Adprime Admin – thirdAGE https://thirdage.com healthy living for women + their families Fri, 20 Oct 2017 15:16:28 +0000 en-US hourly 1 https://wordpress.org/?v=5.7.2 Magnet Hospitals = Nursing Excellence & Better Patient Experiences https://thirdage.com/magnet-hospitals-nursing-excellence-better-patient-experiences/ Mon, 19 Oct 2015 09:00:00 +0000 Read More]]> A study published in October 2015 in Health Services Research shows that Magnet hospitals nationally that are accredited for nursing excellence have higher patient ratings of care than other hospitals. The study, led by Dr. Witkoski-Stimpfel at New York University College of Nursing and the University of Pennsylvania School of Nursing’s Center for Health Outcomes and Policy Research, suggests that hospitals seeking to improve patient satisfaction and qualify for new financial incentives would be well advised to consider investing in nursing excellence.

A release from New York University quotes Amy Witkoski-Stimpfel, PhD, RN as saying, “One straightforward strategy to improve patients’ experience, and thus improve the performance scores, involves registered nurses. Research has shown that patients’ experience with hospital care is significantly related to whether or not hospitals are well-resourced with respect to nursing, as nurses are the ones providing the most direct patient care in hospitals.”

For hospital management and policy makers, despite the evidence showing that patient outcomes are better in hospitals with good nurse work environments, it is not always clear how to translate this evidence into practice and to reform work environments. Dr. Witkoski-Stimpfel points to the Magnet recognition program as a method to implement improvements in nurse work environments.

“Magnet recognized hospitals have consistently been associated with superior patient outcomes, including lower patient mortality and higher nurse job satisfaction,” she says. “And, with an estimated pool of over $1 billion for performance incentives in 2014 fiscal year alone and increases in subsequent years, there is good reason for hospital leaders to be motivated to improve their patients’ experience.”

The study evaluated the performance of 212 Magnet hospitals in comparison to that of 212 matched non-Magnet hospitals, by assessing their Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Designed to evaluate patients’ short-term hospital care experience, the HCAHPS survey constitutes thirty percent of a hospital’s total performance score for reimbursement by the Centers for Medicare & Medicaid Services.

“Our study is one of the most comprehensive studies to date to demonstrate an association between Magnet recognition and patients’ satisfaction with their hospital care using the HCAHPS survey,” said Linda H Aiken, Director of Penn’s Center for Health Outcomes and Policy Research. “Patients who received care in Magnet hospitals reported signi?cantly greater satisfaction with their care.”

“The Magnet recognition process emphasizes innovation; evidence-based, patient-centered care; and a collaborative culture, making these likely contributors to the more favorable patient care experience demonstrated in our results,” said co-investigator, Matthew D McHugh from Penn Nursing’s Center for Health Outcomes and Policy Research. “For example, when nurses work in an environment that is well resourced and management is supportive of nurses, nurses are able to spend time assessing and educating patients and families, which may explain the better communication, pain control, and medication explanation scores that we observed.”

The evidence suggests that nursing excellence is key to achieving good hospital ratings from patients, says Dr. Witkoski-Stimpfel.

]]>
Bad Oral Health Can Ruin Romantic Relationships https://thirdage.com/bad-oral-health-can-ruin-romantic-relationships/ Mon, 19 Oct 2015 09:00:00 +0000 Read More]]> Maybe the sexual flame is waning. Maybe your sex life is really good but you wish it could be even better. Forget the sex toys, lotions, pills, videos, role playing and whatever else you’re trying, and take a good look inside your mouth.  Bad oral health can lead to bad sex!

Dr. Susan Maples, author of Blabber Mouth! 77 Secrets Only Your Mouth Can Tell You To Live a Healthier, Happier, Sexier Life, who has been named one of the top eight innovators in U.S. dentistry, says the mouth can provide important clues about the status of your sexual health and satisfaction.

Here’s how:

Erectile dysfunction: floss or be flaccid?  Erectile dysfunction is associated with gum disease. That doesn’t mean not flossing will make you flaccid, but because there is a link, it’s one of the most convincing arguments for men to take good care of their teeth and gums.

Bad breath: is it something I ate?

Nothing ruins a romantic moment faster than a slow lean-in for a kiss followed by a fast lean-out for a breath of fresh air. Short-term bad breath is usually caused by something you ate. But long-term bad breath means your oral or overall health is at risk.

Chapped lips: not so sexy.

Puckering up is the universal sign for romance. But dry, sore, cracked lips do nothing for your love life – and they could mean more serious trouble from diabetes to autoimmune diseases.  See your doctor or dentist if the problem persists for a few weeks and there is no obvious cause like cold weather, wind or sun.

