9/14/2008

Melanoma Rate Increasing In Young American Women

Melanoma is a type of cancer of the skin. It is a rare type of skin cancer, but an aggressive one. The NIH(National Institute of Health) recently published a study showing an increase in numbers of melanomas in young women in the United States. It is likely that this increase is related to increased exposure to ultraviolet radiation (sunlight and artificial tanning rays).

Ultraviolet light is a mutagen. That means that it causes changes in the DNA that controls the growth of cells and transforms them into cancer cells. Melanin is a pigment in the skin which absorbs ultraviolet radiation and protects the tissues in and below the skin. Darker skinned persons have more melanin than fairer skinned people. melanin is contained in cells called melanocytes. When a melanocyte becomes cancerous, it is called a melanoma.

Other types of skin cancers are basal cell cancers and squamous cell cancers--squamous cell cancers are by far the most common, but much less lethal than melanomas. These types of cancers are most often seen in elderly persons, and as with melanoma, are a consequence of sun exposure.

Austrialians have the highest rate of skin cancers in the world. Australia has only 0.3% of the world's population, but has 6% of the lethal skin cancers. This is thought to be because of the large number of fair-skinned people living in tropical conditions.

In their study, investigators at the NIH found that the incidence of melanoma in young men in the United States increased from 4.7 to 7.7 cases per 100,000 persons between 1973 and 2004. In young women over the same time period, the incidence increased much more rapidly from 5.5 to 13.9 cases per 100,000. Probably because young women are much more likely to purposefully seek out exposure to sunlight or tanning beds.

The good news is that the number of deaths as a consequence of melanoma among young men and young women has decreased from 1981 onward. This is likely due to both an increased awareness about melanoma and changes in screening techniques.

In Australia, an interesting new technology called Solar scan has been recently developed. The key to Solar Scan is advanced computer software. A camera is pointed at a suspicious lesion and photograph is taken, stored, and analyzed by the software. Not only can Solar Scan make a quick diagnosis, it can collect images and compare data over a period of time allowing doctors to monitor suspicious lesions for change.

Staying out of the sun and/or tanning booths is the best way to protect yourself from skin cancer. If that is not possible, wearing sunproof clothing is the next best option. Suntan oils and lotions protect the skin by reflecting or absorbing ultraviolet rays, and are definitely adviseable if sun exposure is contemplated.

Signs and symptoms of melanoma include a new spot appearing on the skin, a spot that grows in size or changes color or shape. Itching and bleeding are also important symptoms. Any spot that is larger than 6 millimeters, or is irregular in color, or shape, should be evaluated by a physician. A Dermatologist is the type of doctor to consult for anyone worried about a spot, or simply wishing to have a thorough skin evaluation.

One more interesting fact about melanoma: it is the most common cancer to spread across the placenta in a pregnant woman.

9/09/2008

HORMONES FOR MENOPAUSE?


What are hormones? Hormones are messengers that carry messages between glands and target cells in various parts of the body. They affect metabolism sleep, reproduction, and just about every other bodily function. Most people have heard of thyroid hormone and "male" and "female" hormones. Most women come in contact with prescription hormones for the first time in the form of oral contraceptives or birth control pills.
As we age, the subject of hormones comes up again when we reach the pre- or peri-menopause. Generally when this discussion arises we are considering the two major "female" hormones estrogen and progesterone.

Why would anyone ever take hormones? There are basically only two good reasons to consider them. The first reason is to maintain healthy bones; by taking hormones, it is possible to reduce the rapid loss in bone density that occurs shortly after a woman's cycle stops and she enters the menopause. Are there ways to keep your bones healthy without taking hormones? Definitely!

The second reason is symptoms. Many women have mild symptoms of hot flushes, or head aches or sleeplessness. Decrease in sex drive, or vaginal dryness are also common. A majority of women can tolerate mild symptoms with no pharmaceutical help at all (our ancestors all did it!); but some women are almost incapacited by severe and miserable symptoms. Many families have legends about "when Aunt Mable went through the change".
A woman with symptoms significant enough to impact her lifestyle may wish to consider a low dose of supplemental hormones for a few months to a few years until the symptoms abate. Frequently too, after oophorectomy (surgical removal of ovaries), especially in young women, taking prescription hormones can help ease the abrupt transition into menopause.

Currently the American College of OB/GYN (ACOG) recommends taking the lowest effective dosage of hormone replacement therapy (HRT) for the shortest period of time necessary to control bothersome symptoms. Different women will require dosages and durations.

What is the risk? Hormones have been linked to increases in breast cancer rates, increases in uterine cancer rates, increases in heart disease in some users and increases in blood clotting and strokes. Interestingly, they have been linked to a reduction in cancer of the ovary and colon, and a decreased risk of heart disease in some users depending upon when they are started.

Which hormones should be taken? Estrogen is the hormone that works the best to control most perimenopausal symptoms. Any woman who has had a hysterectomy should consider taking estrogen alone. (Adding progesterone appears to increase the risk of breast cancer and it is not necessary if the uterus is absent.) A woman who has not had a hysterectomy should take both estrogen and progesterone. (taking estrogen without progesterone could cause cancer of the uterus and this risk is higher than the increased breast cancer risk.)

