research – Living Well While Surviving Cancer

The Value of Vitamin D in Cancer Care

Fresh research to help us live longer.

Earlier this month, we posted about Be Careful with Supplements. Nonetheless, some supplements may be valuable in cancer care. One of them seems to be Vitamin D.

A recent study by researchers at Michigan State found that:

“Vitamin D, if taken for at least three years, could help cancer patients live longer, say researchers. New findings suggest that the vitamin carries significant benefits other than just contributing to healthy bones. A paper on the work was presented at the American Society of Clinical Oncology annual meeting.”

“‘Vitamin D had a significant effect on lowering the risk of death among those with cancer, but unfortunately it didn’t show any proof that it could protect against getting cancer,’ says Tarek Haykal, a lead author of the study and an internal medicine resident physician at Michigan State University and Hurley Medical Center in Flint, Michigan.”

“Researchers looked at data related to disease prevention from more than 79,000 patients in multiple studies that randomly compared the use of vitamin D to a placebo over at least a three-year period. Haykal and his team zeroed in on any information that involved cancer incidence and mortality. ‘The difference in the mortality rate between the vitamin D and placebo groups was statistically significant enough that it showed just how important it might be among the cancer population,’ Haykal says. While these findings show promise, Haykal cautions that the exact amount of the vitamin to take and what levels are needed in the blood are still unknown. He also says that it’s unclear how much longer vitamin D extends lifespan and why it has this result.”

Click on the image to read the full paper.

Understanding Cognitive Aging

Further research on how we age.

Last week, we had a post on How Old Do YOU feel? “The study considered 92 diseases and conditions in 195 countries and territories.”

Let’s continue with that topic. In new research by Lee Ryan, et al., the authors discussed “Applying Precision Medicine to the Field of Cognitive Aging” in Frontiers in Aging Neuroscience:

“The current ‘one size fits all’ approach to our cognitive aging population is not adequate to close the gap between cognitive health span and lifespan. In this review article, we present a novel model for understanding, preventing, and treating age-related cognitive impairment (ARCI) based on concepts borrowed from precision medicine. We will discuss how multiple risk factors can be classified into risk categories because of their interrelatedness in real life, the genetic variants that increase sensitivity to, or ameliorate, risk for ARCI, and the brain drivers or common mechanisms mediating brain aging. Rather than providing a definitive model of risk for ARCI and cognitive decline, the Precision Aging model is meant as a starting point to guide future research. To that end, after briefly discussing key risk categories, genetic risks, and brain drivers, we conclude with a discussion of steps that must be taken to move the field forward.”

Click the image to access the full article.

How Old Do YOU feel?

To answer, think about the new age 65.

For me, this is really a two-part question. At age 70, I feel great both psychologically and mentally. I perceive myself as much younger than I am. On the other, how I feel physically is another story. The key for me is not to let my physical ailments overpower my psychological wellbeing. So, how old do YOU feel?

With the above in mind, consider the highlights of a very interesting article by Robert Roy Britt for Medium:

“By 2050, the percentage of the elderly is expected to double globally compared to today. As people live longer and an ever-higher percentage of the population is beyond their retirement years. This according to the World Health Organization. Meanwhile, conventional measures of longevity don’t reflect the quality of extended time on this Earth.”

“A new study looked at aging, health, and mortality by analyzing at what age people in a country actually feel like 65-year-olds, as defined by experiencing the health problems of the average 65-year old globally. The study considered 92 diseases and conditions in 195 countries and territories. The results are a window into both longevity and health status, revealing how well people age, or how poorly, the researchers report in the journal Lancet Public Health.”

“The findings ‘show that increased life expectancy at older ages can either be an opportunity or a threat to the overall welfare of populations, depending on the aging-related health problems the population experiences regardless of chronological age.’ said Dr. Angela Y. Chang, lead author of the study from the Center for Health Trends and Forecasts at the University of Washington.”

In this study, the United States did not fare so well. For the top 10 countries cited in the chart below, people were all in their mid-70s before feeling 65. The U.S. ranked 54 at 68.5. Certainly, that is food for thought.

Do YOU Agree with This Scary Finding?

Does your appointment time matter?

Although doctors are human, like other service providers, we hope that they are always on top of their game. Especially when they see us!!! But new research offers some scary insights. Do YOU believe these insights?

