Breast cancer awareness

How much do you really know about breast cancer? Are you at risk?

What is breast cancer?

Breast cancer is a group of abnormal cells, which continue to grow and multiply in the breast. Normally cells grow and multiply in an orderly way but changed genes can cause them to behave abnormally. In the breast they may grow into a lump.

These lumps can be benign or malignant. Benign lumps do not spread to other parts of the body. A malignant lump is made up of cancer cells. When it first develops, this malignant tumour is confined to the breast. Most lumps are not cancerous.

Breast cancer develops in either the ducts or the lobules. Lobules are where the milk is produced and ducts are where the milk travels to the nipple. Cancer cells develop when the cells lining the ducts or lobules become abnormal in size and shape and start multiplying in an uncontrolled way. If the cancer is not removed and controlled, the cancer cells can spread to other parts of the body. These are called secondary cancers or metastases.

Breast cancer in men

Breast cancer in men is rare but does still occur. Less than 1% of all people with breast cancer are men. Breast cancer in men is on the rise with about one hundred men being diagnosed in Australia this year.

Breast cancer in men occurs more commonly in those aged 50 years and older.
Both men and women have breast tissue. We don’t know exactly why breast cancer develops in men or in women. We do know that there are risk factors that may increase a man’s risk of developing breast cancer.

When breast cancer strikes

Breast cancer is the major cause of cancer death in Australian women accounting for more than 11,700 new cases of breast cancer and 2,600 deaths each year. Early detection is the best method for reducing deaths from breast cancer.

Women whose cancer is still contained in the breast when diagnosed have a 90% chance of surviving five years, compared with a 20% five-year survival chance when the cancer has spread at diagnosis.

The incidence of breast cancer is increasing, but with continued support and funding from the National Breast Cancer Foundation, improvements in research mean survival rate is on the rise.

What has research taught us about breast cancer?

Research has given us new knowledge in all areas of breast cancer, from the benefits of screening and early detection, to better diagnoses and treatments and finally hope for prevention.

To date, research has given us a greater understanding of breast cancer cells and how they function. This understanding has enabled researchers to develop better, more targeted treatments.

Treatment

Breast cancer treatment does not always mean major disfigurative surgery. Thanks to new knowledge from research, specialists can now treat many breast cancer cases by removing the lump itself, leaving the breast intact.

Research has shown us that breast screening is an effective way to detect breast cancers early for women aged 50-69 years, giving patients a greater chance of survival. However screening mammography is not suitable for young women and we need more research to improve early detection in young women

What should women look out for?

Look for any changes in the breast which are not normal for you, or which you have not seen before. You should visit a GP if you notice any of the following important changes:

  • Lump, lumpiness or thickening in the breast
  • Changes in shape, crusting, ulcerated or sore nipples.
  • Discharge from nipple or bloodstained occurs without squeezing.
  • Changes in the skin of the breast, puckering, dimpling or redness.
  • Persistent unusual pain which is not related to the normal monthly cycle
  • An increase or decrease in the size of the breast.

Breast cancer becomes more common as you grow older, so knowing what is normal for your breasts is just as important after menopause.

How to find changes in your breast?

  • Look at the shape, size and skin on your breasts and nipples in the mirror. Check for any changes that may have occurred in the last few months.
  • Self examination – Remember that your breast tissue spans across from your collar bone, to the armpit and includes the area around the nipple.

Visit your GP promptly

Your GP will know how to investigate any changes in your breast to find out the cause. The vast majority of women who find a breast change will be relieved to know that it is not breast cancer. For those women whose changes are due to breast cancer; the sooner breast cancer is diagnosed, the better the chance of effective treatment.

So visit your GP about any changes in your breasts that are not normal for you. While it may take a week or so to decide whether the breast change is unusual, it is important not to delay too long before seeing a GP.

Are you getting enough sleep?

