Month: September 2021

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A nail-biter week…

It was a long week, waiting for my appointment day to arrive, but my hubby was coaching me to not get overly anxious about what my biopsy results might be. Why get upset over a potential bad result that might not happen? Just keep busy with other things… Good advice.

I also thought about wise counsel from another relative who was diagnosed with breast cancer. Scream, cry and get angry for a week or so, then get busy working to defeat the disease. Ten years or so post-diagnosis, this strategy has worked well for her. She has a zest for life that anyone would envy.

It’s all about keeping your quality of life, I think. It’s easy to let yourself drown in a bad diagnosis, even before you receive it, as you worry about worst-case scenarios. A good life strategy for any of us is to look for what you can do to make whatever time you have the best it can be, regardless of good or bad diagnoses. Take the bull by the horns, my hubby likes to say… live life to the fullest, do all those things you’ve always wanted to do, focus on happy thoughts.

But part of me wanted to prepare myself, just in case… sort of like before childbirth: if you know what’s coming and prepare for it as objectively as possible, it’s not as bad. It can be easier to handle news and stay in control when you’re prepared for anything.

But it was good news!

The first thing the doctor said, is that it’s not bad news. I imagine she’s had to deliver her fair share of devastating diagnoses over the years. So, no cancer, thank goodness! But my heart goes out to others in that situation that didn’t get the results they were hoping for. This week has made me more understanding of what it would be like to learn that you or someone you love has cancer.

My doctor talked about my problem likely being a polyp—a growth of some sort inside the uterus—and described the pain as being due to the uterus’s attempt to push out what shouldn’t be there.

But what’s the cause?

I wanted to discuss potential causes of an overgrowth of hormone-sensitive tissue. I guess I’ve always been a person who wants to understand why things happen. Everything has a cause and, if we learn what drives a disease, we can change our behaviour to lower the risk of it returning or worsening in the future. And maybe we can help to protect our kids from developing the same problems.

But she didn’t have any thoughts on what could be promoting growth of hormone-dependent tissue in a post-menopausal woman currently producing only low amounts of hormones. I briefly explained my previous unintended chemical misadventures and my understanding of the environmental connections I’d learned about—the topic of last week’s blog —but it didn’t appear to be something she’d heard or read about before. I guess doctors have their hands full just trying to cure us all, leaving little time for reading about theories that are not easy to prove.

Still, I can’t help thinking they might not be as busy, nor waiting times as long, if we could make a few behaviour changes that would lower our disease risk. I’ll keep looking for the cause and encouraging research, so we can avoid needing so much treatment!

And the next queue…

So now I’m on another wait list—the one for the OR. Yes, at least the next “surgery” will be done with a general anesthetic in an operating room. It will just be a day surgery, so relatively minor, but apparently some women experience more pain than others when being poked, prodded, and trimmed on the inside. I’m one of the sensitive ones, I guess! So, yes, general anesthetic please!!

The downside is that it could again be a wait—perhaps months, the receptionist says. OR times are assigned at the beginning of each month at our hospital, so no way of knowing very far in advance. Hard to say whether we will get to Spain this winter (booked to leave Jan 18th!) but with COVID the trip is a bit up in the air anyway… They are saying we should expect a mild, wet winter in Canada this year. I wonder how they can make these predictions so far in advance???

So, all is good or, at least, as good as it can be. But it was a nail-biter week… literally. No fingernails left! I’m feeling better, mentally and somewhat physically, but still counting out my Tylenol for the day to make sure I don’t take too much (8 tablets of 500mg is the maximum safe dose!).

I’ve had more good days than bad lately, fortunately. I think I might investigate biofeedback (controlling a body function with your mind) now that I know the mechanism of my pain (spasms in the uterus). I’ve read that people can be trained to lower their blood pressure or increase blood circulation to part of the body by focusing their mind. I wonder whether biofeedback could be similar to the placebo response I’ve written about previously … your subconscious triggering your immune system to do what you want. Stay tuned!