As reported in an article in the JAMA Network Open, authored by Esther Y. Hsiang; Shivan J. Mehta; Dylan S. Small; et al.:

Question: “Are breast and colorectal cancer screening rates associated with the time of day a patient visits the primary care clinician?”

Findings: “In this quality improvement study analysis of 33 primary care practices including 19,254 patients eligible for breast cancer screening and 33, 468 patients eligible for colorectal cancer screening, both clinician ordering and patient completion of cancer screening tests decreased as the time of day progressed.”

Meaning: “Patients with primary care clinic appointment times later in the day were less likely to be ordered for and receive guideline recommended cancer screening.”

As summed up in a Futurity.org article on this study:

“Examining data from 2014 through 2016 across 33 Pennsylvania and New Jersey primary care practices, the researchers found that ordering rates had far-reaching effects.”

“Among eligible patients, primary care doctors ordered breast cancer screening more often for patients seen in the 8 A.M (64 percent) as compared to those with appointments at 5 P.M. (48 percent). Similarly, doctors ordered colon cancer screening tests more frequently for 8 A.M patients (37 percent) compared to those coming in later in the day (23 percent).

“When looking at the entire sample eligible for screenings at these practices, the researchers tracked whether the patients completed a screening within a year of their appointment. The data showed that the downward trend associated with the timing of the appointments carried over. Breast cancer screening — which included mammograms—stood at a 33 percent one-year completion rate for the entire eligible population who had their appointment in the 8 A.M. hour. But for those who had clinic visits at 5 P.M. or later, just 18 percent completed screenings. For colorectal cancer, 28 percent of the patients with appointments in the 8 A.M. hour completed screenings such as colonoscopies, sigmoidoscopies, and fecal occult blood tests. That number dropped to 18 percent for patients who saw the doctor at 5 P.M. or later”.

Click the image to read the full research article.

Be Careful with Supplements

Choose your supplements wisely.

As part of our daily regimens, some of us take dietary supplements. BUT, we must be careful with these supplements.

In a very detailed and informative article, Markham Heid reports on issues related to supplement misuse. After just a short time, this article has received more than 11,100 likes!!!

According to Heid:

Background

“Earlier this year, federal authorities announced plans to strengthen oversight of the supplement industry. ‘The growth in the number of adulterated and misbranded products — including those spiked with drug ingredients not declared on their labels, misleading claims, and other risks — creates new potential dangers,’ said U.S. Food and Drug Administration (FDA) commissioner Dr. Scott Gottlieb in a February press release.”

“Heightened oversight is needed, Gottlieb argued, because expansion and change within the supplement industry has made it difficult for his agency to keep pace. ‘What was once a $4 billion industry comprised of about 4,000 unique products, is now an industry worth more than $40 billion, with more than 50,000 — and possibly as many as 80,000 or even more — different products available to consumers,” he said.”

BE CAREFUL!!!

“From multivitamins and botanicals to probiotics and protein powders, roughly three out of four Americans now take some kind of supplement on a regular basis. Since the days of palliative tonics and snake-oil salesmen, Americans have been readily lured by the promise of health or longevity in the form of a drink, pill, or powder. While the terminology has evolved — ’biohacking’ and ‘nutraceuticals’ are some of the buzzwords du jour — the implied benefits of most supplements still outpace or ignore the science. And despite recent studies that find supplements are frequently contaminated or that the best way to get nutrients is through food, Americans’ interest in supplements is only growing. And experts say many supplement users don’t recognize or appreciate the risks that accompany the use of these products.”

“The lesson here isn’t that supplements give people cancer. Rather, it’s that approaching supplements as though they’re all upside is a misguided and potentially harmful operating philosophy. When you swallow a capsule packed with concentrated amounts of a vitamin, nutrient, or other substance — a practice that did not become widespread until very recently — you can get into trouble.”

Click the image to access Heid’s full article.

AN AUDIO SUMMARY

Click below to access a 15-minute audio summary from Heid.

4,400 Steps Daily Are the New 10,000

No excuses now not to hit the proper number of steps.

