Thursday, 24 November 2016

Diet and Physical Activity: What’s the Cancer Connection?

ref: American Cancer Society
How much do daily habits like diet and exercise affect your risk for cancer? Much more than you might think. Research has shown that poor diet and not being active are 2 key factors that can increase a person’s cancer risk. The good news is that you do something about this.
Besides quitting smoking, some of the most important things you can do to help reduce your cancer risk are:
• Get to and stay at a healthy weight throughout life.
• Be physically active on a regular basis.
• Make healthy food choices with a focus on plant-based foods.
The evidence for this is strong. The World Cancer Research Fund estimates that about 20% of all cancers diagnosed in the US are related to body fatness, physical inactivity, excess alcohol consumption, and/or poor nutrition, and thus could also be prevented.
Control your weight.
Getting to and staying at a healthy weight is important to reduce the risk of cancer and other chronic diseases, such as heart disease and diabetes. Being overweight or obese increases the risk of several cancers, including those of the breast (in women past menopause), colon and rectum, endometrium (the lining of the uterus), esophagus, pancreas, and kidney, among others.
Being overweight can increase cancer risk in many ways. One of the main ways is that excess weight causes the body to produce and circulate more estrogen and insulin, hormones that can stimulate cancer growth.
What’s a healthy weight?
One of the best ways to get an idea if you are at a healthy weight is to check your Body Mass Index (BMI), a score based on the relationship between your height and weight. Use our easy online BMI calculator to find out your score.
To reduce cancer risk, most people need to keep their BMIs below 25. Ask your doctor what your BMI number means and what action (if any) you should take.
If you are trying to control your weight, a good first step is to watch portion sizes, especially of foods high in calories, fat, and added sugars. Also try to limit your intake of high-calorie foods and drinks. Try writing down what and how much you eat and drink for a week, then see where you can cut down on portion sizes, cut back on some not-so-healthy foods and drinks, or both!
For those who are overweight or obese, losing even a small amount of weight has health benefits and is a good place to start.
Be more active.
Watching how much you eat will help you control your weight. The other key is to be more physically active. Being active helps reduce your cancer risk by helping with weight control. It can also help improve your hormone levels and the way your immune system works.
More good news – physical activity helps you reduce your risk of heart disease and diabetes, too! So grab your athletic shoes and head out the door!
The latest recommendations for adults call for at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week, or an equivalent combination, preferably spread throughout the week. This is over and above usual daily activities like using the stairs instead of the elevator at your office or doing housework. For kids, the recommendation is at least 60 minutes of moderate or vigorous intensity activity each day, with vigorous intensity activity occurring at least 3 days each week.
Moderate activities are those that make you breathe as hard as you would during a brisk walk. This includes things like walking, biking, even housework and gardening. Vigorous activities make you use large muscle groups and make your heart beat faster, make you breathe faster and deeper, and also make you sweat.
It’s also important to limit sedentary behavior such as sitting, lying down, watching television, or other forms of screen-based entertainment.
Being more physically active than usual, no matter what your level of activity, can have many health benefits.
Eat healthy foods.
Eating well is an important part of improving your health and reducing your cancer risk. Take a good hard look at what you typically eat each day and try these tips to build a healthy diet plan for yourself and your family:
Choose foods and drinks in amounts that help you get to and maintain a healthy weight.
• Read food labels to become more aware of portion sizes and calories. Be aware that “low-fat” or “non-fat” does not necessarily mean “low-calorie.”
•Eat smaller portions when eating high-calorie foods.
• Choose vegetables, whole fruit, legumes such as peas and beans, and other low-calorie foods instead of calorie-dense foods such as French fries, potato and other chips, ice cream, donuts, and other sweets.
• Limit your intake of sugar-sweetened beverages such as soft drinks, sports drinks, and fruit-flavored drinks.
• When you eat away from home, be especially mindful to choose food low in calories, fat, and added sugar, and avoid eating large portion sizes.
Limit how much processed meat and red meat you eat.
• Limit your intake of processed meats such as bacon, sausage, lunch meats, and hot dogs.
• Choose fish, poultry, or beans instead of red meat (beef, pork, and lamb).
• If you eat red meat, choose lean cuts and eat smaller portions.
• Prepare meat, poultry, and fish by baking, broiling, or poaching rather than by frying or charbroiling.
Eat at least 2½ cups of vegetables and fruits each day.
• Include vegetables and fruits at every meal and snack.
• Eat a variety of vegetables and fruits each day.
• Emphasize whole fruits and vegetables; choose 100% juice if you drink vegetable or fruit juices.
• Limit your use of creamy sauces, dressings, and dips with fruits and vegetables.
Choose whole grains instead of refined grain products.
• Choose whole-grain breads, pasta, and cereals (such as barley and oats) instead of breads, cereals, and pasta made from refined grains, and brown rice instead of white rice.
• Limit your intake of refined carbohydrate foods, including pastries, candy, sugar-sweetened breakfast cereals, and other high-sugar foods.
If you drink alcohol, limit how much
People who drink alcohol should limit their intake to no more than 2 drinks per day for men and 1 drink per day for women. The recommended limit is lower for women because of their smaller body size and slower breakdown of alcohol.
A drink of alcohol is defined as 12 ounces of beer, 5 ounces of wine, or 1½ ounces of 80-proof distilled spirits (hard liquor). In terms of cancer risk, it is the amount of alcohol, not the type of alcoholic drink that is important.
These daily limits do not mean it’s safe to drink larger amounts on fewer days of the week, since this can lead to health, social, and other problems.
Reducing cancer risk in our communities
Adopting a healthier lifestyle is easier for people who live, work, play, or go to school in an environment that supports healthy behaviors. Working together, communities can create the type of environment where healthy choices are easy to make.
We all can be part of these changes: Let’s ask for healthier food choices at our workplaces and schools. For every junk food item in the vending machine, ask for a healthy option, too. Support restaurants that help you to eat well by offering options like smaller portions, lower-calorie items, and whole-grain products. And let’s help make our communities safer and more appealing places to walk, bike, and be active.
The bottom line
Let’s challenge ourselves to lose some extra pounds, increase our physical activity, make healthy food choices, limit alcohol, and look for ways to make our communities healthier places to live, work, and play.

