Medical roundup: Aspirin and cancer prevention; Diabetes on the rise

Aspirin as a cancer preventative

Studies have shown that aspirin is useful in the prevention of heart attacks. But some research demonstrates that it may also be useful to help prevent, or control, some forms of cancer.

Investigators have found aspirin can inhibit the spread of some types of cancer (e.g., breast cancer) and/or decrease the risk of dying from some forms of cancer. The cancer types that seem to show this type of reaction to aspirin are breast, cancers of the GI tract, and prostate.

A recent study from Ireland looked at women who took aspirin regularly and those who didn’t take aspirin on a regular basis. Women who took aspirin had a lower risk of developing breast cancer, had less metastatic cancer, and fewer of them died from breast cancer than the group that didn’t use aspirin.

Of course, as with any drug, there are risks with taking aspirin. Some people are aspirin allergic, and aspirin can cause excessive bleeding. Before starting aspirin, discuss its advisability with your doctor.

Diabetes epidemic

A study shows that diabetes (type 2 diabetes, adult-onset diabetes) is increasing rapidly in the US, especially among minorities.

The researchers estimate that, of US citizens born between 2000 and 2011, about 40% will develop diabetes. That is almost double what the incidence was for US citizens born 10 years earlier than this group. Even before that, the incidence of type 2 diabetes was steadily increasing.

In minority groups the incidence can be as high as 50%. That’s a huge number of diabetic patients. Many of those patients will also suffer from the complications of diabetes: kidney problems, cardiovascular problems, blindness and others can put a tremendous burden on those affected and the healthcare system, as well.

Obesity and other factors can increase the risk of developing type 2 diabetes.

Preventing colon cancer

Sigmoidoscopy (similar to colonoscopy but only the left side of the bowel is viewed internally through a sigmoidoscope) is effective in decreasing the risk of dying from colon cancer.

A Scandanavian study showed that this test can cut people’s risk of developing and dying from colon cancer, just as colonoscopy does. Sigmoidoscopy is a little faster and the preparation may be easier. It can be done without sedation. But it is rarely done in the US. Most often a colonoscopy is preferred because the entire colon, not just the rectal area and left colon, can be seen during colonoscopy.

There are three different options recommended as screenings for colon cancer by the U.S. Preventive Services Task Force (USPSTF):

  • an annual stool test
  • sigmoidoscopy every five years, along with stool testing every three years
  • or colonoscopy every 10 years (John wrote about his experience a few months back)

For most people, screening for colon cancer should begin at age 50. Discuss your options with your doctor.

Beware of downloadable medical apps

Downloadable medical applications can be quite useful in managing people’s medical needs.

Some help users keep track of calories, carbohydrates, fats. Others record blood sugar readings. Some store the patient’s medical history, allergies, medications, etc. and can be given t o a doctor to keep him up to date with the patient’s medical background. There are literally thousands of apps available.

However, a word of caution. Neither the FDA, nor other governing bodies, regulates medical apps.

For example, an app that someone is using may claim to list the number of calories in a serving of a particular food. That number may be accurate – or not. It’s best to randomly check your apps to make sure that they’re doing what they’re supposed to be doing. Verify how well it works by comparing it with a data set from a different source. Verify that the 80 calories that your app says are in that apple are really there.

Similarly, if you’re using an app to track your blood glucose readings, keep a check on how well the app is recording and storing those numbers. The same holds for other apps. Make sure that they work properly before you trust them.

Recently, there have been a few ape published that claim to measure blood pressure and/or pulse by using a smartphone. Yet the authors of these apps have not explained just how a smartphone is capable of measuring or recording these parameters. Until they do, you can’t be sure that the “blood pressure” and “pulse” readings are accurate.

Chikungunya virus in Florida

A while ago I did a post on Chikungunya virus (CHIKV).  This is a virus that was endemic in Africa and has spread to the Caribbean.

It starts with a fever and then joint pain begins. The joint pain can be moderately painful to severe and incapacitating. It is spread by mosquitoes. The mosquito types that spread it in the Caribbean are also found in the US. Most cases in the US have been seen in patients who got infected in the Caribbean. A few weeks ago, there were two documented cases of Chikungunya that had been contracted in Florida.

Doc via Shutterstock

Doc via Shutterstock

Public health officials are now feel that the number of cases of CHIKV will begin to increase. Theoretically, the disease can be spread in any area where these mosquitoes live. That would include most of the continental US. Officials don’t think that it will be anywhere near as much of a problem in the US as it is in Africa and the Caribbean. Mosquito populations are higher in those areas, most people are outdoors more often, few have screens on windows or doors and are not in enclosed air conditioned buildings.