Thanks for all your messages over the past few weeks—I so appreciate the support! Hope I can pay it forward to a couple of dear friends who were not as fortunate as I was when they received their news…

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Environmental links to cancer

I used to give a presentation on breast cancer prevention some years ago, and I just realized I’ve never blogged about this subject. Though years have passed and, sadly, little has changed in information on environmental connections to cancer, much of what I learned is still not well known by the public.

I recall reading somewhere that breast and prostate cancers are suspected to have similar causes, both being hormone-related cancers, so this information will be of interest to the guys too. I’ve always thought it was better to prevent cancer than to have to treat it… and the strategies to prevent cancer may help to prevent a recurrence in someone unfortunate enough to have already been diagnosed with it.

The causes of cancer have eluded us for generations, despite the “war on cancer” announced so many years ago. This may be because the cause, as understood by many researchers is likely to be a combination of factors that add together. These likely include genetics (less than 10% of breast cancers), exposure to cancer-causing chemicals or “carcinogens” (sometimes causing problems years after exposure), a poorly functioning immune system (that does not repair cell damage efficiently enough) and perhaps diet and other lifestyle factors.

However, little research money appears to be allocated to finding the causes, with much more going to early detection and treatment. I guess you’d want this, if you had cancer, but wouldn’t we all rather not get it in the first place? Of course, with much research money being supplied by manufacturers, the fact that preventing disease doesn’t result in income could also be a factor in where research dollars are spent… It’s up to government to take the lead in prevention and environmental research.

And it’s up to us to push them to do it!

My story…

I’ve known too many friends and family members who’ve been diagnosed with cancer. Unfortunately, the incidence continues to increase, even as treatments become more targeted and successful. But, like much I blog about, I have personal reasons for taking a particular interest in this subject.

My story started back 25 or 30 years ago when, for some unknown reason, I started having problems with some “lady parts”—lumps in the breast (fortunately all non-cancerous), bad PAP tests that required cryosurgery. Like most people, I just assumed these things were random occurrences and never thought to search for a cause. No one asked about my lifestyle or medications, to check for a change that might have been connected to my problems.

Tupperware parties were popular then, and I had bought a wonderful set of plastic cups with the “sipper seal” that prevented many spilled milk days in our house. After my kids outgrew the kiddie cup stage, the idea hit me that they would make great coffee cups—ones that would fit into the tiny cupholders in my car. No more spilled coffee on my way to work!

Eventually my coffee started to taste more and more like plastic, as the hot beverage broke down components in the plastic cup. Finally, one day it tasted so bad I pulled over and dumped it out and stopped using the cups for my coffee. A few months afterward, all my health problems went away.

A support group event

I didn’t associate the health events with my plastic consumption until a friend who was a breast cancer survivor invited me to an event her support group was hosting, a year or so later. It would have been the late 1990s. They presented a documentary film created in 1997 called “Exposure: Environmental Connections to Breast Cancer”, hosted by Olivia Newton-John, also a breast cancer survivor.

The 55-minute film interviewed cancer researchers and clinicians, and the award-winning producer and director were there for a discussion afterward. My friend and I bought a VHS copy of the film and I started giving a presentation based on the documentary’s research to any groups of women who wanted to listen.

The information in the film is still relevant now, over 20 years later, and many of the strategies for avoiding known carcinogens still seem to be surprising to many. This is just another example of the lack of “knowledge translation” I talked about last week. I’ll post a link to the film in the references, so you can check it out yourself if you’d like.

Plastic and cancer

So, back to plastic. One of the researchers in the film talked about an experiment they were doing with breast cancer cells. They had placed the cells in a plastic test tube with no nutrients or hormones to help them grow. They should have been just lying there quietly but, instead, they were growing like crazy. Something in the plastic was feeding the cancer cells. It was a revelation to the researchers—the first realization that something in plastic was hormonally active.

