Alcohol Does a Body Good? Study Finds It Boosts Bone Health

2012-07-23

Just as the go-to drink for bone health — milk — has come under attack by New York Times’ food columnist Mark Bittman for not living up to its healthful reputation, a new study suggests an even more controversial beverage as an alternative: alcohol.

Previous research has linked moderate drinking with improved bone density — women who drink moderately have higher bone density than non-drinkers or heavy drinkers — but such observational studies connecting people’s dietary or drinking patterns to health effects have not been able to determine cause and effect. It’s possible, for example, that people who are healthier to begin with are more likely to drink moderately, rather than the other way around. However, experiments in animals that have been designed to show cause and effect have found that moderate doses of alcohol are indeed good for the bones.

Continue reading Alcohol Does a Body Good? Study Finds It Boosts Bone Health →

Lack of Exercise as Deadly as Smoking

2012-07-20

When it comes to being couch potatoes, Americans aren’t alone. Physical inactivity has become a global pandemic, say researchers in a series of related papers published in the journal Lancet. According to one of the reports, lack of exercise causes as many as 1 in 10 premature deaths around the world each year — roughly as many as smoking.

About 5.3 million of the 57 million deaths worldwide in 2008 could be attributed to inactivity, the new report estimates, largely due to four major diseases: heart disease, Type 2 diabetes, breast cancer and colon cancer. The study finds that if physical inactivity could be reduced by just 10%, it could avert some 533,000 deaths a year; if reduced by 25%, 1.3 million deaths could be prevented. Say we got everyone off the couch and eliminated inactivity altogether: the life expectancy of the world’s population would rise by about 0.68 years (more, if you discount those who were already active), comparable to the effect of doing away with smoking or obesity.

For the study, led by I-Min Lee in the division of preventive medicine at Brigham and Women’s Hospital, scientists calculated something called a population attributable fraction (PAF), a measure of the contribution of risk factors like physical inactivity to diseases such as heart disease or diabetes, and even risk of death. The PAF told researchers how many cases of disease could theoretically be prevented if the risk factor were eliminated — that is, if all inactive people in a population were to start exercising sufficiently.

(MORE: Get Up! Sitting Less Can Add Years to Your Life)

Lee and his colleagues collected data on physical inactivity and outcomes of the four major diseases — heart disease, Type 2 diabetes, breast cancer and colon cancer — as well as rates for death from all causes. They then calculated PAFs for 123 countries. Overall, the estimates suggest that lack of exercise causes about 6% of heart disease, 7% of Type 2 diabetes, and 10% of breast and colon cancers worldwide.

Exercise has long been known to can lower risk factors like high blood pressure, high blood sugar and high cholesterol, which in turn reduces the risk of heart disease and diabetes. Physical activity also keeps heart vessels healthy and inhibits the formation of atherosclerotic plaques that can cause blood clots.

As for breast cancer, exercise may protect women by reducing fat — particularly dangerous belly fat, whose metabolic activity may trigger tumor growth in breast tissue. Colon cancer may work differently: researchers believe that exercise helps keep digestion regular and prevents potentially cancer-causing waste from encouraging abnormal growths in the colon.

(MORE: Q&A: How a Little Exercise Brings Big Benefits)

Current guidelines recommend that people get about 150 minutes of moderate exercise a week — a half-hour of brisk walking five times a week would do it. But in another Lancet paper published in the series, Pedro Hallal of the Federal University of Pelotas, in Brazil, and his colleagues found that 31% of adults worldwide (1.5 billion people) and 4 out of 5 teens aren’t exercising enough to meet that standard and therefore putting themselves at risk for chronic disease.

The researchers analyzed self-reports of exercise among adults in 122 countries, representing 89% of the world’s population, and among teens in 105 countries. Rates of physical inactivity were higher in high-income countries than in low-income nations. The Americas were overall the most sedentary region — with 43% of the population not exercising enough — while rates of inactivity were lowest in southeast Asia (17%).

One key reason is that we rely too much on modern conveniences like cars to get around. In the U.S., for example, fewer than 4% of people walk to work and fewer than 2% bike to commute; compare that to about 20% of people who walk to work in China, Germany and Sweden, and the more than 20% who bike their commutes in China, Denmark and the Netherlands, WebMD reports. Add to that the inordinate time most of us spend sitting — at the office, in front of the computer or watching TV.