Interesting blog title, huh? 4,400 Steps Daily Are the New 10,000. To put this in context, consider that for years we have been told that a minimum of 10,000 steps per day are needed to be healthy. Yet, for many of us, this may not be a realistic goal. So, what do we do? Suppose that the 10,000-step figure is wrong.

According to new research, the proper minimum number may be as few as 4,400 steps daily.

As Allison Aubrey observes for NPR:

“There’s nothing magical about the number 10,000. In fact, the idea of walking at least 10,000 steps a day for health goes back decades to a marketing campaign launched in Japan to promote a pedometer. And, in subsequent years, it was adopted in the U.S. as a goal to promote good health. It’s often the default setting on fitness trackers, but what’s it really based on?”

“‘The original basis of the number was not scientifically determined,’ says researcher I-Min Lee of Brigham and Women’s Hospital. She was curious to know how many steps you need to take a day to maintain good health and live a long life, so she and her colleagues designed a study that included about 17,000 older women. Their average age was 72. The women all agreed to clip on wearable devices to track their steps as they went about their day-to-day activities.”

“It turns out that women who took about 4,000 steps per day got a boost in longevity, compared with women who took fewer steps. ‘It was sort of surprising,’ Lee says. In fact, women who took 4,400 steps per day, on average, were about 40 percent less likely to die during the follow-up period of about four years compared with women who took 2,700 steps. Another surprise: The benefits of walking maxed out at about 7,500 steps. In other words, women who walked more than 7,500 steps per day saw no additional boost in longevity. The findings were published in JAMA Internal Medicine.”

“So, if 10,000 steps has been feeling out of reach to you, it may be time reset those factory settings on your fitness tracker. Instead, try to hit at least 4,400 a day, along with daily activities that you enjoy. And stick to it.”

Listen to the brief NPR audio for an overview. And click on the image to access the full NPR article.

https://www.npr.org/sections/health-shots/2019/05/29/727943418/do-you-really-need-10-000-steps-per-day — “New research shows that daily light walking is important for maintaining health as you age. But if you can’t hit 10,000 steps, don’t worry.” Peter Muller/Getty Images/Cultura RF

Two Research-Based Medication Findings

Studies on kidney disease and A-fib.

As we know, particular medications may or may not be for us. Even if they are fine for others. Let’s consider two examples.

Heartburn and Our Kidneys

Marget Robinson of the University of Buffalo reports that:

“Common medications for heartburn, acid reflux, and ulcers are linked to increased risks of kidney failure and chronic kidney disease, according to a new study. Use of proton pump inhibitors (PPI), a group of drugs that reduce the production of stomach acid, may increase risk as much as 20 percent — and also come with a four times greater risk of kidney failure, researchers say. People at least 65 years old have the highest risk.”

“The research, which appears in Pharmacotherapy, is one of the first large, long-term studies to examine the effects of PPIs on kidney function. Researchers examined health data of more than 190,000 patients over a 15-year period. ‘This study adds to a growing list of concerning side effects and adverse outcomes associated with PPIs,’ says David Jacobs, lead investigator and assistant professor of pharmacy practice in the University at Buffalo School of Pharmacy and Pharmaceutical Sciences. ‘Given the increasing global use of PPIs, the relationship between PPIs and renal disease could pose a substantial disease and financial burden to the health care system and public health.'”

Click the image to read more.

A-Fib and Aspirin

Sarah Avery of Duke University reports that:

“The drugs apixaban and clopidogrel — without aspirin — comprise the safest treatment regimen for certain patients with atrial fibrillation (A-fib), according to new research. The finding — which applies specifically to patients with A-fib who have had a heart attack and/or are undergoing percutaneous coronary intervention—should reassure clinicians and patients that dropping aspirin results in no significant increase in ischemic events such as heart attacks, strokes, and blood clots.”

“The researchers presented data from the large study, known as AUGUSTUS, at the American College of Cardiology annual meeting. ‘We have a lot of studies on antithrombotic drugs in patients with coronary artery disease and similarly in patients with A-fib, but few studies in patients with both conditions,’ says cardiologist Renato D. Lopes, principal investigator for the trial and a member of the Duke University Clinical Research Institute. ‘The reality is that doctors and patients have a challenge in treating these patients without causing bleeding. The results of this trial give us an opportunity to better understand how to best treat them.'”

Now, look at a brief video on the study.