and proteins joined together) and surrounds the whole cell. Without it, bacteria swiftly loose their integrity and salt-balance across the membrane, which is why many antibiotics target the cell wall in order to kill bacteria. Both for antibiotic resistance, and for surviving conditions that could damage the cell wall, bacteria have a system of monitoring the state of thee cell membrane and responding quickly to any changes.

Healthcare Hacks writes Aspirin may lower risk of cancer fatalities:

Of the group of patients who did not take any aspirin, about 19% died from the disease. However, when the patient took aspirin on a regular basis after their diagnosis, about 15% died from their cancer. When such risk factors as family history and lifestyle were taken into account, the difference between the two groups amounted to a nearly 30% reduction in the risk of cancer death.

Clinical Depression: Symptoms and Treatment writes Is there a Link between Singulair and Depression?:

In January 2009, the FDA announced that an investigation into Merck’s clinical trial data did not discover a link between Singulair (montelukast) and suicidal behavior. The investigation, which began 9 months before, was prompted by a number of reported suicides, especially that of 15-year-old Cody Miller who took the drug and appeared to have no history of mood or behavioral problems.

Scientific Living writes Vaccine Scandal:

Vaccines undergo extremely strict procedures for production. The chance that this was an accident is almost zero. Of all things that could have “accidentally” contaminated a vaccine, this contaminant happened to be a life threatening virus. But who can say for sure whether or not this was an accident.

How To Live a Longer Life writes Vitamin Supplements Can Worsen Prostate Cancer:

There has been a number of studies over the years suggesting a link between multivitamin usage and fatal prostate cancer however a recent study published in May of 2007 in the Journal of the National Cancer Institute tracked more than 300,000 men where roughly 100,000 took a daily multivitamin and 15,000 of which took more than one a day. The results of the study showed that those who took the vitamins more than once a day had a rate of fatal prostate cancer within five years at roughly twice the rate of everybody else.

Unfermented soy products like soy milk and tofu form the bulk of American soy consumption. In Asian countries, which consume higher amounts of soy overall, the predominant form is fermented as found in soy sauce and miso. The fermentation process is significant because it removes much of the biologically active phylates and isoflavones from the soy.

Phylates are a form of insoluble fiber, and in low quantities are beneficial because they can absorb low density lipoprotiens and therefore lower bad cholesterol levels. They are also known to reduce risks of gastrointestinal cancers. However, in higher quantities they can also block the absorption of other nutrients, leading to vitamin and mineral deficiencies. In particular, calcium, magnesium, copper, and zinc are prone to blockage by phylates, and this can paradoxically increase the risks of osteoporosis that soy is supposed to prevent.

Soy is purported to prevent osteoporosis because of its isoflavone content. Isoflavones are a collection of complex chemical compounds which are manufactured by plants, but physiologically similar to human proteins. One type of isoflavone found in large quantities in soy is called genistein, and in humans this protein binds with some affinity to estrogen receptors. This effect is what gives soy protein the ability to fight menopausal and premenstrual symptoms, and potentially prevent osteoporosis as mentioned above. On the contrary, overconsumption of genistein can lead to the same problems associated with high estrogen levels, namely increased risks of breast, uterine, and ovarian cancer. In males, the weak estrogen activity has translated into a reported reduction in the risk of prostate cancer. High intake has been suggested to suppress testicular cell lines, although this has not been proven. Perhaps the most widely accepted consequence of a high soy diet is an impact on thyroid function. Hypothyroidism and autoimmune disorders such as Hashimoto’s thyroiditis have been linked to excess soy intake in several animal studies.

Although the benefits of soy protein are well documented, no substance can be considered a panacea. Several problems can arise when soy is ingested in excess. Most dietitians recommend 25 grams of soy protein per day, and even the American Heart Association does not recommend exceeding 50 grams per day. The public would do well to adhere to these guidelines, to avoid any potential complications of soy toxicity.

References

R DIVI, H CHANG, D DOERGE (1997). Anti-Thyroid Isoflavones from Soybean Biochemical Pharmacology, 54 (10), 1087-1096 DOI: 10.1016/S0006-2952(97)00301-8

Kumi-Diaka J, Rodriguez R, Goudaze G. Influence of genistein (4′,5,7-trihydroxyisoflavone) on the growth and proliferation of testicular cell lines. Biol Cell. 1998 Jul;90(4):349-54.

M. Lakshman, L. Xu, V. Ananthanarayanan, J. Cooper, C. H. Takimoto, I. Helenowski, J. C. Pelling, R. C. Bergan (2008). Dietary Genistein Inhibits Metastasis of Human Prostate Cancer in Mice Cancer Research, 68 (6), 2024-2032 DOI: 10.1158/0008-5472.CAN-07-1246

Vucenik I, Shamsuddin AM. Cancer inhibition by inositol hexaphosphate (IP6) and inositol: from laboratory to clinic. J Nutr. 2003 Nov;133(11 Suppl 1):3778S-3784S.

