Archive | September 2023

The key to Healthy BONES!

Image result for skeletal bones     Image result for bones              Image result for skeletal bones

The infrastructure of the human body that allows us to perform our daily activities from standing, to sitting, to walking, or even climbing is our skeletal system. The major pillar or beam in the skeletal system is the vertebral column (spinal column). This bone structure allows us to bend, stand upright, twist, to dancing up a storm down the happy trail of life, if taken care of properly. If not, you may not be considering your life a happy tune, during that time of injury that can be a short or long haul before resolved, if ever. This infrastructure is so vital in our activities of our daily life. Many of us don’t realize that until the injury or damage sets in. There is one way you can bypass this disaster, don’t have it become a part of your life which is taking preventative measures; especially if you do heavy lifting in your life; like in my job as a nurse. One major ingredient to preventative measures is proper body mechanics but the trick here is never lift heavy items from below your waist level without bending your legs or even better without a second person helping you or some form of support but there is more to it than just that. There are more factors involved in helping you keep your back with all other bones strong. That would be healthy dieting, maintaining a good weight for your height (body mass index), and good exercise (not necessarily work out but if that is what you enjoy doing, it’s even better and don’t stop). All these ingredients to a better development and maintenance of your skeletal system=HEALTHY HABITS. A plus and benefit that many choose to do is going regularly to a chiropractor who can keep your spine in alignment (see one before injury starts). Recommended in Rockland County, NY is Dr. Diane Gregory, who I go to for my back and who has done both prevention & Rx; www.gregorychiropractic.com.

The key is to be living a healthy life. This consists of diet, exercise, activity and healthy habits learned and practiced in your routine of daily living that will help prevent or assist you in treating bone and back injuries; even problems caused by the inactivity with doing heavy lifting (Ex. lack of any muscle tone or muscle knots), which can inflict bone or back injuries. The better we treat ourselves EVERYDAY regarding health the higher the odds we will live a longer life. One common problem in America that can occur if not living healthy and/or using improper body mechanics with heavy lifting, especially frequently, can increase the risk of sciatica nerve damage. The pain of sciatica is typically felt from the low back (lumbar area) to behind the thigh and radiating down below the knee. The sciatica nerve is the largest nerve in the body that begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock to send the nerve ending down the lower limb to the foot. Depending on the precise cause of the sciatica symptoms with the duration, the outlook for recovery from sciatica ranges from excellent to having long term chronic symptoms. This can be prevented to some extent by avoiding low back trauma injuries. Thinking before lifting is the one of the best ideas. Osteoporosis is a common bone problem that is a abnormal loss of bony tissue resulting in fragile porous bones attributable to a lack of calcium, most common in postmenopausal women. This progressive bone disease that’s characterized by a decrease in bone mass and density leads to an increased risk of a fracture. The causes of this disease that are modifiable (can be changed) would be: Vitamin D deficiency, menopause, excess alcohol, tobacco smoking, malnutrition (identified risk factors include low dietary calcium and/or phosphorus, magnesium, zinc, boron, iron, fluoride, copper, vitamins A,K,E, and C; also D where skin exposure to sunlight provides an inadequate supply. Excess sodium is a risk factor. High blood acidity may be diet related, and is a known antagonist to the bone. Some have identified low protein intake as associated with lower peak bone mass during adolescence and lower bone mineral density in elderly populations. Other risk factors are inactive, underweight, heavy leads-a strong association between cadmium and lead with bone disease has been established. Low-level exposure to cadmium is associated with an increased loss of bone mineral density readily in both genders. Some studies even show soft drinks can increase the risk of osteoporosis related to high phosphoric acid. Others suggest soft drinks may displace calcium containing drinks from the diet rather than causing osteoporosis.

Another bone disorder is osteomalacia that is a softening of the bones caused by defective bone mineralization secondary to inadequate amounts of available phosphorus and calcium. The most common cause of the disease is a deficiency in vitamin D, which is normally obtained from the diet and/or from sunlight exposure. We can help our bones in many ways. There is not just one food to eat or one type of exercise to do or one healthy habit to practice to keep you healthy with strong bones, there are choices.   Wouldn’t you want less risk of bone or back injury or disease for yourself and for others throughout the nation including the future generations? Than join me and others. If you like what you see spread the good cheer. Let’s build a stronger foundation regarding HEALTH in America.

