Health Q & A
Osteoporosis… The Silent Health Threat
It affects over 10 million Americans. Of those affected, 80% are women. Osteoporosis is characterized by the weakening of basic bone structure from calcium loss. This change in structure makes bones porous or full of microscopic holes. Once the bone structure has weakened, it is more likely to break easily. A simple fall can cause a serious fracture in a patient with osteoporosis. According to the National Osteoporosis Foundation, 50% of women and 25% of men over age 50 will have at least one fracture related to osteoporosis in their remaining lifetime.
High Risk Patients
Certain patients are at a higher risk for developing osteoporosis. These patients may have a family history of osteoporosis, a personal history of decreased calcium intake, a history of prolonged steroid use, or the presence of certain chronic diseases. Anyone’s risk can also increase with cigarette use, inactive lifestyle, excessive alcohol use, and advancing age. Hormonal changes such as decreased estrogen in women through menopause or surgical ovarian loss and low testosterone levels in men can also increase the rate at which bone loss occurs.
Detecting The Disease
Because this disease is silent, most people do not know that they have osteoporosis until they have serious symptoms such as broken bones. Fortunately, osteoporosis can now be detected before bones are weak enough to easily break. The test is called a BMD or bone mineral density test. BMD is a quick and painless procedure that is very similar to an x-ray. It does not take long to get results and the information can help you and your doctor make the best decision for your medical care.
The BMD reports bone health in two specific categories called the T and Z-scores. The Z-score is specific for your age and body size while the T-score determines your fracture risk. T-scores are represented in numbers of standard deviation from normal. Normal, for calculation purposes, is the bone density of a healthy 30 year old adult. Low T-scores are represented by negative numbers. A T-score below -2.5 indicates osteoporosis. The National Osteoporosis Foundation recommends BMD testing for patients with significant risk factors, postmenopausal women with new fractures, and all women over age 65.
After having the BMD test, many patients will be reassured to find that they have strong healthy bones. Fortunately, there are many treatments available for those people who do have bone mineral loss. It is always best to begin treatment as early as possible to prevent osteoporosis progression and fractures. The American Academy of Family Physicians recommends a daily intake of 1,000 mg of calcium for adults and 1,500 mg for women after menopause. In general, we can all help prevent osteoporosis with exercise, a calcium rich diet, and by healthy lifestyle choices such as stopping smoking and limiting alcohol use.
The prostate is a gland involved in the male reproductive system. It is surrounded by other glands, nerves and organs involved in sexual function. It is wrapped around the urethra and helps control the flow of urine. While men can live without a prostate, its location makes prostate cancer difficult to treat.
Prostate cancer is a common, but usually slow growing cancer, compared to other types of cancer. It’s growth is fed by, and generally depends on, male hormones. In most cases, prostate cancer is an adenocarcinoma, a cancer of the epithelial cells which compose the inner lining of glands.
Prostate cancer is the most commonly diagnosed non-skin cancer in American men. It is the second greatest cause of cancer related death for men, second only to lung cancer. According to the National Prostate Cancer Coalition, in 2006, approximately 234,460 men will be diagnosed with prostate cancer, and approximately 27,350 will die as a result of the disease – down 10% from 2005.
For the general population, a man has about a 17% chance of getting prostate cancer in his lifetime and a 3% chance of dying from it. Some men have a much higher risk, such as men with a father, brother or other relative who has had prostate cancer, African American men, and Veterans exposed to Agent Orange.
Two tests are commonly used to detect prostate cancer; a blood test, the Prostate Specific Antigen (PSA) test and a physical exam, the Digital Rectal Exam (DRE). They are usually administered by your regular doctor. Typically, men should start yearly screening at age 50.
Men with one or more high risk factors should start yearly testing at 45 or earlier. Some men choose to take a PSA test at 40, to establish a baseline level for future comparison.
There are no noticeable symptoms of prostate cancer while it is still in the early stages, which is why screening is so critical. In more advanced stages, symptoms may include difficult or frequent urination, blood in the urine or bone pain. In order to find prostate cancer in its most treatable form, it must be caught before symptoms appear.
Changing your diet can lower your risk. A low fat diet with lots of fruits and vegetables is a good start. Studies show a strong connection between consumption of saturated fat and red meat, and increased rates of prostate cancer diagnosis and mortality. Large studies are underway to confirm evidence that Soy, Vitamin E, tomatoes and other foods may lower your risk.
Many options for treatment are available, and the right treatment for each man depends very much on their individual case. Some choose to wait and watch for signs of disease progression. Some choose surgery, radiation, hormone therapy or a combination of methods. If these treatments fail, some patients enroll in clinical trials to try therapies that are promising but still in the research phase.
Ten things that every man should know about prostate cancer
- One in every six men will get prostate cancer sometime in his life. Over 234,460 new cases are expected this year— more than breast cancer.
- The chances of getting prostate are 1 in 3 if you have just one close relative (father, brother) with the disease. The risk 83% with two close relatives. With three, it’s almost a certainty (97%).
- African American men are at special risk for the disease, with the highest rate of prostate cancer in the world: 1 in 4 men. African American men are 2.5 times more likely to die from the disease.
- Prostate Cancer is the second-leading cause of male cancer-related death in the United States. An estimated 27,350 men will die from prostate cancer this year, down 10% from 30,350 in 2005.