W.-F. Chen (2004). Genistein Enhances Insulin-Like Growth Factor Signaling Pathway in Human Breast Cancer (MCF-7) Cells Journal of Clinical Endocrinology & Metabolism, 89 (5), 2351-2359 DOI: 10.1210/jc.2003-032065

The researchers conducted a year-long double-blind, placebo-controlled study of more than 800 postmenopausal women with low sexual desire who were not receiving estrogen therapy. The women were randomly assigned to receive a placebo, or a transdermal testosterone patch delivering either 150 micrograms (mcg) or 300 mcg of testosterone per day. The efficacy of the testosterone on libido was evaluated for 24 weeks, while the safety of the testosterone was evaluated for 52 weeks. A small subgroup of women was followed for an additional year to further evaluate the safety of daily testosterone therapy.

The women receiving 300 mcg of testosterone daily received the greatest benefit. The number of satisfying sexual encounters increased significantly to 2.1 episodes per 4-week period, compared to 0.7 episodes in the placebo group. The women receiving 150 mcg of testosterone daily also experienced an increase in sexual encounters (1.2 episodes per 4-week period) compared to the placebo group, but the change was not statistically significant. Both doses of testosterone were associated with significant increases in sexual desire, as well as decreases in distress.

The long-term follow-up period of the study was sufficient to discover some significant adverse effects associated with testosterone treatment. Most significantly was the rate of unwanted hair growth in the women receiving testosterone, with 30% experiencing this effect in the higher-dose group, and 23.1% in the lower-dose group. Also, 4 cases of breast cancer were diagnosed among the study participants receiving testosterone, compared to no new cases in the placebo group. One of these new cases was diagnosed in the first 4 months of the study, and another case had symptoms of breast cancer before the study began.

Another recent study in The Annals of Internal Medicine also studied transdermal testosterone treatment alone for low libido, but evaluated premenopausal women. The 261 women involved in this study applied a testosterone spray to the abdomen daily, and also experienced a significant increase in sexual desire and satisfaction. However, this was a smaller, shorter study, and included women who had low testosterone levels at baseline.

Most studies of low libido in women report success with combination estrogen and testosterone therapy. This new research, however, provides and option for women who cannot or will not be treated with estrogen therapy. It may offer treatment options for younger groups of women experiencing low sexual desire, or offer options for special patient populations, including cancer survivors, or those who have lost ovarian or uterine structures of function due to disease or surgery. More long-term safety studies are needed to fully evaluate the risks associated with long-term testosterone treatment in women, but the results are promising for women with low sexual desire and function.

References

D. L. Barton, D. B. Wender, J. A. Sloan, R. J. Dalton, E. P. Balcueva, P. J. Atherton, A. M. Bernath, W. L. DeKrey, T. Larson, J. D. Bearden, P. C. Carpenter, C. L. Loprinzi (2007). Randomized Controlled Trial to Evaluate Transdermal Testosterone in Female Cancer Survivors With Decreased Libido; North Central Cancer Treatment Group Protocol N02C3 JNCI Journal of the National Cancer Institute, 99 (9), 672-679 DOI: 10.1093/jnci/djk149

S. R. Davis, M. Moreau, R. Kroll, C. Bouchard, N. Panay, M. Gass, G. D. Braunstein, A. L. Hirschberg, C. Rodenberg, S. Pack, H. Koch, A. Moufarege, J. Studd (2008). Testosterone for Low Libido in Postmenopausal Women Not Taking Estrogen New England Journal of Medicine, 359 (19), 2005-2017 DOI: 10.1056/NEJMoa0707302

Davis S, Papalia MA, Norman RJ, et al. Safety and efficacy of a testosterone metered-dose transdermal spray for treating decreased sexual satisfaction in premenopausal women: a randomized trial. Ann Intern Med. Apr 15 2008;148(8):569-577.

The easiest method of screening is, of course, self-examination. This is easy and can be performed in the privacy of one’s home. Many reliable medical websites provide information on the step-by-step process of the breast self-examination. A new tool called Cue is being released this month — this is a small device that may be placed in the shower. It is a small disc like instrument that reminds women of the best time in the month for breast exams, and also provides reminders when it is time for a mammogram.

The CDC recommends that women above 40 years of age schedule a mammogram every two years in addition to regular self-exams. A newer method of screening is the breast ultrasound, using the reflective properties of sonic waves to detect lumps and areas of calcification. When used as an adjunct to mammograms, more diagnoses of Cancer can be made. MRI is the most sensitive at detecting such potentially cancerous masses at much earlier stages of the disease. However, a MRI is recommended for women who are at a high risk (due to genetic, familial and environmental factors) of developing cancer. If lumps or masses are detected, a biopsy usually follows to check if the lump is malignant or benign.