Hallal estimates that sedentary people have a 20% to 30% greater risk of heart disease and diabetes than regular exercisers. But despite the deadly effects of lack of exercise, Hallal says physical activity doesn’t get the same attention or funding as other health risk factors. “It gets underfunded and undervalued,” Hallal told the Los Angeles Times. “But it’s huge everywhere in the world.”

(MORE: Long Commute? Your Heart and Waistline May Suffer for It)

There was some encouraging news in the results as well: thanks to greater awareness about the importance of physical activity in improving health, about 31% of adults do report engaging in vigorous exercise three or more days a week.

Another paper in the Lancet series also examined what kinds of interventions might help people get active. Researchers analyzed 100 reviews of clinical and community-based efforts to encourage exercise and found some simple strategies that seemed to work: using signs to motivate people to use the stairs instead of the elevator, for instance, or offering free exercise classes in public places such as parks, especially geared toward women, lower-income folks and the elderly, groups who are less likely to get the recommended amount of exercise. Studies from the U.S., Australia, Belgium, Canada, England and Germany indicate that maintaining streets and improving lighting can boost activity levels by as much as 50%.

The authors of the study pointed to a particularly effective program called Ciclovía, which started in Bogotá, Columbia, and has spread to 100 other cities in the Americas. On Sunday mornings and public holidays, the program closes city streets to motorized vehicles, leaving roadways open for walkers, runners, skaters and bikers. Ciclovía attracts about a million people each week, the study notes, mostly people on lower incomes, and accounts for 14% of people’s weekly recommended exercise.

(MORE: Extreme Workouts: When Exercise Does More Harm than Good)

Commenting on the Lancet series, many experts agreed that physical activity should be a global priority, though some took issue with the comparison with smoking. In an interview with WebMD, Timothy Armstrong, coordinator of the surveillance and population-based prevention program for the World Health Organization, noted that if the authors of the first paper had calculated the effects of smoking the same way they had for inactivity, the death statistics wouldn’t be quite so similar. Further, as Dr. Claire Knight of Cancer Research U.K. told the BBC, even if smoking and inactivity kill the same number of people, far fewer people smoke than are sedentary, making tobacco more risky to the individual.

Nevertheless, no one disagrees that the world population as a whole must start exercising more — and soon. “This is a super, super analysis,” Dr. James Levine, professor of medicine at the Mayo Clinic, told WebMD regarding Lee’s paper in the Lancet. “We know that as soon as somebody gets out of their chair, their blood sugar improves, their blood cholesterol and triglycerides improve, and that’s very consistent. Every time you get up it gets better. Every time you sit down it gets worse.”

The message, he says, is simple — get moving.

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

Read more: http://healthland.time.com/2012/07/18/lack-of-exercise-as-deadly-as-smoking-study-finds/#ixzz218h05GDA

No Such Thing as a ‘Normal’ Vagina?

2012-06-25

Perhaps it need not be said that one vagina is not the same as the next, but medically speaking, doctors have long thought that all “healthy” vaginas had certain things in common — namely levels of some good bacteria.

But a new study led by Jacques Ravel at the University of Maryland School of Medicine reports that in fact not all women are created equal. The vaginal microbiome — the community of bacteria living in the vagina — varies considerably between women, the study found, and even within the same woman at different times.

The results, published this week in Science Translational Medicine, suggest that there may not be a single standard for a “normal” or “healthy” vaginal environment. Levels of bacteria that may signify bacterial infection in one woman may be healthy in another. The study involved 32 women who submitted vaginal bacterial swabs taken twice a week for 16 weeks.

Continue reading No Such Thing as a ‘Normal’ Vagina? →

Blessed Are the Sleek? Why God Wants You to Be Thin

2012-06-05

Let’s say you believe in God (most Americans do). Let’s say you’re deeply religious (most Americans say they are). So what does God want for you? You can be pretty sure God wants you to be happy, to be charitable, to be honest, to be kind. You can be pretty sure God doesn’t care if you’re rich, beautiful, famous or thin, right? Well, that thin part may take a little explaining.