Since then, plastics have been classified into safer or more harmful types. You may have noticed a number enclosed in a triangle of arrows on most plastic containers. This is a classification of the plasticers (chemicals that make plastic flexible) in the plastic into various types. Although safety recommendations vary slightly by source, most recommend 2, 4 and 5 as the safest, and 1, 3, 6 and 7 to be used in moderation and never reused. No plastics are recommended to be heated, including in the microwave, or used for hot food.

Here’s a chart from the David Suzuki Foundation:

So, you see, my plastic cup didn’t just make my coffee taste like plastic, it was delivering a hormonally active substance into my body daily, that was making me sick. The worst part is that these chemicals are fat-soluble… they dissolve in oils and fats and are stored in the fatty tissues of the body. Now, 25 years later, I expect they’re still hiding in my body. Losing weight could be expected to liberate these chemicals as my body converts to using up fat I’ve stored away over the years.

If you look closely at the packaging, you’ll notice that Styrofoam cups and plastic utensils are generally made of plastic #6, a plastic that should not be used with food. Of course, we can choose not to use these items, but why are they still being manufactured and sold? Our governments are often slow to create regulations that protect us!

As a hormone specialist pharmacist, I learned that the hormone, progesterone, “opposes” or balances the action of estrogen. It’s not a leap to expect that it would also counter the action of estrogen-like chemicals as well, although I’ve not seen studies that specifically looked at this—and I have to wonder why these studies haven’t been done. I still use a low dose of progesterone to try to prevent problems because of what I learned as a compounding pharmacist.

Cellphones

While searching for an online version of the Exposure video, I stumbled across case reports of breast cancer that appeared to be associated with storing a cellphone close to the breast. These cancers were unusual, occurring in young women, exactly beneath the area where they habitually carried their phone, sometimes with several different types of cancer occurring at once. These women had developed a habit of carrying their phone tucked into their bra for hours each day.

In the report, they pointed out that most cellphone manufacturers recommend holding your phone slightly away from the body (or using a Bluetooth headset), and not storing the phone close to the body, especially not against the skin. I think I’ll start carrying mine in the front pocket of my purse, farther away from my body, rather than in the back pocket so I can feel it vibrate (telling me I have a message or call). I’ll just turn up the volume instead! Microwave radiation drops quickly with distance… creating a small space or non-metal layer quickly makes a large difference in the strength of the radio waves.

However, it is noteworthy that these cases were in people who carried their phone in direct contact with the skin, in the same spot for many hours each day. Overall, cellphone use has not been demonstrated to increase risk of cancer significantly. (See Mayo Clinic reference below).

And more…

Of course, there are other environmental factors that are of concern that should be discussed–pesticides being one. Chemicals that are designed to kill pests could be expected to do us harm too, if we are exposed. How much is too much? Which (if any) are safer? A subject for a future blog, perhaps.

But I’d encourage you to watch the “Exposure” video (link below in the references) that delves into the subject… an hour well spent in my opinion (and I’ve watched it quite a few times!)

PS…

One thing that has changed since the documentary was made, is that mammograms use less radiation now, resulting in a safer test. The test is also less accurate when breast tissue is more dense, as it is in premenopausal women. Many jurisdictions (with the notable exception of the US) begin screening mammograms only at age 50 and perform them only every 2 to 3 years to minimize exposure and maximize benefit.

PPS…Faith restored

On the “good news” front, I just got an appointment for early next week to hopefully (finally!) find out what is causing my “falling through the cracks” symptoms. My faith in the Canadian healthcare system has been restored! Fingers crossed for a clear explanation of what’s going on and a plan to get things back to normal as quickly as possible…

References:

Women’s reproductive system as balanced estradiol and progesterone actions—A revolutionary, paradigm-shifting concept in women’s health—Science Direct

Exposure: Environmental Links to Breast Cancer (1997)—Culture Unplugged

Cellphones and Breast Cancer—Environmental Health Trust

Is there any link between cellphones and cancer?—Mayo Clinic

Photo credit: Ishan @seefromthesky on Unsplash

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Staying positive… taking control

As you can imagine, waiting (not always so patiently!) for test results has made me even more interested in reading articles about lifestyle strategies for disease prevention. Doing something positive by creating a healthier lifestyle, one that can reduce the risk of cancer and other diseases, is something patients can do for themselves. Feeling that you’re in control of something in your life is good for both your mental and physical health.

