In July, Danish researchers published a study in the British Medical Journal that 1 in 3 breast cancers diagnoses will not actually cause a problem. After examining breast cancer screening in five countries, they found that some breast cancers ‘may naturally disappear without treatment.’ They call it an ‘overdiagnosis rate of 35%.’
Talk about controversial! In my practice, there is a large split surrounding mammograms. Some women are incredibly diligent and go every year. Some go every few years and some absolutely refuse to go at all. There is the fear of radiation, squishing, mis-diagnosing, having to get a biopsy, and the idea that not knowing is better than knowing.
The problem lies in the diagnosis, of which the researchers readily admit. How does one tell between the lethal and the harmless cancers?
How do you know whether you have been overdiagnosed or properly diagnosed? And more importantly, are you willing to take that risk if you choose the former?
Patients always ask me what I would do and I tell them I believe in mammograms. I also believe in ultrasounds and thermography but at this time, there is no perfect imaging option. If stage I breast cancer is found by mammogram, there is a 95% 5-year survival rate. I want to be one of those odds if it were me. And if the mammogram finds something and if I have to endure a biopsy and if it turns out to be negative – then hallelujah!
As with anything, it’s ultimately your choice because they are your breasts. I repeat the paragraph above all the time because it’s my job as a doctor to inform and educate but not to force. There is a risk with anything and I recommend risking it for great odds.
Sunday, July 12, 2009
Ovarian Cancer: Don’t Miss These Signs
Ovarian cancer is an elusive one because the signs and symptoms mimic other common complaints. Women often blow them off or chalk them up to everyday life before seeing a doctor. On the flip-side, healthcare practitioners might also view the vague complaints as dietary or stress related instead of getting a work-up.
There is no easy diagnosis for ovarian cancer. Breast cancer usually comes with a lump, change in skin, inverted nipples, or discharge. Endometrial cancer usually comes with post-menopausal bleeding/spotting or discharge. Ovarian cancer moves much more stealthily than that.
Here are some things to watch out for:
1)Chronic bloating that won’t go away no matter what you do. (It doesn’t generally come and go)
2)Abdominal swelling in the lower pelvic area. Makes it hard to button your pants.
3)Feeling full quickly when eating.
4)Urinary urgency – you have to go NOW!
5)Pelvic pain
6)Vague back pain not from sprain/strain, overuse or trauma.
Here are some risk factors for ovarian cancer:
1)Starting your period before 12years old. This causes more ovulations.
2)Never having been pregnant allows you to cycle and ovulate more.
3)Going into menopause later means you have more cycles.
4)Obesity
5)Having certain mutations of BRCA1 or BRCA2 gene
Please keep in mind that the symptoms are vague. You may have urinary urgency but yours could be due to the vaginal births you had not ovarian cancer. You may experience chronic bloating but you also eat cheese everyday and are intolerant to it. Is your low back pain from your desk job or 3-inch heels, or maybe from gardening all Saturday?
After examining these concerns with no relief from treatments, please talk with your healthcare practitioner about a pelvic ultrasound and possibly some blood-work. Ovarian cancer is often caught in the late-stage and survival isn’t that promising. If you recognize yourself in this article, please examine the possibilities and talk with your doctor.
There is no easy diagnosis for ovarian cancer. Breast cancer usually comes with a lump, change in skin, inverted nipples, or discharge. Endometrial cancer usually comes with post-menopausal bleeding/spotting or discharge. Ovarian cancer moves much more stealthily than that.
Here are some things to watch out for:
1)Chronic bloating that won’t go away no matter what you do. (It doesn’t generally come and go)
2)Abdominal swelling in the lower pelvic area. Makes it hard to button your pants.
3)Feeling full quickly when eating.
4)Urinary urgency – you have to go NOW!
5)Pelvic pain
6)Vague back pain not from sprain/strain, overuse or trauma.
Here are some risk factors for ovarian cancer:
1)Starting your period before 12years old. This causes more ovulations.
2)Never having been pregnant allows you to cycle and ovulate more.
3)Going into menopause later means you have more cycles.