Friday, 18 November 2016

Lifestyle Changes After Having Ovarian Cancer

Ref : American Cancer Society
You can't change the fact that you have had cancer. What you can change is how you live the rest of your life − making choices to help you stay healthy and feel as well as you can. This can be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even start during cancer treatment.
Making healthier choices
For many people, a diagnosis of cancer helps them focus on their health in ways they may not have thought much about in the past. Are there things you could do that might make you healthier? Maybe you could try to eat better or get more exercise. Maybe you could cut down on the alcohol, or give up tobacco. Even things like keeping your stress level under control may help. Now is a good time to think about making changes that can have positive effects for the rest of your life. You will feel better and you will also be healthier.
You can start by working on those things that worry you most. Get help with those that are harder for you. For instance, if you are thinking about quitting smoking and need help, please see your family physicians or addiction therapist.  The tobacco cessation and coaching service can help increase your chances of quitting for good.
Eating better
Eating right can be hard for anyone, but it can get even tougher during and after cancer treatment. Treatment may change your sense of taste. Nausea can be a problem. You may not feel like eating and lose weight when you don't want to. Or you may have gained weight that you can't seem to lose. All of these things can be very frustrating.
If treatment caused weight changes or eating or taste problems, do the best you can and keep in mind that these problems usually get better over time. You may find it helps to eat small portions every 2 to 3 hours until you feel better. You might also want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you ideas on how to deal with these treatment side effects.
One of the best things you can do after cancer treatment is to start healthy eating habits. You may be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Getting to and staying at a healthy weight, eating a healthy diet, and limiting your alcohol intake may lower your risk for a number of types of cancer, as well as having many other health benefits.
Rest, fatigue, and exercise
Extreme tiredness, called fatigue, is very common in people treated for cancer. This is not a normal tiredness, but a "bone-weary" exhaustion that doesn't get better with rest. For some people, fatigue lasts a long time after treatment, and can make it hard for them to exercise and do other things they want to do. But exercise can help reduce fatigue. Studies have shown that patients who follow an exercise program tailored to their personal needs feel better physically and emotionally and can cope better, too.
If you were sick and not very active during treatment, it is normal for your fitness, endurance, and muscle strength to decline. Any plan for physical activity should fit your own situation. A person who has not been physically active will not be able to take on the same amount of exercise as someone who plays tennis twice a week. If you haven't exercised in a few years, you will have to start slowly – maybe just by taking short walks.
Talk with your health care team before starting anything. Get their opinion about your activity plans. Then, try to find a buddy so you're not doing it alone. Having family or friends involved when starting a new activity program can give you that extra boost of support to keep you going when the push just isn't there.
If you are very tired, you will need to balance activity with rest. It is OK to rest when you need to. Sometimes it's really hard for people to allow themselves to rest when they are used to working all day or taking care of a household, but this is not the time to push yourself too hard. Listen to your body and rest when you need to.