Apart from these specific screening tools, a healthy daily lifestyle may also help decrease the risk of cancer. Foods high in beta-carotene and fiber such as carrots, legumes, squash, and whole grains may have anti-oxidant properties, lowering cancer risk. Foods high in saturated fats such as red meats, margarine, whole fat creams and cheeses may increase risk of all forms of cancer. Getting regular exercise and avoiding smoking and excessive alcohol consumption also contributes towards decreasing the risk of cancer.

Talking to friends and family to spread awareness is more important now than ever. Print, internet and broadcast media are doing an excellent job of promoting an understanding of this condition. Little steps can go a long way, and spreading awareness and encouraging everyone to do the same will help early detection and potentially save lives.

Reference

C. K. Kuhl (2005). Mammography, Breast Ultrasound, and Magnetic Resonance Imaging for Surveillance of Women at High Familial Risk for Breast Cancer Journal of Clinical Oncology, 23 (33), 8469-8476 DOI: 10.1200/JCO.2004.00.4960

Who would have thought that oranges and lemons, fruits easily found in a local grocery store, may hold the answer to curing cancer? Oranges vs. cancer — it does not seem like a contest. Cancer has been winning for decades almost unmitigated. Dedicated researchers for years have diligently pursued a cure for cancer. Sometimes the paths they take are not original, but are extensions of concepts previously unexplored or not fully developed. Such is the case with treatment of cancer with vitamin C, or ascorbic acid, an essential nutrient contained in citrus fruits like oranges and lemons.

Vitamin C was previously explored as a treatment for cancer. The hydrogen peroxide generated by high concentrations of vitamin C (above 1,000 µmol/L) were found to be selectively cytotoxic to cancer cells in vitro. Normal cells were not harmed. Nobel Prize laureate in chemistry, Linus Pauling, advanced this idea in the 1970s with trials involving large doses of orally ingested ascorbic acid. The trials, unfortunately, did not show conclusive benefits and the controversial method for cancer treatment was largely ignored by most oncologists. It did, however, remain a popular alternative cancer treatment for many health practitioners.

What’s old may be becoming new again. Treating cancer with ascorbic acid is generating new buzz. This time, however, treatment will be in the form of injections of vitamin C. It turns out that no matter how many oranges, lemons, or vitamin C tablets are ingested, it does not enter the system in sufficient amounts to effect cancer cells. Only injected doses of vitamin C raise the blood level concentration to levels necessary to disrupt and harm cancer cells in laboratory experiments.

Even now, it is not universally accepted that injected vitamin C will be the successful cancer therapy that has been eluding scientists for generations. Some case reports have advanced the use of parenteral vitamin C as an agent against cancer. In three such reports, terminally ill cancer patients with pulmonary metastatic renal cancer, bladder tumor, and diffuse large B-cell lymphoma were injected with vitamin C. The patients improved significantly and had a prolonged life span. These results have not, however, passed the guidelines of the US National Cancer Institute because of insufficient data and inadequate follow-up. In addition, the cases did not have objective pathologic confirmation. So, although promising, injected vitamin C will require larger studies and conclusive benefits before expanding beyond an alternative therapy for cancer.

References

Q. Chen, M. G. Espey, A. Y. Sun, C. Pooput, K. L. Kirk, M. C. Krishna, D. B. Khosh, J. Drisko, M. Levine (2008). From the Cover: Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice Proceedings of the National Academy of Sciences, 105 (32), 11105-11109 DOI: 10.1073/pnas.0804226105

S. J. Padayatty (2006). Intravenously administered vitamin C as cancer therapy: three cases Canadian Medical Association Journal, 174 (7), 937-942 DOI: 10.1503/cmaj.050346

So why do experts think that cell phones might cause cancer? First, cell phones are instruments that receive and emit radiofrequency (RF) waves. These are low frequency radiations that could potentially penetrate body tissues and cause increase in cellular temperature. Second, traditional cell phone use forces us to hold the instrument in such close proximity to the head; it concentrates the radiation into the brain. It is not known for sure if these radiations cause mutations in DNA or ions in the body fluid. But at the same time, the long-term effects of the radiation on the body have not been studied.

In the 1980’s, there was a tremendous increase in the number of cell phone users. This trend continued over the next decade and into the next millennium. The number of cellular phone subscribers has more than doubled in the last 8 years (from 110 million in 2000 to 255 million in 2008). Cell phones are used so frequently and for such prolonged time periods that it is highly important to conduct studies that throw some light on the cumulative effect of radiation exposure. Another important area to focus on is children’s cell phones and their effects. Since the child’s nervous system is still growing and developing, the cells are more susceptible to changes in structure. This increases their risk of cancer.