- There are no noticeable symptoms of prostate cancer while it is still in the early stages. This is why screening is so critical.
- Every man age 50 or over should resolve to be screened annually. African American men or those with a family history of the disease should start screening at 40 or 45.
- Before early detection through PSA screening, only 1 in 4 prostate cancer cases were found while still in the early stages. With the widespread use of screening, about 9 out of 10 cases are now found early – giving men a fighting chance.
- Nearly 100% of men diagnosed with prostate cancer while it is still in the early stages are still alive 5 years from diagnosis.* Of men diagnosed in the late stages of the disease, 33.4% survive 5 years.*
- Screening for prostate cancer involves a simple blood test and a physical exam. It takes about 10 minutes and is covered by health insurance in many states.
- Obesity is a significant predictor of prostate cancer severity. Men with a body mass index over 32.5 have about 1/3 greater risk of dying from prostate cancer. Research shows high cholesterol levels are strongly associated with advanced prostate cancer.
*not including those who died from causes other than prostate cancer.
Seasonal Allergies and How to Deal With Them
If you are dealing with seasonal allergies, you may have hay fever (allergic rhinitis), which is an allergic response to certain substances in your environment. Hay fever is the most common allergic condition in the United States, affecting about 20 percent of the population.
If you have seasonal hay fever, you may be allergic to pollens released by trees, grasses or weeds. If you have year-round hay fever, you may be sensitive to indoor allergens such as dust mites, cockroaches, mold or pet dander.
Hay fever signs and symptoms can range from mild to severe. If your condition is mild, you may have brief, infrequent episodes of a runny nose and itchy, watery eyes. At the other extreme, you may experience persistent, severe symptoms that last more than four days a week or more than four weeks at a time. Chronic congestion may cause facial pressure and pain, alter your sense of taste and smell, and affect your appearance.
Hay fever symptoms usually develop immediately after you’re exposed to specific allergy-causing substances (allergens). Common allergens include pollen, dust mites, cockroaches, mold and pet dander. Sometimes, exposure to irritants such as perfume and tobacco smoke may trigger or worsen symptoms.
Signs and symptoms of hay fever may include:
- Runny nose
- Watery eyes
- Frequent sneezing
- Itchy eyes, nose, roof of mouth or throat
- Postnasal drip
- Facial pressure and pain
Often it can be difficult to distinguish between hay fever and a cold. Keep in mind that typically colds will run their course within five to seven days, whereas hay fever will act up every time you’re exposed to your allergy. Also, fevers are not actually a symptom of hay fever — so if you have a low-grade fever, you’re probably suffering from a cold.
Causes Of Hay Fever
Heredity plays a key role in determining who gets allergies, including hay fever. If one of your parents has an allergic condition, your risk of developing an allergic condition is 48 percent. If both of your parents are allergic, your risk increases to 70 percent. So you may be more likely to develop hay fever if allergies run in your family.
Although hay fever can begin at any age, you’re most likely to develop it in childhood or early adulthood. As you get older, your symptoms may worsen or improve. Symptoms are usually most severe in children and in people in their 30s and 40s.
If you have hay fever, you may react to one or more common inhaled allergens. One of the best-known offenders is ragweed pollen, which makes millions of Americans miserable every fall. No matter what you’re allergic to, the underlying cause of your misery is the same. During a process called sensitization, your immune system mistakenly identifies the allergen as an invader and produces an antibody against it called immunoglobulin E, or IgE.
The next time you’re exposed to the allergen, your immune system launches an allergic reaction. The IgE antibodies trigger the release of inflammatory chemicals such as histamine, which swells the mucous membranes in your nose, sinuses and eyes, causing a runny nose, watery eyes and sneezing.
While it’s impossible to completely avoid allergens, you can reduce your symptoms to allergens by reducing your exposure to them.
To reduce exposure to pollens and molds:
- Close doors and windows during pollen season
- Use air conditioning in house and car
- Stay indoors on sunny, windy days
- Use a dehumidifier to reduce indoor humidity to less than 50 percent
- Use a high-efficiency particulate air (HEPA) filter in your bedroom
- Avoid mowing the lawn or raking up leaves, which stirs up pollen and mold
- When To Seek Medical Attention
By itself, hay fever can impair your quality of life. Congestion and constant nose blowing can cause discomfort and social embarrassment. The resulting sleeplessness, fatigue and irritability can also affect your performance at work or school.
But hay fever may increase your risk of developing more serious allergic conditions such as asthma, a chronic condition that occurs when the main air passages of your lungs, the bronchial tubes, become inflamed. Hay fever and asthma often occur together. If you have asthma, you may have symptoms such as difficulty breathing, shortness of breath, a tight feeling in the chest, coughing and wheezing.
Prolonged sinus congestion due to hay fever may increase your susceptibility to sinusitis — bacterial infection of the membrane that lines the sinuses. Sinusitis causes pain, tenderness and swelling around your eyes, cheeks, nose or forehead and can be either acute or chronic.
If you experience occasional symptoms of hay fever and haven’t found relief from using over-the-counter medications, see your doctor to design a treatment program. Also see your doctor if your symptoms are persistent or if you experience side effects from over-the-counter medications.
After your doctor has identified the substances that trigger your symptoms, he or she will help you develop a plan to avoid these substances. In some cases, avoidance alone can effectively control your hay fever symptoms.