4)Obesity
5)Having certain mutations of BRCA1 or BRCA2 gene
Please keep in mind that the symptoms are vague. You may have urinary urgency but yours could be due to the vaginal births you had not ovarian cancer. You may experience chronic bloating but you also eat cheese everyday and are intolerant to it. Is your low back pain from your desk job or 3-inch heels, or maybe from gardening all Saturday?
After examining these concerns with no relief from treatments, please talk with your healthcare practitioner about a pelvic ultrasound and possibly some blood-work. Ovarian cancer is often caught in the late-stage and survival isn’t that promising. If you recognize yourself in this article, please examine the possibilities and talk with your doctor.
Sunday, July 5, 2009
Pre-Diabetes and Weight Gain
Included in routine screening is a fasting glucose test (otherwise known as your blood sugar). If this number is below 126mg/dl then you do not have diabetes. What happens if the number is between 100mg/dl and 125mg/dl? You have what’s called, ‘pre-diabetes.’ This means that you’re right up next to the cliff about to fall over - do something about it!
Please don’t take the ‘watch and wait’ approach. My question is, watch and wait for what? Full blown diabetes? As your blood sugar climbs higher and higher, your body processes it and puts it into that tire ring you have around your belly. You increase the fat around your organs and begin a slow destruction of your heart and circulatory system.
What can you do? Definitely do something! Because diabetes is caused by elevated blood sugar, do all that you can to lower the sugar in your diet. This includes alcohol, candy, cookies, cakes, brownies, ice cream, high sugar yogurt, fruit juice, high sugar protein powder and protein bars, actual sugar, brown sugar, sodas…and more!
Read labels and see just how much sugar is in your food. Did you know spaghetti sauce can have 9 or 10 grams of sugar per serving? Yogurt is very healthy for you if it’s plain. Otherwise you’re looking at 12, 15 or 20 grams of sugar. Add some cinnamon, vanilla flavoring or berries to plain yogurt. Fruit juice is straight sugar, even if it’s from 100% real fruit. Please, just eat the fruit!
Watch out for dried fruit and trail mixes – they are loaded with unnecessary sugar you don’t need.
Read the label of your flavored water. It usually has several grams.
Eat a diet higher in protein and lower in carbs. Skip the chips and French fries, eat only ½ a piece of bread on your sandwich and cut up the rest. Cut-up your hamburger with the lettuce, tomato, and onion to make a mini-salad.
Exercise most days of the week and include weight bearing exercise which burns blood sugar faster than regular cardio. Your muscles and brain use sugar for energy but you don’t need to overload it.
Once you become fully diabetic, you enter a whole new realm you don’t need to be in. Please take responsibility and change your ways for the healthier.
Please don’t take the ‘watch and wait’ approach. My question is, watch and wait for what? Full blown diabetes? As your blood sugar climbs higher and higher, your body processes it and puts it into that tire ring you have around your belly. You increase the fat around your organs and begin a slow destruction of your heart and circulatory system.
What can you do? Definitely do something! Because diabetes is caused by elevated blood sugar, do all that you can to lower the sugar in your diet. This includes alcohol, candy, cookies, cakes, brownies, ice cream, high sugar yogurt, fruit juice, high sugar protein powder and protein bars, actual sugar, brown sugar, sodas…and more!
Read labels and see just how much sugar is in your food. Did you know spaghetti sauce can have 9 or 10 grams of sugar per serving? Yogurt is very healthy for you if it’s plain. Otherwise you’re looking at 12, 15 or 20 grams of sugar. Add some cinnamon, vanilla flavoring or berries to plain yogurt. Fruit juice is straight sugar, even if it’s from 100% real fruit. Please, just eat the fruit!
Watch out for dried fruit and trail mixes – they are loaded with unnecessary sugar you don’t need.
Read the label of your flavored water. It usually has several grams.
Eat a diet higher in protein and lower in carbs. Skip the chips and French fries, eat only ½ a piece of bread on your sandwich and cut up the rest. Cut-up your hamburger with the lettuce, tomato, and onion to make a mini-salad.
