The Healthy Blogger

Esophageal cancer is common amongst alcoholics and smokers

I recently heard that an uncle of mine has been suffering from esophageal cancer for about a year and a half.  My first reaction was, I’m amazed he has even survived that long.  My second reaction was, yet another one in the family with cancer.  Finally, it must have been his drinking.  I do not recall this uncle smoking or drinking when I was younger, and it was very probable that he didn’t or he managed to hide it well.  However, as he got older and underwent a midlife crisis, he became a heavy smoker and especially, drinker.  He always appeared at functions drunk or extremely red-faced.  That included my wedding and my mother’s funeral.

Alcohol-related illnesses are extremely costly.  Similarly, smoking-related illnesses are a huge burden to the medical system.  The combination, therefore, is enormous.  But, though esophageal cancer is not rare, it does not get the same attention as other alcohol and smoking-related illnesses, namely, cirrhosis and lung cancer, respectively.  But cancers of the stomach and esophagus are very common amongst smokers and drinkers.  That is because the toxins from cigarettes and alcohol come in direct contact with the lining in the esophagus and stomach, causing damage.

My uncle has undergone surgery to remove the tumour.  It is possible that he has managed to survive because all the tumour has been removed.  He had had a feeding tube prior to the surgery and it was removed right after.  Yet, he still has difficulty swallowing and eats very little.  Consequently, he is very weak; though reports are that he  is improving somewhat. His immediate family are frustrated because they feel he is not putting in much effort to eat and walk.  Yet, it must be remembered that cancer weakens a person, and tumours have been shown to produce a chemical that causes depression.

Surgery is one option for esophageal and stomach cancers.  However, sometimes the tumours are too extensive to be entirely removed.  As a result, sometimes radiation is offered.  Yet, radiation has its own risks, especially scarring and the possibility of radiation-induced tumours.  Which ever course is taken, feeding tubes will often be necessary to provide adequate nutrition.  With increasing ethical problems regarding feeding tubes, decisions to have the tubes placed and/or removed need to be made early on.

Having been physically and emotionally separated from my family for many years now, I do not have the inside scoop on my uncle’s condition.  However, I have been able to make contact with several family members recently and I’m sure they’ll keep me updated. Unfortunately, as with many other cancers, the survival rate is low for esophageal cancer, so I can only look forward to hearing more bad news.

When to stop cervical cancer screening?

There’s on-going debate about when cervical cancer screening should be stopped.  Current UK recommendations suggest that those over 50 should have screening every 5 years, whereas those between 25 and 49 should be screened every 3 years.  This is much less frequent than in the US, where screening is every year.  This decreases to every three years if you are over 30, have never had an abnormal smear, and in a monogamous or low-risk relationship.  If there is a change in the relationship, it is recommended to undergo screening yearly until stable.  Women over the age of 65 and have never had an abnormal smear are given the option of not having any more tests.

But UK researchers are worried about calls to end screening in women over 50.  They found that although few women have abnormal smears, about 1% will show abnormalities.  They did not comment on the severity of the abnormality or whether it required intensive treatment.  Statistics show that most cervical cancer occurs in young women, under 35 years of age.  Most of the cases are due to infection with HPV, which is sexually-transmitted.  However, the HPV may remain dormant and cause problems later in life, so some cancers may occur in those older than 35.

It’s interesting to note that they would consider ending the programme of screening in women over 50.  After all, you cannot say that women over 50 suddenly stop having sex.  In fact, many of them are still very active.  Some have entered into late-life relationships with new partners.  Some of these partners may be much younger themselves.  I remember attending an infection control seminar where it was reported that some older women were coming home from cruises, where they had “one-night stands” with a fellow passenger, with sexually-transmitted diseases, including HIV.

There is this public perception that older people do not engage in sex.  Perhaps, it’s like denying your own parents having sex.  So, until someone is free and clear of the act, they should probably continue to be screened for cervical cancer.

On the flip side, I can never understand why some women insist on having smears done when they’ve undergone complete hysterectomies.  Is it because their doctor is trying to get extra payment?  I would not be in a hurry to have it done unnecessarily.

Malignant melanoma can definitely be linked to sunbeds

Despite all the warnings about malignant melanoma, people, especially women, are still sunbathing, whether in the sun or on the tanning beds. Of course, The Sunbed Association would like to insist that tanning beds are safe. After all, if they didn’t, they wouldn’t make any money. They point out that there is no association between UV exposure and malignant melanoma. That is a very ignorant and dangerous statement.

Studies have shown that UV exposure does cause skin damage. And skin damage can lead to many skin disorders, some of which go on to further develop various types of skin cancer. Malignant melanoma is the deadliest, of course. So, you may not have a study linking UV exposure directly to malignant melanoma, the implications are all there. It does not take much intelligence to make the correct deductions. Need we put more women at risk by ignoring the evidence? Need we create more problems all for the sake of the almightly dollar, so to speak?