Good quality sleep. Are you getting enough? Go back to sleeping like a baby…

Sleep is a state of consciousness that happens every 24 hours. It is a period of rest and recuperation for the body and much needed ‘down time’ for the brain.

People vary in the amount of sleep they need, depending on their age, lifestyle, diet, personality and environment. Generally, we sleep less as we age and our sleep tends to be more broken. Newborn babies tend to sleep for around 16 hours out of every 24, while adults average seven hours and the elderly only six.

The body clock
Sleep is regulated by an internal ‘clock’, which is tuned by the day–night cycles (circadian rhythm). When the sun sets, your brain starts to release melatonin, a sleep inducing hormone until eventually you feel the need to retire for the night. In the morning, the hormones adrenocorticotropin or ACTH from the pituitary gland and cortisol from the adrenal gland, send a message that alerts the brain to wake up. Exposure to daylight prompts your brain to release these hormones.

Sleep stages

Sleep isn’t a static state of consciousness. We all go through various distinct stages of sleep, over and over, every night. Generally, the brain moves from light sleep to deeper sleep and eventually to rapid eye movement sleep. REM sleep occurs regularly, about once every 90 to 120 minutes.

Brain waves in REM sleep are faster than in non-REM sleep. REM sleep is associated with dreaming and with stimulation of the parts of the brain used for learning, while body repair and growth tends to happen during non-REM sleep. It is important to get the right mix of both REM and non-REM sleep to maintain your natural sleep cycle and help you wake rested and refreshed.

Common sleep disorders

Sleep seems to be a complicated state of consciousness, since it can be disturbed in so many ways. Some of the more common sleep complaints include:

  • Insomnia – Difficulties in falling asleep or staying asleep. The most common sleeping disorder  in adults.
  • Narcolepsy – Extreme tiredness with intermittent sleepiness during the day which can include voluntary napping.
  • Periodic Limb Movement Disorder – Muscle spasms of the legs that often wake the sleeper.
  • Restless leg syndrome – This feels like cramps or some kind of irritation in the lower legs. The person feels they need to move their legs or walk around.
  • Sleep apnoea – The upper airway is blocked causing airflow and breathing to stop for a time during sleep.
  • Sleepwalking – This tends to affect children more than adults.
  • REM sleep behaviour disorder –  The sleeper acts out what’s happening in their dreams.

Treatment

Some disorders such as sleepwalking, sleep starts and snoring often don’t require any treatment because they are harmless. Lifestyle changes can help relieve mild or occasional symptoms if they are causing an unwanted disruption to your life.

Insomnia, the most common form of sleep complaint, requires assessing and treatment of the cause (or causes) rather than insomnia itself. Some of the more involved sleep disorders need to be treated at a sleep disorder clinic. While snoring may be harmless (benign snoring), it may indicate a more serious medical condition, obstructive sleep apnoea.

Tips for improving your sleep

  1. Get out of bed as soon as you wake. Don’t go back to sleep or try to make up for ‘lost sleep’.
  2. Try to get up at about the same time each morning.
  3. Go outside into the fresh air.
  4. Do some physical activity, go for a walk.
  5. Do not nap during the day. If you nap, you’ll be less tired when you go to bed and you’ll probably take longer to fall asleep.
  6. If you’re worrying about things during the night, set aside some time for problem-solving during the day. Identify problems that are causing you stress.
  7. Keep a sleep-wake diary.
  8. Review your sleep-wake progress with your doctor at each visit.
  9. Avoid drinking caffeine after 4pm and try not to drink more than two cups of caffeine-type drinks each day eg. coffee, strong tea, cola or energy drinks.

Overcoming long term sleep problems

For some people, sleeping problems may last for weeks, months or even years. Not surprisingly this may lead to anxiety about getting to sleep, which in turn makes the problem even worse. It can be helpful to take specific steps to break the cycle of feeling anxious and restless in bed. Below are some steps to follow when you can’t get to sleep.