With the U.S. tottering under an obesity epidemic that has left two-thirds of all adults and one-third of all kids overweight or obese, public health experts are despairing of finding new ways to get Americans off their duffs, away from the fridge and back into at least nominally healthy habits. Fad diets are useless; gym memberships do nothing — at least if they go unused; public service ads get ignored. But, as we explore in this week’s issue of TIME (available to subscribers here), where all of those efforts have failed, faith could succeed — at least according to Pastor Rick Warren.

Two years ago, Warren, the author of the über-bestseller The Purpose Driven Life and the leader of the Saddleback mega-church in Lake Forest, Calif., was struck by how out of shape his 20,000-strong congregation had gotten and, he readily admitted, he was no better, tipping the scales at 295 lbs. — or a full 90 lbs. too much for his 6-ft.-3-in. frame. He suspected he had a way to fix all that — one that might work in the wider world as well — and the secret, he believed, lay in Scripture, specifically in the Book of Daniel.

(MORE: The Book of Daniel: Is It Really About Diet?)

There’s a lot that happens in the Book of Daniel, but the critical passage occurs when Daniel and three other Jewish boys are brought to the court of the conquering King Nebuchadnezzar, where they are to be fed and trained so that they may serve in the royal circle. But as the Biblical passage recounts, the boys resist at least in part, refusing the rich foods of the king’s table and choosing a more spartan fare instead:

…Daniel resolved not to defile himself with the royal food and wine, and he asked the chief official for permission not to defile himself this way… “Please test your servants for ten days: Give us nothing but vegetables to eat and water to drink. Then compare our appearance with that of the young men who eat the royal food, and treat your servants in accordance with what you see.”

What the chief official saw, of course, was that Daniel and his friends had grown fitter and stronger than the other servants. It wasn’t vegetarianism or vigorous exercise that had worked that magic — though those were part of it. Instead, it was a belief that it was impossible to serve God fully if you were out of shape or unwell. For Daniel, getting fit was a triumph of faith — and Warren was convinced his church members could find motivation the same way.

With that was born the Daniel Plan, a sweeping program of smart eating (and yes, lean meats are included), workout classes, small-group support meetings, walk and worship sessions and more, much of it made available both in person and online. Warren recruited three marquee names from the world of medicine — Drs. Mehmet Oz, Daniel Amen and Mark Hyman (all of different faiths) — to help spread the good-health message, and the Saddleback members fell in love with the plan. More than 15,000 of them have signed up so far and in the past 18 months alone, they have lost a collective 260,000 lbs.

(MORE: Dr. Oz: How Faith and Health Go Hand in Hand)

The bigger question about the Daniel Plan is whether it could work in other churches — both evangelical and non-evangelical — not to mention in synagogues, mosques and other houses of worship. Warren is betting it can, and, according to Hyman, is considering rolling out the program to 1 billion people worldwide over the next decade. Non-believers may grumble at the religious component of the plan, and Warren himself has stirred controversy over time with the strictness of his evangelical teachings. But this mission may transcend all of that. “We all get sick, regardless of religion,” says Hyman. When it comes to getting well, he and others argue, we can’t be choosy about where we get our answers.

Read more: http://healthland.time.com/2012/05/31/blessed-are-the-sleek-why-god-wants-you-to-be-thin/?iid=hl-article-mostpop1#ixzz1wuydG8gZ

PE: The ‘other’ male sexual problem

2012-05-10

Given the ease with which the average person can rattle off brand names like “Viagra” and “Cialis,” or joke about “four hour erections,” it would seem that erectile-dysfunction drugs are just about as common as ibuprofen.

We take it for granted, but the little blue pill has drastically changed the way we think about erectile disorder (ED).

Once known as “impotence,” ED was originally thought to be caused by anxiety, nerves, or low self-esteem; now it’s commonly known to be a health issue that hinges on the flow of blood to the penis and taking a pill to deal with the issue is often no big deal.

Don’t get me wrong: this is not to say that Viagra and its brethren – Levitra, Cialis and the new FDA-approved Stendra – are the be-all end-all, or even that they’re unequivocally effective. It’s just that these medications have helped to spur a national dialogue (and often a debate) that has changed the way we think about sexual problems.

