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| HEALTH & FITNESS |
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Cancer screening: Does it save lives? Menopausal zone: How not to break your backbone
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Cancer screening: Does it save lives? The total cancer cases are likely to go up to 11,48,757 in the year 2020 from 9,79,786 cases in 2010. In a recent study from India, around 5,55,000 people died of cancer in 2010. Cervical, breast and stomach cancer cases accounted for 41% of cancer deaths in women in rural and urban areas. Tobacco-related cancer represented around 42% of male and 18% of female cancer deaths. In men, two of the most fatal cancers were oral cancer and lung cancer. Rates of cancer deaths were similar between rural and urban areas of India. A total of 16,38,910 new cancer cases and 5,77,190 deaths from cancer are projected to occur in the United States in 2012. Cancer screening is a means of detecting the disease early in asymptomatic people. Detection of cancer at an early stage is reported to yield better outcomes. Estimates of premature deaths that could have been avoided through screening vary from 3% to 35%. Screening may reduce cancer morbidity since treatment for early stage is often less aggressive than that for more advanced cancer. Cancers for which screening tests are advocated are those of the cervix, breast, lung, large intestine and prostate. Screening is either organised (population based) or opportunistic. Opportunistic screening is an examination of the individual on his/her own initiative. Screening rates remain woefully inadequate in our country. Some individuals are known to be at a high risk of cancer like those with a strong family history of cancer — in two or more first-degree relatives. A high risk person should regularly undergo screening procedures that have been shown to be of benefit. Positive results of screening tests identify persons at an increased risk of cancer and warrant further evaluation. Following positive screening tests, the diagnosis is confirmed by biopsy and a histopathological examination. Screening for specific cancers has been shown to improve longevity and quality of life. Screening for breast cancer by mammography has been demonstrated to be effective in reducing mortality from the disease in women aged 50 and above. Regular mammographic screening between 50 and 70 years of age reduces breast cancer mortality by 25% to 35%. The cancers in screened women are smaller and amenable to breast-conserving surgery. Mammography performed once every two years seems to be more effective than screening mammography every one or three years. For women with an increased risk of developing breast cancer (family history), annual screening is recommended. High participation rates are needed to ensure that breast cancer screening effectively reduces mortality. For patients with mammography that is considered abnormal, further diagnostic examinations are made. In organised service screening programmes, a 40% to 60% reduction in breast cancer mortality is reported. Oral cancer accounts for over 30% of all cancers in India. The primary reason for an unusually high incidence is the indiscriminate use of chewing tobacco in its various forms. Despite the fact that oral cavity is accessible for visual inspection, in India 60% to 80% of patients present with an advanced disease. A study from India has reported that oral cancer screening by trained health workers can lower the mortality rate. In this study, there was a significant reduction in mortality due to the detection of cancer at an early stage. A study from Banglore involving 30,530 participants investigated the effectiveness of mouth self-examination and identified 28 early stage oral precancerous and cancerous lesions. Visual examination of the oral cavity can significantly reduce oral cancer mortality among the users of tobacco and alcohol. The incidence of colorectal cancer is increasing in India. Screening methods in colorectal cancer target the disease before it becomes malignant by detecting and removing precancerous lesions. Fecal occult blood testing is a reasonable good cancer detection test and reduces cancer deaths. Fecal immunochemical testing and colonoscopy are accepted strategies for colorectal cancer screening. All those aged 50 to 75 years should undergo fecal occult blood testing annually, flexible sigmoidoscopy every five years and colonoscopy every 10 years. More than half of colorectal cancer deaths can be prevented with screening because precancerous polyps can be identified and removed before cancer develops. The results of lung cancer low dose CT screening trials with regards to the effectiveness and cost-effectiveness of CT screening are awaited even though the preliminary data are promising. Various studies have concluded that CT screening will detect lung cancer at an early stage in 38% to 66% cases. In data from the Netherlands of National Lung Cancer Screening trial, a 20% lung cancer mortality reduction is reported after seven years of follow-up. Most cancer screening tests are non-invasive or minimally invasive. Some may involve the risk of complications. Another limitation of screening is a false positive test result which may lead to anxiety and unnecessary invasive diagnostic procedures. A false negative test may falsely reassure a person. In any case, cancer remains a major public health problem in India. Dedicated and sustained efforts towards early detection can reduce the burden of cancer. Early detection not only improves the cure rate but also lowers the morbidity associated with the treatment. People need to have knowledge about screening methods. Screening at regular intervals for breast and cervical cancer is a must. For screening to be effective, it is important to have facilities for diagnosis, treatment and follow-up of screen-positive individuals. Such programmes should concentrate on those at the greatest risk of invasive cancer. The writer, a former Professor and Head of General Surgery, PGI, Chandigarh, is associated with Fortis Hospital,
Mohali.