Get up if you can’t sleep after trying for 15 to 20 minutes. Staying in bed when you’re feeling restless and anxious is unlikely to result in sleep.

Do something quiet and distracting such as read or enjoy a warm bath. If your mind is very active or you can’t stop worrying, it may be helpful to concentrate on something else, such as doing a crossword or watching television. By distracting yourself from your worries, you may find it easier to wind down and become sleepy.

Go back to bed when you feel more relaxed and sleepy.

If you’re still awake after a further 15 to 20 minutes, get out of bed again. Repeat this process until you fall asleep shortly after returning to bed.

Remember, sleep disorders can be serious and should be investigated and treated at a sleep disorders centre.

Source:Better Health channel

Bright eyes

Taking care of your health and your eyes is the first step in preventing blindness from common eye problems…

Low and degenerative loss of vision is on the rise. It is estimated common eye problems that are leading causes of blindness will double by the year 2030. Lifestyle choices such as smoking, excessive alcohol consumption, lack of exercise, poor food choices, obesity, as well as age related eye diseases can all factor into poorer health and subsequently poorer vision.

  • Signs of possible eye trouble may include:
  • Difficulty focusing on objects near of far
  • Line and edges appear distorted or blurred
  • Dark spots in the centre of viewing
  • Red rimmed, encrusted or swollen eyes
  • Hazy or blurred vision

If you notice any signs of potential problems, see an eye doctor for an eye exam. Regular eye exams are especially recommended for those with high blood pressure and diabetes.

For Facts sheets on eye related health concerns, click here


Your prostate

How much do you know about the inner workings of your prostate? Should you get yours checked?

The prostate gland is part of the male reproductive system. It produces some of the fluid that makes up semen. Prostate cancer affects one in 11 Australian men and is common in the over-65 age group. Around 3,000 Victorian men are diagnosed with prostate cancer every year. Many cases are not life threatening because the cancer may be slow growing and usually occurs in older men.

Symptoms
Early prostate cancer usually causes no symptoms. When symptoms do occur, they may include:

  • Difficulties starting and stopping urination
  • Pain or a burning sensation when passing urine
  • Urinating more often than usual, particularly at night
  • The feeling that the bladder can’t be fully emptied
  • Dribbling urine
  • Blood in the urine or semen
  • Pain during ejaculation

All of these symptoms can also be caused by conditions other than prostate cancer. You should discuss them with your doctor.

The cause is unknown

The exact causes of prostate cancer are unknown. However, the chance of getting prostate cancer increases:

As you get older, if you have a father or brother who had prostate cancer. The risk becomes greater if they were diagnosed at an early age.

Diagnosing prostate cancer

Prostate cancer is diagnosed using a number of tests, which may include:

PSA test – the prostate makes a protein called prostate specific antigen (PSA). Large quantities of PSA in the blood can indicate prostate cancer or other prostate problems.

Digital rectal examination – using a gloved finger in the back passage, the doctor feels for enlargement and irregularities of the prostate.

Biopsy -Six to 12 tissue samples are taken from the prostate and examined in a laboratory for the presence of cancer cells.

If prostate cancer is diagnosed, other tests may be needed to see if the cancer has spread to other areas of the body.

Treatment options

Treatment for prostate cancer depends on a range of factors, such as the man’s age, physical condition, the stage of his prostate cancer and his personal preference.

  • Watchful waiting – sometimes your doctor will advise that treatment is not needed. However, you will still need to be examined and have PSA tests regularly to monitor any changes.
  • Surgery – removal of the prostate is called a radical prostatectomy and will involve a six to 10 day stay in hospital. If the prostate can’t be removed, other surgery may be performed to remove blockages in the prostate to relieve urination problems. This operation is called transurethral resection of the prostate (TURP).
  • Radiotherapy – x-rays are used to target and destroy cancer cells. Treatment usually lasts a few weeks, although this depends on the cancer and the person’s general health
  • Brachytherapy – a radioactive implant is placed inside the prostate to target cancer cells. The implant may be temporary or permanent.
  • Hormone therapy – prostate cancer relies on the hormone testosterone for growth. Hormone therapy reduces testosterone levels and ‘starves’ the tumour, this is given with either medication or hormone injections. Sometimes surgical removal of the testicles (orchidectomy) is suggested which has the same effect.

