As I head into the new year I've decided to take the advice I have often shared with people when life becomes a little too hectic.  This past fall, I accepted a full-time position as a news anchor in the Washington, D.C. area which is taking up much of the time I had previously devoted to writing for this blog.  In this case, simplification means taking a break from blogging.  Thank you for reading my posts and I hope you will stay connected with me on Twitter and watch me on the morning news 5 a.m. to 9 a.m. Monday through Friday on NewsChannel 8 (www.news8.net).  Have a happy and healthy new year!!!

Marriage and Cancer Survival

  It's no secret that tying the knot can have a positive effect on health.  Couples who have happy marital unions have been found to have better mental and physical health than their single counterparts.  Now a new study explores the possible impact of marriage on cancer survival.
 (USA TODAY)  Scientists say they may have found the key to surviving cancer: marriage.  Married people with cancer were 20% less likely to die from their disease, compared to people who are separated, divorced, widowed or never married, according to study published online Monday in the Journal of Clinical Oncology.
Married people in the study fared better than singles no matter what type of cancer. In certain types of tumors — prostate, breast, colorectal, esophageal and head/neck cancers — the survival benefits of marriage were larger than those from chemotherapy.
"Improving social support for our patients may be equally important as providing effective therapy, and it is less costly to develop and implement," said senior author Paul Nguyen, a radiation oncologist at Dana-Farber Cancer Institute and Brigham and Women's Hospital in Boston, in a statement.
The real secret to survival may be "social support," rather than a wedding ring, said first author Ayal Aizer, chief resident of the Harvard Radiation Oncology Program in Boston, in a statement.
Spouses provide many practical services, nursing their partners through therapy, driving them to the hospital, helping with medications and making sure that patients eat well.
This kind of help can allow patients to complete recommended therapy, rather than skip treatments or drop out early, Aizer said.
Other studies have shown that married people are more likely than singles to stick with a treatment plan, even when that therapy is physically punishing or requires frequent trips to the hospital.
Belonging to a close family boosts the odds that a patient will stick with treatment by 70%, according to an accompanying editorial written by David Kissane, of Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College in New York.
Spouses also provide affection and moral support, which can be critical during cancer therapy.
Earlier research also has shown that married patients "display less distress, depression and anxiety than their unmarried counterparts," the study says. While stress can take a toll on the body, depression also can prevent patients from getting out the door to the doctor.
Other studies have found that depressed patients with cancer are up to 39% more likely to die than others, Kissane writes.
Of course, researchers couldn't actually test marriage vs. chemo in a head-to-head trial.
While marriage was associated with a better prognosis, a study like this — in which authors examined the records of 734,889 Americans diagnosed with cancer from 2004 to 2008 — can't definitively prove that being married allowed patients to survive. To truly prove cause and effect, researchers would have had to randomly assign people to be married or single.
It's possible, authors say, that married people were more likely to survive because they have lower rates of smoking and heavy drinking, a finding shown in previous studies.
But marriage also may allow people to take better care of themselves, the study suggests.
Among patients with cancer, married people were 17% more likely than singles to be diagnosed at an earlier stage, when cancer is more curable, according to an analysis of a National Cancer Institute database of 734,889 Americans. It's possible, doctors say, that spouses encourage their partners to see a doctor at the first sign of a problem, rather than wait until it gets worse.
Married folks were also 50% more likely to get the "definitive" treatment, or therapy most likely to result in a cure.