Keep in mind exercise can improve your physical and emotional health.
v  It improves your cardiovascular (heart and circulation) fitness.
v  Along with a good diet, it will help you get to and stay at a healthy weight.
v  It makes your muscles stronger.
v  It reduces fatigue and helps you have more energy.
v  It can help lower anxiety and depression.
v  It can make you feel happier.
v  It helps you feel better about yourself.
And long term, we know that getting regular physical activity plays a role in helping to lower the risk of some cancers, as well as having other health benefits.

Sunday, 13 November 2016

Obesity : Potential Health Risks To Women

Obesity is a global problem and a health threat to developing and developed countries as its prevalence is rising. It is estimated that more than 1 billion people are overweight with 300 million meeting the criteria for obesity. Twenty six percent of non-pregnant women ages 20-39 are overweight and 29% are obese.

Classification of Obesity Based on Body Mass Index (BMI)
BMI (kg/m2)
Normal weight
Obese              Class I
Obese              Class II
Obese              Class III
The above table shows a classification for overweight and obesity based on BMI. Another classification is based on waist circumference. In women, a waist circumference of > 35 inches (88cm) is high risk and in men, the level is > 40 inches (102cm).
Health Risks For Women

An increased risk of Diabetes Mellitus (DM) was seen in women with BMI values > 24 and a waist-to-hip ratio > 0.76. The risk increases with the degree and duration of being overweight or obese and with a more central or visceral distribution of fat. Increased central fat enhances the degree of insulin resistance and increased risk of metabolic syndrome (DM and cardiovascular syndrome).
Compared to normal population, women with a BMI > 35 have an increased risk 2.7 times for developing coronary artery diseases and 5.4 times for hypertension.
More than 31% of obese adults have arthritis compared with only 16% of non-obese adults. Obesity at age of 23 increases the risk of low back pain onset for women within 10 years. Studies showed that women with a diagnosis of knee osteoarthritis (OA) have an average BMI that is 24% higher than women without OA. An estimated 69% of knee replacements in middle-aged women have been attributable to obesity.
Obesity is frequently associated with menstrual problems. About 30-47% of overweight and obese women have irregular menses. Obesity affects fertility throughout a woman’s life. Abdominal obesity is associated with an increase in circulating insulin level, hormonal imbalance and menstrual cycle abnormalities which result in anovulatory cycles (no egg production) and subfertility. Some studies demonstrate increased female sexual dysfunction in obese patients whether caused by the physical or psychological impacts of obesity on female sexuality.

