It is hard to imagine on a stormy day like today, but for many of us, Spring Break is right around the corner. You are never too young or too old, to take care of your skin. Dr. Hughes explains his state-of- the-art treatment for skin cancer that is simple and painless. No cutting. No scars. And takes just a few minutes to have fresh new healthy cancer free skin.
Many men with early-stage, less aggressive prostate cancer are now opting for active surveillance or watchful waiting. But in my opinion, the focus should be on the active part of active surveillance and not just watching and waiting around to see your PSA go up. And in my opinion, active means focusing on diet and exercise.
So why should men change? Because study after study now suggest that low-fat eating, along with exercising and reducing stress, can stop or reverse the progression of prostate cancer in its early stages. The research was spearheaded by Dr. Dean Ornish of the University of California at San Francisco, best known for using the same approach in treating coronary heart disease.
Although the studies were small, the results were huge. By eating a low-fat diet, PSA levels actually decreased after only a few months. And in another Dr. Ornish study, the low-fat diet, along with exercise and stress reduction, actually changed the way cancer genes behaved. Remarkably, the low-fat diet switched on tumor killer genes and turned down tumor promoter genes.
Dr. Ornish told the prestigious journal Scientific American, “We found that simple changes have a powerful impact on our gene expression…Genes may be our predisposition, but they are not our fate.” – Read More Here
So what is good for prostate cancer treatment is usually good for prostate cancer prevention. If you have prostate cancer, or if your spouse or significant other has a risk of prostate cancer, I would take a careful look at the Dr. Dean Ornish program on the internet. And you’ll also lose weight and help prevent heart disease. Talk about a win-win program. There is a lot of good stuff on the Dr. Ornish website.
If you have any questions about your prostate cancer, please call me, Dr. Edward Hughes, at 855-DAYTON1.
Watch this TED Talk by Dr. Ornish as he discusses the importance of lifestyle and disease.
Dr. Edward Hughes discusses the importance of exercise not only to prevent cancer, but to prevent cancer recurrence. Exercise is especially important for breast cancer survivors to prevent lymphedema. Share this video with everyone you know.
In a landmark study in 2015, Dr. Bert Vogelstein of the Johns Hopkins School of Medicine showed that 2 out of 3 breast cancers are due to bad luck – changes in your DNA caused by lifestyle choices. But if nature deals you a bad set of genes, all is not lost. There is hope.
By analyzing genetic and lifestyle risk factors for breast cancer in over 26,000 women, Dr. Nilanjan Chatterjee of the Johns Hopkins School of Public Health concluded the 28.9% of all breast cancers could be prevented. In fact, women with the highest genetic risk factors were no more at risk if they did not smoke, drink a lot of alcohol, use hormonal therapy at menopause, or had maintained a normal body weight. Dr. Chatterjee’s study was reported in the May 26, 2016 issue of the Journal of the American Medical Association Oncology.
Healthy lifestyle changes really are important to prevent cancer. Even if you have a family history of breast cancer. A 30% reduction in your risk of breast cancer is under your control. So eating right, exercising, and getting yearly mammograms are key to not only preventing breast cancer but catching it early.
If you have any questions about your breast cancer or its treatment, please feel free to call me, Dr. Edward Hughes, at 855-Dayton 1
1. Stop PSA Screening – Not so Fast!
In 2012, the US Preventative Services Task Force (USPSTF) came out against routine PSA screening for prostate cancer in men, regardless of age. But the major study used for this recommendation was likely flawed.
More importantly, since 2012, the number of men diagnosed with advanced stage prostate cancer is increasing (Cancer Epidemiology Biomarkers Prev. 2016; 25:259-263).
Dr. Richard Hoffman, an expert in shared decision-making about prostate screening, told Medscape Medical News that “abandoning PSA screening is proving harmful.”
From my own vantage point in our clinic, PSA testing for men ages 55-70 makes a lot of sense. Urologists and radiation oncologists are now well aware of overtreatment of patients with early-stage prostate cancer. Active surveillance can be offered for a number of our patients. But missing advanced stage prostate cancer or aggressive prostate cancers can be deadly. Most of the patients that I see in my clinic are not aware of the fact the prostate cancer is the second biggest killer of men in the US, second only to lung cancer.
2. Artery-Sparing Radiation May Help with Erectile Dysfunction
Dr. Patrick McLaughlin of the University of Michigan Medical School reported on the benefits of using MRIs in radiation planning for patients with early stage prostate cancer. His study was published recently in the British journal, Lancet Oncology. While sparing the critical arteries and nerves going into the prostate gland, Dr. McLaughlin and colleagues reported that 92% of men were still able to be sexually active even 5 years after radiation.
In my opinion, Cyber Knife offers the best sparing of the arteries and nerves leading into the prostate of any of the radiation technologies. And at First Dayton Cancer Care, our patients have the choice of Cyber Knife or IMRT or IMRT combined with temporary, robotic seed implants.
3. Atkins Diet Can Help Some Side Effects of Hormonal Therapy for Prostate Cancer
Dr. Stephen Freedland of Cedars-Sinai Medical Center in Los Angeles reported on the low carbohydrate diet and hormonal therapy at the recent American Urologic Association (AUA) annual meeting.
