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Prostate Screening – to Screen or not Screen?

All Cancers aren’t created equal.  In fact, there has been discussion about changing the wording for “cancers” that aren’t as terminal or agressive as other cancers.  This NY Times article talks about how scary using the word cancer can be – especially in patients diagnoses with breast or prostate “cancers”.  

The pathologist Donald Gleason, who invented Gleason scoring for prostate tumors, wanted to rename a very common tumor — the so-called Gleason 3 + 3 — “adenosis” instead of cancer, Dr. Brawley said. His idea was that by calling a 3 + 3 “cancer,” men and their doctors would feel they had to get rid of it right away. 
Despite Dr. Gleason’s wishes, 3 + 3 cells are still called cancer.
And despite the panel’s advice about D.C.I.S., that name has not changed either. 
Cervical cancer specialists had better luck. In 1988, they changed the name of a sort of Stage 0 of the cervix. It had been called cervical carcinoma in situ. They renamed it cervical intraepithelial neoplasia, Grades 1 to 3, taking away the cancer connotation.

In this article, Four Reasons I won’t have a Prostate Cancer Blood Test, by consultant oncologist Ian Haines talks about the overmedication, surgery, and unnecesary treatments for “cancers” that aren’t fatal.  

While some prostate cancers are harmful and require treatment, many are not. So the prevailing wisdom – that early detection and treatment is best – doesn’t necessarily apply. At least 70% of men over 70 have prostate cancer detected in autopsies, and only 3% of men die because of prostate cancer.

He states that the PSA is a poor testing tool.  He states that a positive PSA only means 1 in 4 men actually have prostate cancer.  That means, 3 out of 4 men were told they have elevated PSA and prostate cancer.  

PSA tests also miss many cancers. A 2003 study found that 21% of men who had a “normal” PSA of 2.6 to 3.9 at the end of a seven-year study did, in fact, have prostate cancer. Of the men with a PSA of 2.5 or less, 15% had cancer.

So what happens to those 3 out of 4 men who are being treated for “cancer” due to an elevated PSA?  Dr. Haines days that detection and treatment comes with side effects:

One in six men will be diagnosed with prostate cancer during his lifetime. Their lives will be profoundly changed by this cancer diagnosis, whether or not they proceed with treatment.
I do not want the anxiety, depression and relationship changes that follow diagnosis, radical surgery, active surveillance or any regular monitoring.
I do not want to be impotent, which is very likely after radical treatment, or have urinary incontinence.
Even before treatment commences, after an abnormal PSA result, men are referred for a prostate biopsy: a surgical procedure that, even though it can indicate cancer, cannot give reliable information about how that cancer will behave.
I do not want the 1-2% risk of life-threatening infectionscaused by prostate biopsies.

I am a big fan of monitoring, testing, and preventing cancer – I advocate strongly for a complete approach to such things.  I would suggest continuing prostate screening with the caveat that abnormal results be treated and monitoed without being misaligned an unnecessary cancer diagnosis.  

Cleveland Clinic reports on Acupuncture Myths!

The Cleveland Clinic published a wonderful piece about the myths associated with acupuncture.  It is fantastic to see “mainstream” medicine giving a much deserved nod to the community of alternative medicines.

Traditionally, Chinese Medicine and Acupuncture are not considered “alternative” care – it’s conjunctive care.  Our clinic practices an Integrative approach to medicine, utilizing the compliment of care available.

What myths did you believe before you tried acupuncture?

 

 

Needles? Ouch! And 9 Other Acupuncture Myths

Test your knowledge about this ancient medical art

By  | 4/17/14 10:01 a.m.

There are a lot of misconceptions about acupuncture, but the truth is that this practice has been around for more than 3,500 years and provides relief to people around the world.

Below, find ten of the most common myths about acupuncture:

Myth 1: Acupuncture hurts — after all, we’re talking needles

Fact: Although we use needles, they are very slender and fine (about the size of a cat whisker). You may or may not feel an initial prick, sometimes described as a mosquito bite. Any discomfort will either fade on its own or ease up as your acupuncturist adjusts the needles. You should experience a Qi (pronounced “chee”) sensation, often described as heaviness, throbbing or an electrical sensation. That’s your body’s healing energy doing its work

Myth 2: Acupuncture is ancient folk medicine; no legitimate healthcare professional would recommend it

Fact: Acupuncture is a treatment option that many medical institutions recommend. Even the United States military uses acupuncture. The National Institutes of Health (NIH) funds many clinical research trials on acupuncture. Both the NIH and the World Health Organization (WHO) recognize acupuncture as a valid treatment for a wide range of conditions.

Myth 3: Most people who use, or practice, acupuncture are into ‘New Age’ healing

Fact: On the contrary, you probably have a friend, coworker or neighbor who receives acupuncturetreatments.

Myth 4: Acupuncture may conflict with medication, physical therapy and other ‘mainstream’ conventional medical treatments

Fact: There is no conflict between acupuncture and conventional medicine; they complement one another. Acupuncture works nicely as an adjunct to your conventional treatment plan.