To help prevent infection it is suggested that people wear long sleeves and long pants and use mosquito repellant in areas where mosquitoes are present. Stay indoors when possible, behind intact screens or with doors and windows closed and using air conditioning. Since, to date, CHIKV is little known in the US, if you develop flu-like symptoms, fever, joint pain and/or joint swelling you may want to tell your doctor about CHIKV. While health departments, the CDC, medical societies and other organizations are putting out information on CHIKV, until the medical community gets saturated, some doctors who haven’t seen a case may not consider it as a possible diagnosis.

There is no vaccine or specific medications to prevent or cure Chikungunya. Care is supportive to lower fever and control pain.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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19 Responses to “Medical roundup: Aspirin and cancer prevention; Diabetes on the rise”

  1. jorgemandrews says:

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  2. cambridgemac says:

    LOL. Refined sugar has been around for 200 years. Your statement is like saying that bourbon and gin have been around as along as mankind, because under certain conditions fruits ferment – and our ancestors occasionally ingested a gram of alcohol.

  3. Silver_Witch says:

    100% agreed….since the “low fat” craze more fat people, more demented people, more diabetics. It is probably a sort of perfect storm of many things coming together – but “low fat” is not the way.

  4. Silver_Witch says:

    Wheat – don’t eat it – you will feel better and you won’t have spikes in your blood sugar levels. Also, since I personally have given up wheat I have no acid reflux and you are talking to a woman that lived on Prilosec for over 15 years!

    It is tough – it can be done though (albeit I do miss bread).

    P.S. I am not a doctor so my advice and $4.75 will buy you a Starbucks…..

  5. Naja pallida says:

    Reading the health warnings for Texas… Dengue fever, Chagas disease, West Nile virus, and rabies all on the rise. We’re kidding ourselves if we think we’re in some kind of protective bubble where tropical diseases can’t ever find us. Drought and climate change are going to drive all sorts of things that we never even saw coming.

  6. just_AC says:

    things I am doing to help myself

    1: free, has nutrional stuff as well as exercise tracking etc etc. and of course apps on apple, android, etc to keep you on track

    2: The rated best diet by usnews is the dash diet and NOBODY has heard of it! Amazing
    their meal plans are good and you can actually eat the food!

    and, last, I am thinking about doing a dietbet. – You bet $25 that you can lose 4% of your weight in a month. For me, I weigh 200lbs. Can I lose 8 lbs in a month? For money? Gives you that extra incentive you might need – chocolate milkshake or $100?

  7. nicho says:

    Not so fast. In very old times, people only got sugar once a year, when fruit ripened. That usually preceded the bad weather setting in. So, eating fruit – sugar — helped you put on weight and survive the winter. Now, people have access to fruit — not to mention tons of dietary sugar year round.

    At the turn of the last century, three things happened. First, the Swiss developed a method to process/mill wheat, turning it pretty much into sugar. Then, Dr. Kellog, concerned that his patients in a vegetarian hospital weren’t thriving, invented a way to turn corn into tasty flakes as a way to get sugar into people and fatten them up. Then, United Fruit discovered that you could pick green bananas in Central America (when you weren’t overthrowing their governments) and have them ripen on the way here. Bananas have the highest concentration of sugar of any fruit.

    People didn’t know what to do with bananas — they had never seen them — so the banana companies advocated putting them on your newly invented cereal. They even went so far as to put banana coupons inside cereal boxes.

    So, basically, your healthy breakfast of corn flakes, a banana, and skim milk (which has had the fat removed, leaving the sugar) gives you a bowl of sugar, topped with sugar, drenched in sugar.

    Our brains are wired to eat sugar when available because it’s what helps you survive the bad weather. Food companies discovered this and haver subsequently put sugar in anything and everything to sell more shit — so bkmn, they’re not going to stop doing that.

    Anyway, after sugar was introduced into our diet in a major way at the beginning of the 20th Century, it took about 20 years for cancer, heart disease, and diabetes to start their upward climb (dramatically) and they haven’t looked back. They call it the 20 Year Rule. Whenever a society begins to adopt a sugar-laden western diet, these diseases start to crop up in about 20 years.

    And no real difference between sugar and HFCS — they’ll both kill you.

  8. nicho says:

    Skinny isn’t necessarily healthy. Exercise if good. Avoiding sugar — of all kinds — is essential.