Adults need 700mg of calcium a day. You should be able to get all the calcium you need by eating a varied and balanced diet.

Foods healthy for bones and Good sources of calcium include::

  • milk, cheese and other dairy foods.
  • green leafy vegetables, such as broccoli, cabbage and okra, but not spinach.
  • soya beans.
  • tofu.
  • plant-based drinks (such as soya drink) with added calcium.
  • nuts.
  • bread and anything made with fortified flour.
  • fish where you eat the bones, such as sardines and pilchards.

QUOTE FOR FRIDAY:

“Gaucher disease can affect anyone, occurring in up to 1 in 40,000 live births in the general population.

Gaucher disease is more common among Jewish people of Ashkenazi (Eastern European) descent, occurring in approximately 1 in 450 within this population. As many as 1 in 10 may carry the mutated gene responsible for Gaucher disease.

Gaucher (go-SHAY) disease is the result of a buildup of certain fatty substances in certain organs, particularly your spleen and liver. This causes these organs to enlarge and can affect their function.  The fatty substances also can build up in bone tissue, weakening the bone and increasing the risk of fractures.  If the bone marrow is affected, it can interfere with your blood’s ability to clot.  An enzyme that breaks down these fatty substances doesn’t work properly in people with Gaucher disease.  Treatment often includes enzyme replacement therapy.”

National Gaucher Foundation (https://www.mayoclinic.org/diseases-conditions/gauchers-disease/symptoms-causes/syc-20355546)

 

Gaucher (go-SHAY) disease

Gaucher (go-SHAY) disease is the result of a buildup of certain fatty substances in certain organs, particularly your spleen and liver. This causes these organs to enlarge and can affect their function.

The fatty substances also can build up in bone tissue, weakening the bone and increasing the risk of fractures. If the bone marrow is affected, it can interfere with your blood’s ability to clot.

An enzyme that breaks down these fatty substances doesn’t work properly in people with Gaucher disease. Treatment often includes enzyme replacement therapy.

An inherited disorder, Gaucher disease is most common in Jewish people of Eastern and Central European descent (Ashkenazi). Symptoms can appear at any age.

Types of Gaucher Disease:

Scientists divide Gaucher disease into 3 different types based on the presence or absence of early-onset brain involvement, including:

  • Gaucher disease type 1: Gaucher disease type 1 is the most common form of the disease in western countries, making up roughly 95 percent of patients there. Symptoms include spleen and liver enlargement, bone problems, and fatigue. Brain development is normal.
  • Gaucher disease type 2: This type of Gaucher disease is rare and involves severe neurological (brain stem) abnormalities. It is usually fatal within the first 2 years, and it is currently untreatable because of the severe, irreversible brain damage.
  • Gaucher disease type 3: This type of Gaucher disease is rare in the United States and Europe; however, it is the most common form of the disease worldwide. Gaucher disease type 3 has a severity between types 1 and 2, causing the same symptoms as type 1 plus some neurological involvement. While patients typically have a shortened lifespan, some can live into their 50s with treatment.

Symptoms

There are different types of Gaucher disease, and signs and symptoms of disease vary widely, even within the same type. Type 1 is by far the most common.

Siblings, even identical twins, with the disease can have different levels of severity. Some people who have Gaucher disease have only mild or no symptoms.

Most people who have Gaucher disease have varying degrees of the following problems:

  • Abdominal complaints. Because the liver and especially the spleen can enlarge dramatically, the abdomen can become painfully distended.
  • Skeletal abnormalities. Gaucher disease can weaken bone, increasing the risk of painful fractures. It can also interfere with the blood supply to your bones, which can cause portions of the bone to die.
  • Blood disorders. A decrease in healthy red blood cells (anemia) can result in severe fatigue. Gaucher disease also affects the cells responsible for clotting, which can cause easy bruising and nosebleeds.

More rarely, Gaucher disease affects the brain, which can cause abnormal eye movements, muscle rigidity, swallowing difficulties and seizures. One rare subtype of Gaucher disease begins in infancy and typically results in death by 2 years of age.

Causes

Gaucher disease is passed along in an inheritance pattern called autosomal recessive. Both parents must be carriers of a Gaucher changed (mutated) gene for their child to inherit the condition.

Risk factors

People of Eastern and Central European Jewish (Ashkenazi) ancestry are at higher risk of developing the most common variety of Gaucher disease.