Myth 5: Acupuncture is only useful in treating pain

Fact: It’s true that acupuncture helps relieve joint pain, including knee pain; back pain; headache; stomach pain and menstrual cramps. However, acupuncture is also used to treat nausea/vomiting, chemotherapy side effects, morning sickness, hypertension (high blood pressure), allergies, depression, infertility and other conditions.

Myth 6: Acupuncture has a lot of side effects and you’ll need time off work

Fact: Acupuncture has few to no side effects. After your acupuncture session, you can usually carry on with your day without any restrictions.

Myth 7: Acupuncture’s effects are psychological. It doesn’t really do anything

Fact:  Acupuncture and its effects are far from psychological. Studies show that during acupuncture, our brains begin to release chemicals such as endorphins (natural painkillers) Acupuncture also has an anti-inflammatory effect and helps people’s immune system.

Myth 8: Once you start acupuncture, you’ll always need acupuncture

Fact: For most conditions, acupuncturists strive to improve your main problem so you do not have to return for more treatment. For chronic conditions, some people stay on a maintenance schedule, however, such as returning once a month, because acupuncture continues to help.

Myth 9: If you do not see results in one or two treatments, then you’re unlikely to benefit from acupuncture

Fact: The response to acupuncture is always an individual one. Some people respond quickly — within one, two or three treatments. Others need a full course of eight to 10 treatments. Acupuncture’s effects are cumulative, building with each treatment, so the acupuncturist will assess its effects after you complete a full series of treatments. Acupuncturists use a variety of styles and techniques, so if you do not see results with one clinician, seek out another acupuncturist.

Myth 10: You’ll need a doctor’s referral or a prescription for acupuncture

Fact: Guidelines vary by state. In the state of Ohio, you do not need a doctor’s referral or prescription for acupuncture but a physician should perform a diagnostic exam  for the condition you plan to treat. It is important you seek out a qualified and medically licensed acupuncturist before starting any course of treatment.

Top Tips for Cardiac Health

The CDC lists the No. 1 killer of men in America as heart disease.  Statistics show that 1 in 4 men over 40 will suffer from a cardiac event at some point in their life.  Knowing how to prevent heart disease is just as important as knowing the signs of a cardiac event.

 

Prevention, It’s the Best Medicine

 

1. Screen Shot 2014-06-23 at 2.04.24 PMRoutine Exams. Work with your physician to monitor your cholesterol, your blood pressure, and your inflammatory markers.  I recommend working with Laboratory companies like Atherotech to check lipids.  Basic lipid panels (BLPs) are inaccurate and inadequate at assessing residual risk in all patient

  • 50% of patients hospitalized with coronary artery disease had “normal” cholesterol according to traditional lipid panels
  • Patients with diabetes are at increased risk for MI, stroke, amputation, and death
  • Diabetes causes metabolic abnormalities that induce vascular dysfunction, which predisposes this population to atherosclerosis
2. apple-18721_640-199x300.jpgDiet.  A heart healthy diet is something that we’ve been chasing for decades within our country.  The truth in the research is that the best food is real, unprocessed, and natural.  Eating grassed, organic meats, seasonal vegetables, and local fruits will keep your body healthy and balanced.  The inflammation that comes from processed foods directly impacts coronary health
Check out the following resources:
3. new-years-resolution-1_l.jpgExercise.  We all know we need to exercise more.  Changing little habits to make our sedentary lives more active will have a profound effect on your cardiac health.  Try to incorporate 3-4 hours a week of walking, jogging, biking, and weight training into your routine.  Walking for 15 minutes every lunch break will easily chip away at that goal of 4 hours of added exercise a week.

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4.Stop Smoking.  This isn’t a novel idea but is certainly one that many American’s are still battling.  Working with an acupuncturist, a counsellor, or your primary care provider may give you the extra edge to help you finally put down the cigarettes for good.
stress-06092014-282x300.jpg5. De-Stress.
Certainly activities like tai chia, yoga, and meditation work towards bringing our stress levels down.  However, simply reading a book listening to music, exercising, or walking your dog can all be wonderful ways to de-stress.  Check out this article on ways to reduce your stress.
6. Sleep. sleepy-owl.jpgQuality sleep goes a long way in disease prevention and rehabilitation.  Shooting for 8 uninterrupted hours of sleep is great goal though there isn’t a magic number for everyone.  Sleep requirements vary based on age, disease, stress, and activity levels.  Paying attention to your body and having good sleep habits are important in health and wellness.

The Definitive Guide to Chronic Fatigue and Alternative Treatments

sleepy-owlChronic fatigue syndrome (CFS) is a mysterious condition. There is no known cause. While the symptoms can be debilitating, there is no test to diagnosis it. Women are twice as likely as men to be diagnosed with CFS. And most sufferers are between 25 and 45 years old, although there are cases in childhood and middle age.

Some people with CFS live active lives while 25% of the cases are disabled. Sometimes the disease is persistent and other times there is a pattern of relapse and remission. No one knows how many cases there are of CFS because The CFIDS Association of America estimates that fewer than 20 percent of CFS patients in the United States have been properly diagnosed.