Some of the other factors that determine cancer risk are size of the cellular phone, strength of connecting signal, proximity to the ear, and frequency of use. Some people are already genetically predisposed to getting cancer; and it is especially necessary for them to be extra cautious. The vice-president of the American Cancer Society advises using headsets while talking over cell phones, using text messaging and using the speaker phone tool to greatly decrease risk. The general consensus is also that extensive research that needs to be done on the long-term effects.

In today’s wireless world, human beings are islands in a sea of radiation from every possible type of electronic device — from laptop machines to the complex gaming systems and phones that let you do a million things other than just talk! In an environment such as this, do we really have to actually talk over the cell phone to tap into the radiations? Aren’t we already exposed to them radiations just by being outdoors, or near a satellite dish receiver or a digital recorder? We can eat foods that are rich in antioxidants; we can refrain from smoking and drinking. But what can we do about the millions of E-toxins flying around us in the form of lethal radiations?

Reference

Cellular Telephone Use and Cancer Risk. National Cancer Institute Factsheet.

I have a box full of these journals that I don’t want to get rid of and yet they are painful (and boring) to look through. I don’t care to get bogged down in the muck and mire of bygone emotions. It seems the journals and diaries served their purpose; they allowed me to share my feelings and thoughts so that I could move on. I didn’t realize it at the time but I was engaged in therapeutic writing.

An in-depth article regarding the effects of this type of writing was recently published in Medical Humanities. The article clarifies the definition of therapeutic writing and sheds light on how this form of therapy helps people with cancer. Although the research is mainly qualitative instead of quantitative, the information presented is a substantial nod to the powerful healing properties of writing.

Therapeutic writing, unlike many forms of writing, is not necessarily written for others. The main purpose is for the writer to create something that is beneficial for them. In this study the participants were in total control of their writing. They choose the form of the writing as well as the content. The benefits to this type of writing are many. It allows the writer to express emotions and thoughts that they couldn’t express in other ways. It allows the writer to “get stuff off their chest.” And it allows the writer to say anything they want, without concerning themselves with audience response.

Past research shows many benefits to therapeutic writing. In the case of the terminally ill, writing was the medium that allowed individuals to address “existential and relational concerns.” It seems that without this opportunity, these important issues weren’t always processed. Once the patients had the opportunity to face these issues they were oftentimes more able to handle their upcoming death better as well as gain a sense of closure to their lives.

It’s no surprise to me that writing can have profound effects on people. Sometimes just the act of getting thoughts out of your head and onto paper can help you to feel more grounded, more clear-headed. This type of writing, therapeutic writing, is like a conversation you have with yourself. And unlike a conversation you have with somebody else, you are free to express yourself totally, completely, until you are empty. And instead of turning to others for wise words or comforting suggestions, your inner wisdom has a chance to voice itself. You are both the burdened and the comforter.

Without realizing it, I’ve engaged in therapeutic writing for years. Not only for the terminally ill, journaling can soothe troubled minds and strong emotions.

Reference

G Bolton (2008). “Writing is a way of saying things I can’t say”–therapeutic creative writing: a qualitative study of its value to people with cancer cared for in cancer and palliative healthcare Medical Humanities, 34 (1), 40-46 DOI: 10.1136/jmh.2007.000255

The main sources of protein for vegetarians are legumes, nuts, whole grain and dairy products. The protein content in these foods per serving portion is in fact comparable to that in meats, fish and poultry. For example, broad beans and fava beans have approximately 26.12 grams (gm) of protein per 100 gm, while salmon and some other fish have only 25.72 gm / 100 gm. Soy based products have 36.49 gm of protein per 100 gm and pork and ham have 30.94 gm / 100 gm. The vegetarian foods mentioned above are significantly higher in fiber and lower in cholesterol, all of which bumps up their overall nutritive value. A more detailed break up of individual nutritional value is provided in the USDA Nutrient guide website. In addition, almost all whole foods are rich in protein, and are great sources of essential minerals like potassium, iron, magnesium and zinc; making them a well rounded and healthier option.

Of late, there has been a renewed interest in the vegetarian lifestyle, which includes exclusively fruits, vegetables, grains, cereal and legumes and soy products. The benefits of an exclusively vegetarian diet includes lower risk of cancer, lower overall Body Mass Index, lower risk for diabetes and heart disease. A recent study by Fu and associates suggested that vegetarians had statistically significant lower systolic and diastolic blood pressure, and lower serum total cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting blood sugar, and hemoglobin levels compared with the non-vegetarians.

Being vegetarian is also better for the environment as a decrease in the demand for beef and poultry will eventually lead to fewer meat farms. Lower number of cattle and poultry reared will mean decreased depletion of grasslands and fields, which will ultimately free up more pastures for production of food for humans. There are increasing vegetarian options available at the market and in restaurants. Numerous recipes are also available and it is easy to modify some of the existing meat recipes to make it vegetarian. Ethnic cuisines like Thai, Indian and Chinese are especially easier to adapt to suit a vegetarian. If this is an option you were contemplating, I suggest that you give Vegetarianism a fair shot and observe how your body and mind feel after a sustained period of this lifestyle.