An Australian study found that 34% of pregnant women were overweight, obese or extremely obese. Prepregnancy obesity contributes to development of pregnancy complications including pregnancy-induced hypertension, pre-eclampsia, gestational diabetes, Caesarean section and congenital fetal abnormalities neonatal death.
Maternal obesity is associated with a decreased intention to breastfeed, decreased initiation of breast-feeding and decreased duration of breast-feeding. Obese women are at greater risk of a delay in milk production due to lower hormone (prolactin) responses to suckling in the first week compared to normal-weight women.

There are a lot of evidence that obesity is a risk factor for developing gynaecologic and breast cancers. Endometrial cancer (lining tissue of the uterus) is strongly related to obesity. Obese women have 2-5 times increased risk of developing endometrial cancer compared to normal-weight women. This is mainly due to hormonal imbalance, irregular scanty menses result in an endometrium is chronically exposed to oestrogen. This causes cancerous changes in the endometrium. Obesity increases risk of breast cancer for postmenopausal women with poorer outcomes – more aggressive diseases, a higher likelihood of delayed detection and treatment failure.

Evidence from studies on body weight and ovarian cancer has been inconsistent and showed no correlation between obesity and ovarian cancer. However obese women are at an increased risk of complications from ovarian cancer surgeries like infection, bleeding, organ injuries and venous thrombosis. Studies shows increased incidence and mortality from cervical cancer among obese women. It could be due to decreased screening compliance among obese women, because of embarrassment or discomfort.
Importance of weight loss for risk reduction measurement
Weight loss is the most important measures to reduce health risk for obese women. Combined management with dietitians, endocrinologists, bariatric surgeons and gynaecologists may produce desirable results. Patients must be motivated throughout the weight loss programme.

Weight loss surgery can be considered if conservative measures fail. Researches show that bariatric surgery resulted in complete resolution of diabetes in 78% of patients and improvement in diabetic control more than 86% of patients. This surgery also improved lipidaemia in 70% of patients, 62% resolved hypertension and 62% improved hypertension. In these researches, 72-80% of patients are women.
A reduction 10 % of body weight may regulate menses, increased ovulation and fertility rate for obese women. Weight-loss intervention (mainly diet and exercise) is the best initial management of infertile overweight and obese women.
Weight loss especially after obesity surgery reduces risk of endometrial cancer but no significant impacts on reduction in incidence of breast, cervical and ovarian cancers.

Obesity becomes more prevalent worldwide and has significant bad effects on women’s health. Women should be counselled on negative consequences of obesity and importance of controlling weight or achieving ideal body weight to prevent medical and health problems. 