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Menopausal zone: How not to break your backbone It was another day for Sheela, 60, to get ready for the evening session of cards and drinks after a busy day of socialising and partying. As she hurriedly walked towards her car, she felt unstable on her high heel sandals and felt pain in the back. Before she could fall she was given support by her driver, who took her to the family doctor instead of the club. As the stretcher-borne patient entered the doctor’s chamber for being examined, she complained, “I can’t bear this pain, I can’t get up, I can’t move….” The doctor counselled, “I have been telling you about your osteoporosis, ever since you entered the menopausal zone at the age of 45, but you were too busy. If you had not ignored the advice you could save this sudden and unexpected fracture of your backbone. These fractures can be debilitating for life. Unfortunately, once you have an osteoporotic fracture, you are at a high risk of having another. The lifetime risk of spinal fracture in women is about one in three, and that for hip fracture is one in six”. Multiple vertebral fractures lead to a stooped posture, loss of height and chronic pain with the resultant reduction in mobility. There are serious risks associated with a hip fracture, such as deep vein thrombosis and a pulmonary embolism, and death. How is osteoporosis related to menopause? There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. After menopause, bone breakdown outpaces the building of new bone due to estrogen decline. Bone mineral density (BMD) tests can determine the severity of any osteoporosis. Medical scientists advice following tests to detect other diseases as the underlying cause of osteoporosis — complete blood counts for cancers, calcium level for parathyroid disease, phosphate values for osteomalacia, creatinine for kidney disease, thyroid function tests and liver function tests. Preventing osteoporosis
How is osteoporosis treated? Treatments for established osteoporosis include:
Alternatives to HRT
The writer is a Chandigarh-based senior gynaecologist.
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Vaccines to fight obesity Washington:
In a new study, researchers have accessed the effectiveness of two somatostatin vaccinations, JH17 and JH18, in reducing weight gain and increasing weight loss in mice. Somatostatin, a peptide hormone, inhibits the action of growth hormone (GH) and insulin-like growth factor (IGF-1), both of which increase metabolism and result in weight loss. Vaccination with modified somatostatin causes the body to generate antibodies to somatostatin, effectively removing this inhibition without directly interfering with the growth hormones and subsequently increasing energy expenditure and weight loss. Keith Haffer from Braasch Biotech LLC tested the vaccinations in two groups of 10 diet-induced obese male mice compared with a control group of 10 mice which received saline injections.
— ANI Math anxiety more likely to affect girls’ performance than boys Washington:
A number of school-age children suffer from mathematics anxiety and although both genders’ performance is likely to be affected as a result, girls’ maths performance is more likely to suffer than boys’, a new study has revealed. Mathematics anxiety is a state of discomfort associated with performing mathematics tasks and is thought to affect a notable proportion of both children and adults, having a negative impact on their mathematics performance. Researchers from Cambridge University, UK, set out to investigate in 433 British secondary school children whether mathematics anxiety has any effect on mathematics performance on boys and girls. The investigators found that children with higher mathematics anxiety have a lower mathematics performance, but girls showed higher levels of mathematics anxiety than boys and it was a significant indicator of their performance. The fact that there were no gender differences in maths performance despite higher mathematics anxiety in girls could suggest that girls could have the potential to perform better in mathematics were it not for higher levels of anxiety.
— ANI Arsenic-friendly bacteria discovery in Mono Lake refuted Washington: Researchers have claimed that the finding by a young researcher in 2010 about bacteria in Mono Lake, California, was wrong, insisting instead that they were using phosphorus, a very common building block of living things, instead of arsenic compounds. In 2010, a young researcher, Felisa Wolfe-Simon, published a paper in the journal Science, reporting that she and her colleagues had found bacteria in Mono Lake, California, that could be made to live on arsenic. But now two papers have been published proving her wrong. “We conclude that GFAJ-1 is an arsenate-resistant, but still a phosphate-dependent bacterium,” ABC News quoted Tobias Erb and several fellow microbiologists in Zurich as writing. Wolfe-Simon’s paper drew international attention because it potentially broadened the definition of life as we know it, including life on other planets.
— ANI |
Cancer has become an important public health problem globally. The overall number of cases are increasing mostly as a result of the ageing of the population. Common cancer cases in India include cancer of the breast, cervix, lung, oral cavity, esophagus, colorectum and prostate. The National Cancer Registery programme published a report on time trends in cancer incidence rates and made an attempt to project the number of cancer cases at the India level.