Chocolate Appears to Improve Brain Health

  If you love chocolate, you'll likely love this story.  Researchers say chocolate isn't only pleasing to the taste buds, it's also good for the brain.  Although the study applies to older Americans, the findings could be reason enough for chocoholics of all ages to feel a little less guilty the next time they indulge in their favorite treat.
(Los Angeles Times)  
 In a study published Wednesday in the journal Neurology, researchers reported that chocolate may help improve brain health and thinking skills in the elderly. The Boston-based team found that older people who initially performed poorly on a memory and reasoning test and also had reduced blood flow to their brains showed improvement after drinking two cups of cocoa every day for a month.  The researchers had set out to test whether chocolate could increase blood flow to the brain during problem solving, boosting performance, after finding in earlier studies that consuming chocolate high in the antioxidant flavanol was associated with better brain and blood vessel functioning. They recruited 60 elderly subjects for the new study. Since they suspected that flavanol would improve the subjects’ thinking skills and blood flow, they randomly assigned subjects to drink either flavanol-rich or flavanol-poor hot chocolate.
  The participants drank two cups of hot chocolate every day for 30 days.  Before and after the study period, they completed a memory and reasoning test, which assessed their ability to recognize patterns in a series of letters on a computer screen. Additionally, the researchers used ultrasound to indirectly measure the blood flow to subjects’ brains, as well as magnetic resonance imaging, or MRI,  to examine subjects’ white matter — the nerve fibers that connect different parts of the brain.
People who performed poorly on the initial cognitive test — about a third of the participants — also had reduced blood flow to their brains and widespread white matter damage. Those who scored high on the test had signficantly better blood flow and more intact white matter, indicating that blood flow, cognitive functioning and brain structure were linked.
  At the end of the 30 days, the team found that drinking hot chocolate benefited only the subjects who had poor cognitive and neurovascular function to begin with.  After the hot cocoa regimen, those individuals showed an 8% improvement in blood flow and a roughly 1 minute faster reaction time on the cognitive task. There was barely any improvement among those who had started out with normal blood flow and cognitive skills.
To the scientists’ surprise, there weren’t significant differences in the neurovascular or cognitive changes between the flavanol-rich and flavanol-poor groups — suggesting that something else in the chocolate was causing the improvements. The researchers plan to identify and test this component in future trials, said study leader Dr.  Farzaneh A. Sorond, a neurologist at Brigham and Women’s Hospital in Boston.  After identifying the substance, the researchers may even be able to produce it in pill form, said Dr. Costantino Iadecola, a neurologist at Weill Cornell Medical College in New York City, who was not involved in the study.
 Although the study results may tempt some to add chocolate to their diet,  Sorond noted that the participants’ food intake was strictly regulated to offset the excess fat and sugar in hot chocolate. For people seeking to keep their brains healthy, she recommends an intervention already known to improve cognitive function: exercise.

Americans Living Longer, Not Necessarily Healthier

 

  There's positive news to report in the area of life expectancy for Americans.  The good news is that we're living longer.  Today the average life expectancy in the U.S. stands at 78 years.  That's an increase of three years since 1990. 
  What's troubling is that although our lives are being extended, many older Americans are not spending their golden years in good health.
Wall Street Journal
  Americans are living longer than they did two decades ago, a new study shows, but they are losing ground in key measures of health status to counterparts in other developed nations around the globe.
The findings, from the most comprehensive analysis of the health of the U.S. population in more than 15 years, show progress in reducing death rates, adjusted for age, across a variety of diseases. But death rates from illnesses associated with obesity, such as diabetes and kidney disease, as well as neurological conditions like Alzheimer's disease, are on the rise.
Meanwhile, the number of years of living with chronic disability, an indicator of quality of life, rose for the average American in the past 20 years, partly reflecting increased longevity.
Despite gains in longevity, Americans are living the extra years "not necessarily in good health," said the researchers, led by Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.
The study was published Wednesday by JAMA, the Journal of the American Medical Association. Dr. Murray also presented the results, along with separate reports on physical activity and obesity in counties across the U.S., at a White House event hosted by first lady Michelle Obama as part of her campaign against childhood obesity.
Dr. Murray said the U.S. has also made important headway against such problems as strokes; certain cancers, including colon and breast cancers; and HIV, the virus that causes AIDS. "It's important to recognize that there are some areas where we do well," he said.

  Michael Roizen, chief wellness officer at the Cleveland Clinic in Ohio, said much of the problem could be addressed by better diet, smaller food portions, increased physical activity, quitting smoking and better management of stress. "They are things we totally have control over," he said."It's a matter of us getting serious about this."