Possible side effects of treatment

The side effects of treatment can be distressing. You should talk through options and concerns with your doctor before making a choice. Typical side effects include:

  • Surgery – many men will have temporary urinary incontinence (loss of bladder control). Almost all men will have a change to their sexual function and most men will have erectile dysfunction (impotence).
  • Radiotherapy – A small number of men will have bowel problems. Between 40 and 80 per cent of men who have radiotherapy will experience erectile dysfunction (impotence).
  • Brachytherapy – erectile dysfunction (impotence) and bowel problems can occur. Some men may experience painful urination and irritation of the bladder for several months after therapy. Urinary incontinence is not usually a problem.
  • Hormone therapy – side effects may include erectile dysfunction (impotence), tiredness, hot flushes and loss of sex drive.

Consult your doctor if you feel you have one or more of the above symptoms.

For more information on your prostate click here.

Asthma risk in pregnancy

Results recently published in the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society,  reveal that allergens found in some nuts may increase the chance of the foetus being born allergy prone. Four thousand pregnant women participated in a dietary survey and their children were subsequently monitored for eight years.

Comparing women who ate nuts daily during pregnancy to those who ate them “rarely” consistently displayed results of increased risk, between 40% to 60% rise in the chances of wheezing and other asthma symptoms in general, reports the BBC.

The research also discovered a link between lower asthma rates and increased intake of fruit during pregnancy. This may be possibly due to the increased levels of antioxidants.

Dr. Saskia Willers, from the University of Utrecht, who led the study said:

While it’s too early to make recommendations of avoidance, it is important for pregnant women to eat healthily and what is true for many foods is that too much is never good.

Professor John Heffner, a past president of the American Thoracic Society, said there was not enough evidence that the nut diet had caused the problem and he called for more studies.

For a more health information relating to nuts and the role they play as part of a healthy diet click here.

Hearing awareness

Currently, one in six Australians has some form of hearing loss and this is projected to increase to one in four by 2050. This means hearing loss is more common than cardiovascular disease, diabetes mellitus, asthma, cancer and mental illness.

Causes of hearing loss

  • Hereditary disorders: These are passed on by parents and, in most cases, deafness is caused by malformations of the inner ear.
  • Genetic Disorders: Genetic mutations may happen at the moment of conception. Some of the many genetic disorders that can cause deafness include osteogenesis imperfecta, Trisomy 13 S and multiple lentigines syndrome.
  • Prenatal: Babies exposed in the uterus to certain disease may be born deaf or with hearing disorders. These include: German measles (rubella), influenza and mumps. Other factors that are thought to cause congenital deafness include exposure to methyl mercury and drugs such as quinine.
  • Noise: Loud noises (gun shots, firecrackers, explosions and rock concerts) can damage the delicate mechanisms inside the ear. If you are standing next to someone at a rock concert and have to shout to be heard, the noise is considered loud enough to be damaging to your ears.
  • Trauma: Perforation of the eardrum, changes in air pressure and a fractured skull can all cause hearing loss.
  • Disease: Some diseases can cause deafness. These include meningitis, mumps, cytomegalovirus and chicken pox and exposure to certain chemicals.
  • Age-related hearing loss: Our hearing gradually becomes less effective as we get older. At around 20 years of age, our hearing begins a gradual decline, with higher frequency sounds usually the first to go. This hearing loss is considered normal as we age and doesn’t lead to total loss of hearing.
  • Tinnitus is a sensation of ringing in the ears. Some of the causes of tinnitus include middle ear infections and damage to the ear from loud noises. Tinnitus may occur on its own, or in conjunction with hearing loss.