But now that ED has come out of the shadows, what about the other major male sexual issue — premature ejaculation (PE)?

As I discussed in an earlier column, PE, (the inability to maintain intercourse for more than a minute without ejaculating) is known to affect up to a third of all men, making it even more prevalent than ED. And yet we tend to think about PE in much the same way we once thought about erectile disroder – shrouded in myth.

Most still think of PE as a function of psychology or behavioral conditioning, rather than physiology and neurochemistry. For example, many wrongly assume that:

PE only affects young men who are sexually selfish or immature
it’s the result of early masturbation habits
it hints at deeper, psychological issues

But in my professional work, I’ve observed that men who struggle with PE don’t do anything differently than men who don’t have the problem. They don’t masturbate differently; they don’t have different psychological issues; they don’t approach sex differently.

Much like a predisposition toward right-handedness, premature ejaculators are often just born that way.

Fortunately, PE is increasingly recognized as a health issue, and this is a relief to those men who struggle with it and can’t help but ask themselves: What’s wrong with me?

As with the little blue pill, the pharmaceutical industry has been on the hunt for a PE drug. Just as the discovery of Viagra was somewhat of an accident (its erectile-enhancing qualities were only discovered after the drug was being developed as a potential heart medication), it’s been observed that certain SSRI-based medications can delay ejaculation.

Ironically, what is a sexual side-effect to many may actually be a sexual boon to the man who suffers from PE, and so some doctors will prescribe the off-label use of an SSRI to help manage the condition.

One drug – Priligy – is a short-acting selective serotonin reuptake inhibitor that is being marketed in parts of Europe as a premature ejaculation pill, but it has not yet received FDA approval here in the U.S..

Another medication potentially awaiting FDA approval is PSD502, a topical numbing agent that can be applied to the penis to decrease penile sensitivity. The use of such numbing agents as a treatment for PE dates back to 1943, but these products have had their limitations.

For one thing, it’s been difficult to establish a recommended dosage.
For another, these topical solutions need to be applied at least 20 to 30 minutes before intercourse in order to be effective.
Additionally, if numbing agents are being used, the man may be required to use a condom to ensure that his partner’s genital area does not also become numb.
While helping to diminish penile sensitivity, a numbing agent does not address a man’s “ejaculatory trigger” which is neurochemically activated.

Still, those behind PSD502 claim to have developed a formula that doesn’t suffer from many of these drawbacks. Like Priligy, PSD502 is not yet available, but a very similar product has been FDA-approved based on a pre-existing monograph.

Dubbed Promescent, this product carries many of the same benefits of PSD502 and effectively decreases penile sensitivity without transmitting any numbness to a man’s partner.

But as helpful as a product like Promescent can be, I still counsel men to focus first on partner-communication, as well as “sex scripts” that de-emphasize intercourse while vouchsafing female pleasure – both of which I discuss exhaustively in my e-book, “Overcoming Premature Ejaculation.”

From there, many men who suffer from PE may find that they still need to pursue a broader “biopsychosocial” approach: one that combines behavioral, medical, and interpersonal approaches. In the absence of a single “silver bullet” to do away with PE, it’s often necessary to do a little bit of everything.

Let’s not wait for the next blockbuster drug to arrive in order to have a meaningful, well-informed conversation about PE. It may never come, but the conversation should.
Post by: Ian Kerner Ph.D. – sex counselor

Learning how to relax!

2012-04-10

Planned relaxation calms anxiety and helps your body and mind recover from everyday rush and stress. Music, a long soak in the bath, or a walk in the park do the trick for some people, but for others it’s not so easy. If you feel you need help with learning to relax, try a relaxation or meditation class. Your GP and local library will have information about these.

Choose a quiet place where you won’t be interrupted.
Before you start, do a few gentle stretching exercises to relieve muscular tension.
Make yourself comfortable, either sitting or lying down.
Start to breathe slowly and deeply, in a calm and effortless way.
Gently tense, then relax, each part of your body, starting with your feet and working your way up to your face and head.
As you focus on each area, think of warmth, heaviness and relaxation.
Push any distracting thoughts to the back of your mind; imagine them floating away.
Don’t try to relax; simply let go of the tension in your muscles and allow them to become relaxed.
Let your mind go empty. Some people find it helpful to visualise a calm, beautiful place such as a garden or meadow.
Stay like this for about 20 minutes, then take some deep breaths and open your eyes, but stay sitting or lying for a few moments before you get up.