CFS has several names. It is called Myalgic Encephalomyelitis (ME), chronic fatigue and chronic fatigue immune dysfunction syndrome (CFIDS).  No matter what it is called, the most effective way to manage chronic fatigue is with alternative treatments. continue reading »

Chronic Pain? Let's talk.

I seriously have patients ask me, an acupuncturist, if acupuncture works.  

My head screams “8 years of schooling, student loans, tons of continuing eduction, a life’s work…. what do you think?!”.  I realize, however, what they’re really asking is “Would acupuncture work for me?“.  

I also, very often, hear “I tried acupuncture and it didn’t work.  I only felt better for a few days/weeks/months before the pain returned”.  

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Let me touch on the second point, duration of relief, and then return to efficacy.

It is insane for me to hear a patient complain about an improvement that lasts longer then 4-6 hours.  The typical long-term use of muscle relaxers, narcotics, pain relievers, and anti-inflammatories cannot provide relief longer than 12 hours.  If a treatment, acupuncture included, brings benefits that last longer than the VERY transient effects of the pharmaceutical industry we should mark that down as a success.

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In my experience the duration of relief is completely individualized.  There are a number of variables that play into the successes of the treatment.

1. Patient Compliance – are they following instructions on icing/heating, stretching, changes in posture, activity, lifestyle modifications

2. Timeline of Injury – how long has the patient been in pain?

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In chronic pain it will often take some time to change the body’s perception of pain, response to injury, posture, structural alignment, etc.

Pain is so individualized.  It is a multidimensional stimuli that is hard to even quantify.

In a study conducted on pain perception, Psychologic Aspects of Pain perception, researcher Mcgrath says “The perception of, expression of, and reaction to pain are influenced by genetic, developmental, familial, psychological, social and cultural variables. Psychological factors, such as the situational and emotional factors that exist when we experience pain, can profoundly alter the strength of these perceptions.” 









More and more research is being conducted on acupuncture’s efficacy in pain management.  We are finding that complimentary and alternative approaches to pain can be very effective.  If this is true, why are patient’s still preferring a pharmaceutical solution to their pain? 

Leave your answers in the comments section!

 

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In the News: Acupuncture for Chronic Pain

A recent NCCAM-funded study, employing individual patient data meta-analyses published in the Archives of Internal Medicine, provides the most rigorous evidence to date that acupuncture may be helpful for chronic pain. In addition, results from the study provide robust evidence that the effects of acupuncture on pain are attributable to two components. The larger component includes factors such as the patient’s belief that treatment will be effective, as well as placebo and other context effects. A smaller acupuncture-specific component involves such issues as the locations of specific needling points or depth of needling.

Although millions of Americans use acupuncture each year, often for chronic pain, there has been considerable controversy surrounding its value as a therapy and whether it is anything more than an elaborate placebo. Research exploring a number of possible mechanisms for acupuncture’s pain-relieving effects is ongoing.

Reference

  • Vickers AJ, Cronin AM, Maschino A, et al. Acupuncture for chronic pain: a meta-analysis. Archives of Internal Medicine. 2012.

Water. Make it Happen

Our bodies are 60% water.  It amazes me when I have to remind people to drink more water.  Then again, it amazes me when I reflect on my day and realize I need to drink more water.  Hyper-hydrating, or carrying around a gallon jug with you, isn’t necessary to get proper hydration.  The 8 glasses of water adage isn’t a bad one, but not necessarily based in any real science.  Drinking according to what your body is telling you is a much better indicator.  

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Signs you need to be drinking more water

1. Dark Urine or lack of urine – urine should be no darker than a pale yellow

2. Dizziness

3. Hunger

4. Sluggishness

5. Inability to sweat

6. Confusion

7. Headaches

8. Palpitations 

9. Pain – especially in the low back

10. Fainting

Very often the water you are drinking with your medications helps your symptoms faster than the pill itself.  Drinking a big glass of water with your Tylenol might be doing more to offset that stress headache than you realize.

  • Muscle consists of 75% water
  • Brain consists of 90% of water
  • Bone consists of 22% of water
  • Blood consists of 83% water


Benefits of Drinking Water

1. You need it to live.  This goes without saying.  Need more convincing?

2.  Stressed?  You can control, your stress hormones, by staying properly hydrated. 

3.  Kidney troubles?  Creatinine and arginine vasopressin, markers of kidney function, are dramatically improved with increased water consumption.  If you tend towards kidney stones you need to keep the intake up!  

4. According to The Complete Guide to Sports Nutrition you can Gain a 30% improvement in Athletic Performance

5. Bad mood?  The USDA has shown that hydrating can improve memory and attitude.

 

Fun Fact: 20% of water come from our food.  Eat your vegetables!

 

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The Institute of Medicine determined that an adequate intake (AI) for men is roughly 3 liters (about 13 cups) of total beverages a day. The AI for women is 2.2 liters (about 9 cups) of total beverages a day.

Here’s a good PDF recommending water consumption.

 

Benefits of Drinking Water

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