JB Johor Gynaecologist
Obstetrician, Gynaecologist, GynaeOncologist ( Pakar Perbidanan, Sakit Puan, Kanser Wanita ) Johor Bahru, Johor Darul Takzim, MALAYSIA
Monday 18 September 2017
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)
Classification
|
BMI (kg/m2)
|
Underweight
|
<18.5
|
Normal weight
|
18.5-24.9
|
Overweight
|
25.0-29.9
|
Obese Class I
|
30.0-34.9
|
Obese Class II
|
35.0-39.9
|
Obese Class III
|
>40.0
|
·
Class III = EXTREME/MORBID OBESITY
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.
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.
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