Snoring: The sexual buzzkill.

The number-one reasons couples sleep apart: snoring.  Not only can snoringimpact your sex life because you’re not in the same bed as your partner, but thesleep deprivation that comes from constantly being woken by snoring increases your risk of diabetes, high blood pressure and heart disease. Talk to your dentist and physician about ways to reduce snoring.

Cold sores (aka Herpes):

A cold sore usually occurs on the lip or near where it is first contracted from another person, and are usually caused by the herpes simplex I virus whichis highly contagious. If someone with a cold sore performs oral sex, this can spread HSV-1 to the genitals and cause herpes sores there. Once you experience an episode, the virus is yours forever. There is no cure. We can only treat the symptoms.

Oral cancer and HPV:

The risk of oral cancer does not increase simply from having sex but rather from transmission of certain high-risk types of HPV through intimate contact. Actor Michael Douglas is one such example, who said his cancer was caused by HPV, which can be contracted through oral sex. Smoking and drinking put you at an increased risk. Find out if you’re infected with HPV, get an oral cancer screening from your dentist, stop smoking/chewing and drink in moderation.

]]>
Dying at Home: Pros and Cons https://thirdage.com/dying-home-pros-and-cons/ Fri, 16 Oct 2015 20:25:23 +0000 https://thirdage.com/dying-home-pros-and-cons/ Read More]]> Dying at home could be beneficial for terminally ill cancer patients and their relatives, according to research published in October 2015 in the open-access journal BMC Medicine. On the other hand, an article published the same week in the British Medical Journal (BMJ) contends that home is not always the best or preferred place to die.

The BMC study shows that according to questionnaires completed by their relatives, those who die at home experience more peace and a similar amount of pain compared to those who die in hospital, and their relatives also experience less grief. However, this requires discussion of preferences, access to a comprehensive home care package, and facilitation of family caregiving.

Previous studies have shown that most people would prefer to die at home. In the UK, US and Canada, slightly more appear to be realizing this wish, while in Japan, Germany, Greece and Portugal, a trend towards institutionalized dying persists.

Despite differing trends, the most frequent location of death for cancer patients remains hospital. Evidence regarding whether dying at home is better or worse than in hospital has, however, been inconsistent.

The BMC study took place in four health districts in London covering 1.3 million residents. 352 bereaved relatives of cancer patients completed questionnaires after their death – 177 patients died in hospital and 175 died at home. The questionnaires included validated measures of the patient’s pain and peace in the last week of life and the relative’s own grief intensity.

A release from the publisher quotes lead author Barbara Gomes from the Cicely Saunders Institute at King’s College London, UK as saying, “This is the most comprehensive population-based study to date of factors and outcomes associated with dying at home compared to hospital. We know that many patients fear being at home believing they place an awful burden on their family. However, we found that grief was actually less intense for relatives of people who died at home.

“Many people with cancer justifiably fear pain. So it is encouraging that we observed patients dying at home did not experience greater pain than those in hospitals where access to pain relieving drugs may be more plentiful. They were also reported to have experienced a more peaceful death than those dying in hospital.”

The study found that over 91% of home deaths could be explained by four factors: patient’s preference; relative’s preference; receipt of home palliative care in the last three months of life and receipt of district/community nursing in the last their months of life. When Marie Curie nurses (which provide additional home support) were involved, the patient rarely died in hospital. The number of general practitioner home visits also increases the odds of dying at home.

Three additional factors were also identified that had been previously overlooked – length of family’s awareness of that the condition could not be cured, discussion of patient’s preference with family, and the days taken off work by relatives in the three months before death. The authors say this challenges current thinking about the influence of patient’s functional status, social conditions, and living arrangements, which showed no association once other factors are considered.

Barbara Gomes said: “Our findings prompt policymakers and clinicians to improve access to comprehensive home care packages including specialist palliative care services and 24/7 community nursing. This is important because, in some regions, the workforce providing essential elements of this care package is being reduced.”

The researchers also highlight the crucial role of families in caring for patients at home and in decision-making processes, and the need to facilitate family caregiving.

Barbara Gomes added: “Many relatives see dedicated care as something they would naturally do for their loved one, but it still represents out-of-pocket money or days off their annual leave. Some governments, for example, in Canada, the Netherlands, Norway and Sweden, have set up social programmes or employment insurance benefits, similar to maternity leave, aimed at supporting families to provide care for their dying relatives.

“We urge consideration of similar schemes where they do not exist, with the necessary caution associated with complex public health interventions – careful development, piloting and testing, prior to implementation.”