Studies show that young skin is fragile and vulnerable to damage. Early exposure to UV radiation causes damage which subsequent and persistent exposure adds to. Malignant melanoma is now the third leading cause of death in women in their 30s, behind breast and cervical cancer. Those women with malignant melanoma had a history of sun exposure, especially the use of tanning beds, before the age of 30. Does that not show that there is some cause and effect?

Though tanning beds have been promoted as a safe way to tan, some beds deliver radiation at 10-times the strength of the sun. How can this be considered safe? Burns cause skin damage, so if radiation is too strong, it can cause burns. I have seen many people coming out of tanning salons looking like lobsters. It is most unattractive. Until this tan culture is dissipated, women will be at risk for skin damage in their quest for the ultimate bronze.

In an age where everyone is pushing for equal rights regardless of age, sex, religious or political affiliation, why do we not have people pushing for a return to nature? Can we not accept that ethnically not all of us are brown? Does everyone suddenly wish they had an African or Asian or, perhaps, Latino heritage? I look forward to the day when someone goes around with a T-shirt proudly displaying “Fair-skinned and proud of it” or “Yes, I am Fair”.

Cool it now!

On cold winter days, I love to eat some hot chicken noodle soup. Though winter is officially over, the spring weather can get quite blustery at times, such as today. Hot soup is just the thing to warm your insides as well as your outsides.

But, in my impatience, I sometimes swallow a mouthful of burning liquid. It is painful as it travels down my esophagus, finally settling into my stomach. I always imagine the damage as it is moving downwards. In my mind’s eye, I can see the lining turning red and inflamed. It always worries me. And quite rightly.

Hot liquids are linked to esophageal cancers. Well, very hot, steaming liquids. The kind that is painful. The reason for this is that the heat does injure the esophageal lining. The damaged cells are at risk of become cancerous. It is similar to the case of acid reflux. People suffering from GERD (gastroesophageal reflux disease) and PUD (peptic ulcer disease) are at risk of esophageal cancers because the stomach acids that reflux into the esophagus cause damage. Tobacco and alcohol also inflict similar damage and smokers and drinkers are at high risk as well.

So if you want to lower your risk of developing esophageal cancer, which is incurable even with surgery, don’t smoke or drink alcohol, and be sure your hot liquids are sufficiently cooled (below 65C or 135F). That includes tea, coffee, soups, etc. But I would also extend that to all foods – make sure you blow on your food to cool it before stuffing it into your mouth. Never swallow it piping hot!

Can mushrooms and green tea prevent breast cancer?

Scientific studies are flawed in so many ways, but it’s nice to think that foods such as mushrooms and green tea, both of which I enjoy, may help reduce the risk of breast cancer. As I’m always quick to advise, take these scientific studies with a pinch of salt. Not too much, though, since it might increase your blood pressure.

Now, the study was done on Chinese women, so if you are not of Chinese descent, this study might not apply to you. But they did find that those who ate at least 10g of fresh mushrooms a day were 64% less likely to develop breast cancer. Dried mushroom had a slightly less protective effect. I wonder where canned/tinned or frozen mushrooms fell.

As for green tea, the beneficial effects have been touted for ages now. Tea, in general, is known to contain antioxidants that help reduce risk of cancers. There’s been talk of red tea, green tea, black tea, and just plain tea. However, each of the teas contain different ingredients, so each are protective of different things. And, apparently, it’s the green tea that is protective of breast cancer.

Well, to be sure, the scientists warn that the best thing is always to maintain a healthy diet, but if you like mushrooms and green tea, it wouldn’t hurt to stock up.

Unexpected link between cancer and vegetarian diet?

In the promotion of healthy eating, we are all told to have 5-7 servings of vegetables and 3-5 servings of fruits a day. In addition, we are warned to decrease our consumption of meat, especially red meat. This is most likely due to the high quantity of fat found in red meat. On the other hand, the consumption of fish is good for you. All the health experts are constantly inundating us with new findings indicating the link between a poor diet and poor health. No surprise. They further report that red meat is linked to many different cancers.

So it is no surprise that yet another study has shown that those who follow a strictly vegetarian diet have lower rates of cancer than those who eat red meat. It is also no surprise that the consumption of fish reduced the rates of cancer. But wait! There is a surprise. The new study showed that despite the lower risk of overall cancer, those who followed the vegetarian diet had a higher risk of colorectal cancer than those who eat red meat. This goes against prior preachings on eating more vegetables and less meat to prevent colorectal cancer.