References

C FU, C YANG, C LIN, T KUO (2006). Effects of Long-Term Vegetarian Diets on Cardiovascular Autonomic Functions in Healthy Postmenopausal Women The American Journal of Cardiology, 97 (3), 380-383 DOI: 10.1016/j.amjcard.2005.08.057

Liliane Chatenoud, Alessandra Tavani, Carlo La Vecchia, David R. Jacobs, Eva Negri, Fabio Levi, Silvia Franceschi (1998). Whole grain food intake and cancer risk International Journal of Cancer, 77 (1), 24-28 DOI: 10.1002/(SICI)1097-0215(19980703)77:13.3.CO;2-0

From pneumonia to the shingles to the flu, I wasn’t one to win the perfect attendance awards handed out at the end of the year. In contrast, my best friend M, seldom missed school. When she came down with something, strep throat was the usual culprit, she was whisked off to the doctor, started on a round of antibiotics, and then returned to school later that day or the next at the latest. Even today, when M or her children get sick she follows her usual protocol, a quick visit to the doctor, the appropriate medicine and all is well.

The difference in our getting-well-routines no doubt had something to do with the fact that M’s mother worked outside the home whereas my mother was a stay-at-home mom. Of course, I now understand how difficult it is to take off days, not to mention weeks, at a time to take care of a sick child. My mother had the luxury of letting my body heal itself, when it would comply, because she wasn’t having to use up precious sick days.

Because of my childhood I’ve always hesitated to use medicine. Not always a blessing, this has caused me some problems when medicine has truly been the best course of action for one ailment or another. But besides from my belief that in many cases the body can heal itself is my weariness at the possible negative effects of taking this or that drug. Once again I blame my childhood because I was known for having reactions to numerous drugs: hives, bruises, etc.

So when articles such as, Antibiotics account for 19% of emergency department visits in US for adverse events and Antibiotics may be linked to risk of cancer, are released my anxiety increases dramatically. Whereas many people would shrug off articles like these, I examine the facts trying to make heads or tails of the significance of the findings.

And in these cases, both articles provide good information about antibiotic usage. The first article discusses the fact that about 19% of ER visits are related to adverse events related to antibiotics. Many of these cases, about 80%, have to do with allergic reactions while some are caused by overdoses or errors.

In the second article, researchers have found some evidence that antibiotics may increase the risk of certain types of cancer. The results are far from concrete though and researchers note that:

… the observational design of the study means that they cannot say whether antibiotic use causes cancer or whether other factors, such as infectious agents or behavioral factors, explain the findings.

The most useful information is related to the use of antibiotics for respiratory tract infections. John Bartlett, a specialist in infectious diseases at Johns Hopkins University, Baltimore notes that many respiratory tract infections are not due to bacterial infections and therefore are not going to respond to antibiotics. In those cases of course, using antibiotics would not be the smart choice.

Both studies seem to add fuel to the already current idea that prescribing antibiotics should not be done recklessly. But even though this overriding attitude has been standard for a few years now, many people still think of antibiotics as the answer to their aches and pains. And, like my friend M, there are reasons for this that are far-removed from any medical implications. Allowing your body to heal itself is not necessarily a quick process. And in today’s fast paced world, that is an unpopular notion.

References

R. Dobson (2008). Antibiotics may be linked to risk of cancer BMJ, 337 (aug21 3) DOI: 10.1136/bmj.a1381

B. Roehr (2008). Antibiotics account for 19% of emergency department visits in US for adverse events BMJ, 337 (aug15 2) DOI: 10.1136/bmj.a1324

A recent study published in the British Medical Journal reported that muscle strength is inversely associated with mortality in men. This prospective cohort study followed nearly 9,000 men, aged 20 to 80, for nearly 19 years. The study concluded that increased muscle strength led to decreased death from all causes, as well as decreased death from cancer. The association between muscle strength and death from cardiovascular disease was inversely related, but not statistically significant once the researchers accounted for cardiovascular fitness levels. Personal data was adjusted for confounding factors, including age, physical activity, smoking status, alcohol intake, body mass index, family history, and comorbid disease states. The resulting relationship between muscle strength and lower risk of death was consistent across all age groups, as well as in normal and overweight men.

We have known for many years that exercise and fitness play a role in maintaining healthy, active lives, and that aerobic and resistance training improves the prognosis of cardiovascular disease, diabetes complications, and many types of cancer. However, previous studies that have related muscle strength to death rates have used a handgrip test to assess muscular strength, had short follow-up periods, or examined only older adults. The current study used single-repetition maximum-weight bench press and leg press to quantify muscle strength. Cardiovascular fitness was measured by a maximum-effort treadmill test. Further, participants included men in several age groups and the study employed a long follow-up period.

