Don't assume a normal annual test for fecal occult blood (FOBT) means you can postpone your colonoscopy. According to Frank Herlong, M.D., Associate Professor of Medicine, Gastroenterology Division at Johns Hopkins and Health After 50 Board Member, FOBTs are no longer relied upon for colon cancer screening -- though some doctors may use them to test for gastrointestinal bleeding from causes other than cancer.
Before colonoscopies became widely available and covered by insurance, annual FOBTs were an affordable and easy-to-use tool for colon cancer screening. But FOBTs have always been notoriously unreliable. Most employ a chemical called guaiac that changes color if blood is present in the stool sample. Guaiac also reacts with certain fruits and vegetables and with blood from red meat, which increases the likelihood of "false positive" results. All positive results must be confirmed by colonoscopy.
Immunochemical FOBTs, or IFOBTs, test for a protein specific to human blood. They are widely available and more accurate than guaiac based tests. But no matter which FOBT you use, a negative result does not necessarily mean that you are safe. Case in point: A recent study published in The New England Journal of Medicine found that an expensive DNA-based FOBT was capable of detecting 26% more invasive cancers and potentially precancerous growths than a common guaiac-based FOBT. But even this vastly superior DNA-based test identified only 51% of all invasive cancers detected by colonoscopy.
The most important thing to keep in mind is that not all precancerous growths or colon cancers cause bleeding; by the time they do, the cancer may be advanced. In contrast to all types of FOBTs, a colonoscopy detects -- and removes -- growths whether or not they cause bleeding. Thus, colonoscopy is your best protection against colon cancer.
Tuesday, June 24, 2008
Fecal Occult blood test screening for Colon Cancer
Tuesday, June 10, 2008
Dave Barry's Colonoscopy Journal
June 10, 2008
This is from newshound :
... I called my friend Andy Sable, a gastroenteritis, to make an appointment for a colonoscopy. A few days later, in his office, Andy showed me a color diagram of the colon, a lengthy organ that appears to go all over the place, at one point passing briefly through Minneapolis . Then Andy explained the colonoscopy procedure to me in a thorough, reassuring and patient manner. I nodded thoughtfully, but I didn't really hear anything he said, because my brain was shrieking, quote, 'HE'S GOING TO STICK A TUBE 17,000 FEET UP YOUR BEHIND!'
I left Andy's office with some written instructions, and a prescription for a product called 'MoviPrep,' which comes in a box large enough to hold a microwave oven. I will discuss MoviPrep in detail later; for now suffice it to say that we must never allow it to fall into the hands of America 's enemies.
I spent the next several days productively sitting around being nervous. Then, on the day before my colonoscopy, I began my preparation. In accordance with my instructions, I didn't eat any solid food that day; all I had was chicken broth, which is basically water, only with less flavor. Then, in the evening, I took the
MoviPrep. You mix two packets of powder together in a one-liter plastic jug, then you fill it with lukewarm water. (For those unfamiliar with the metric system, a liter is about 32 gallons.) Then you have to drink the whole jug. This takes about an hour, because MoviPrep tastes - and here I am being kind - like a mixture of goat spit and urinal cleanser, with just a hint of lemon.
The instructions for MoviPrep, clearly written by somebody with a great sense of humor, state that after you drink it, 'a loose watery bowel movement may result.' This is kind of like saying that after you jump off your roof, you may experience contact with the ground.
MoviPrep is a nuclear laxative. I don't want to be too graphic, here, but: Have you ever seen a space-shuttle launch? This is pretty much the MoviPrep experience, with you as the shuttle. There are times when you wish the commode had a seat belt. You spend several hours pretty much confined to the bathroom. You eliminate everything. And then, when you figure you must be totally empty, you have to drink another liter of MoviPrep, at which point, as far as I can tell, your bowels travel into the future and start eliminating food that you have not even eaten yet.
After an action-packed evening, I finally got to sleep. The next morning my wife drove me to the clinic. I was very nervous. Not only was I worried about the procedure, but I had been experiencing occasional return bouts of MoviPrep spurtage. I was thinking, 'What if I spurt on Andy?' How do you apologize to a friend for something like that? Flowers would not be enough.