Exercise most days of the week and include weight bearing exercise which burns blood sugar faster than regular cardio. Your muscles and brain use sugar for energy but you don’t need to overload it.
Once you become fully diabetic, you enter a whole new realm you don’t need to be in. Please take responsibility and change your ways for the healthier.
Can Fish Oil Help Depression?
In a recent study from the American Journal of Nutrition, taking 1500mg of fish oil (specifically, 500mg of EPA three times/day) slightly helped peri-menopausal women with their depression. Now, it didn’t rock anyone’s world but fish oil is so helpful for so many concerns, that women may find improvement with distressed feelings while taking it for overall health balance.
When taking a fish oil, make sure that it doesn’t have a lot of filler oil such as soybean oil. You want a reputable brand that tests its fish oil for toxins, mercury, pesticides, and, herbicides. If you bite into the capsule and it tastes/smells overwhelmingly fishy, you have a problem bottle. Yes it is fish oil but the reputable companies have their oil so screened and cleaned that it’s not repugnant.
Don’t leave your fish oil in the heat. Because it’s oil, heat can cause the oil to become rancid, making it taste and smell bad. Also, don’t buy your fish oil from a discount store or overstock store. Yes it’s cheaper but you may be swallowing rancid, dirty oil. Who knows how long that bottle has been sitting on shelves?
When reading the label, make sure you’re swallowing 300mg – 500mg of EPA per capsule. Don’t buy 1000mg capsules of ‘fish oil’ with only 120mg of the good stuff inside. What makes up the other 860mg?
Lastly, eat the fish that make up fish oil! Go for wild caught salmon or anchovies on a regular basis.
When taking a fish oil, make sure that it doesn’t have a lot of filler oil such as soybean oil. You want a reputable brand that tests its fish oil for toxins, mercury, pesticides, and, herbicides. If you bite into the capsule and it tastes/smells overwhelmingly fishy, you have a problem bottle. Yes it is fish oil but the reputable companies have their oil so screened and cleaned that it’s not repugnant.
Don’t leave your fish oil in the heat. Because it’s oil, heat can cause the oil to become rancid, making it taste and smell bad. Also, don’t buy your fish oil from a discount store or overstock store. Yes it’s cheaper but you may be swallowing rancid, dirty oil. Who knows how long that bottle has been sitting on shelves?
When reading the label, make sure you’re swallowing 300mg – 500mg of EPA per capsule. Don’t buy 1000mg capsules of ‘fish oil’ with only 120mg of the good stuff inside. What makes up the other 860mg?
Lastly, eat the fish that make up fish oil! Go for wild caught salmon or anchovies on a regular basis.
Tuesday, June 23, 2009
Endometrial Cancer – What is it and what to look for?
In the last 3 weeks I have been told about two acquaintances diagnosed with endometrial cancer. One has excellent chances and the other is preparing to die. The endometrium is the layer in your uterus that grows up then sheds during your period. Endometrial cancer is the cancer of this layer and is quite common in the United States. It is most often thought of as a post-menopausal cancer; however younger women should be aware too.
The most common symptom in women is bleeding. In a woman who is post-menopausal, she might bleed or spot again when she hadn’t bled in 12 months or she may experience thin white or clear discharge.
In a woman who is still cycling, she may experience very heavy or prolonged periods, multiple periods in a month, or spotting between periods. This could be due to other reasons such as thyroid abnormalities, hormone imbalance, or clotting disorders, however if this has been ruled out then ask for additional work-up.
Diagnostically, a pelvic ultrasound and sampling of the endometrial layer through a biopsy is important. Routine Pap smear tests and pelvic exams may not show any abnormality in the early stages. An ultrasound will show a thickening in the lining while the endometrial biopsy will give an actual diagnosis of the cells inside the uterus.
Risk factors for any woman are as follows: high levels of estrogen, low levels of progesterone, unopposed estrogen (ie. estrogen therapy without progesterone), obesity, prior diagnosis of endometrial hyperplasia, never having been pregnant, starting your period at a very young age, menopause begins after 55 years old, polycystic ovarian disease, irregular ovulation or not ovulating, and a personal history of diabetes, breast cancer and/or ovarian cancer.