Muscle strength and cardiovascular fitness were moderately correlated in this study, and, as expected, men with high levels of both muscle strength and cardiovascular fitness had lower death rates than men with lower fitness and strength levels. Still, the association between muscle strength and death was not completely independent of cardiovascular fitness, highlighting the importance of cardiovascular fitness in reducing the risk of death and disease.

The underlying mechanism of muscle strength on reducing mortality is not completely understood. It may be due to the muscle strength itself, the type of muscle or its configuration, or simply a consequence of regular physical activity. Muscle type and configuration have genetic components, but regular physical activity, including resistance training, influences overall muscle strength as well. Most practitioners recommend resistance training 2 to 3 times weekly as a complement to aerobic training programs.

While most of us may not be the examples of athletic prowess that we see in the Olympic games, we should strive to maintain at least moderate levels of muscle strength and cardiovascular fitness. We may never win a gold medal, but we just might live longer.

Reference

Ruiz, J.R., Sui, X., Lobelo, F., Morrow, J.R., Jackson, A.W., Sjostrom, M., Blair, S.N. (2008). Association between muscular strength and mortality in men: prospective cohort study. BMJ, 337(jul01 2), a439-a439. DOI: 10.1136/bmj.a439

At the sixth annual International Conference of the American Association for Cancer Research, Dr. Andrew J. Dannenberg stated, “I believe that, conservatively, 15 to 20% of all cancer is caused by infections, however, the number could be larger, maybe double.”

Dr. Dannenberg is director of the Cancer Center at New York-Presbyterian Hospital/Weill Cornell Medical Center. He went on to say, “Unfortunately, the public, as well as many health-care workers, are unaware of the significance of chronic infection as a potentially preventable cause of cancer.” Some examples he gave were liver cancer, caused by chronic Hepatitis B and C, and MALT lymphoma and adenocarcinoma of the stomach caused by Helicobacter pylori bacteria. Also, schistosome parasite infection has been implicated in bladder cancer (transitional cell carcinoma) .

Probably the most well known example is HPV, or human papilloma virus, known to cause genital warts and now known to be the major cause of cervical cancer. According to the National Cancer Institute, 11,000 women were diagnosed with cervical cancer in 2007, and nearly 4,000 of these would die from it. Oropharyngeal cancer is also thought to be caused, in some cases, by HPV infection and past HPV exposure.

The FDA approved Gardasil vaccination in 2006 to prevent infection against high-risk HPV’s known to cause cervical cancers and genital warts. Gardasil is approved for use in girls only, and can be given as young as nine years of age. This has led to some questions as to why the vaccine is not offered to boys if it is known that HPV causes oropharyngeal cancer as well as vaginal cancer. This may be because the vaccine is expensive and oropharyngeal is rare in comparison to cervical cancer.

What does the future hold for virus research? Likely much more research will be done to attempt to identify which viruses are associated with certain types of cancer. If this can be accomplished, perhaps the key to fighting cancer in the future will be to prevent people from getting cancer in the first place. If scientists can create a vaccine like Gardasil to prevent cervical cancer, it is not out of the realm of possibility to hope that some day they will come up with a vaccine for all cancers. One can always hope.

Reference

Report on Carcinogens, Eleventh Edition; U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program.

Further Reading

Human Papillomaviruses and Cancer: Questions and Answers; National Cancer Institute, US National Institutes of Health.

Your doctor charged $400 and your insurance company only allows $200. This is not a bill.

I used to flinch when I’d receive these until I finally called up someone and found out that the statement was not indeed a bill. Somehow or another I never ended up having to pay any more to my doctor unless you count a random $20 here or there.

And then this changed.

My family has a strong history of cancer and being in my early 30’s I hit the point where some preventative testing was needed. So, being 10 years younger than my dad was when he was diagnosed with cancer, I scheduled myself for a routine, in-patient exploration. With my $100 co-pay, this wasn’t a big deal.

Well, luckily for me, they didn’t find anything malignant but they did have to send in some samples for testing. And along with this came my whooping bill for $400 (give or take a few dollars). Now, I know that many people would scoff at a mere $400 but to us, that’s a chunk of change… especially when we didn’t see it coming. A small part of me wonders if I should have waited… just not had the test done right now. Apparently I’m not alone.

A recent article in BMJ, Underinsurance threatens physical and financial wellbeing of US families, discusses this very problem. According to the authors, people are struggling with healthcare costs mainly in the form of higher deductibles that are being passed on from companies who are themselves having a difficult time with the increasing costs of healthcare. (Yes, this may explain my $400 bill: my personal deductible towards my test. Strangely enough though I don’t feel any better about handing over the money.)