At the clinic I had to sign many forms acknowledging that I understood and totally agreed with whatever the heck the forms said. Then they led me to a room full of other colonoscopy people, where I went inside a little curtained space and took off my clothes and put on one of those hospital garments designed by sadist perverts, the kind that, when you put it on, makes you feel even more naked than when you are actually naked.
Then a nurse named Eddie put a little needle in a vein in my left hand. Ordinarily I would have fainted, but Eddie was very good, and I was already lying down. Eddie also told me that some people put vodka in their MoviPrep. At first I was ticked off that I hadn't thought of this, but then I pondered what would happen if you got yourself too tipsy to make it to the bathroom, so you were staggering around in full Fire Hose Mode. You would have no ch oice but to burn your house.
W hen everything was ready, Eddie wheeled me into the procedure room, where Andy was waiting with a nurse and an anesthesiologist. I did not see the 17,000-foot tube, but I knew Andy had it hidden around there somewhere. I was seriously nervous at this point. Andy had me roll over on my left side, and the anesthesiologist began hooking something up to the needle in my hand. There was music playing in the room, and I realized that the song was 'Dancing Queen' by ABBA I remarked to Andy that, of all the songs that could be playing during this particular procedure, 'Dancing Queen' has to be the least appropriate.
'You want me to turn it up?' said Andy from somewhere behind me. 'Ha ha,' I said. And then it was time, the moment I had been dreading for more than a decade. If you are squeamish, prepare yourself, because I am going to tell you, in explicit detail, exactly what it was like.
I have no idea. Really. I slept through it. One moment, ABBA was yelling 'Dancing Queen, Feel the beat of the tambourine,' and the next moment, I was back in the other room, waking up in a very mellow mood. Andy was looking down at me and asking me how I felt. I felt excellent. I felt even more excellent when Andy told me that It was all over, and that my colon had passed with flying colors. I have never been prouder of an internal organ.
ABOUT THE WRITER
Dave Barry is a Pulitzer Prize-winning humor columnist for the Miami Herald.
Sunday, June 1, 2008
Protect Yourself Against Prostate Cancer
Simple Steps to Protect Yourself Against Prostate Cancer
Reducing your risk of prostate cancer begins with the big picture, those well-publicized major lifestyle changes that are widely recommended but often difficult to accomplish. Then there are the smaller details: cancer-protective foods, supplements, and medications. A serious prostate cancer risk-reduction program encompasses both approaches.
Achieving a healthy weight, committing to regular exercise, and altering long-ingrained dietary habits are the most important steps you can take to protect yourself from prostate cancer. And their payoff goes far beyond the prostate. These lifestyle changes could reduce your risk of nearly all the most devastating diseases: heart disease, stroke, diabetes, Alzheimer’s disease, and many other forms of cancer. What’s more, they work together to improve your health. Here are some strategies to consider:
Weight management.
The links between obesity and prostate cancer continue to strengthen. Fat cells churn out a slew of substances that fuel the development and progression of cancer. These include estrogen, testosterone, and insulin-like growth factor. Men who are obese also are more likely to be diagnosed with advanced prostate cancer. The possible reasons are that obese men tend to have larger prostates (making tumor detection more difficult), and their prostate specific antigen (PSA) scores are often deceptively low.Regular exercise.
Vigorous physical activity appears to protect against prostate cancer. Men who exercise regularly are less likely to be diagnosed with advanced or fatal prostate cancer. Some evidence suggests that vigorous physical activity may also slow its progression.Dietary changes.
Adopting a plant-based diet can reduce your risk of prostate cancer and improve your overall health. This dietary approach focuses on fruits, vegetables, legumes (like beans and peas), whole grains, seeds, and nuts. Soy foods (like soy nuts and tofu) also appear to be protective. Aim for at least nine fruits and vegetables a day.
To get all the cancer-fighting nutrients you need, try to include a “rainbow” of fruits and vegetables each day -- reds, oranges, yellows, greens, and blues/purples. Brightly colored fruits and vegetables are rich in carotenoids, cancer-fighting substances that serve as coloring agents in plant foods. Also be sure to include at least one serving per day of a cruciferous vegetable (like broccoli, cabbage, or cauliflower). These vegetables contain other types of cancer-fighting chemicals.