Top
Practising a regular relaxation routine

It’s important that you make time to practise a thorough routine on a regular basis. There are plenty of resources out there to help you do this – the anxiety section lists just a few.

Relaxation is one of the most effective self-help activities for mental health. It can be a useful addition to any other form of treatment as well as being an effective measure to prevent the development of stress and anxiety, and at the end of the day to help you sleep.

Relaxation exercises can be divided into two broad categories: those for the body and those for the mind. Body-centred exercises also have an effect on the mind. Having a relaxed body may not prevent a constant flow of anxiety-inducing thoughts but it’s a good basis for getting some control of them. So for best results try to combine the two techniques.
Disclaimer

All content within BBC Health is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of the BBC Health website. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. See our Links Policy for more information. Always consult your own GP if you’re in any way concerned about your health.

Meet the Active Couch Potato

2012-04-06

Can someone exercise and still be a couch potato? That peculiarly modern question motivated a new study from Finland in which a group of healthy, physically active volunteers donned special shorts that measure muscular activity in the legs. The volunteers then went about their daily lives.

All were diligent exercisers. Some ran. Others lifted weights or played soccer. A few Nordic-walked. On one day during the study, they worked out as usual. On another, they did not exercise.

Throughout, the shorts measured how much they actually moved.

A growing body of science suggests that prolonged inactivity, a practice known more familiarly as sitting a lot, is both widespread and unhealthy. In a representative study published last month in The Archives of Internal Medicine, Australian researchers compared medical records and lifestyle questionnaires for more than 220,0000 Australian adults 45 and older.

They found that the more hours the men and women sat every day, the greater their chance of dying prematurely. Those people who sat more than eight hours a day — which other studies have found is about the amount that a typical American sits — had a 15 percent greater risk of dying during the study’s three-year follow-up period than people who sat for fewer than four hours a day.

That increased risk held true in the Australian study even if the people sitting eight hours a day spent at least part of that day exercising.

But that study and many others examining sitting and health have relied on self-reported measures of physical activity, like questionnaires. A few have used accelerometers to determine how many steps people were taking during the day.

No one, though, had directly studied people’s muscular activity during sitting and exercising, outside the artificial environment of an exercise physiology lab, until the Finnish researchers came up with the idea of embedding flexible electrodes into shorts fabric.

And measurement of muscle activity matters. In earlier studies with animals whose legs were immobilized with casts or traction devices, physiologists noticed swift, dramatic and deleterious changes in the levels of certain enzymes in cells throughout the animals’ bodies that affect fat metabolism and blood sugar regulation. The researchers concluded that the lack of muscular contractions in the animals’ legs had caused a chain of biological reactions that led to the alterations in enzyme production.

In the current Finnish study, after volunteers donned the shorts, the electrodes began constantly tracking contractile activity in the quadriceps and hamstring muscles, two of the largest sets of muscles in the body. The volunteers also completed detailed logs about their activities during the days of the study.

The researchers had hypothesized that they would see considerably less muscular inactivity over all on the days the volunteers exercised, says Taija Juutinen Finni, a professor of kinesiology at the University of Jyvaskyla in Finland, who led the study.

But the results did not turn out that way. There was, in fact, virtually no difference in how much time people spent being couch potatoes on the days when they exercised compared with days when they did not. On nonexercise days, about 72 percent of volunteers’ waking time, or about nine hours, was spent sitting.

When they formally exercised, volunteers used about 13 percent more energy over all than on days they didn’t exercise. But they still sat 68 percent of the time.

Surprisingly, how much people exercised or what kind of exercise they chose did not change sitting time. Whether volunteers worked out for less than an hour or for more than 90 minutes, they spent an equivalent amount of time the rest of the day being mostly torpid physically.

It seems that after exercising, the study authors concluded, people “substitute either lighter and/or sedentary activities.”