Limitations of the study include its retrospective and observational nature, showing associations that do not necessarily indicate causality. The transferability of findings to regions outside of London, where home care services are less available, is uncertain. Subjective factors, pain and peace are also vulnerable to recall and observer bias from respondents.

A release from the publisher of the BMJ article notes that the UK government has marked place of death as a key indicator for the quality of end of life care. This is based on the idea that most people would prefer to die at home, but the evidence for this is not as strong as previously thought, argues Kristian Pollock from the University of Nottingham.

She writes that “focusing on place of death as the key indicator of quality in end of life care distracts attention from the experience of dying,” and calls for “more attention and resources to be spent on improving end of life care wherever this occurs, in hospitals or elsewhere.”

Dr. Pollock argues that more research is needed regarding what matters most to people at the end of life. For example, the difference between people’s preference regarding place of care, as opposed to place of death, is often overlooked.

In addition, she says a preference to die at home does not mean that place of death is the highest priority. Evidence suggests that dying in pain is the greatest concern of patients and the public, and that pain is less well controlled at home.

Idealized accounts of “the good death” at home often do not recognize the reality of the pain and discomfort experienced by some dying patients, she adds. “The person may have been alone, inadequately supported, in pain, distressed, and fearful.”

Hospitals have become widely regarded as inappropriate and undesirable places to die, she explains. There are concerns about poor quality of care and the high costs incurred by deaths in hospital.

However, hospitals may be preferred by patients who see them as places of safety and effective control of symptoms, especially for those who suffer distress and pain. Many patients wish to avoid imposing a burden on their families and may prefer to transfer responsibility for care from home to hospital, she says.

She adds that it is important to recognize and accommodate the diversity of patient preferences for place of death.

“When patients wish to die at home, every effort should be made to achieve this outcome. However, until resources are in place to adequately and equitably support home deaths, the current promotion of patient choice risks raising expectations that are not realized”, she says.

Dr. Pollock concludes that as hospitals will remain the most common place of death for the foreseeable future, instead of “neglecting and disregarding the hospital as a site of terminal care, much greater thought and adequate resources must be directed to enabling hospitals to provide excellent support for dying patients and their families.”

]]>
Antioxidant Supplements Cause Malignant Melanoma to Metastasize Faster https://thirdage.com/antioxidant-supplements-cause-malignant-melanoma-metastasize-faster/ Fri, 16 Oct 2015 20:10:04 +0000 https://thirdage.com/antioxidant-supplements-cause-malignant-melanoma-metastasize-faster/ Read More]]> Research at Sahlgrenska Academy of University of Gothenburg in Germany has found that antioxidant supplements can double the rate of melanoma metastasis in mice. The results reinforce previous findings that antioxidants hasten the progression of lung cancer. According to Professor Martin Bergö, people with cancer or an elevated risk of developing the disease should avoid nutritional supplements that contain antioxidants.

A release from the university reports that the researchers demonstrated in January 2014 that antioxidants hastened and aggravated the progression of lung cancer. Mice that were given antioxidants developed additional and more aggressive tumors. Experiments on human lung cancer cells confirmed the results.

Given well-established evidence that free radicals can cause cancer, the research community had simply assumed that antioxidants, which destroy them, provide protection against the disease. Found in many nutritional supplements, antioxidants are widely marketed as a means of preventing cancer. Because the lung cancer studies called the collective wisdom into question, they attracted a great deal of attention.

Double the rate

The follow-up studies at Sahlgrenska Academy have now found that antioxidants double the rate of metastasis in malignant melanoma, the most perilous type of skin cancer. Science Translational Medicine published the findings on October 7.

The release quotes Professor Bergö as saying, “As opposed to the lung cancer studies, the primary melanoma tumor was not affected. But the antioxidant boosted the ability of the tumor cells to metastasize, an even more serious problem because metastasis is the cause of death in the case of melanoma. The primary tumor is not dangerous per se and is usually removed.”

Confirmed the results

Experiments on cell cultures from patients with malignant melanoma confirmed the new results.

“We have demonstrated that antioxidants promote the progression of cancer in at least two different ways,” Professor Bergö says.

The overall conclusion from the various studies is that antioxidants protect healthy cells from free radicals that can turn them into malignancies but may also protect a tumor once it has developed.

Avoid supplements

Taking nutritional supplements containing antioxidants may unintentionally hasten the progression of a small tumor or premalignant lesion, neither of which is possible to detect.

“Previous research at Sahlgrenska Academy has indicated that cancer patients are particularly prone to take supplements containing antioxidants,” Dr. Bergö says. Our current research combined with information from large clinical trials with antioxidants suggests that people who have been recently diagnosed with cancer should avoid such supplements.”