Complications

Gaucher disease can result in:

  • Delays in growth and puberty in children
  • Gynecological and obstetric problems
  • Parkinson’s disease
  • Cancers such as myeloma, leukemia and lymphoma

When to see a doctor

If you or your child has the signs and symptoms associated with Gaucher disease, make an appointment with your doctor ASAP.

QUOTE FOR THURSDAY:*

“If you’ve been diagnosed with ovarian cancer, your cancer care team will discuss your treatment options with you. It’s important that you think carefully about each of your choices. Weigh the benefits of each treatment option against the possible risks and side effects.  Typically, treatment plans are based on the type of ovarian cancer, its stage, and any special situations. Most women with ovarian cancer will have some type of surgery to remove the tumor. Depending on the type of ovarian cancer and how advanced it is, you might need other types of treatment as well, either before or after surgery, or sometimes both. Typically the range of treatments are from surgery to chemo therapy, hormone therapy, targeted temperature therapy and/or immunotherapy depending on the oncologist team on the case.”

American Cancer Society (https://www.cancer.org/cancer/types/ovarian-cancer/treating.html)

 

 

 

Part II Ovarian Cancer in treatments.

 

1-Local Treatments/Therapies:

Some treatments are local, meaning they treat the tumor without affecting the rest of the body.

Types of local therapy used for ovarian cancer include that include:

A-Surgery

That is the main treatment most ovarian cancers. How much surgery you have depends on how far your cancer has spread and on your general health.  For women of childbearing age who have certain kinds of tumors and whose cancer is in the earliest stage, it may be possible to treat the disease without removing both ovaries and the uterus.

B-Radiation

Radiation is another form of therapy that might be used.  Radiation therapy uses high energy x-rays or particles to kill cancer cells. These x-rays may be given in a procedure that is much like having a regular x-ray. Aggressive chemotherapy is usually more effective, so radiation therapy is rarely used in this country as the main treatment for ovarian cancer. However, it can be useful in treating areas where the cancer has spread, either near the main tumor or in a distant organ, like the brain or spinal cord.  External beam radiation – This is the most common type of radiation therapy for women with ovarian cancer. External radiation therapy is much like getting an x-ray, but the radiation is stronger.

2-Systemic Treatment/Therapies:

This includes Chemo therapy, Hormone Therapy and Targeted Therapy.

A. Chemo Therapy:

Chemotherapy (chemo) is the use of drugs to treat cancer. Most often, chemo is a systemic treatment, meaning the drugs enter the bloodstream and reach almost all areas of the body. Chemo can be useful to kill very small amounts of cancer cells that may still be around after surgery, for cancers that have metastasized (spread), or to shrink very large tumors to make surgery easier. Most of the time, chemo uses drugs that are injected into a vein (IV) or given by mouth. In some cases, chemotherapy may also be injected through a catheter (thin tube) directly into the abdominal cavity. This is called intraperitoneal (IP) chemotherapy.

Chemo for ovarian cancer usually involves getting two different types of drugs together. Getting a combination of drugs instead of just one drug alone seems to work better as a first treatment for ovarian cancer. Usually, the combination includes a type of chemo drug called a platinum compound (usually cisplatin or carboplatin), and another type of chemo drug called a taxane, such as paclitaxel (Taxol®) or docetaxel (Taxotere®). These drugs are usually given as an IV (put into a vein) every 3 to 4 weeks.

The typical course of chemo for epithelial ovarian cancer involves 3 to 6 cycles of treatment, depending on the stage and type of ovarian cancer. A cycle is a schedule of regular doses of a drug, followed by a rest period. Different drugs have varying cycles; your doctor will let you know what schedule is planned for your chemo.

Epithelial ovarian cancer often shrinks or even seems to go away with chemo, but the cancer cells may eventually begin to grow again. If the first chemo seemed to work well and the cancer stayed away for at least 6 to 12 months, it can be treated with the same chemotherapy used the first time. In some cases, different drugs may be used.

There are numerous other chemo drugs used that might be helpful in treating ovarian cancer.

B-Hormone Treatment/Therapies

It’s another treatment that may be used with the use of hormones or hormone-blocking drugs to fight cancer. This type of systemic therapy is rarely used to treat epithelial ovarian cancer, but is more often used to treat ovarian stromal tumors. 