On the upside, two health professionals have told me that slow results usually mean the test result will be negative. More suspicious samples are fast-tracked through the system, as they should be. So, perhaps slow is good. I’m afraid last week’s blog was a bit of a frustrated rant… so I’m trying to shift to a better, more positive frame of mind by taking control of what I can, and changing to a healthier lifestyle!

Looking at the research…

While I still like Michael Pollan’s Food Rules best for their simplicity: [Eat food (real food, not processed), mostly plants, and not too much], there certainly is some interesting research that many of us don’t hear about.

It’s always been difficult to conduct diet research on humans—it’s just too hard to completely control a person’s diet for the years it would take to really learn what’s best. But here are some of the diet recommendations and strategies being investigated that have caught my attention and that seem to make sense…

Eat more foods with flavonoids

For years researchers have found that some people who eat more foods with antioxidants, called flavonoids, have extra protection against heart attack, stroke, Type 2 diabetes, and some types of cancer, as well as lower blood pressure. But they weren’t sure why eating more of these foods didn’t work as well for everyone.

New research has discovered that certain bacteria in the gut break these compounds down into substances that deliver the benefit. Those with more diverse gut bacteria are the ones who benefit more.

Foods rich in flavonoids include berries, apples, pears, dark chocolate, and red wine. Ensuring you also have some fermented foods in your diet, like sauerkraut, yoghurt, kombucha and others, can help to ensure you benefit maximally from these tasty flavonoid-containing foods.

Meanwhile, increased diversity of gut bacteria is being found to be associated with reduced risk of several inflammatory and autoimmune diseases. Antibiotic overuse and poor diets are believed to have reduced the variety of microbes in our guts, with some species actually now extinct in some populations.

Ditch sugar and processed food

For all that we’ve been warned to avoid fatty foods, sugar is now believed by some researchers to be much worse. And when the fat is removed from food, it loses a lot of its taste. So, food processers have been making up for this by adding sugar (which we all love!). Multiple studies have suggested that increased amounts of processed foods in our diets can increase risk of cancer and heart disease.

Besides the obvious weight gain too much sugar can cause, there’s also Non-alcoholic Fatty Liver disease (NAFL) that is caused by the body storing some of that excess sugar in the liver as fat. Fatty liver disease is a risk factor for liver dysfunction as well as cancer.

Of course, if one were to eliminate both fat and sugar, that would leave only protein… and high protein diets can be hard on kidney function, as the kidneys are required to filter all the amino acids from the excess protein. To me this suggests a balanced diet with some fat and protein, plenty of fiber (think vegetables!) and a very low amount of sugar.

My sister (also a retired pharmacist) loves to watch videos of researchers discussing their work and she passes some of them on to me. A recent one discussed the effects of sugar on cancer cells and whether cancer is a genetic disease (caused by damage to DNA), or a disease of damaged mitochondria (the tiny energy-producing organelles in the cytoplasm (the fluid part of the cell outside the DNA-containing nucleus). Transferring damaged over-producing mitochondria from a cancer cell to a normal cell caused it to become cancerous but transferring DNA did not.

This suggests that cancer could be a disease of excess energy production by damaged mitochondria, allowing a cell to grow non-stop, rather than a disease of damaged DNA. The researcher suggests the damage seen in DNA could well be a “downstream” result of the rampant cell growth, not the cause of it. He also discussed that, since cancer cells are known to use mainly sugar for energy (and not fat or ketones, produced when fat is used for energy rather than sugar), removing sugar from the diet may be a strategy for future cancer treatment.