  The analysis was based on data for 291 diseases and 67 risk factors for disease, as well as a variety of government-sponsored health surveys. It included data from 187 countries, making it one of the most ambitious efforts undertaken to assess the disease burden not only in the U.S. but around the world.
  In the U.S., life expectancy rose three years to 78.2 years in 2010 from 75.2 in 1990, researchers found. But the nation's ranking among OECD countries fell to 27th from 20th 20 years earlier.

Moreover, people were in good health, or without short- or long-term disabilities, for just 68.1 of those years on average, the report found. The gap of 10.1 years between total life span and a healthy life span rose from 9.4 years in 1990, and the U.S. ranking for a healthy life span fell to 26th from 14th two decades ago.

  Despite progress on cardiovascular disease and some cancers, the lead causes of premature death in the U.S. remained heart disease, lung cancer and strokes. Leading contributors to disability were lower-back pain and other disorders of muscles, nerves and joints, as well as depression and anxiety.
Researchers also found that poor dietary habits have overtaken smoking as the most important risk factor associated with years of life lost to disability and to premature death.
  Findings from the county studies presented at the White House show a substantial increase in physical activity, including in Kentucky, a state that traditionally has trailed in healthy living habits. But over 20 years, he said, not one county in the U.S. reduced the burden of obesity among its residents.

Extended Concussion Recovery for Younger Athletes

  Any parent who has a child involved in sports should take note of this latest research.  The study finds younger athletes may need more time to recover from concussions. 
(Reuters Health) - Young people may take longer to recover after their second or third concussion, a new study suggests.
Researchers typically believe the average athlete needs up to two weeks to stop having symptoms - such as headaches and memory problems - after a concussion.
But in the new study, children and young adults who had just suffered their second concussion in the last year took an average of 35 days to get back to normal.
"We have to be cautious in terms of after two weeks, if you still have symptomatic athletes, that you're not trying to hurry them back," said Dr. Paul Comper, a concussion researcher from the University of Toronto.
"The most important piece of information that comes out of this study is, if you've had prior concussions, the 10- to 14-day (recovery) thing may be completely out the window," Comper, who wasn't involved in the new study, told Reuters Health.
"For you, it might be a month."
He said the findings aren't totally surprising - it's clear that multiple head injuries are a bad thing - but they give doctors more information to pass on to their young patients after a concussion.
Studies have been piling up showing the potential harms of concussions among kids.
And the apparent suicides of Junior Seau and other professional football and hockey players, some of whose brains showed damage from multiple head injuries, have raised concerns about depression tied to repeat concussions.
The new study included 280 youth, age 11 to 22, who came to the emergency room within a few days of having a concussion. About two-thirds of them were injured playing sports, most commonly hockey, soccer, football and basketball.
After going home, kids filled out up to six questionnaires about their symptoms over the next 12 weeks, and reported the last day they had any concussion-related problems.
Of the 235 kids who completed the study, 68 had a history of concussion.
On average, participants who had never had a concussion before took 12 days to recover from their head injury. That compared to 24 days among those with at least one past concussion, and 35 days if that prior concussion had been within the last year, the study team reported Monday in Pediatrics.
That finding, the lead author said, gives parents and doctors "even more reason for caution" when deciding how long a child should be kept out of sports or school after a head injury.
"Even after symptoms have improved and even after these neuropsychological tests have returned to normal, there's still a vulnerability that can lead to a much more severe second concussion," Dr. Matthew Eisenberg, from Boston Children's Hospital, told Reuters Health.
The researchers said one limitation to their study was that they relied on kids to report when their symptoms were gone - and some may have had incentives to say they were better to return to sports, or to say they weren't to stay home from school.
Eisenberg said the next goal is to look for something on a blood test, urine test or brain scan that will tell doctors when a child is truly back to normal.
There's also a need for follow-up research on kids with concussions, he said, because what parents want to know most is whether their child will have any lingering issues years down the line.
"The big question that still needs to be answered is, what are the long-term effects of these concussions?"
SOURCE: bit.ly/cxXOG Pediatrics, online June 10, 2013.