High mortality rate

One of the fastest expanding types of cancer in the developed world, malignant melanoma has a high mortality rate – which is one reason that researchers at Sahlgrenska Academy were so anxious to follow up on the lung cancer studies.

“Identifying factors that affect the progression of malignant melanoma is a crucial task,” Professor Bergö says.

Lotions next

The role of antioxidants is particularly relevant in the case of melanoma, not only because melanoma cells are known to be sensitive to free radicals but because the cells can be exposed to antioxidants by non-dietary means as well.

“Skin and suntan lotions sometimes contain beta carotene or vitamin E, both of which could potentially affect malignant melanoma cells in the same way as antioxidants in nutritional supplements,” Professor Bergö says.

Other forms of cancer

How antioxidants in lotions affect the course of malignant melanoma is currently being explored.

“We are testing whether antioxidants applied directly to malignant melanoma cells in mice hasten the progression of cancer in the same way as their dietary counterparts,” Professor Bergö says.

He stresses that additional research is badly needed.

“Granted that lung cancer is the most common form of the disease and melanoma is expanding fastest, other forms of cancer and types of antioxidants need to be considered if we want to make a fully informed assessment of the role that free radicals and antioxidants play in the process of cancer progression.”

]]>
Four in 10 Older Adults Burdened by Demands of Health Care System https://thirdage.com/four-10-older-adults-burdened-demands-health-care-system/ Fri, 16 Oct 2015 19:46:26 +0000 https://thirdage.com/four-10-older-adults-burdened-demands-health-care-system/ Read More]]> Nearly four in ten older adults say that managing their health care needs is difficult for them or their families, that medical appointments or tests get delayed or don’t get done, or that all of the requirements of their health care are too much to handle, according to a research done at Johns Hopkins Bloomberg School of Public Health. The findings are published in the October 2015 issue of the Journal of General Internal Medicine.

A release from Johns Hopkins quotes study author Jennifer L. Wolff, PhD, an associate professor in the Department of Health Policy and Management at the Bloomberg School, as saying, “Medical providers must be aware that when they ask older adults to take a new medication or suggest they see another doctor that this is happening in a broader context of treatment. High quality care is not only about a single disease or visit, but rather the overall treatment plan across multiple providers. If we look at each visit in a vacuum, the health of these older adults could really suffer.”

While Wolff and her Hopkins co-author Cynthia M. Boyd, MD, MPH, found a high level of what they call “treatment burden,” they also found that the vast majority of older adults surveyed prefer to play an active role in making decisions about their health care either in conjunction with their doctors (85 percent), or their family or close friends (96 percent). The strong degree of interest in participating in decisions was a surprising finding given that previous surveys using smaller samples or comparisons by age group have shown that those over 65 prefer to take a more passive role in health care decision-making. Two-thirds of older adults said they were managing their own health care independently. Those who delegate the management of health care activities to others tend to be older and sicker than those who manage their own care, the researchers found.

For the research, Wolff and Boyd examined the results of the 2012 National Health and Aging Trends Study, a nationally representative survey of 2,040 Medicare patients age 65 or older. Participants were asked a series of questions to understand the roles they play – and wish to play – in their own health care.

Older adults are among the heaviest users of health services and their care is often not well coordinated among their various physicians. This can be problematic for a variety of reasons including the high prevalence of cognitive and physical decline that can impair the ability of older patients to make sense of the many demands their doctors may make of them. Doctors are not typically trained or have not traditionally been reimbursed by Medicare for taking extra time to work with patients and families to ensure that they are getting what they need out of their health care experience.

The system also isn’t always welcoming of the involvement of friends of family in medical decision-making, Wolff says, mainly because of concerns over privacy and practical considerations, too.

“What we have found is there isn’t a one-size-fits-all approach to caring for adults,” she says. “The health care system is complex and it is important to understand and incorporate individual patient preferences and perspectives about care. We need to ask these patients not only about their urgent health needs but their overall goals and experiences with care.”

]]>
5 Behaviors That Help Teens Learn To Bounce Back https://thirdage.com/5-behaviors-help-teens-learn-bounce-back/ Fri, 16 Oct 2015 19:40:40 +0000 https://thirdage.com/5-behaviors-help-teens-learn-bounce-back/ Read More]]> As a parent or grandparent of teens, you know that adolescence is a time of high stress for many youngsters.

Although some young people navigate these difficult years with reasonable aplomb, many struggle and are unable to cope as they run into troubles in school, at home or in their neighborhoods.

That’s where adults can step in and aid them in cultivating the mental tools they need to bounce back from life’s most trying moments.

“It’s our job as parents and educators to help our young people develop the flexibility and resiliency to withstand the challenges they face on their path to adulthood.