So, what the heck—I figure I might as well go “Keto” for a while, as I wait for my test results. At least I’ll be doing something positive rather than just sitting around waiting for a letter in the mail…

Intermittent Fasting

While I’ve blogged about intermittent fasting before, it’s worth mentioning again. When you limit your eating to less than 8 hours each day, your body goes into “clean up” mode, devouring dead and damaged cells… basically clearing out the garbage. This is called “autophagy” … eating oneself! (I’ll post the link to my article below, if you’re interested in reading it.)

The premise behind intermittent fasting is to stop eating and snacking throughout our waking hours so our body can spend time cleaning house rather than just processing a constant intake of food. This can be done either by compressing daily food intake into 8 hours or less, or by taking in less than 600 calories on 2 non-consecutive days of the week.

Many cultures have fasting rituals—the month-long celebration of Ramadan is one example, where followers do not eat during daylight hours. Historically, humans did not have the plentiful food supply we have today, and this has created a huge change in modern eating habits, with 3 full meals plus 2 to 4 snacks every day. Grazing, as one friend calls it, leaves little time for cleaning out the garbage in our cells.

“Knowledge translation” takes a long time…

When I retired from active pharmacy practice and started this blog, I had the time and interest to read as much as I could about creating a healthy lifestyle. I subscribed to several health newsletters that give me a steady stream of research-based information to share with you all. It is notable that new medical discoveries take an average of 17 years to become standard medical practice. They call this transfer of knowledge into practice “knowledge translation” and it’s a big problem in the world of science. Writers like me are trying to speed this up a little…

The IF Diet (Intermittent Fasting blog (Jan 2020) link: https://jeanniebeaudin.wixsite.com/author/post/the-if-diet

References:

Consumption of ultra-processed foods and cancer risk—British Medical Journal

The Effects of High-Protein Diets on Kidney Health and Longevity—Journal of the American Society of Nephrology https://jasn.asnjournals.org/content/31/8/1667

Flavonoid-rich foods lower blood pressure via gut bacteria–

Medical News Today

Microbial Diversity and Abundance of Parabacteroides Mediate the Associations Between Higher Intake of Flavonoid-rich Foods and Lower Blood Pressure—Journal of Hypertension

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Falling through the cracks…

Some patients have always fallen through the cracks of our medical system, with unnecessary delays in diagnosis. We’re all human… a significant symptom can be ignored or misinterpreted, or we can put off investigating the cause of a nagging problem that could suggest a serious condition. But during the COVID pandemic, the cracks in the system have become wider. With fewer in-person appointments, cancelled screening clinics and hesitation to seek treatment because of worry about virus exposure, experts are warning that diseases are likely being diagnosed later when they’re harder to treat.

They worry that because early-detection procedures like PAP tests, mammograms and the PSA test for prostate cancer are being postponed, we may see cases where the diseases these tests screen for are more advanced at diagnosis. This can sometimes mean more expensive treatment and worse outcomes because diseases are more likely to have spread when diagnosed. Just like a house fire, cancers and infections are best treated sooner before they have a chance to advance and spread.

It will take time for statistics to show how much of this is happening and to what extent the problem of decreased health screening is affecting our health and our chances of surviving health problems that are detected further along in the course of the disease. But, anecdotally at least, I’m seeing that this is happening.

Of course, for privacy reasons, I don’t want to describe the cases I’ve learned about amongst family and friends, but I can tell you my story. You may have noticed that I took a break from blogging this summer… but it wasn’t because I was having too much fun to write. The truth is, I haven’t been feeling well for the past several weeks. And I still don’t know the cause.

So, from my point of view, here are some of the “cracks” that it’s easy to fall through…

Crack #1: one thing at a time

In mid-May I noticed some abdominal discomfort—nothing too terrible. Then a week later a sudden severe pain sent me to Emergency… Crack #1 to avoid: try not to have 2 things going on at once (not that we really have that choice…). If you do, be sure to explain that there seem to be two unrelated things going on. Turned out I had a kidney stone (perhaps obvious from the level of pain…) but since they couldn’t see the stone on a CT scan it was diagnosed as a kidney infection. I spent the next 2 weeks on an antibiotic that made no difference. A later scan showed several smaller stones, confirming what I had suspected must be the cause at the time because the pain was so severe.