David W. Dunstan, a professor at the Baker IDI Heart and Diabetes Institute in Australia, who has studied inactivity and wrote an editorial to accompany the new Australian paper, says he found the study fascinating. By measuring muscular inactivity using electromyography, he says, “the measurement is getting closer to the heart of the sitting problem, that being a problem of muscular disuse.”

Dr. Finni agrees. Although she and her colleagues did not look directly at the downstream biochemical effects of the inactivity, she says, their results suggest that normal exercise, which fills so few hours of even active people’s days, “may not be enough in terms of health.”

Of course, exercise remains valuable, she and Dr. Dunstan are both quick to add. It reduces risks for cardiovascular disease and other conditions and burns calories.

But exercise paired with otherwise unalloyed sitting should be avoided, Dr. Dunstan says. “It is important the general public become more conscious about what they do in their nonexercise time,” he says. Almost everybody, he says, “should look for opportunities to reduce their daily sitting time and move more, more often, throughout the day.”

Shisha pipes: Is smoking them really harmless?

2012-04-04

The sweet smelling tobacco is gaining in popularity, but most people who smoke it in cafes are unaware of the potential risks.
You might call it shisha in Egypt and Sudan, nargile in Turkey and Syria or hookah in India. Some are made from clay, others from ornately carved metals or plastics. But the principle is same – these water-pipes allow you to smoke flavoured tobacco as it is bubbled through water. Maybe you know it simply as hubble-bubble.

Sharing a water-pipe is thought to be harmless, relaxing fun. They are now enjoying something of a resurgence in popularity in India and the Middle East, where they are said to have originated. In the Middle East the trend has extended to teenagers and women, many of whom do not smoke cigarettes.

This shisha cafe culture has also extended to Europe, Brazil and the United States. If I run home from my office in London, I pass a street filled with cafes where groups of people sit outside engulfed in clouds of honey-scented smoke. In the United States many hookah cafes have opened in college towns and a recent study found that as many as a fifth of American students have tried it. In many countries these pipes are seen as safe enough to be exempt from legislation on smoking in public places.

But the idea that these pipes are harmless is a myth.

Smoke on the water

One of the main misconceptions is that the risks of tobacco are minimised because it is purified as it passes through the water. But this ignores the complete source of the smoke that enters your mouth.

The tobacco burns in a small dish on top of the main body of the water-pipe. You inhale through a mouthpiece connected by a pipe to a reservoir of water at the bottom. As you breathe in smoke is drawn from the burning tobacco and bubbles through the water and up into your mouth. The tobacco is sweetened with glycerine, which can make it damp, so charcoal is added to keep the tobacco burning. This means the smoke inhaled derives from charcoal too, and charcoal contains several toxic substances, including carbon monoxide, heavy metals and tar.

Some water-pipes are sold with mouthpieces containing cotton filters or a plastic mesh. This does result in smaller bubbles, but a report by the World Health Organisation says there is no evidence that these mouthpieces reduce the harm.

Unknown risk

But surely the water cools the smoke, making it less dangerous than a cigarette? It is true that this might make an individual puff less harmful, but this does not factor in the quantity of puffs. A typical water-pipe session lasts for at least 20 minutes, often for an hour. So instead of taking 8-12 puffs of a single cigarette a person is inhaling 50-200 puffs in a session. This, in effect, makes it more like chain smoking. In an hour-long session a person can inhale the equivalent of 100 to 200 times the smoke from a single cigarette, which may come as a surprise to most people. A survey carried out this year by the British Heart Foundation found that 84% of respondents thought the amount of smoke inhaled was equivalent to 10 cigarettes or fewer.

In a study in Florida, USA, customers’ carbon monoxide levels were tested as they left bars that allowed the smoking either of cigarettes or hookah pipes. The people leaving the bars that had water-pipes had triple the levels of carbon monoxide in their bodies. Some reported feeling high, which the authors say could have been the early stages of carbon monoxide poisoning.

But what do we know about any long-term consequences? Here, the science is incomplete, as long-term studies of the kind conducted on cigarette tobacco have not been carried out. Researchers admit the evidence is scant, but suggest that smokers of water-pipes could be at long-term risk for nicotine dependence, cardiovascular disease and even cancer. Professor Hani Najm, Head of Cardiac Surgery at National Guard Health Affairs in Saudi Arabia told me in an interview that he fears that water-pipe smoking could result in an escalation in heart disease in the Gulf States.