Meds used in Hormone therapy is:

-Luteinizing Hormone Release Hormone Agonists

LHRH agonists (sometimes called GnRH agonists) can be used in systemic treatment also that will switch off estrogen production by the ovaries. These drugs are used to lower estrogen levels in women who are premenopausal. Examples of LHRH agonists include goserelin (Zoladex®) and leuprolide (Lupron®). These drugs are injected every 1 to 3 months. Side effects can include any of the symptoms of menopause, such as hot flashes and vaginal dryness. If they are taken for a long time (years), these drugs can weaken bones (sometimes leading to osteoporosis).

-Tamoxifen

Tamoxifen is a drug that is often used to treat breast cancer. It can also be used to treat ovarian stromal tumors and is rarely used to treat advanced epithelial ovarian cancer. Tamoxifen acts as an anti-estrogen in many tissues in the body, but as a weak estrogen in others. The goal of tamoxifen therapy is to keep any estrogens circulating in the woman’s body from stimulating cancer cell growth. The anti-estrogen activity of this drug can lead to side effects like hot flashes and vaginal dryness. Because tamoxifen acts like a weak estrogen in some areas of the body, it does not cause bone loss but can increase the risk of serious blood clots in the legs.

-Aromatase inhibitors

Aromatase inhibitors are drugs that block an enzyme (called aromatase) that turns other hormones into estrogen in post-menopausal women. They don’t stop the ovaries from making estrogen, so they are only helpful in lowering estrogen levels in women after menopause. These drugs are mainly used to treat breast cancer, but can also be used to treat some ovarian stromal tumors that have come back after treatment as well as low grade serous carcinomas. They include letrozole (Femara®), anastrozole (Arimidex®), and exemestane (Aromasin®). These drugs are taken as pills once a day.

Common side effects of aromatase inhibitors include hot flashes, joint and muscle pain, and bone thinning. The bone thinning can lead to osteoporosis and bones that break easily.

C-Targeted Drug Therapy:

Targeted therapy is a type of cancer treatment that uses drugs to identify and attack cancer cells while doing little damage to normal cells. These therapies attack the cancer cells’ inner workings − the programming that makes them different from normal, healthy cells. Each type of targeted therapy works differently, but they all change the way a cancer cell grows, divides, repairs itself, or interacts with other cells.

-Bevacizumab

Bevacizumab (Avastin) belongs to a class of drugs called angiogenesis inhibitors. For cancers to grow and spread, they need to make new blood vessels to nourish themselves (called angiogenesis). This drug attaches to a protein called VEGF (that signals new blood vessels to form) and slows or stops cancer growth.

Bevacizumab has been shown to shrink or slow the growth of advanced epithelial ovarian cancers. Bevacizumab appears to work even better when given along with chemotherapy having shown good results in terms of shrinking (or stopping the growth of) tumors. But it doesn’t seem to help women live longer.

Bevacizumab can also be given with olaparib (see below) as maintenance treatment in women whose cancers have the BRCA mutation or genomic instability (see below) and have shrunk quite a bit with chemotherapy containing carboplatin or cisplatin.

This drug is given as an infusion into the vein (IV) every 2 to 3 weeks.

Side effects of bevacizumab

Common side effects include high blood pressure, tiredness, bleeding, low white blood cell counts, headaches, mouth sores, loss of appetite, and diarrhea. Rare but possibly serious side effects include blood clots, severe bleeding, slow wound healing, holes forming in the colon (called perforations), and the formation of abnormal connections between the bowel and the skin or bladder (fistulas). If a perforation or fistula occurs it can lead to severe infection and may require surgery to correct.

PARP inhibitors

Olaparib (Lynparza), rucaparib (Rubraca), and niraparib (Zejula) are drugs known as a PARP (poly(ADP)-ribose polymerase) inhibitors. PARP enzymes are normally involved in one pathway to help repair damaged DNA inside cells. The BRCA genes (BRCA1 and BRCA2) are also normally involved in a different pathway of DNA repair, and mutations in those genes can block that pathway. By blocking the PARP pathway, these drugs make it very hard for tumor cells with an abnormal BRCA gene to repair damaged DNA, which often leads to the death of these cells.

If you are not known to have a BRCA mutation, your doctor might test your blood or saliva and your tumor to be sure you have one before starting treatment with one of these drugs.

All of these drugs are taken daily by mouth, as pills or capsules.