I have worked with teenagers for almost 45 years, both through her private counseling practice and as founder of the highly effective nonprofit organization Summer Search, which provides disadvantaged young people with challenging and even life changing mentoring and summer opportunities.

I know that encouraging the following five behaviors can help teens learn to bounce back rather than fold under the stresses of the adolescent years.

• Reach out rather than retreat. Recent research tells us that the adolescent brain is flexible and highly sensitive to stress, Mornell says. “Many teens withdraw into themselves when they are stressed, rather than reaching out to others,” she says. “When they do that, they miss out on learning different ways of handling and relieving those stresses, as well as diffusing intense feeling in more positive ways.” As parents try to address this, they need to understand that adolescents routinely say the opposite of what they feel. “‘Go away’ often means ‘please stay,’ ” Mornell says. “Parents should not leave but sit down and wait.”

• Tell their story. The ability to put their story into coherent words gives teens the chance to see it from a distance and gain perspective, Mornell says. They also can compare their story to the stories of others, and that creates a sense of community. She says parents should avoid interrupting and be willing to listen when an adolescent feels like talking.

• Separate from home and parents. For adolescents to gain autonomy and confidence, it’s essential that they sometimes separate themselves physically and psychologically from their parents, Mornell says. That’s becoming harder and harder to do in today’s world where cell phones give people instant and constant communication. “For teenagers, this over communication reinforces the idea that the world is a challenging and even dangerous place, and that they aren’t capable of learning to handle those challenges and dangers on their own.” Mornell suggests that parents avoid constant texting and connection, and give their teens room to make their own decisions.”

• Engage in exploration and positive risk-taking. It’s hard for teens to learn how to bounce back from challenges if they’ve been protected from encountering any significant difficulties to bounce back from. “Parents should encourage teens to reach out of their familiar and safe comfort zones and take positive risks like meeting new people, exploring different activities and participating in scary sounding summer opportunities like wilderness expeditions,” Mornell says.

• Take responsibility for others. Caretaking is one of the best ways to increase resiliency, whether you are babysitting, volunteering in a home for elders, or standing up for kids who are bullied, Mornell says. “When teens lend a hand to help others, they experience and support eternal values and enhance the sense of their own worth. Parents should spend time talking with teens about their family values for helping others.”

 

]]>
Risks and Benefits of Hysterectomy with Morcellation Vary with Age https://thirdage.com/risks-and-benefits-hysterectomy-morcellation-vary-age/ Fri, 16 Oct 2015 04:00:00 +0000 Read More]]> Laparascopic hysterectomies are less invasive than abdominal ones, with fewer perioperative deaths and faster recovery, but in some cases the uterus cannot be removed without prior morcellation, a process that cuts of the organ into small pieces. The use of electric power morcellators was approved by the FDA in 1995 but has become controversial because of the risk of dissemination of hidden uterine cancer cells. However, the risks and benefits of this procedure may vary with age, according to a study published October 8th 2015 in the Journal of the National Cancer Institute.

A release from the publishers explains that to assess the risks and benefits of three types of hysterectomy procedures, laparascopy, laparascopy with morcellation, and abdominal hysterectomy, Jason D. Wright, of the Division of Gynecologic Oncology, Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York, NY, and colleagues, developed a model simulating morbidity, mortality, quality of life, and cost for women younger than 40, 40-49, 50-59, and 60 years and older who underwent hysterectomy for presumed benign gynecologic disease. The authors used cancer incidence and survival rates from Surveillance, Epidemiology, and End Results (SEER) data, as well as clinical, epidemiological, and oncological data from the literature.

Overall, laparascopic hysterectomy without morcellation was the most effective and least costly of the three procedures. Laparascopic hysterectomy with power morcellation was associated with approximately 81 more intraoperative complications per 10,000 women but fewer perioperative complications and readmissions than abdominal hysterectomy. Compared to abdominal hysterectomy, laparoscopic hysterectomy with morcellation was associated with 2, 4, 13, and 47 excess cases of disseminated cancer for women under 40, 40-49, 50-59, and 60 years of age and over, respectively. However, when the risk of mortality from cancer as well as operative complications were analyzed, morcellation was associated with 1 death less than abdominal hysterectomy in women younger than 40 and 0.3, 5, and 18 excess deaths in women 40-49, 50-59, and 60 years of age or older, respectively.

Wright et al. were unable to stratify by other variables such as race and uterine size because data are lacking on characteristics of women who have undergone the procedure, and they write “The controversy around electric power morcellation clearly demonstrates the need for better data and heightened regulation before new devices are allowed to diffuse into widespread practice.” The authors suggest that “Surgical technique should be individualized, and all patients should be thoroughly counseled regarding the risk of electric power morcellation.”