Prevention is best

This can be done in various ways:

  • Protect your ears in noisy environments by wearing noise reducing ear muffs.
  • Avoid loud music and noises for exessive periods of time.
  • Get your hearing tested periodically. Regular testing of your ears can provide early detection of hearing loss.

Noise Levels

It’s not just the amount of noise, but the length of time you’re exposed to it that determines its ability to damage your hearing. Noise levels are measured in decibels (dB). The higher the decibel level, the louder the noise. Sounds louder than 80dB are considered potentially hazardous.

If you feel you have abnormal hearing loss please consult with a doctor.

For information on Hearing Awareness week click here.

For the Deafness Forum Australia click here.

Weight and stroke prediction

A new study from Germany suggests that stomach size and other markers of abdominal fat may be a better predictor of stroke than body mass index (BMI).

Previous studies have already suggested that waist circumference is a better predictor of cardiovascular risk than body mass index (BMI), and Dr.Winter from the University of Heidelberg in Germany and colleagues wanted to see if this was the case for cerebrovascular events such as stroke and transient ischemic attack (TIA). TIA is commonly called mini stroke, where there is a temporary interruption to the blood supply to a part of the brain, and is often a precursor to a stroke, which is a permanent disruption to blood supply in a part of the brain.

For the case control study, Winter and colleagues enrolled 379 adults with stroke and/or TIA and matched them with 758 controls of the same age and sex. 79 per cent (301 members) of the stroke/TIA group had previously had a stroke, 10 per cent (37) had previous bleeding in the brain, and 11 per cent had already suffered a TIA. The stroke/TIA group had an average age of 67 and comprised 141 women and 238 men.

The researchers used various methods to calculate obesity in their test subjects, including BMI, waist to hip ratio, waist circumference and waist to height ratio (these last three being what they called markers of abdominal  fat). They then analysed the links between these measures and stroke or TIA risk.

The results showed that:
While there was a positive strong link between BMI and cerebrovascular risk, it became non-significant when the researchers took out risk factors like physical inactivity, smoking, blood pressure, and diabetes.

Markers of abdominal fat were strongly linked to risk of stroke/TIA, regardless of the other risk factors. Participants with bigger waists (more than 40 inches for men and 35 inches for women) had 4 times the risk of developing a stroke or TIA compared to those with more typical waist sizes. Also, participants with the largest waist-to-hip ratio had nearly 8 times the risk of developing a stroke or TIA.

“Markers of abdominal adiposity showed a significant association with risk of stroke/TIA, independent of other vascular risk factors. Waist circumference and related ratios can better predict cerebrovascular events than BMI.” said Dr.Winter.

According to a report in WebMD, Dr Tobias Back, the senior author of the study, who is based at Saxon Hospital Arnsdorf in Dresden, has warned that people should keep and eye on their waistline. While gaining too much weight has health risks of it’s own , they should abdominal weight gain is even more dangerous.

The researchers noticed that there were more physically active people in the healthy group than in the stroke group. They also strongly encourage adding essential fatty acids to one’s diet such as olive oil and fish to lower stroke risk.

Dr.Back said that as well as considering a patient’s whole vascular risk profile, doctors should use waistline measures such as the waist to hip ratio as defined by the World Health Organization (WHO) to monitor stroke risk.

The WHO estimates that about 17 million people a year die of cardiovascular diseases, particularly heart attack and strokes. A great number of these can be attributed to tobacco smoking, which increases the risk two or three-fold, while physical inactivity and poor diet are other main risk factors.

The study was the work of lead author Dr Yaroslav Winter from the University of Heidelberg and other colleagues based there and at other research and clinical centres in Germany, and is published online before print on August 14th in the journal Stroke.

(Source: Stroke: World Health Organization: August 2008)