Pesticides and Parkinson's

  A few weeks ago I sat down with the Chief Executive Officer of the Parkinson’s Action Network (PAN) in Washington, D.C. 
  As we prepped for our five minute television interview we discussed the risk factors associated with Parkinson's disease including the connection to pesticides. 
  One study found people who simply live near farm fields that have been sprayed with  pesticides have a 75-percent increased risk of developing Parkinson's. 
  Now  a just-released study offers even more insight into the potential dangers of pesticide exposure.

  (Reuters Health) - Exposure to pesticides and other chemicals is linked to an increased risk of developing Parkinson's disease, according to a fresh look at some past research.
Dr. James Bower, a neurologist from the Mayo Clinic in Rochester, Minnesota, said the finding is consistent with previous research but the study still can't prove that pesticides cause people to develop the neurological condition.
"We're definitely learning that Parkinson's disease is not caused by one thing. We're finding a lot of risks for Parkinson's and pesticides are just one of many," said Bower, who wasn't involved with the new study.
In 2011, a study of U.S. farm workers from National Institutes of Health found some pesticides that are known to interfere with cell function were linked to the development of Parkinson's disease.
Another study that was published in 2012 also reported that people with Parkinson's disease were more likely to report exposure to pesticides, compared to people without the condition.
The disease affects about 500,000 Americans.
For the new study, Dr. Emanuele Cereda, of the IRCCS University Hospital San Matteo Foundation in Pavia, Italy, and his coauthor pulled data from 104 studies that were published between 1975 and 2011 and examined the link between pesticides and Parkinson's disease.
Overall, they found exposure to pesticides was tied to a 58 percent increased risk of developing the disease.
That increase, according to Bower, would be equivalent to 10 more Parkinson's cases among every 1,000 40-year-old residents living in Olmstead County, Minnesota.
Currently, Bower said about 17 of every 1,000 40-year-old Olmstead County residents will go on to develop Parkinson's disease.
The new study's researchers also found that certain pesticides - such as the plant killer paraquat and fungus killers maneb and mancozeb - were tied to a doubling of Parkinson's disease risk.
Bower said these findings are more applicable to farm workers who regularly use pesticides - not necessarily people who use weed killers around their homes.
SOURCE: bit.ly/Zc2z2q Neurology, May 28, 2013.

Brisk Walking as Beneficial for Heart as Running

  I've always admired people who can run for miles without the slightest ache or pain.  Although I enjoy running immensely I've had to surrender to the fact that my body doesn't feel the same way.  Like many other Americans, I now turn to more knee-preserving activities like cycling, swimming and brisk walking for cardiovascular exercise. 
  If you're a former runner who's had to reluctantly switch to walking, be encouraged!  New research indicates that brisk walking can be as good for your ticker as running. 
From Science World Report
  In order to maintain good physical and mental health, many people consider running. It is considered good for the heart as it strengthens the heart, and also lowers the actual resting heart rate. But a latest finding asserts that brisk walking is as good for your heart as running.
The study, published in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology, states that brisk walking can reduce the risk of high blood pressure, high cholesterol and diabetes as much as running does.
For the current study, researchers focused on two groups, runners and walkers. They analyzed 33,060 runners who were part of the National Runners' Health Study and 15,045 walkers who were part of the National Walkers' Health Study. The participants belonged to the age group of 18-80 years. Of them, 21 percent men were walkers and 51 percent were runners.
Previous studies have based their evaluations on time but this study assessed walking and running expenditure by distance. Apart from this, the participants were asked to fill in a questionnaire that collected their activity data.
"Walking and running provide an ideal test of the health benefits of moderate-intensity walking and vigorous-intensity running because they involve the same muscle groups and the same activities performed at different intensities," Paul T. Williams, Ph.D., the study's principal author and staff scientist at Lawrence Berkeley National Laboratory, Life Science Division in Berkeley, Calif., said in a press statement.
The researchers noticed that an equal amount of energy used in moderate intensity walking and vigorous intensity running resulted in a similar reduction in the risk for high cholesterol, diabetes and high blood pressure.
Williams continued to say that, greater the distance the runners ran and walkers walked, the more they gained health benefits. The health benefits were comparable only if both the groups burned the same amount of energy.
The risk for first-time hypertension was reduced by 4.2 percent in runners and 7.3 percent in walkers. Apart from this, running lowered first-time cholesterol by 4.3 percent and walking by 7 percent. The first-time diabetes in runners dropped to 12.1 percent, and in walkers it dropped to 12.3 percent. Coronary heart disease dropped 4.5 percent by running and 9.3 percent by walking.
"Walking may be a more sustainable activity for some people when compared to running, however, those who choose running end up exercising twice as much as those that choose walking. This is probably because they can do twice as much in an hour," Williams said.