Specific Foods, Supplements, and Medications. Ongoing research into prostate cancer prevention has identified a number of individual substances that may be protective:
Lycopene. The carotenoid lycopene is found in tomatoes, pink grapefruit, and watermelon. Cooked tomato products such as spaghetti sauce and ketchup are the richest source.
Pomegranates. Pomegranates and pomegranate juice have recently been found to cause prostate cancer cells to self destruct. Among men with prostate cancer, daily glasses of pomegranate juice have slowed the increase in PSA levels after treatment.
Omega-3 fatty acids. Omega- 3 fatty acids are a type of polyunsaturated fat found abundantly in fatty fish (like salmon, sardines, tuna, and halibut) and fish oil. Flaxseeds, walnuts, and canola oil contain a weaker, but still beneficial, plant-based form of these healthful fats. Omega-3s have anti-inflammatory and anticancer effects. Several studies have suggested that men who eat fish two or more times per week have a lower risk of developing prostate cancer.
Selenium and vitamin E. These two nutrients are being tested for their potential protective effects in SELECT (Selenium and Vitamin E Cancer Prevention Trial) -- the largest clinical study ever launched about prostate cancer prevention, coordinated by the U.S. National Cancer Institute. Several smaller studies have shown benefits, but until the SELECT results are in, doctors recommend against taking large amounts of either nutrient. A multivitamin that includes both is the best bet for now.
Vitamin D. Vitamin D plays an important role in regulating cell growth and has been associated with a reduced risk of prostate cancer. The dietary sources of vitamin D include fortified milk and fatty fish. The way to boost your body's natural productin of vitamin D is to spend about 15 minutes a day (without sunscreen) in the sun.
Statins. Prostate cancer researchers are discovering the important role inflammation plays in the development of prostate cancer. High cholesterol levels also may increase the risk. The cholesterol-lowering medications known as statins tackle both problems. In a study that Johns Hopkins researchers participated in, men who took statins had half the risk of developing prostate cancer compared with nonusers.
NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) also reduce inflammation and appear to lower the risk of prostate cancer. These medications target a protein called COX-2, which is believed to help prostate cancer cells spread.
Prostate Disorders Special Report by Johns Hopkins Health Alerts is owned and operated by University Health Publishing. June 1, 2008
Our email is: customerservice@johnshopkinshealthalerts.com
Thursday, May 29, 2008
Cold Blooded
Cold Blooded
I sat in the oncologist’s waiting room and stared at cold-blooded fish that circled in the fish tank. Like sharks who wait patiently for the kill. There will be a kill today. At 10 AM.
The cold frosted glass door opened. The receptionist asked if there have been any change of address or health insurance since my last visit.
No was my reply.
Two more minutes passed. The fish stared at me as I stared back. The nurse opened the door, announced my name, I followed her to the tiny treatment room. A chill was in the air. Chemo treatment rooms are never warm.
I sat in cold fake leather chair. I covered my lap with a tiny blue flannel blanket. The same blankets the stingy airlines offer their cold customers. I draped one blanket around my legs and tried to cover my chest with another baby blanket. The artic air conditioning cooled the room. Baby blankets tried to keep me warm. They failed.
The busy nurse looked drained of life from this job. Just another patient getting chemo. Her icy fingers found a vein. She inserted a cold needle into my body. She taped the tube to my arm and hung a clear bag of saline solution over my head.
A hot-blooded man began to chill.
Ten minutes passed. I looked at the plastic bag over my head. Empty. Nurse returned with a brand new bag of the old chemo (A cocktail that has been so effective for so many years!). The nurse removed the empty bag of saline and plugged in my cold cancer cocktail.
I sat in the chair motionless. I watched chemo float through the clear tube to the needle in my arm. The chemo crept up my arm slowly. Arm began to freeze. The chemo cocktail circulated my carcass. The chemo entered my heart. Cold chemo cocktail was pumped thru my entire body. Cold chemo killed some cancer cells. Cold chemo cocktail killed some of my brain cells too. I think. Can’t really remember that part I was cold and numb.
Drip, drip, drip.
The chemo bag emptied poison into my cold dying body. I sat helpless in a chair.