The good news is many women are diagnosed early and stage I endometrial cancer has a 75%-95% 5-year survival rate. If you are experiencing any of the symptoms listed in this article and you haven’t been worked up, or if you begin bleeding or experiencing discharge again after your periods have stopped, please talk with your healthcare provider.
The most common symptom in women is bleeding. In a woman who is post-menopausal, she might bleed or spot again when she hadn’t bled in 12 months or she may experience thin white or clear discharge.
In a woman who is still cycling, she may experience very heavy or prolonged periods, multiple periods in a month, or spotting between periods. This could be due to other reasons such as thyroid abnormalities, hormone imbalance, or clotting disorders, however if this has been ruled out then ask for additional work-up.
Diagnostically, a pelvic ultrasound and sampling of the endometrial layer through a biopsy is important. Routine Pap smear tests and pelvic exams may not show any abnormality in the early stages. An ultrasound will show a thickening in the lining while the endometrial biopsy will give an actual diagnosis of the cells inside the uterus.
Risk factors for any woman are as follows: high levels of estrogen, low levels of progesterone, unopposed estrogen (ie. estrogen therapy without progesterone), obesity, prior diagnosis of endometrial hyperplasia, never having been pregnant, starting your period at a very young age, menopause begins after 55 years old, polycystic ovarian disease, irregular ovulation or not ovulating, and a personal history of diabetes, breast cancer and/or ovarian cancer.
The good news is many women are diagnosed early and stage I endometrial cancer has a 75%-95% 5-year survival rate. If you are experiencing any of the symptoms listed in this article and you haven’t been worked up, or if you begin bleeding or experiencing discharge again after your periods have stopped, please talk with your healthcare provider.
Surviving Summer Naturally
It’s that time of year for vacations at the beach, camping in the mountains and lazy afternoon bbq’s. Unfortunately, even the best intentions to enjoy the weather may have a few boo-boo’s along the way. Here are a few tips for surviving minor incidences a little more naturally…
1) Sunburn: if you were exposed a little too long the best thing to do is to stay hydrated and soothe pink skin with aloe vera. Either break the leaf of a plant and apply the thick gel or buy aloe vera in a bottle for instant relief.
2) Over-strained muscles: too much hiking or cleaning out the garage? Try using homeopathic arnica found at any food store in the natural section. Rub the cream onto tired muscles for support. Mix a few drops of lavender essential oil into almond or jojoba oil and gently apply to the area.
3) Bruises: you can also use homeopathic arnica orally and as a cream when you’ve been bumped. Do not apply into broken skin.
4) Insect Repellant: If you aren’t too keen on using bug spray with chemicals, try using natural bug repellants or blending essential oils of citronella, geranium, rosemary, eucalyptus, sage, lavender, pennyroyal and/or tea tree into a spray bottle of water. Shake and apply regularly when outdoors or mix into Almond or Jojoba oil and rub onto skin.
5) Relief for bug bites: Once you’ve been bitten, apply a drop of peppermint or Lavender essential oil onto the bite or place a hot wash cloth to the area. This opens up the circulation and diffuses the histamine reaction out.
6) Overindulgence: a little too much at the BBq? Chew on some fennel seeds or brew up a tea of fennel, peppermint and chamomile. Let cool and sip slowly. Ginger root or ginger capsules also works well.
7) Sea-sickness: first outing on the boat cause some wooziness? Try chewing on ginger or take ginger capsules before leaving the dock.
8) Swimmer’s ear: place a few drops of undiluted white vinegar into the ear twice-a-day for a week.
9) Dehydration: severe dehydration and heatstroke should seek medical care. If you feel it’s a minor case, mix ¼ tsp. salt, ¼ tsp. baking soda, 2 Tbsp. of sugar and 5 cups of water together. Sip slowly until you are feeling better and your urine is clear. If baking soda is unavailable, add another ¼ tsp of salt.
10) Cuts and scrape: First wash the area well with clean water and pat dry. Apply the herb calendula either in a cream or spray as a natural antiseptic and cover with a band-aid. All-natural honey is another great antiseptic – smear a little bit onto the cut to keep bacteria out.