In an accompanying editorial, David G. Mutch of the Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, writes that this work will help to better define the risks to patients by taking both the risk of cancer dissemination and the risks of abdominal hysterectomy into account. He agrees that more studies on the real risks of this procedure are needed so that women will be better able to weigh the risks and benefits.

]]>
What You Should Know about Male Breast Cancer https://thirdage.com/what-you-should-know-about-male-breast-cancer/ Fri, 16 Oct 2015 04:00:00 +0000 Read More]]> Although it’s uncommon, breast cancer can occur in men, and it can be serious. According to the American Cancer Society, about 2,350 cases of invasive male breast cancer will be discovered in 2015, and about 440 men will die of the illness. Those figures highlight the importance of knowing as much as possible about male breast cancer. 

Overview

Male breast cancer is a disease in which malignant cells form in the tissues of the breast.

Radiation exposure, high levels of estrogen, and a family history of breast cancer can increase a man’s risk of breast cancer. Male breast cancer is sometimes caused by inherited gene mutations (changes).

Men with breast cancer usually have lumps that can be felt. Tests that examine the breasts are used to detect and diagnose breast cancer in men. Certain factors affect prognosis  and treatment options.

Breast cancer may occur in men at any age, but it is usually detected in men between 60 and 70 years of age. Male breast cancer makes up less than 1% of all cases of breast cancer.

Types of Male Breast Cancer

The following types of breast cancer are found in men:

  • Infiltrating Ductal Carcinoma: cancer that has spread beyond the cells lining ducts in the breast, most men with breast cancer have this type of cancer
  • Ductal Carcinoma in Situ: abnormal cells that are found in the lining of a duct; also called intraductal carcinoma
  • Inflammatory Breast Cancer: a type of cancer in which the breast looks red and swollen and feels warm
  • Paget Disease of the Nipple: a tumor that has grown from ducts beneath the nipple onto the surface of the nipple

Risk Factors

Risk factors for breast cancer in men may include the following:

  • Being exposed to radiation
  • Having a disease linked to high levels of estrogen in the body, such as cirrhosis (liver disease) or Klinefelter syndrome (a genetic disorder)
  • Having several female relatives who have had breast cancer, especially relatives who have an alteration of the BRCA2 gene
  • Male breast cancer is sometimes caused by inherited gene mutations (changes)

The genes in cells carry the hereditary information that is received from a person’s parents. Hereditary breast cancer makes up about 5% to 10% of all breast cancers. Some mutated genes related to breast cancer are more common in certain ethnic groups. Men who have a mutated gene related to breast cancer have an increased risk of this disease.

There are tests that can detect (find) mutated genes and are sometimes done for members of families with a high risk of cancer.

Lumps and other signs may be caused by male breast cancer or by other conditions. Check with your doctor if you notice a change in your breasts.

Diagnostic Tests

Physical Exam and History: an exam of the body to check general signs of health, including signs of disease, such as lumps or anything else that seems unusual, a history of the patient’s health habits and past illnesses and treatments will also be taken

Clinical Breast Exam (CBE): an exam of the breast by a doctor or other health professional – the doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual

Ultrasound Exam: a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes, which form a picture of body tissues called a sonogram

MRI (Magnetic Resonance Imaging): a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, this procedure is also called nuclear magnetic resonance imaging (NMRI)

Blood Chemistry Studies: a procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body – an unusual (higher or lower than normal) amount of a substance can be a sign of disease

Biopsy: the removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer, including:

  • Fine-Needle Aspiration (FNA) Biopsy: the removal of tissue or fluid using a thin needle
  • Core Biopsy: the removal of tissue using a wide needle
  • Excisional Biopsy: the removal of an entire lump of tissue

If cancer is found, these tests can be done to measure the severity of the cancer cells:

  • How quickly the cancer may grow
  • How likely it is that the cancer will spread through the body
  • How well certain treatments might work
  • How likely the cancer is to recur

Tests include the following:

Estrogen and Progesterone Receptor Test: Measuring the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If cancer is found in the breast, tissue from the tumor is checked in the laboratory to find out whether estrogen and progesterone could affect the way cancer grows. The test results show whether hormone therapy may stop the cancer from growing.

HER2 Test: Measuring the amount of HER2 in cancer tissue. HER2 is a growth factor protein that sends growth signals to cells. When cancer forms, the cells may make too much of the protein, causing more cancer cells to grow. If cancer is found in the breast, tissue from the tumor is checked in the laboratory to find out if there is too much HER2 in the cells. The test results show whether monoclonal antibody therapy may stop the cancer from growing.