My body went cold. I began to shiver. Whenever I get cold I feel like I am dying. Parts of my body were dying during chemo.
Sixty minutes later the nurse inspected the bag with fingers covered with plastic gloves.
You are done Mr. Beckstein.
The nurse held my elbow with polar paws. She pulled the cold needle out of my vein. I held the white round cotton ball over my leaking vein. The efficient nurse wrapped eight inches of adhesive tape over the fat cotton ball and around my elbow. Not much hair left inside my arm anymore.
“Do you think you can stand up? She asked.
Yes.
I will find your friend to take you home Mr. Beckstein.
Thanks
I slowly shuffled out of the cold chemo treatment room.
I hate the cold.
Wednesday, May 28, 2008
Finding Your Best Diet
Finding Your Best Diet
The limited research on popular weight-loss plans drives home two messages: (1) weight loss is hard, and (2) finding the optimal diet for you as an individual is the only way to succeed. Here is some common-sense advice on how to choose a diet that suits you.
Long-term weight control is based on changing your eating patterns (and your physical activity habits) for a lifetime. Anyone can go on a diet for a couple of weeks, or even a couple of months, but those who lose weight and keep it off adopt a diet plan they can sustain (with some calorie adjustments) for years. Here, then, are some tips on how to choose a diet that suits you:
Do a self-assessment.
Most overweight people eat out of habit and in response to emotions rather than because they’re hungry. To learn what leads you to overeat, observe your usual diet for a week: Keep track of what you eat, when and where you eat, who you’re with when you eat, and how you’re feeling when you eat. Also make note of your portion sizes (many overweight people eat larger portions and more calories than they think).
This process will give you an idea of your trouble spots and help you decide what diet plan will work best for you. For example, if your portion sizes are too large, you might find that a diet program that provides prepackaged or prepared meals, because you won’t need to make decisions about portion size.
If you are an emotional eater, a diet plan that offers counseling or support groups might be best for helping you cope with the emotional issues that are driving you to overeat.
Find a diet that fits your personality and lifestyle.
You might be the type of person who is most comfortable with a diet that provides daily menus and recipes -- or you might prefer a plan that offers lists of foods from which you can pick and choose (or even provides prepackaged foods). You might require a diet plan that addresses some of your health concerns -- the need to lower your sodium, cholesterol, or fat intake -- or allows you to eat meals away from home because you travel a lot.
Choose a diet that is well balanced.
Trendy diets such as the Atkins plan may produce quick weight loss, but they don’t offer the full complement of vitamins, minerals, and other nutrients your body needs to stay healthy -- and they typically lead to weight regain when you go off the diet. These diets are also hard to stay on for the long term because they strictly limit the types of foods you can eat. The best strategy is to go on a calorie-controlled diet plan that includes all of the food groups and doesn’t deprive you of your favorite foods.
Posted in Nutrition and Weight Control on May 28, 2008
Tuesday, May 13, 2008
Lifetime Probability of Developing Colon Cancer
Colon Cancer is highly preventable when patients are regularly checked and screened via colonoscopy. For years there was only one drug to treat this cancer. Now there are five.
The five year survival rates have increased to 65 percent, but when localized colon cancer is detected early and treated surgically, the survival rate is 95 percent.
Source : May 2008 AARP Bulletin page 13
Monday, May 12, 2008
Dietary Factors and the Development Of Colon Cancer
- high fat,
- red-meat ,
- obesity
- lack of vegetables
- lack of fiber in the diet.
In the great majority of cases, colorectal cancer arises from an initially benign overgrowth of colonic lining, a so-called adenomatous polyp which acquires with time harmful mutations and transforms into a dangerous colonic carcinoma. Observational studies suggest that the adenoma-to-carcinoma sequence takes up to 10 years. Although nearly half of Western population may harbor adenomatous polyps by the age of 50, it is estimated that only a few percent of adenomas will progress to cancer.
Adapted from materials provided by University of Helsinki, via EurekAlert!, a service of AAAS.University of Helsinki (2008, May 7). Discovery Of A Novel Mechanism For The Development Of Colon Cancer. ScienceDaily. Retrieved May 12, 2008, from http://www.sciencedaily.com /releases/2008/05/080505125625.htm