Testosterone is a "male" hormone and is sometimes given to improve sex drive. Study results are mixed on this one with some showing a benefit of increased sex drive, and others showing no benefit.

What about "bio-identical hormones", or over the counter products? Unfortunately these seem to be equally as risky as the more orthodox (FDA approved) products in terms of their potential to cause cancer or blood clots (a hormone is a hormone). At this time the ACOG position is that "There is no scientific evidence to support claims of increased efficacy or safety for individualized estrogen or progesterone regimens."

Should you take hormones? Each woman should educate herself as thouroughly as possible about her individual risk factors, versus the potential benefits and make her decision accordingly. More information is available at the government's http://www.fda.gov/womens/menopause and ACOG's sites.
Are there other ways to control menopausal symptoms? That's another post!

9/03/2008

GOOD THINGS COME IN THREE'S


In the United States, since 1980 there has been a 65% increase in the frequency of twins and a 500% increase in the number of triplet pregnancies or higher-order births. The vast majority of this increase has resulted from assisted reproductive technologies (in-vitro or fertility drugs). The risk of a multiple pregnancy resulting from infertility treatments is a very high 25%. Very recently reproductive endocrinologists have been trying to reduce the number of multiple pregnancies resulting from in-vitro procedures by transferring only one embryo per cycle, even in older patients who have traditionally been considered less fertile.



Interestingly, however there is a much higher identical twin rate (identical twins result from one embryo splitting into two, three or even four embryos) associated with in-vitro techniques, so that even when only one embryo is transfered, a multiple pregnancy can result. When infertile couples are surveyed, many are actually thrilled to be "blessed" with a multiple pregnancy--as often they have waited for years before conceiving.

Although multiple pregnancies account for only 3% of all live births, they are responsible for a much larger percentage of pregnancy complications and poor outcomes. 17% of preterm births are the result of multiple pregnancy. Twenty-four % of low-birth weight infants are the product of a multiple pregnancy. It is interesting to note however, that although these statistics are accurate, the babies born to parents who have undergone infertility treatments, even if premature or low birth weight, tend to do very well. In part this is because of dramatic advances in the medical care of the premature infant, but another factor is that the parents of these pregnancies are often doing everything possible to optimize their outcomes.


What can you do if you've been "blessed"? Strategies to optimize your outcome include:



  1. Get in early with your doctor! If you have been diagnosed with a multiple pregnancy you are going to get to know your doctor very well! If you have been through infertility treatments, your RE (reproductive endocrinologist) will likely have a number of good references for Obstetricians or Perinatologists (doctors who will follow your pregnancy). Choose a doctor that you are comfortable with and that you feel will answer all your questions.


  2. Eliminate any remaining bad habits! If you have been through infertility you have likely cleaned up your act pretty thoroughly already, but if there are any vices that linger, such as smoking, drinking alcohol, excessive caffeine intake, etc. now is the time to dispense with these!


  3. Maximize your nutrition. You are going to want to gain a significant amount of weight, but make sure you do it gradually and by eating the right mix of proteins, carbohydrates, and fats. You are also going to want to supplement iron, calcium and folic acid, and you are going to need to choose a supplement you can tolerate! (In another article, we'll talk about nausea of pregnancy!)


  4. Take up a low impact excercise program such as yoga for prenancy. You will want to stay as fit as possible without risking the complications that could be associated with a more aggressive exercise routine.


  5. Consider setting up a home office in your bedroom--as you will very likely end up on bedrest for at least a short period of time you may want to consider a good mattress, lots of pillows, a good laptop, and lots of good books.


  6. Join a forum MedHelp.Org for answers to your questions and support from others who are going through the same thing.


  7. Get going on your nursery and stock up on supplies--you can't shop while you're on bed rest. Join TheTripletConnection this site has lots of discount codes and suggestions for stores with hard-to-find items. They also have used items for sale by other parents of multiples which can be very handy and save lots of money!


  8. Get lots of film, or even better, a digital camera or video camera. A good book of names can come in handy too when you are chosing more than one!

9/02/2008

Why Your Daughter Should Never Have Cervical Cancer

Did you know that cervical cancer is caused by the Human Papilloma Virus(HPV)? Did you know that there is a vaccine that protects against the strains of HPV which most commonly cause cervical cancer? Did you know that the vaccine is widely available and protects against genital warts too?

Cervical cancer is cancer which occurs in the lower portion of a woman's uterus. It was once the leading cause of death for women in the United States. By 1995, the Pap test had decreased the death rate from cervical cancer by 74%. Still, in 2005, over 10,000 new cases of cervical cancer were diagnosed and over 3000 women died from the disease. The majority of women who are diagnosed with cervical cancer are between the ages of 35 and 55. They were probably exposed to HPV in their late teens to early 20's. Smoking is also a risk factor for cervical cancer. The good news is that there is the potential to completely eliminate cervical cancer--this could happen within your daughter's lifetime!

What can you do?

Talk to your doctor! All sexually active women over 21 should have a Pap smear (a screening test for cervical cancer). NEED A DOCTOR ? visit http://www.acog.org/ for an MD near you!

Vaccines are currently available for girls age 9-26. MORE INFORMATION go to http://www.gardasil.com/

Get your FREE REPORT at http://www.bigfileswapper.com/k6llio-1vffgk
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