Survival Factors

Survival for men with breast cancer is similar to that for women with breast cancer when their stage at diagnosis is the same. Breast cancer in men, however, is often diagnosed at a later stage. Cancer found at a later stage may be less likely to be cured.

The prognosis and treatment options depend on the following:

  • The stage of the cancer (whether it is in the breast only or has spread to other places in the body)
  • The type of breast cancer
  • Estrogen-receptor and progesterone-receptor levels in the tumor tissue
  • Whether the cancer is also found in the other breast
  • The patient’s age and general health

After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body. There are three ways that cancer spreads in the body and cancer may spread from where it began to other parts of the body.

Evaluating the Cancer

After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body. This process is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Breast cancer in men is staged the same as it is in women. The spread of cancer from the breast to lymph nodes and other parts of the body appears to be similar in men and women.

The following tests and procedures may be used in the staging process:

  • Sentinel Lymph Node Biopsy: The removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node to receive lymphatic drainage from a tumor. It is the first lymph node the cancer is likely to spread to from the tumor. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes.
  • Chest X-Ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • CT Scan (CAT Scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Bone Scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
  • PET Scan (Positron Emission Tomography Scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bone, the cancer cells in the bone are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

Stages of Breast Cancer

Stage 0 (Carcinoma in Situ)

Ductal carcinoma in situ (DCIS) is a noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues. At this time, there is no way to know which lesions could become invasive.

Paget disease of the nipple is a condition in which abnormal cells are found in the nipple only.

Stage I

In stage I, cancer has formed. Stage I is divided into stages IA and IB.

In stage IA, the tumor is 2 centimeters or smaller. Cancer has not spread outside the breast.

In stage IB, small clusters of breast cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes and either: no tumor is found in the breast; or the tumor is 2 centimeters or smaller.

Stage II

Stage II is divided into stages IIA and IIB.

In stage IIA, no tumor is found in the breast or the tumor is 2 centimeters or smaller. Cancer (larger than 2 millimeters) is found in 1 to 3 axillary lymph nodes or in the lymph nodes near the breastbone (found during a sentinel lymph node biopsy); or the tumor is larger than 2 centimeters but not larger than 5 centimeters. Cancer has not spread to the lymph nodes.

In stage IIB, the tumor is:

larger than 2 centimeters but not larger than 5 centimeters. Small clusters of breast cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or larger than 2 centimeters but not larger than 5 centimeters. Cancer has spread to 1 to 3 axillary lymph nodes or to the lymph nodes near the breastbone (found during a sentinel lymph node biopsy); or larger than 5 centimeters. Cancer has not spread to the lymph nodes.

Stage IIIA

no tumor is found in the breast or the tumor may be any size. Cancer is found in 4 to 9 axillary lymph nodes or in the lymph nodes near the breastbone (found during imaging tests or a physical exam); or

the tumor is larger than 5 centimeters. Small clusters of breast cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or

the tumor is larger than 5 centimeters. Cancer has spread to 1 to 3 axillary lymph nodes or to the lymph nodes near the breastbone (found during a sentinel lymph node biopsy).

Stage IIIB

In stage IIIB, the tumor may be any size and cancer has spread to the chest wall and/or to the skin of the breast and caused swelling or an ulcer. Also, cancer may have spread to : up to 9 axillary lymph nodes; orthe lymph nodes near the breastbone.

Cancer that has spread to the skin of the breast may also be inflammatory breast cancer. Click here to see the section on Inflammatory Male Breast Cancer for more information.

Stage IIIC

In stage IIIC, no tumor is found in the breast or the tumor may be any size. Cancer may have spread to the skin of the breast and caused swelling or an ulcer and/or has spread to the chest wall. Also, cancer has spread to:

  • Ten or more axillary lymph nodes
  • Lymph nodes above or below the collarbone
  • Axillary lymph nodes and lymph nodes near the breastbone.

Cancer that has spread to the skin of the breast may also be inflammatory breast cancer. Click here to See the section on Inflammatory Male Breast Cancer for more information.

For treatment, stage IIIC breast cancer is divided into operable and inoperable stage IIIC.

Stage IV

In stage IV, cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.

Treatments

Five types of standard treatment are used to treat men with breast cancer:

  • Surgery
  • Chemotherapy
  • Hormone therapy
  • Radiation therapy
  • Targeted therapy

For more information, click here.

Reprinted courtesy of the National Cancer Institute (www.cancer.gov).