11) Bee sting: ouch! Gently scrape stinger out with a fingernail or tip of a credit card and apply Neem oil to the spot. You can also make a paste out of apple cider vinegar or Lemon juice and baking soda and apply to relieve the toxin effect.
12) Stress! Not everything in summer is easy breezy – place 3-5 drops of Rescue Remedy (found in the health section of your grocery store) under your tongue or in your water when you feel a moment coming on. Take before a stressful occasion (in-laws? reunion? road-trip? kids?) and as needed afterwards for instant sanity.
For any serious summer boo-boos or if you are pregnant/nursing, please consult with your doctor. The summer weather and great escapes makes us excited for summer but even a masterful outdoorsman (or woman!) gets the occasional scrape, bump or bruise. Please use these guidelines for quick and natural relief.
1) Sunburn: if you were exposed a little too long the best thing to do is to stay hydrated and soothe pink skin with aloe vera. Either break the leaf of a plant and apply the thick gel or buy aloe vera in a bottle for instant relief.
2) Over-strained muscles: too much hiking or cleaning out the garage? Try using homeopathic arnica found at any food store in the natural section. Rub the cream onto tired muscles for support. Mix a few drops of lavender essential oil into almond or jojoba oil and gently apply to the area.
3) Bruises: you can also use homeopathic arnica orally and as a cream when you’ve been bumped. Do not apply into broken skin.
4) Insect Repellant: If you aren’t too keen on using bug spray with chemicals, try using natural bug repellants or blending essential oils of citronella, geranium, rosemary, eucalyptus, sage, lavender, pennyroyal and/or tea tree into a spray bottle of water. Shake and apply regularly when outdoors or mix into Almond or Jojoba oil and rub onto skin.
5) Relief for bug bites: Once you’ve been bitten, apply a drop of peppermint or Lavender essential oil onto the bite or place a hot wash cloth to the area. This opens up the circulation and diffuses the histamine reaction out.
6) Overindulgence: a little too much at the BBq? Chew on some fennel seeds or brew up a tea of fennel, peppermint and chamomile. Let cool and sip slowly. Ginger root or ginger capsules also works well.
7) Sea-sickness: first outing on the boat cause some wooziness? Try chewing on ginger or take ginger capsules before leaving the dock.
8) Swimmer’s ear: place a few drops of undiluted white vinegar into the ear twice-a-day for a week.
9) Dehydration: severe dehydration and heatstroke should seek medical care. If you feel it’s a minor case, mix ¼ tsp. salt, ¼ tsp. baking soda, 2 Tbsp. of sugar and 5 cups of water together. Sip slowly until you are feeling better and your urine is clear. If baking soda is unavailable, add another ¼ tsp of salt.
10) Cuts and scrape: First wash the area well with clean water and pat dry. Apply the herb calendula either in a cream or spray as a natural antiseptic and cover with a band-aid. All-natural honey is another great antiseptic – smear a little bit onto the cut to keep bacteria out.
11) Bee sting: ouch! Gently scrape stinger out with a fingernail or tip of a credit card and apply Neem oil to the spot. You can also make a paste out of apple cider vinegar or Lemon juice and baking soda and apply to relieve the toxin effect.
12) Stress! Not everything in summer is easy breezy – place 3-5 drops of Rescue Remedy (found in the health section of your grocery store) under your tongue or in your water when you feel a moment coming on. Take before a stressful occasion (in-laws? reunion? road-trip? kids?) and as needed afterwards for instant sanity.
For any serious summer boo-boos or if you are pregnant/nursing, please consult with your doctor. The summer weather and great escapes makes us excited for summer but even a masterful outdoorsman (or woman!) gets the occasional scrape, bump or bruise. Please use these guidelines for quick and natural relief.
Tuesday, June 16, 2009
Dealing With The Chronic Itch ‘Down There.’
How many women have had a yeast infection? How many women thought they had a yeast infection and instead it was bacterial vaginosis (BV)? What’s the difference?