And the individual and collaborative results of this widespread financial burden is pronounced. Bankruptcy is one problem, albeit a big one. But there are other results of increasing health care that from a short-term perspective may not seem alarming. Issues such as individuals refusing to get suggested tests performed or decisions to stop taking prescribed medicine for a little while. And while these don’t grab your attention like the word BANKRUPTCY may, these other situations are just as dangerous and in some cases more so.

As the article mentions, universal healthcare options are on the board this presidential election year. This is good. This is a start. Because while the costs of practically everything is increasing — gas, food, entertainment — healthcare is not one of those “luxury” items that can be done away with. Or at least it shouldn’t be. But increasingly, consciously or unconsciously, medical needs are being regulated to the discretionary section of budget sheets everywhere.

Reference

Lenzer, J. (2008). Underinsurance threatens physical and financial wellbeing of US families. BMJ, 336(7658), 1399-1399. DOI: 10.1136/bmj.a419

The New England Journal of Medicine recently published an article from a joint collaboration between several cancer centers on both the east and west coast. A 52 year-old man with stage IV malignant melanoma, a very aggressive and potentially lethal form of skin cancer, donated blood to the scientists who have developed a technique to isolate specific CD4+ T cells and clone them in vitro.

In our bodies, our immune system is responsible for attacking all cells that may pose a threat to our well-being, whether they be bacteria, viruses, foreign bodies, or even cancerous cells. Each T cell is responsible for recognizing a specific cell line which is potentially threatening, then targeting (where the “T” comes from) those cells for destruction by the production of antibodies, and large vacuum cleaner-type cells called macrophages. The trouble with cancer is that the cells are multiplying very rapidly, and there are only a few circulating T cells which are specific to that cancerous cell line. Therefore the cancerous cells overwhelm our ability to tag them fast enough, and the cancer grows and spreads.

What the scientists in this study have done is isolate the T cells which are targeted towards the malignant melanoma. Then they used a chemical and biological process to multiply those T cells several thousands of times over. Finally, they injected those thousands of T cells back into the patient, and let them go to work. Now there were so many T cells compared to cancerous cells, that tagging them was easy and the body was naturally able to break down the cancer using its own immune system. The man went into complete remission and has stayed there for the past two years.

The beauty and elegance of this new technique is that scientists are augmenting our body’s inherent ability to fight cancer. Because the patient was injected with his own T cells, there was no threat of rejection, and no side effects whatsoever. Additionally, by unleashing the patient’s immune system he was able to attack cancer cells wherever they were in his body, rather than just the primary site. It doesn’t matter if the cancer is multiplying in the lungs, in the brain, on skin, or in lymph nodes. As long as there is a blood supply, the body is able to fight back and win.

This technology is still a long way off from being implemented in the mainstream, but it definitely holds promise as a new tool in the fight against cancer.

Reference

Hunder, N.N., Wallen, H., Cao, J., Hendricks, D.W., Reilly, J.Z., Rodmyre, R., Jungbluth, A., Gnjatic, S., Thompson, J.A., Yee, C. (2008). Treatment of Metastatic Melanoma with Autologous CD4+ T Cells against NY-ESO-1. New England Journal of Medicine, 358(25), 2698-2703. DOI: 10.1056/NEJMoa0800251

The most recent case of a 9-year old female child in Georgia refueled the debate about the link between vaccinations and the onset of neuro-developmental disorders. The child had a pre-existing, but non-symptomatic cellular disorder. However, after a round of vaccinations, she began to demonstrate classic behaviors associated with autistic spectrum disorder. The link between the vaccinations and exacerbation of the pre-existing condition was confirmed in this case. Over the years literature has suggested that the sudden surge of autism to near epidemic proportions may be linked to the high mercury content in some vaccine preparations. I make it a point to read ingredient lists in most of the packaged food products that I purchase (I am positive I am not the only one doing this!) Why then would we accept vials of liquid concoctions being injected into our bodies (or our children’s bodies) with no knowledge of ingredients? Here are some of the buffers, preservatives and fixers used in vaccines in addition to the attenuated virus:

Formaldehyde, Mercury, Aluminum, Antifreeze, Methanol, Phenol, Foreign DNA and even extracts from aborted human fetuses. All of these are certainly toxic, and many of these chemicals have no “minimum” levels that may be deemed “safe.” They are toxic to the human body, period.

In spite of the potential threat, pharmaceutical companies are only manufacturing newer vaccines, for all kinds of syndromes and diseases. The flu vaccine was introduced in 1976, and revived in the 1990’s. For teens, multiple vaccines are available for protection against meningitis, chicken pox, diphtheria — many of these are also available as combinations. The most recent entrant into the vaccine race is the Human Papilloma Virus (HPV) vaccine.