Olaparib (Lynparza) is used to treat advanced ovarian cancer, typically after chemotherapy has been tried. This drug can be used in patients with or without mutations in one of the BRCA genes.

In women with a BRCA mutation:

  • Olaparib can be used as maintenance treatment for advanced ovarian cancer that has gotten smaller in response to first treatment with chemotherapy containing cisplatin or carboplatin.
  • Olaparib can be used with bevacizumab (see above) as maintenance treatment in women whose cancers have shrunk quite a bit with chemotherapy containing carboplatin or cisplatin.

In women without a BRCA mutation:

  • If the tumor has a high genomic instability score (a test measuring the amount of abnormal genes in cancer cells), olaparib can be used with bevacizumab as maintenance treatment in women whose cancers have shrunk quite a bit with chemotherapy containing carboplatin or cisplatin.

In women with or without a BRCA mutation:

  • Olaparib can be used as maintenance treatment for advanced ovarian cancer that has come back after treatment, and then has shrunk in response to chemotherapy containing cisplatin or carboplatin.

Niraparib (Zejula) may be used in some situations to treat ovarian cancer.

In women with or without a BRCA gene mutation:

  • Niraparib might be used as maintenance treatment for advanced ovarian cancer, where the cancer has shrunk with firsrt-line chemotherapy containing cisplatin or carboplatin.
  • Niraparib might be used as maintenance treatment for advanced ovarian cancer that has come back after treatment, where the cancer has then shrunk with chemotherapy containing cisplatin or carboplatin.

Rucaparib (Rubraca) can be used in women with or without a BRCA mutation, as maintenance treatment for advanced ovarian cancer that has come back after treatment, and then has shrunk in response to chemotherapy containing cisplatin or carboplatin.

These drugs have been shown to help shrink or slow the growth of some advanced ovarian cancers for a time. So far, though, it’s not clear if they can help women live longer.

Side effects of PARP inhibitors

Side effects of these drugs can include nausea, vomiting, diarrhea, fatigue, loss of appetite, taste changes, low red blood cell counts (anemia), belly pain, and muscle and joint pain. Rarely, some patients treated with these drugs have developed a blood cancer, such as myelodysplastic syndrome or acute myeloid leukemia.

Drugs that target cells with NTRK gene changes

A very small number of ovarian cancers have changes in one of the NTRK genes. Cells with these gene changes can lead to abnormal cell growth and cancer. Larotrectinib (Vitrakvi) and entrectinib (Rozlytrek) are targeted drugs that stop the proteins made by the abnormal NTRK genes. These drugs can be used in people with advanced ovarian cancer whose tumor has an NTRK gene change and is still growing despite other treatments.

These drugs are taken as pills, once or twice a day.

Side effects of drugs that target NTRK gene changes

Common side effects include dizziness, fatigue, nausea, vomiting, constipation, weight gain, and diarrhea.

Less common but serious side effects can include abnormal liver tests, heart problems, and confusion.

Typically, any treatment plans for a patient with ovarian cancer are based on the type of ovarian cancer, its stage, and any special situations. Most women with ovarian cancer will have some type of surgery to remove the tumor. Depending on the type of ovarian cancer and how advanced it is, you might need other types of treatment as well, either before or after surgery, or sometimes both.

Those who to expect in treating ovarian cancer?

Based on your treatment options, you might have different types of doctors on your treatment team. These doctors could include:

  • A gynecologic oncologist: a gynecology doctor who is specially trained to use surgery to treat ovarian cancer; many times they are also the ones to give chemotherapy and other medicines to treat ovarian cancer
  • A radiation oncologist: a doctor who uses radiation to treat cancer
  • A medical oncologist: a doctor who uses chemotherapy and other medicines to treat cancer

Many other specialists might be part of your treatment team as well, including physician assistants, nurse practitioners, nurses, psychologists, sex counselors, social workers, nutritionists, genetic counselors, and other health professionals.

Your treatment plan will depend on many factors, including your overall health, personal preferences, and whether you plan to have children. Age alone isn’t a determining factor since several studies have shown that older women tolerate ovarian cancer treatments well.

It’s important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. It’s also very important to ask questions if there’s anything you’re not sure about.

If time permits, it is often a good idea to seek a second opinion. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.