Thursday, 10 November 2016

Other Benefits of Birth Control ( Contraceptive ) Pills

Ref.: webMD
You know that birth control pills can keep you from getting pregnant. But the pill can have other benefits, too. One survey found that more than half of women who take birth control pills do so for reasons other than avoiding pregnancy.
It can make your periods more regular. With the pill, you'll know when you'll have your period.
With traditional birth control pills, you'll take 3 weeks of hormone-containing active pills, followed by one week of inactive pills. You'll get your period the week you the inactive pills.
With a type called extended-cycle, you take active pills for a longer amount of time. Most often you'll take 3 months of active pills before taking a break. That means you have your period only three or four times a year.
It can make them lighter, too. Heavy menstrual bleeding (called menorrhagia) affects about 10% of reproductive-age women. If it's not treated, it can lead to anemia. The pill lowers your blood loss by thinning the lining of your uterus.
It may make you more comfortable. Birth control pills keep your ovaries from releasing eggs every month. It essentially tricks your body into thinking you're pregnant. Because of that, your uterus makes less of the chemicals that trigger painful cramps. This pain, known as dysmenorrhea, is the most common menstrual problem, affecting up to 90% of reproductive-age women.
Birth control pills with the hormone drospirenone can also help ease symptoms of a severe form of PMS called premenstrual dysphoric disorder, or PMDD.
It can stop menstrual migraines. 60% of women who get migraines associate the timing of them with their period. Migraines can be triggered by a drop in estrogen, which occurs during menstruation. Taking extended-cycle birth control pills stops hormonal ups and downs.
It can help your skin. All women make male sex hormones, just in much smaller amounts than men do. Some women, though, make more than others, which can result in acne and excessive hair growth. Among other things, the pill slows the making of male hormones. As a result, many women have fewer breakouts and less unwanted body or facial hair.
It can ease endometriosis. In this condition, tissue normally inside the uterus grows outside of it. It causes painful, heavy periods. Taking birth control pills can help ease the symptoms by thinning out the uterine lining, and, in the case of extended-cycle pills, blocking your period from happening each month.
It can help with polycystic ovarian syndrome (PCOS). This condition, which is brought on by a hormonal imbalance, causes irregular periods, acne, excess body hair, ovarian cysts, and infertility -- all symptoms that can be helped by birth control pills. The pill has a number of benefits in patients with PCOS, [who are] making higher-than-normal levels of male hormones and not ovulating regularly. The pill lowers testosterone levels and controls when you menstruate.
It lowers your risk of some cancers. Women that have taken the pill for 5 years or longer have a 50% reduction in the risk of developing ovarian cancer, and that benefit continues even after stopping the pill. We're talking about a cancer for which there's not a good screening tool, and a cancer that's frequently diagnosed in an advanced stage, so to have this kind of risk reduction is important.
A recent analysis of 36 studies found that for every 5 years that a woman takes birth control pills, her risk of endometrial cancer decreases by nearly a quarter. The benefit continued even more than 30 years after the women stopped taking the pill.

Monday, 31 October 2016

Can Ovarian Cancer Be Prevented?

ref: American Cancer Society
Most women have one or more risk factors for ovarian cancer. But most of the common factors only slightly increase your risk, so they only partly explain the frequency of the disease. So far, what is known about risk factors has not translated into practical ways to prevent most cases of ovarian cancer.
There are several ways you can reduce your risk of developing epithelial ovarian cancer. Much less is known about ways to lower the risk of developing germ cell and stromal tumours of the ovaries. The remainder of this section refers to epithelial ovarian cancer only. It is important to realize that some of these strategies reduce the risk only slightly, while others decrease it much more. Some strategies are easily followed, and others require surgery. If you are concerned about your risk of ovarian cancer, you may want to discuss this information with your health care professionals. They can help you consider these ideas as they apply to your own situation.
Oral contraceptives
Using oral contraceptives (birth control pills) decreases the risk of developing ovarian cancer, especially among women who use them for several years. Women who used oral contraceptives for 5 or more years have about a 50% lower risk of developing ovarian cancer compared with women who never used oral contraceptives. Still, birth control pills do have some serious risks and side effects. Women considering taking these drugs for any reason should first discuss the possible risks and benefits with their doctor.
Gynaecologic surgery

Both tubal ligation and hysterectomy may reduce the chance of developing ovarian cancer, but experts agree that these operations should only be done for valid medical reasons -- not for their effect on ovarian cancer risk.

If you are going to have a hysterectomy for a valid medical reason and you have a strong family history of ovarian or breast cancer, you may want to consider having both ovaries and fallopian tubes removed (called a bilateral salpingo-oophorectomy) as part of that procedure.

Even if you don’t have an increased risk of ovarian cancer, some doctors recommend that the ovaries be removed with the uterus if a woman has already gone through menopause or is close to menopause. If you are older than 40 and you are going to have a hysterectomy, you should discuss the potential risks and benefits of having your ovaries removed with your doctor.