  9. Baal says:

    In fact the most recent and best designed studies have shown that risks (of serious bleeding events) may outweigh benefits in reducing cardiovascular disease, at least in older patients, and there are significant uncertainties and this continues to be a matter of considerable debate. This is especially true when patients are taking certain other drugs such as proton pump inhibitors. There are some very large ongoing long term clinical trials that will hopefully clarify things, but in the last couple of years, working groups of the American and European cardiology associations have backed off their earlier recommendations for preventative use of aspirin. Clinical trials in some of the most vulnerable populations, e.g. patients with diabetes and or kidney disease, failed to show an effect of aspirin.

    As for data on cancer, drugs like aspirin have to be used for a long time in order to see an effect–at least five years, and then primarily in gastric and colorectal cancers. This effect on breast cancer had not been detected in earlier studies.

    This entire class of drugs by themselves — the NSAIDs — can increase risks for serious cardiovascular events, which is why some of the COX-2 inhibitors were removed from the market.

    It is a bit too soon to be buying into this.

  10. perljammer says:

    That last paragraph is really on the mark. Almost 6 months ago, I was contemplating the approach of my 65th birthday, and decided that although I couldn’t do anything about becoming an old man, I could do something to avoid becoming an old fat man. I took a very simple approach: no snacking between meals; avoid sweets; salads instead of sandwiches or burritos for lunch — and when I do indulge in the occasional cheeseburger, I have fruit on the side instead of french fries or onion rings. This routine has turned out to be eminently sustainable; I’ve lost 37 pounds so far. Another 10 or 12 and I’ll be down to my weight as a college freshman.

  11. TheAngryFag says:

    It’s not that simple. The problem is this pathological fear of dietary fat. We’re in this mindset as a society that “If I eat fat, I will become fat” when we need fat to survive.

    But the food industry responds to these fears with “fat free” and “reduced fat” versions of things that taste just as good as the full-fat versions. The problem is in order to maintain the taste the fat is swapped out for sugar/

  12. goulo says:

    “Recently, there have been a few ape published”

    s/ape/apps/ ?

  13. Tatts says:

    I had a torn (not detached like John had) retina about 3 years ago and have to go back every 6 months for a checkup. I’m fortunate that I was at work, within a few blocks of Wills Eye Hospital, when I noticed the problem. It’s the first (and best) eye hospital in the nation. My doctor told me to go right away; I walked over to the Wills Emergency Room, and 3 1/2 hours later I walked home with a lasered-up tear and did Christmas shopping on the way home. The laser is really something to experience.

    Anyway, once on my visit to the retina floor for my checkup I commented to the doctor about how many people had problems walking and were overweight. He told me that that is about half their business in that floor–people who are being crippled and blinded by their obesity.

    And to a great extent, it’s preventable. Put down the X-Box and go for a walk. Stop binge watching anything and go for a bike ride. Get at least 30 minutes of exercise a day (walking is fine). Don’t bother with fad diets or worry about the HFCS bugaboo; just balance your intake and expenditure of calories; physics and chemistry will handle the rest.

  14. Tatts says:

    High fructose corn syrup has only a small difference in the ratio of glucose and fructose, and some HFCS (used for baking) actually has less fructose than white sugar.

    HFCS is not some kind of Bogey Man. The problem is simply too many calories in and too few expended. Get more exercise and the problem fixes itself.

  15. bkmn says:

    Sugars are fundamental substances in cells. Concentrated sugar that is added to all sorts of foods is really a different subject.

  16. Indigo says:

    Yes, I understand the importance of bench marking the colonoscopy at age 50. And every five years thereafter until . . . is it worthwhile to continue the colonoscopy ritual past the age of 75? I’ve read that past that age, a colonoscopy might call for overnight hospitalization rather than an early morning outpatient procedure.

  17. pricknick says:

    Sugar has been around as long as mankind. Now, high fructose corn syrup is another matter.

  18. bkmn says:

    Gee what could the US do to halt the obesity and accompanying diabetes epidemic? How about stop subsidizing the sugar industry.

    If sugar is no longer cheap they won’t put it in everything under the sun.

  19. emjayay says:

    My we’re certainly getting medical here lately. I’m just a little disappointed you aren’t the cute model posing as a doctor in the as-usual total worthless crap Shutterstock photo.

    It seems to me that sigmoidoscopies were done more a few years ago, but I thought some studies indicated that colonoscopies were lots better, or something(?). They must cost far less, so you would think insurance companies would be using their leverage to encourage them. I got a couple at Kaiser, who maybe was doing that. I’m sure anesthesiologists are all in favor of the colonoscopy and no doubt the gastroenterologist cleans up too.

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