So bear in mind one thing. Whether you call it shisha, nargile or hubble bubble, it might smell nice, but it is not as harmless as you might think.

Disclaimer
All content within this column is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you’re in any way concerned about your health.

Study: Mammograms May Overdiagnose Some Early Breast Cancers

For years, women have been urged to get screened for breast cancer because the earlier it’s found, the better. Now researchers are reporting more evidence suggesting that’s not always the case.

A study in Norway estimates that between 15 and 25 percent of breast cancers found by mammograms wouldn’t have caused any problems during a woman’s lifetime, but these tumors were being treated anyway. Once detected, early tumors are surgically removed and sometimes treated with radiation or chemotherapy because there’s no certain way to figure out which ones may be dangerous and which are harmless.

“When you look for cancer early and you look really hard, you find forms that are ultimately never going to bother the patient,” said Dr. H. Gilbert Welch of the Dartmouth Institute for Health Policy and Clinical Practice, who was not part of the research. “It’s a side effect of early diagnosis.”

(PHOTOS: A Photographer’s Intimate Account of Her Mother’s Cancer Ordeal)

The study is the latest to explore overdiagnosis from routine mammograms — finding tumors that grow so slowly or not at all and that would not have caused symptoms or death. Previous estimates of the problem have varied.

The researchers took advantage of the staggered decade-long introduction of a screening program in Norway, starting in 1996. That allowed them to compare the number of breast cancers in counties where screening was offered with those in areas that didn’t yet have the program. Their analysis also included a decade before mammograms were offered.

They estimated that for every 2,500 women offered screening, one death from breast cancer will be prevented but six to 10 women will be overdiagnosed and treated.

Study leader Dr. Mette Kalager and other experts said women need to be better informed about the possibility that mammograms can pick up cancers that will never be life-threatening when they consider getting screened. The dilemma is that doctors don’t have a good way of telling which won’t be dangerous.

“Once you’ve decided to undergo mammography screening, you also have to deal with the consequences that you might be overdiagnosed,” said Kalager, a breast surgeon at Norway’s Telemark Hospital and a visiting scientist at Harvard School of Public Health. “By then, I think, it’s too late. You have to get treated.”

(MORE: Most Young Women with Cancer Don’t Try to Preserve their Fertility)

Kalager and her colleagues looked only at invasive breast cancer. The study did not include DCIS, or ductal carcinoma in situ — an earlier stage cancer confined to a milk duct.

Under the Norway program, screening was offered every two years to women ages 50 to 69.

Researchers analyzed nearly 40,000 breast cancer cases, including 7,793 that were detected after routine screening began. They estimated that between 1,169 and 1,948 of those women were overdiagnosed and got treatment they didn’t need.

Their findings appear in Tuesday’s Annals of Internal Medicine.

The problem of overdiagnosis has been long recognized with prostate cancer. Darthmouth’s Welch said it’s also a problem in thyroid and lung cancer, a childhood tumor called neuroblastoma and even melanoma. He considers breast cancer screening a close call.

“The truth is that we’ve exaggerated the benefits of screening and we’ve ignored the harms,” he said. “I think we’re headed to a place where we realize we need to give women a more balanced message: Mammography helps some people but it leads others to be treated unnecessarily.”

(VIDEO: Pink Light: Burlesque and Breast Cancer Survivors)

An editorial published with the study said overdiagnosis probably occurs more often in the United States because American women often start annual screening at an earlier age and radiologists in the U.S. are more likely to report suspicious findings than those in Europe.

Radiologists could help by raising the threshold for noting abnormalities, wrote Dr. Joann Elmore of the University of Washington School of Medicine and Dr. Suzanne Fletcher of Harvard Medical School.

A “watch-and-wait” approach has been suggested instead of an immediate biopsy, but the editorial writers acknowledge that could be a “tough sell” for some women and radiologists alike.

They said most women aren’t aware of the possibility of overdiagnosis.

“We have an ethical responsibility to alert women to this phenomenon,” they wrote.

Read more: http://healthland.time.com/2012/04/02/study-finds-some-early-breast-cancer-overdiagnosed/#ixzz1r3vMcTZs