It has stupefied scientists, who will now need to look further into this unexpected link. So, it appears that there will need to be a shift in our thinking. I would not suggest that vegetarians eat meat. However, I would caution them to beware lest they are complacent in their belief that all is well for them in health. Perhaps, the best diet would be one that is high in fruits, vegetables and fish, and less in red meat. We will need to wait and see.

Night shifts linked to cancer

I have pointed to all the dangers of not getting enough sleep, but I was surprised to find that some study in the past had pointed to an association between disrupted or lack of sleep and cancer risk. How they discovered this, I have no idea. But the fact that there was a link between working late night hours (or night shifts), which causes the disrupted sleep pattern, and the risk of cancer has now led to Denmark compensating women who worked night shifts and developed cancer. Of course, only those women who demonstrat that the cancer was caused by working night shifts and no other causes are the ones getting the compensation.

There is a theory that melatonin, which is produced by the brain in response to sunlight, has some protection against cancer. For those working night shifts, the production of melatonin is suppressed, which makes them vulnerable to developing cancer. So far, it appears that the women being compensated are those who developed breast cancer. It is still unclear, however, what role melatonin plays in breast cancer protection.

So, in addition to getting adequate sleep, now we must ensure that we sleep at the right time. Which means that those in financial hardships may have to give up their night jobs if they have to protect their health. For, if they are not healthy, they cannot work.

Cervical cancer screening for lesbians

There is new concern that lesbians have been given misleading information regarding cervical cancer screening. Because most cases of cervical cancer result from infection with HPV, which is sexually-transmitted, many lesbians have been under the impression that they are not at risk. The fact is, they are at low risk, but not at ‘no risk’. Remember, most but not all cervical cancer are caused by HPV. Also, studies have revealed that many lesbians have had sexual contact with men. It is not enough, however, to say that lesbians who have had no sexual contact with men are not at risk. Their partners may have had contact with men, or even further up the ladder, their partners’ previous partners. Though the risk of transmission of the HPV virus is much lower between women and women compared to heterosexual contact, it can still occur.

UK should lower age of cervical cancer screening

I was surprised to hear that the UK does not screen for cervical cancer until age 25. Previously, I had mentioned that Pap smears are recommended at 18 or when the woman first becomes sexually active. This is the case in the US. Apparently, the NHS does not feel there is enough evidence to support screening for the disease earlier than 25.

The NHS now fear that Jade Goody’s case will scare women into thinking that they need it earlier. That seems to be the case as many health charities are pleading with the NHS to change their stance on this. The NHS has pointed out that many young women have abnormal tests which turn out to be nothing, but which can cause unnecessary emotional distress. On such grounds, they oppose having the tests earlier. Are they saying women can’t cope with the distress? Shouldn’t it be up to the woman to decide whether she wants that distress or not? If she wants to take that risk, the NHS should allow it to her and pay for the test.

Sexual promiscuity is a leading factor in cervical cancer. Not necessarily that the woman has multiple partners (although that can be the case), but that she is sexually active at a young age. HPV, the human papillomavirus, is a sexually-transmitted virus that comes in many forms. Many of these forms can cause changes in the cervix as a result of the infection, which can lead to cervical cancer. The more sexually active, the more likely you will get the infection.

We know that not all women remain virgins until they marry at the ripe old age of 30. So, why not have the test available to those women who are sexually active but younger than 25? It might save their life in the long-run.

Jade Goody brings cervical cancer to forefront

Jade Goody has been getting a lot of attention due to her metastatic cervical cancer. I never watched Big Brother, so I was completely unaware of her celebrity status. And although I resent these minor celebrities getting more than their 15 minutes worth of fame, I do feel for this woman’s pain. Most of all, I feel for her children. Just as I would if I had known her story personally, rather than publicly. As one commentator noted in a recent paper, if she could give attention to a serious medical condition, for which many women would like to ignore, then Ms. Goody’s life has been worthwhile. I hope she realises that.

Getting a Pap smear is extremely humiliating and uncomfortable for most women. In fact, I do not know anyone who looks forward to it. It is worse than the digital rectal exam – and men really deplore that. But the Pap is absolutely necessary for every woman, starting when she becomes sexually active or age 18, whichever is first. Though there is a vaccine for HPV, the virus that is responsible for many cervical cancers, it is not absolute protection, and young women need to be aware of this. For those who are not sexually active or at low risk of cervical cancer, experts recommend that they do not need annual Paps, but may decrease it to every 3 years. That is welcome news. However, if there is ever any abnormality, the frequency needs to be increased.

Unfortunately, when there is even a hint of bad news, most people like to run shy. It appears Ms. Goody is like many other women in this respect. But, hopefully, others will now learn that they need to investigate potential problems and face up to the consequences earlier than later. I admit that I’m one of those who have avoided getting a Pap for years. However, I have been lucky that I have never had an abnormal one. Still, it’s time I take the step and get back into the doctor’s office.