QUOTE FOR WEDNESDAY:

“Ovarian cancer is the second most common gynecologic cancer in the United States. Ovarian cancer causes more deaths than any other cancer of the female reproductive system.  In 2020, the latest year for which incidence data are available, in the United States, 18,518 new cases of Ovarian cancer were reported among women, and 13,438 women died of this cancer. For every 100,000 women, 9 new Ovarian cancer cases were reported and 6 women died of this cancer.

Cancer is the second leading cause of death in the United States, exceeded only by heart disease. One of every five deaths in the United States is due to cancer.

Centers for Disease Control and Prevention – CDC  (https://gis.cdc.gov/Cancer/USCS/#/AtAGlance/)

Part I Ovarian Cancer

Most people are aware that October is Breast Cancer Awareness Month, but how many of you are also aware that September is Ovarian Cancer Awareness Month?

This cancer, Ovarian Cancer, is the more silent sister to breast cancer-which takes over the month of October with a worldwide pink party and numerous product promotions, some tasteful and some less so. Maybe people and product promoters are just drawn to pink versus the more reserved teal blue color for ovarian cancer. More likely it’s because breasts are visual and ovaries are invisible to the eye.

Remember ovarian cancer is very visible to those diagnosed with it and to their loved ones.  We need to make more noise about ovarian cancer awareness.  First you have to listen… to your body. Ovarian cancer can be sneaky.

Symptoms such as indigestion, bloating, painful intercourse, menstrual irregularities and back pain, can point to other less invasive conditions. While breast cancer has screening protocols like mammograms and breast self-examination, there is no reliable screening for ovarian cancer. Unfortunately for many women the disease is often detected at an advanced stage. Both breast and ovarian cancer are diagnosed in women of all ages and ethnic backgrounds.

Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone.

Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat, just like most other cancers in late stages as well, and is unfortunately frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully.

Early-stage ovarian cancer rarely causes any symptoms. Advanced-stage ovarian cancer may cause few and nonspecific symptoms that are often mistaken for more common benign conditions, such as constipation or irritable bowel.

Signs and symptoms of ovarian cancer may include and don’t ever ignore them:

  • Abdominal bloating or swelling
  • Quickly feeling full when eating
  • Weight loss
  • Discomfort in the pelvis area
  • Changes in bowel habits, such as constipation or diarrhea
  • A frequent need to urinate (urgency including difficulty to void)
  • Increased Abdominal Size
  • Painful Sex
  • Heavy menstrual bleedingWhen to see a doctorIf you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. Your doctor may refer you to a genetic counselor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers. Only a small number of women are found to have genetic mutations that can lead to ovarian cancer.
  • Certain factors may increase your risk of ovarian cancer:
  • Make an appointment with your doctor if you have any signs or symptoms that worry you. 

Risk Factors:

  • Age. Ovarian cancer can occur at any age but is most common in women ages 50 to 60 years.
  • Inherited gene mutation. A small percentage of ovarian cancers are caused by an inherited gene mutation. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes were originally identified in families with multiple cases of breast cancer, which is how they got their names, but women with these mutations also have a significantly increased risk of ovarian cancer.
  • The gene mutations that cause Lynch syndrome, which is associated with colon cancer, also increase a woman’s risk of ovarian cancer.
  • Estrogen hormone replacement therapy, especially with long-term use and in large doses.
  • Age when menstruation started and ended. If you began menstruating before age 12 or underwent menopause after age 52, or both, your risk of ovarian cancer may be higher.
  • Never being pregnant.
  • Fertility treatment.
  • Smoking.
  • Use of an intrauterine device.
  • Polycystic ovary syndrome.  In years past ovarian cancer used to be call  the silent killer but it’s really not completely silent, at least in some patients.  You shouldn’t ignore your symptoms!

 

QUOTE FOR TUESDAY:

“In Lower Manhattan, the plane crashes—which resulted in the collapse of the Twin Towers—created massive dust clouds that filled the air and left hundreds of highly populated city blocks covered with ash, debris, and harmful particles, including asbestos, silica, metals, concrete, and glass. Fires within the debris pile and the collapse of 7 WTC burned through the end of December 2001 with continued flare-ups in 2002, releasing carcinogenic combustion by-products. These contaminants remained in Lower Manhattan and parts of Brooklyn for an undetermined amount of time after 9/11.”

Center for Disease Control and Prevention – CDC (https://www.cdc.gov/wtc/exhibition/toxins-and-health-impacts.html)

Health Effects from 9/11 Disaster.