While on hormonal therapy for prostate cancer, the Atkins diet or low carbohydrate diet resulted in better blood sugar control and weight loss than in those men who ate a regular diet.
So there is some hope in managing the side effects of hormonal therapy or androgen deprivation therapy (ADT) for patients with prostate cancer. Unfortunately, there was no difference in PSA levels.
If you have any questions about your prostate cancer, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1.
Fasting for 13 or more hours at night, including sleep, just may help reduce the risk of breast cancer recurrence. And the effects were huge – a 36% higher risk for breast cancer recurrence for women who did not fast. This study of 2,413 non-diabetic women with early-stage breast cancer was published in the March 31, 2016 issue of JAMA Oncology.
Dr. Ruth Patterson, the senior author of the study, told Medscape Medical News “To our knowledge, this is the first paper examining nightly fasting and breast cancer progression.” Dr. Patterson went on to say, however, that “the data are not mature enough to make clinical or public health recommendations.”
As always, the study raised more questions that it answered. And is likely to take a decade of research to confirm these results. But I believe the current results are simple and yet profound. So do what your grandmother always told you, “The kitchen is closed after dinner.” This simple recommendation of not eating after dinner results in a huge decrease in the chances for breast cancer cure after treatment.
If you have any questions about your breast cancer, please feel free to write or call me, Dr. Edward Hughes, at 855-Dayton1.
A new study of over 32,000 patients showed that survivors of certain cancers, namely head and neck cancer, bladder cancer, and lung cancer are at an increased risk of another, yet different cancer. And the second cancer can be lethal – and it’s called non-small cell lung cancer.
Dr. Geena Wu presented her research from the City of Hope National Medical Center at the recent 2016 annual meeting of the Society of Thoracic Surgeons. Dr. Wu and colleagues looked at the SEER national database of 32,058 patients with a prior cancer who then went on to be diagnosed with a lung cancer 6 months or later following completion of their initial treatment.
Dr. Wu found that patients with a history of certain, specific cancers had higher rates than expected of getting non-small cell lung cancer years after their first cancer was cured. Survivors of head and neck cancer, lung cancer, and bladder cancer were especially at risk. Even survivors of lung cancer were at risk for coming down with a completely different second, unrelated lung cancer. And it follows that smoking is not only the likely culprit of not only the first cancer, but the second one as well. Smoking can cause multiple cancers.
As a cancer specialist, I see patients for follow-up visits each and every day. I hear the same story. “I’m finally done with surgery. I’ve been through months of chemotherapy and weeks of radiation. And now I have to come for follow-up visits, not just for months but for years? So why won’t you specialists just give me a break?” The answer, without question is that follow-up visits are important. You need to continue to be screened for other cancers.
Unfortunately there is no limit on the number of cancers a person can get. Especially when you are talking about cancers that can be driven by lifestyle choses such as tobacco use. Cancer screenings like mammograms, colonoscopies, skin checks, and low dose lung cancer CT scans all still need to be performed on a regular basis for cancer survivors. These routine follow ups are more important for survivors than for those who have never had cancer.
I hear our survivors tell me on a day-to-day basis, “But can’t my family doctor just do the follow-up visits?” I think that follow-up visits by primary care physicians are ideal, but a recent poll of primary care physicians showed the two thirds preferred follow-up visits for cancer be done by cancer specialists, not the family doctor. I think that primary care physicians are already put upon to look after your general health in a 15 minute visit. I think the cancer specialists are uniquely trained to spot early signs of recurrent cancer as well as spotting the symptoms of a new, unrelated cancer. Once again, early detection is key to survival. Follow-up visits with your cancer specialist is time well spent.
If you have any questions, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1.
Often times people experience sudden weight loss that sends them to see a doctor. All too often this is the symptom that leads to a cancer diagnosis. Cachexia-the loss of muscle mass associated with cancer-is a fancy word for an all too common symptom of newly diagnosed patients with advanced lung cancer. Every doctor knows cachexia when they see it, especially in patients with locally advanced lung cancer. Patients experience loss of muscle instead of fat because muscle is easier for the body to metabolize into the much needed calories. Cancer itself can also cause a dramatic inflammatory response which adds to this loss regardless of how many calories are eaten.
The overall weight loss and loss of muscle mass in cancer patients can be profound. Cachexia affects 50-80% of cancer patients. And the results of cachexia can lead to a continuing decline in overall health and continued impairment of immune function. Remarkably, cachexia is the direct cause of death in 20% of cancer patients. So patients with locally advanced lung cancer are already behind the 8 ball even before starting treatment, treatments that may include chemotherapy and radiation therapy. A vicious cycle starts that can lead to further loss of appetite and fatigue, compounding the cachexia.
But a recent study published in the journal Lancet Oncology shows that help is on the way for locally advanced lung cancer patients who suffer from cachexia (Lancet Oncology February 19, 2016) Dr. Jennifer Temel, a cancer specialist at Harvard’s Dana-Farber Cancer Institute, looked at 2 different phase 3 studies-the gold standard of clinical studies-of 979 patients with advanced cancer. 653 of these 997 patients were treated with the new drug Anamorelin and 326 were treated with a placebo-a pill with no active ingredients.