 

]]>
Can Exercise Be Replaced with a Pill? https://thirdage.com/can-exercise-be-replaced-pill/ Fri, 16 Oct 2015 04:00:00 +0000 Read More]]> Everyone knows that exercise improves health, and ongoing research continues to uncover increasingly detailed information on its benefits for metabolism, circulation, and improved functioning of organs such as the heart, brain, and liver. With this knowledge in hand, scientists may be better equipped to develop “exercise pills” that could mimic at least some of the beneficial effects of physical exercise on the body. But a review of current development efforts, published on  October 2nd 2015 in Trends in Pharmacological Sciences, explores whether such pills will achieve their potential therapeutic impact, at least in the near future.

A release from the publisher quotes coauthor Ismail Laher, of the Department of Pharmacology and Therapeutics at the University of British Columbia in Vancouver, as saying, “We have recognized the need for exercise pills for some time, and this is an achievable goal based on our improved understanding of the molecular targets of physical exercise.”

Several laboratories are developing exercise pills, which at this early stage are being tested in animals to primarily target skeletal muscle performance and improve strength and energy use–essentially producing stronger and faster muscles. But of course the benefits of exercise are far greater than its effects on only muscles.

“Clearly people derive many other rewarding experiences from exercise–such as increased cognitive function, bone strength, and improved cardiovascular function,” says Laher. “It is unrealistic to expect that exercise pills will fully be able to substitute for physical exercise–at least not in the immediate future.”

While exercise pills may provide some benefits for people in the general population, they might be especially helpful for those who are unable to exercise for a variety of reasons, as the review by Laher and his coauthor Shunchang Li notes. “For example, a pill for people with spinal cord injury could be very appealing given the difficulties that these individuals face in exercising due to paralysis–in such patients, a large number of detrimental changes occur in cardiovascular and skeletal muscle function,” explains Laher.

Much more research is needed to fully understand the side effects of candidate exercise pills, in addition to determining their optimal dosages, and the potential for misuse in humans and animals (e.g., races). (The first doping case regarding one candidate pill was reported in a cycling competition in 2013.)

“We are at the early stages of this exciting new field,” says Laher. “Further development of exercise pills that act in combination may be more effective than single compounds. We just don’t know anything about their long-term use in humans yet.”

]]>
Good Bone Health Essential for Independence https://thirdage.com/good-bone-health-essential-independence/ Fri, 16 Oct 2015 04:00:00 +0000 Read More]]> Good nutrition can make a difference in your bone health and affect your ability to live an independent life, according to a new scientific review.

The conclusion is true no matter what age you are.

The review was published in the journal Osteoporosis International by leading bone and nutrition experts, in anticipation of World Osteoporosis Day on October 20.

According to a news release from the International Osteoporosis Foundation (IOF), the review summarizes the latest evidence relating to the nutritional needs of mothers, children and adolescents, adults and seniors, in relation to developing and maintaining a healthy skeleton. Placing particular emphasis on calcium, vitamin D and protein, it shows how adequate nutritional intake of these and other micronutrients can support the primary objectives for good bone health:

Achieving genetic potential for peak bone mass in children and adolescents

Avoiding premature bone loss and maintaining a healthy skeleton in adults

Preventing and treating osteoporosis in seniors

Findings from international studies and trials are summarized as well as current dietary guidelines.

Professor Cyrus Cooper, co-author and chair of the International Osteoporosis Foundation (IOF) Committee of Scientific Advisors, said, “This new report shows just how important nutrition is for our bone health throughout life. In fact, nutrition plays a key role in the development of a healthy skeleton even before birth. Healthy maternal diets as well as adequate vitamin D levels are associated with greater bone mass in the off-spring.”

The report also underlines how lifestyle trends which lead to poor diet and nutrient deficiencies are a growing cause of concern in people of all ages, and particularly in children. Milk and dairy products comprise the mainstay of calcium intake for most children, yet a decline in milk consumption has been observed across the world during the last few decades. Furthermore, vitamin D insufficiency is widespread among youth, which has led to recommendations in several countries for vitamin D supplements to be given to infants and young children.

In adults and seniors, studies have shown that calcium intakes are often considerably below those recommended by national guidelines. Similarly, alarmingly low levels of vitamin D have been found in populations around the world. Lifestyle factors such as excessive alcohol consumption, smoking, and a very high or low body mass index (BMI) also elevate fracture risk for a substantial number of people.

The researchers also analyze the impact of nutrition on falls and fracture prevention in seniors, who are a growing segment of the population and most affected by osteoporosis. The review shows how deficits in protein intake as well as malnutrition, which is sadly common in older people, can negatively affect their bone and muscle health. It also highlights how together with appropriate exercise, adequate nutritional intake in those at high risk of fracture plays an important complementary role to pharmacotherapy.

 

]]>