Prevention strategies for women with a family history of ovarian cancer or BRCA mutation
If your family history suggests that you (or a close relative) might have a syndrome linked with a high risk of ovarian cancer, you might want to consider genetic counseling and testing. During genetic counseling (by a genetic counselor or other health care professional with training in genetic risk evaluation), your personal medical and family history is reviewed. This can help predict whether you are likely to have one of the gene mutations associated with an increased ovarian cancer risk.
The counselor will also discuss the benefits and potential drawbacks of genetic testing with you. Genetic testing can help determine if you or members of your family carry certain gene mutations that cause a high risk of ovarian cancer. Still, the results are not always clear cut, and a genetic counselor can help you sort out what the results mean to you.
For some women with a strong family history of ovarian cancer, knowing they do not have a mutation that increases their ovarian cancer risk can be a great relief for them and their children. Knowing that you do have such a mutation can be stressful, but many women find this information very helpful in making important decisions about certain prevention strategies for them and their children.
Using oral contraceptives is one way that many women can reduce their risk of developing ovarian cancer. Oral contraceptives also seem to reduce this risk for women with BRCA1 and BRCA2 mutations. But birth control pills can increase breast cancer risk in women without these mutations. This increased risk continues for some time after these pills are stopped. Studies that have looked at this issue in women with BRCA mutations haven’t agreed about what effect birth control pills have on breast cancer risk. Some studies have shown an increased risk of breast cancer, while some have not. Research is continuing to find out more about the risks and benefits of oral contraceptives for women at high ovarian and breast cancer risk.
It isn’t clear if tubal ligation effectively reduces the risk of ovarian cancer in women who have BRCA1 or BRCA2 mutations. Studies that have looked at this issue haven’t agreed about this. Researchers do agree that removing both ovaries and fallopian tubes (salpingo-oophorectomy) helps protect women with BRCA1 or BRCA2 mutations against ovarian (and fallopian tube) cancer.
Sometimes a woman has this surgery to reduce her risk of ovarian cancer before cancer is even suspected. If the ovaries are removed to prevent ovarian cancer, the surgery is called risk-reducing or prophylactic. Generally, salpingo-oophorectomy is recommended only for very high-risk women after they have finished having children. This operation lowers ovarian cancer risk a great deal but does not entirely eliminate it. That’s because some women who have a high risk of ovarian cancer already have a cancer at the time of surgery. These cancers can be so small that they are only found when the ovaries and fallopian tubes are looked at under the microscope (after they are removed). Also, women with BRCA1 or BRCA2 gene mutations have an increased risk of primary peritoneal carcinoma. Although the risk is low, this cancer can still develop after the ovaries and fallopian tubes are removed.
The risk of fallopian tube cancer is also increased in women with mutations in BRCA1 or BRCA2. Sometimes early fallopian tube cancers are found unexpectedly when the fallopian tubes are removed as a part of a risk-reducing surgery. In fact, some cancers that were thought to be ovarian or primary peritoneal cancers may have actually started in the fallopian tubes. That is why experts recommend that women at high risk of ovarian cancer who are having their ovaries removed should have their fallopian tubes completely removed as well (salpingo-oophorectomy).
Research has shown that premenopausal women who have BRCA gene mutations and have had their ovaries removed reduce their risk of breast cancer as well as their risk of ovarian cancer. The risk of ovarian cancer is reduced by 85% to 95%, and the risk of breast cancer cut by 50% or more.
Another option for women who do not wish to have their ovaries removed because they don’t want to lose ovarian function (and go through menopause early) is to have just the fallopian tubes removed (a salpingectomy). They may choose to have their ovaries removed later. This has not been studied as well as removing both the ovaries and fallopian tubes at the same time, so it isn’t clear how much this affects the risk of cancer. It is clear that to have the greatest effect on breast cancer risk, the ovaries need to be removed by the time the woman is 35.
Some women who have a high risk of ovarian cancer due to BRCA gene mutations feel that having their ovaries and fallopian tubes removed is not right for them. Often doctors recommend that those women have screening tests to try to find ovarian cancer early. These tests are discussed in the next section.