Breast Radiation and the Heart

 

Undergoing breast cancer treatment can be a harrowing experience.  Some women who face radiation therapy worry about short and long term side effects like nausea, fatigue, skin problems or changes to the heart and lungs.  Now a new study provides more information about how radiation treatment can influence a woman's chances of developing heart disease.
From The New York Times

  Radiation treatment for breast cancer can increase a woman’s risk of heart disease, doctors have long known. But the size of the added risk has not been clear.

Now, a new study offers a way to estimate the risk. It finds that for most women the risk is modest, and that it is outweighed by the benefit from the treatment, which can halve the recurrence rate and lower the death rate from breast cancer by about one-sixth.

According to the study, a 50-year-old woman with no cardiovascular risk factors has a 1.9 percent chance of dying of heart disease before she turns 80. Radiation treatment for breast cancer would increase that risk to between 2.4 percent and 3.4 percent, depending on how much radiation hits the heart.

“It would be a real tragedy if this put women off having radiotherapy for breast cancer,” said Sarah Darby, a professor of medical statistics at the University of Oxford in Britain, and the lead author of the study, published Wednesday in The New England Journal of Medicine.

   Dr. Darby’s study is based on the records of 2,168 women who had radiation for breast cancer from 1958 to 2001 in Sweden and Denmark; 963 of the women had “major cardiac events” sometime after their cancer treatment, meaning a heart attack or clogged coronary arteries that needed treatment or caused death.

From the treatment records, the researchers estimated the radiation dose to the women’s hearts. They found that the risk began to increase within a few years after exposure, and that it continued for at least 20 years. The higher the dose, the higher the risk, and there was some increase in risk at even the lowest level of exposure.

“It was certainly a surprise to us that the risk started within the first few years after exposure, as radiation-related heart disease has traditionally been thought of as usually occurring several decades after exposure,” Dr. Darby said.

  To read more about the study click here:  http://www.nejm.org/doi/full/10.1056/NEJMoa1209825

Millennial Stress

 The economic downturn has left many Americans feeling financially strained, stressed out and depressed.  Who's suffering the most?  New research indicates  twenty somethings are experiencing more stress than you might realize.
From HealthDay News 
  Young Americans between 18 and 33 years old -- the so-called millennials -- are more stressed than the rest of the population, according to a new report from the American Psychological Association.  What's stressing them out? Jobs and money mostly, said Norman Anderson, CEO of the American Psychological Association, during a Thursday morning press conference.
On a scale of 1 to 10, the millennial generation stands at 5.4 stress-wise, significantly higher than the national average of 4.9, the association found after surveying more than 2,000 Americans.
"Clearly there are a number of pressures facing young people that might account for this increase in stress," Anderson said. "These individuals are growing up in an era of unprecedented economic upheaval. This coincides with the time they are finishing school and trying to establish themselves in society."
Getting a job, starting a family and repaying student loans are all stressful, he added. "They have great difficulty finding jobs because of the higher unemployment and underemployment rates," Anderson said.
These young adults also don't feel they're getting support from the health system. Only 25 percent of millennials give the health care system an A grade, compared with 32 percent of the rest of the population, according to the report, Stress in America: Missing the Health Care Connection.
In addition, 49 percent said they aren't managing their stress well, and only 23 percent think their doctor helps them make healthy lifestyle and behavior changes "a lot or a great deal." Only 17 percent think their doctor helps them manage their stress.
"When people receive professional help to manage stress and make healthy behavior changes, they do better at achieving their health goals," Anderson said.