 

HEALTH EFFECTS FROM SEPTEMBER 11 DISASTER

The world trade center (WTC) terrorist attact and its aftermath exposed hundreds of thousands of people to dust, debris, smoke and fumes.  I was one that went down that day as a volunteer RN to help out my country.  It was a sight I will never forget and thank God nothing like it has happened since including developing anything from being exposed to the environment of this disaster.  September 11, 2001, among rescue and clean up workers, office workers, building evacuees, and residents of lower Manhattan living down their have shown increased respiratory and other physical health problems, like developing cancers after this terrible terrorist tragedy.  Following is a outline of the most common conditions experienced by individuals exposed to the WTC attacks and their aftermath.  The types of conditions are:

Upper Airway Cough Syndrome:  Formerly named postnasal drip syndrome which is commonly caused by continuous irritation or infection of the sinuses and the nose either due to allergies or from environmental irritants.  The signs or symptoms that arise from this are cough, nasal congestion, postnasal drip and frequent need to clear the throat.

Asthma/Reactive Airways Dysfunction Syndrome:  Some people exposed to the WTC disaster area have developed asthma related to exposure to irritants (also called reactive airways dysfunction syndrome [RADS]).  Signs and symptoms include:  Shortness of Breath (SOB); chest tightness, wheezing, coughing, phlegm, possible triggering of symptoms by colds or seasonal allergies or exercise or fragrances or extremes of temperature or humidity, recurrent episodes of respiratory infections requiring antibiotic treatment.

GASTROESOPHAGEAL REFLUX DISEASE OR LARYNGOPHARYNGEAL REFLUX DISEASE:  Some people exposed to the WTC disaster developed this condition.  GERD results from the flow back or return (reflux) of stomach contents into the esophagus. LPRD results from the reflux of stomach contents into the voice box or throat.

Symptoms of GERD: Heartburn, acid regurgitation, upset stomach, cough made worse with meals or at night

Symptoms of LPRD: Hoarseness or other vocal changes, sore throat, cough, sensation of having a lump in the throat

Long-Term Physical Health Concerns

There has been increased concern about sarcoidosis and cancer among individuals who were highly exposed during the WTC disaster. The NYC Department of Health and Mental Hygiene, in conjunction with other programs, is closely monitoring these conditions in order to detect any increases in these diseases.

At this time, there is no evidence of an increased rate of cancer among individuals highly exposed to the WTC disaster. Increased rates of sarcoidosis have been documented among fire department personnel ( Izbicki G, Chavko R, Banauch, GI, et al. World Trade Center “Sarcoid-Like” Granulomatous Pulmonary Disease in New York City Fire Department Workers. Chest. 2007;3:131;1414-1423). Rates of sarcoidosis among other groups are currently under investigation.

Sarcoidosis is difficult to verify because NYC providers are not required by law to report sarcoidosis cases to the Health Department.  Based on New York City death certificate records over the   past 10 years, there have been an average of 32 sarcoidosis deaths per year, with the annual number remaining the same since the WTC attacks. During the   same period, there have been between 362 and 439 sarcoidosis-related hospitalizations per year in NYC (five per 100,000 people), with the annual   rate remaining the same since the disaster.

* Breathing in beryllium, other metal dust or fumes or moldy materials can cause lung disease, which may resemble sarcoidosis.

.Sarcoidosis

Sarcoidosis* is an auto-immune disease that can attack any organ   of the body, although it often starts in the lungs or lymph nodes. It mainly   affects people between 20 and 40 years of age, with African-Americans three  times more likely to develop the condition than Caucasians and women twice as   likely to develop it as men. While most sarcoidosis patients recover without treatment, less than one-third develop chronic debilitating sarcoidosis and  fewer than 5% die from the disease. The exact cause of sarcoidosis is unknown.

Sarcoidosis and World Trade Center (WTC) Dust Exposure

While studies have not definitively linked dust exposure from   the WTC disaster to new-onset sarcoidosis among exposed workers, the data   does suggest elevated levels of sarcoidosis among firefighters.

There have been a few reported sarcoidosis cases among rescue   workers that may be related to Ground Zero dust exposure. In May 2007, the New York City Chief Medical Examiner determined that dust exposure from the disaster contributed to a sarcoidosis death, based on published epidemiologic findings among exposed firefighters.