This vaccine, however, offers protection against only 4 strains of HPV viruses — types 16, 18, 6, 11. It should be also be known that the vaccine only may offer protection against viruses possibly causing cause only 70% of cervical cancers. Of course, this is being publicized as the only vaccine that protects against cancer, but the fact that even vaccinated persons may contract cervical cancer is left to the fine print. I would certainly not opt to be injected with those toxins in the vaccines for that kind of “probable protection.” Marketing for the vaccine also conveniently leaves out the fact that abstinence or practicing safe sex will also lead to the same level of protection. The indirect message that this vaccine sends to girls as young as 9 years of age (the recommended age for administering the HPV vaccine) is — hey you can go out and have unprotected sex now, and with the HPV vaccine, you will be protected.

I am not recommending scaring children off sex as an effective educational technique, but come on — tell it as it is. Having a group of happy looking girls say “We don’t want to be just one more statistic” and playing jump rope… seems to me to embellishing a hard truth with unnecessary niceties.

The debate about vaccination is certainly not new, it is an ongoing one; fervent discussions are sporadically sparked by incidents like the one cited earlier. Many communities are voting to not vaccinate their children at all, even in infancy. In all cases where the child has a compromised immune system, doctors do not vaccinate — as vaccination in these children may increase the risk of infection. In some states in the USA, doctors may even grant waivers to parents who refuse vaccination on religious or philosophical grounds. All said and done, as is the case with most issues — gather expert opinion, consider the positive as well as the negative implications of the matter, analyze for possible outcomes, and then make your own decision.

Brand new research [2] from a study of over 77,000 people has shown that higher than recommended doses of Vitamin E can lead to a “significant” increase in the risk of developing lung cancer, irrespective of whether they smoked or not. The strength of the findings was somewhat unexpected — a 7% rise in lung cancer for every extra 100 mg of Vitamin E taken daily for 10 years. With an average daily Vitamin E supplement of 400 mg, this could mean a 28% excess risk for someone to develop lung cancer taking just one pill a day.

An important question is: do we need Vitamin E supplementation at all on top of an average diet? The UK Food Standard Agency website estimates daily dietary requirements of Vitamin E to be just 4 mg for men and 3 mg for women. It also mentions that not enough is known about the side-effects of high-dose vitamin E supplements, and that 540 mg or less a day is “unlikely” to be harmful. This new study could change all that.

While the protective effects of Vitamin E against heart disease and many forms of cancer are acknowledged, dietary deficiency is rare today [3]. This is mainly related to the fact that vitamin E intake in modern diets is mainly dependent on polyunsaturated fatty acids, and with diets rich in vegetable oils and green leafy vegetables, the amount of daily vitamin E intake could well exceed 20-40 mg — just a tablespoon of sunflower oil has 6 mg, while wheatgerm oil has 20 mg or so.

Do we actually need any extra vitamin E supplements if we can make up for our daily requirement through diet? An editorial from the American Journal of Clinical Nutrition in 2006 [4] concluded that intervention studies did not support a beneficial effect of antioxidant supplements, and there was a growing body of evidence that with anti-oxidant vitamins, “just enough” was more than adequate. About 15 mg per day of Vitamin E was enough to provide us with maximum protection against chronic disease, according to the journal.

The debate about Vitamin E supplementation as a potential cause of premature death is however not new. In 2004, the Times [5] reported the results from a John Hopkins study [6] that pooled the result of 19 studies on vitamin E supplementation worldwide. The study found that doses of 400 international units (IU) of Vitamin E, “often the equivalent of a single capsule were associated with a 10% increased risk of death.” Ominously, the study found that many people were taking as much as 400-800 mg of Vitamin E a day. Even the Lancet had earlier estimated that out of a million people taking Vitamin E supplements, 9,000 were expected to die premature deaths.

The question therefore is not “if,” but rather “how much.” Supplementation can increase the intake of Vitamin E by up to a hundred times of that of daily requirements, and as the latest study shows, the increase in risk of lung cancer can also be substantial. Dietary adjustment can well increase our intake of Vitamin E to well above our recommended daily allowances. The question therefore remains: is it at all justifiable to use “killer” doses of a supplement that has no demonstrable benefits at all above its physiological limits?

References

1. Wellcome Trust. Anti-ageing treatments.

2. Byers, T. (2007). Nutrition and Lung Cancer: Lessons from the Differing Effects of Foods and Supplements. American Journal of Respiratory and Critical Care Medicine, 177(5), 470-471. DOI: 10.1164/rccm.200711-1681ED

3. British Nutrition Foundation. (2004). Vitamins.

4. Traber, M.G. (2006). How much vitamin E? … Just enough! American Journal of Clinical Nutrition, 84(5), 959-960.

5. Lister, S. (2004). The vitamin boost that could cause early death. TimesOnline.

6. MILLER, E., PASTORBARRIUSO, R., DALAL, D., RIEMERSMA, R., APPEL, L., GUALLAR, E. (2005). Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality. ACC Current Journal Review, 14(5), 17-17. DOI: 10.1016/j.accreview.2005.04.017