After only 12 weeks, those patients who took the drug Anamorelin gained weight compared with patients who took only the placebo. Of course, there were side effects-the main one was elevated blood sugar.
From my point of view as a cancer specialist, the studies with Anamorelin are a good start. Our advanced lung cancer patients need all the help that they can muster to help combat the side effects of chemotherapy and radiation therapy. More research will be needed to refine the role of Anamorelin to treat cancer related weight loss and muscle loss. But I’m glad that help is on the way.
If you have any questions about your cancer, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1
Can You Prevent Cancer Just by Eating Right and Exercising?
As the Season Holidays are upon us, you’ll hear a lot about improving your health through lifestyle choices. The ads to sell you expensive fitness equipment will be coming on strong. So get out your list of bad habits and dust off your holiday resolutions. You’ll also hear a lot about how healthier lifestyle choices can reduce your risk of cancer. But by how much? And where do you get the most bang for your buck? At the gym? At the dinner table? Colleen Doyle, MS, RD the managing director of the American Cancer Society’s “Healthy Eating, Active Living Environments” program stated “Right now, at a time when it’s estimated that 14% of all cancer deaths in men and 20% in women are related to being overweight, 64% of adults are overweight, including 28% who are obese.” In October, the World Health Organization pulled out all the stops by placing eating red meat and processed meat like bacon in the same cancer-causing category as tobacco, asbestos and formaldehyde. Don’t get me wrong, I think exercising, eating right, stopping smoking, limiting alcohol, and staying out of the sun really can help in preventing cancer. But hold on, it appears you can’t control everything.
Are Lifestyle Changes Really the Whole Answer?
In a breakthrough study in the January 2, 2015 issue of the prestigious journal Science, the internationally recognized cancer researcher Dr. Bert Vogelstein and his bio-mathematician colleague Dr. Cristian Tomasetti from Johns Hopkins Medical School concluded “Two thirds of all cancer incidence across tissues is explained by random mutations that occur when stem cells divide.” To put it another way, the bad luck of random mutations or changes in DNA account for 2 out of 3 of all cancers. So does this mean that most causes of cancer are out of our control? Lifestyle choices and family heredity certainly play a role, and account for 1 out of 3 of all cancers. The key finding is that the “bad luck” of stem cell mutations or changes in your DNA that happen by chance over your lifetime play a much bigger role-twice as much.
Maybe We Should Focus More On Screening?
Drs. Vogelstein and Tomasetti came to a blockbuster conclusion and stated, “We should focus more resources on finding ways to detect such cancer at early, curable stages.” From their study of stem cell mutations as the cause of cancer, it seems we should focus even more of our efforts on screening, not less. Recently, the American Cancer Society recommended drastically decreasing screening for breast cancer with mammography. The US task force recommended not screening at all for prostate cancer with a PSA test.
But I believe we need to double down on screening. Medicine has developed powerful tools for screening the common cancers, and better tests are being developed all the time. For my money, Dr. Vogelstein’s study shows that it’s more important to screen for cancer. And in some ways, it’s easier to do. So add cancer screenings to your list of resolutions for 2016.
Breast cancer – 2D and 3D mammograms
Cervical cancer – Pap smears and pelvic examinations
Colon cancer – colonoscopy
Lung cancer – low-dose CT scans
Prostate cancer – PSA and digital rectal exams
Nearly half of all adult Americans can breathe a sigh of relief. Weight cycling or so-called yo-yo dieting-does not appear to increase their risk for getting cancer.
In a 10 year study of over 96,000 men and women, who lost more than 10 pounds only to regain that weight, Dr. Victoria Stevens and co-researchers from the American Cancer Society found that yo-yo dieting did not increase the risk of getting cancer. The yo-yo dieting study was reported in the July issue of the American Journal of Epidemiology.
The study looked at the following 12 cancers:
BREAST COLON ESOPHAGUS KIDNEY
LIVER LUNG MELANOMA NON-HODGKIN’S LUMPHOMA
PANCREAS PROSTATE RECTUM STOMACH
Of note, the effect of yo-yo dieting on the risk of breast cancer was not reported. Dr. Stevens noted that BMI or body mass index may have clouded a study reported in 2005 that found a link between the risk of breast cancer and yo-yo dieting.
SO WHAT DO I RECOMMEND?
The whole lifestyle approach is key-smart food choices and daily exercise. I like the hybrid approach between the Mediterranean diet and the DASH diet-Dietary Approaches to Stop Hypertension. And one glass of wine is allowed each day!
The key points of the diet is eating at least 3 servings of whole grains, a green leafy vegetable and one other vegetable each day. Snack on nuts most days, have a serving of beans every other day, and eat poultry and berries at least 2 times per week, with fish once per week.
The hard part is avoiding the 5 unhealthy groups-red meat, butter and stick margarine, cheese, pastries and sweets, along with fried and fast foods.
Stay healthy Dayton! If you have any questions, call me Dr. Hughes at 855 DAYTON1.