Cancers

The collapse and burning of the WTC and neighboring buildings   released a complex mixture of irritant dust, smoke and gases. The dust cloud   also contained heavy metals, as well as asbestos and other carcinogens. In   addition, smoke released from the fires contained hazardous and potentially   cancer-causing substances.

Because of these exposures, there has been concern about the   possibility of increased cancer rates among WTC-exposed people. The NYC   Department of Health and Mental Hygiene, the Fire Department of New York and   other researchers are carefully monitoring cancer rates among highly exposed   people.

In 2007, the NYC Department of Health and Mental Hygiene brought together a panel of experts, including representatives from FDNY, the Mount Sinai School of Medicine, the New York State Department of Health and the National Institute for Occupational Safety and Health, to discuss the potential impact of the WTC disaster on cancer rates and mortality.

In 2010, after beginning the process of confirming cancer   diagnoses within their cohorts, the NYC Department of Health and Mental   Hygiene and FDNY co-chaired another conference of outside experts, including biostatisticians, environmental health scientists and cancer epidemiologists,   to help address the complex methodological questions associated with their   preliminary cancer investigations. The conference produced several   recommendations which are described in the 2010 WTC Medical Working group annual report.

Although cancer associated with specific exposures takes a long   time to develop, three early cancer studies based on verified diagnoses   within their cohorts through 2008 (the latest year for which data was   available when these analyses began) have been published:

  • FDNY found that nearly 9,000 firefighters with WTC exposure may be at greater risk for cancer than firefighters  who weren’t exposed.
  • The WTC Health Registry found small increases in rates of prostate cancer, thyroid cancer and multiple myeloma, a blood cancer, among nearly 34,000 WTC rescue and recovery workers in comparison to rates among New York State residents after adjusting for age, race/ethnicity and sex.
  • Prostate and thyroid cancer rates were higher than expected among nearly 21,000 rescue and recovery workers enrolled in the WTC Health Program in comparison to rates in New York, New Jersey, Connecticut and Pennsylvania where the majority  of workers lived.

Cancer analyses continue at FDNY, the WTC Health Registry and at   the Mount Sinai School of Medicine.

In 2012, the National Institute for Occupational Safety and Health  added many different types of cancers to the list of conditions that can be treated at the World Trade Center Health Program.

What the New York City  Health Department Is Doing:

Through the World Trade Center (WTC) Health Registry, the Health Department is conducting a cancer study that will help determine if cancer rates are higher among those exposed to the WTC disaster. Results of   the study will appear on this Web site and will be submitted to peer-reviewed scientific journals.

The Department is also conducting a broader public awareness campaign about cancer testing, and is working with its clinical partners to offer free cancer screenings. Identifying cancer early in the course of the disease reduces the risk of developing disability from cancer. Department efforts to reduce the rates of smoking among WTC disaster-exposed people also help reduce their risk for developing cancer and other diseases.

What You Can Do

Seek medical care.

If you were exposed to the WTC disaster and have developed symptoms or conditions you feel are related to this exposure, tell your doctor and bring the Clinical Guidelines for Physicians Treating Adults   Exposed to the WTC Disaster to   help your doctor diagnose and treat your symptoms. The Health Department also   released clinical guidelines  for   health care providers on how to treat children and adolescents exposed to the WTC disaster.

If you or your doctor believe that you require more specialized   care, you may be eligible for free treatment at a WTC   Center of Excellence or affiliated facility.

Practice preventive   health.

Whether or not you are currently experiencing symptoms, there   are things you can do to maintain your current health status, prevent   worsening of your health, and detect any new conditions. Suggested measures   include:

    1. If you smoke, quit! Tobacco is known to cause   cancer and make existing respiratory conditions worse. If you currently   smoke, there are programs in place to help you quit.
    2. Lead a healthy lifestyle by drinking alcohol   in moderation and avoiding more than moderate sun exposure. Increase physical   activity, keep your weight down and eat a healthful and nutritious diet.
    3. Have a physical exam every year that includes a   complete blood count (CBC). Be sure your exam includes all tests appropriate   for your sex and age, including cancer screenings.
    4. Avoid   risks at work and during leisure time. If you have any respiratory conditions  try to reduce your exposure to irritants such as dust, pollen, grass and   smoke both at home and at work. Consider giving up activities that expose you to irritants, and if activities cannot be avoided, wear personal protective   equipment to minimize exposure.