The vagina is its own little ecosystem. It plays host to a number of flora that live in there and has the ability to self-correct if things get off balance. Typically your pH runs from 3.5-4.5 so it’s relatively acidic. Blood (from your period) and semen increase the pH to be around 7. Ovulation also increases your pH to match that of potential incoming sperm (making it a friendly environment instead of killing them off).
When your pH shifts, the healthy lactobacillus bacteria count shifts and can make way for other things to grow up such as yeast, BV, and bacteria. This is when the symptoms begin. You may experience itching, redness, discharge, burning, and/or odor. But how do you know what’s what?
First of all, get yourself tested. The itch of yeast and the itch of BV may be the same yet the treatments are very different.
Bacterial vaginosis always occurs with a higher pH (typically above 5). Very characteristic is the ‘fishy odor’ especially after sex, although it is not always there. The discharge is usually thin and gray, white, or yellow.
Yeast can grow up in either a high or low pH. It typically resides in your vagina however it’s the job of your healthy bacteria (lactobacillus) to keep it under control. Many women know the symptoms to include itching, burning, redness, white discharge, and possibly swelling of the labia.
There are other bacteria that can grow up and cause similar symptoms such as E.coli and Beta hemolytic strep. The only way to know for sure is to have your healthcare practitioner collect a swab to look under the microscope and send out for culture.
To help protect yourself, practice good hygiene, take probiotics (the good bacteria such as lactobacillus) especially if you are on antibiotics, eliminate sugar (yeast feed on this), use cotton underwear, be wary of tight thongs, and do not use scented soaps, lotions, douches or tampons in and around the vagina.
Don’t forget about fertile mucus! Sounds strange but I have had women concerned about the amount of discharge they produce every month and treat themselves for yeast. Upon examination, the discharge comes around ovulation and is on the stretchy-side.
Of course, there are a number of sexually transmitted diseases that also cause vaginal symptoms. Trichomoniasis (Trich), Chlamydia, Gonorrhea, and Syphilis require medical attention and antibiotics. Probiotics and cotton underwear will not make these go away.
The vagina is its own little ecosystem. It plays host to a number of flora that live in there and has the ability to self-correct if things get off balance. Typically your pH runs from 3.5-4.5 so it’s relatively acidic. Blood (from your period) and semen increase the pH to be around 7. Ovulation also increases your pH to match that of potential incoming sperm (making it a friendly environment instead of killing them off).
When your pH shifts, the healthy lactobacillus bacteria count shifts and can make way for other things to grow up such as yeast, BV, and bacteria. This is when the symptoms begin. You may experience itching, redness, discharge, burning, and/or odor. But how do you know what’s what?
First of all, get yourself tested. The itch of yeast and the itch of BV may be the same yet the treatments are very different.
Bacterial vaginosis always occurs with a higher pH (typically above 5). Very characteristic is the ‘fishy odor’ especially after sex, although it is not always there. The discharge is usually thin and gray, white, or yellow.
Yeast can grow up in either a high or low pH. It typically resides in your vagina however it’s the job of your healthy bacteria (lactobacillus) to keep it under control. Many women know the symptoms to include itching, burning, redness, white discharge, and possibly swelling of the labia.
There are other bacteria that can grow up and cause similar symptoms such as E.coli and Beta hemolytic strep. The only way to know for sure is to have your healthcare practitioner collect a swab to look under the microscope and send out for culture.
To help protect yourself, practice good hygiene, take probiotics (the good bacteria such as lactobacillus) especially if you are on antibiotics, eliminate sugar (yeast feed on this), use cotton underwear, be wary of tight thongs, and do not use scented soaps, lotions, douches or tampons in and around the vagina.
Don’t forget about fertile mucus! Sounds strange but I have had women concerned about the amount of discharge they produce every month and treat themselves for yeast. Upon examination, the discharge comes around ovulation and is on the stretchy-side.
Of course, there are a number of sexually transmitted diseases that also cause vaginal symptoms. Trichomoniasis (Trich), Chlamydia, Gonorrhea, and Syphilis require medical attention and antibiotics. Probiotics and cotton underwear will not make these go away.
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