But in spite of visits with 4 doctors and a nurse practitioner, along with a series of tests, there’s still something else going on that hasn’t been diagnosed yet. At least I’ve progressed from phone appointments to in-person ones as my symptoms have gradually worsened.

Crack#2: describe symptoms clearly

I can see that the system is backed up, with longer delays than usual in getting appointments and results of tests. Crack #2: make sure the person on the phone understands your symptoms and how severe they are. Avoid the “Fine, thank you” automatic response when a health professional asks how you’re feeling—be truthful and accurate. Let them know how the symptoms are affecting your daily life.

Crack #3: know your receptionist

One important lesson I’ve learned is that the receptionist is the gatekeeper of the doctor’s time. While it may seem weird to be describing details of an illness over the phone to someone who isn’t a health professional, she is the person who decides how soon you need to be seen. So, heed Crack #3 and treat the receptionist like the important person that they are… describe what’s going on politely and carefully along with any frustration or desperation that you may be experiencing! And thank them profusely for helping you to be seen in a timely manner—it’s probably due to their actions. Usually, they’re the ones who manage the doctor’s schedule and often are the ones with the connections to the receptionists in the specialists’ offices.

Crack #4: communicate well

Crack #4 is about lack of communication. If you go to an after-hours clinic or emergency department, your doctor may or may not know about it afterward. Even if the Nurse Practitioner in your Family Doctor’s office sees you and documents her observations on your chart, your doctor may not see it until your next visit with them. Your family doctor should be the central hub of your healthcare and seeing them regularly, especially when you have a health issue, helps keep your care from various sites coordinated. Make sure they are well informed and aware of any care you receive outside their office. At least now we have electronic health records in most areas, so information about various treatments in different locations is accessible to everyone who is treating you and needs it. They just need to know it’s there and to look.

Crack#5: avoid vacations!

And Crack #5 is: don’t get sick during vacation (as if we have a choice!). Many doctors are not able to find locums to cover the office when they take vacation, leaving patients to rely on after-hours clinics and emergency departments. Even our local blood collection/lab sample drop off clinic, usually lined up daily to overcapacity, just closed up for a week to take a holiday. For many like me, we were left wondering where to go and this resulted in yet another extra week’s delay for me and many others in getting test results needed to help find a diagnosis.

My story…

So, where am I now? I just learned this week that my latest test, the one that should finally provide a diagnosis and the test I’ve waited 2 months to get, has a 2 to 3 month wait for results. I can’t believe it. I’m unbelievably frustrated that any lab could take 2 months to process a sample and that, as the receptionist told me, it could take an additional month in this age of electronic communication to send me a letter by snail mail with an appointment to hear the results. I think I cried on the phone in frustration. I’m hoping my newest favourite receptionist may be able to work some magic and expedite this process somewhat for me, the way the receptionist in my family doctor’s office was able to get me into the specialist more quickly. The words “possible carcinoma” on a June 30th test should have resulted in quick action but here I am, 2 months later, still waiting for a diagnosis. Whatever it is, I just want to know. It’s more than a little stressful and certainly not the norm in any medical system, including ours. Might be time to send an email to my local politician…

The bottom line

I guess, the bottom line is that we all need to be proactive about our health. Even in these days of the continuing pandemic, we still should insist that routine care and screening tests are completed in a timely manner. Vaccines and well-fitting masks are tools we have to make sure we stay safe from the virus while we do this. If you have unusual unexplained symptoms, insist that they be diagnosed. Keep asking for investigations until the problem is resolved. Remember that your family doctor is usually the most important healthcare professional to work with you and to coordinate and oversee your care.

So, if you’ve missed any screening tests in the past year and a half, now is the time to book an appointment. Just like a house fire, it makes a big difference if you catch it early. If something seems to be wrong with your health, check it out right away and keep pushing until you get an answer… that’s what I’m doing, even though it seems to be taking much longer than it should.