Health related information and news from around the world.

Ovarian cancer is the fourth leading cause of cancer death for women, killing nearly 14,000 in 2000. Because its symptoms are often nonspecific (vague feelings of stomach bloating, digestive irregularities, unusual amounts of gas or stomachaches), it often goes undiagnosed in its early stages. The most common sign is enlargement of the abdomen (or a feeling of bloating) in women over the age of 40. Other symptoms include vague digestive disturbances, such as gas and stomachaches that persist and cannot be explained.The risk for ovarian cancer increases with age, with the highest rates found in women in their 60s. Women who have never had children are twice as likely to develop ovarian cancer as are those who have. This is because the main risk factor appears to be exposure to the reproductive hormone estrogen. Women who have multiple pregnancies or use oral contraceptives, both of which inhibit estrogen, are at lower risk. In addition, having one or more primary relatives (mother, sisters, and grandmothers) who have had the disease appears to increase individual risk. With the exception of Japan, the highest incidence rates are reported in the industrialized countries of the world. New research indicates that mutations in the BRCA1 and BRCA2 genes may increase risks.
PreventionA pivotal Yale University study indicated that diet may also play a role in ovarian cancer. Researchers found that when comparing 450 Canadian women with newly diagnosed ovarian cancer with 564 demographically similar, healthy women, the women without ovarian cancer had a diet lower in saturated fat. For every 10 grams of saturated fat a woman ate per day, her risk of ovarian cancer rose 20 percent. Conversely, women who lowered their saturated fat consumption by 10 grams a day experienced a 20 percent drop in risk. Every 10 grams of vegetable fiber (but not fruit or cereal fiber) added to a woman’s daily menu lowered her risk by 37 percent. The study also found that each full-term pregnancy lowered risk by about 20 percent and each year of oral contraceptive use lowered it by 5 to 10 percent. So, should you go out and get pregnant or start taking birth control pills to reduce risk? Probably not. Although isolated studies provide useful information that may lead to definitive results when combined with similar findings from other studies, when considered alone, they do not make for scientific certainty. However, such results, particularly when combined with cardiovascular risks and other health risks, may provide yet another reason to hold the fat – or at least cut down on your overall intake.To protect yourself, annual thorough pelvic examinations are important. Pap tests, although useful in detecting cervical cancer, do not reveal ovarian cancer. Women over the age of 40 should have a cancer-related checkup every year. Transvaginal ultrasound and a tumor marker, CA125, may assist in diagnosis but are not recommended for routine screening. If you have any of the symptoms of ovarian cancer and they persist, see your doctor. If they continue to persist, get a second opinion.*26/277/5*

Oncogenes (literally ‘cancer genes’) were first discovered in the genetic material of viruses that are capable of causing cancers in animals. As the powerful tools of biology were applied to these viruses it became clear that particular genes within them were responsible for altering the cells in the animals that were infected. Although this finding was of great scientific importance, it was initially felt not to be central to the understanding of cancer in humans because viruses are unusual, and often only indirect, causes of cancer in man. The immediate importance of oncogenes in human cancer became clear with the discovery that most of the virus oncogenes had very close relatives that were present in the normal human cell. Moreover, these seem to be very important genes and there are close similarities between these genes in man and in other animals, including mice. When a particular kind of gene occurs in many, many species, this usually means that this type of gene is carrying out a very important function and that it has been conserved for that purpose by each species.
Oncogenes are present in normal cells where they do not cause cancer. In this situation they are called proto-oncogenes. The immediate question was: how do they cause cancer when a virus infects an animal cell? The answer lies in an alteration in the level of activity and the type of activity of such genes. It became clear that although these oncogenes would normally influence the control of cellular proliferation and differentiation in a beneficial and appropriate way, if they were altered so that the sequence of their DNA was slightly different, or if they became overactive because too many copies were present, or if they moved to the wrong part of the genetic material of the cell, then their activity would be disordered. This could result in disordered proliferation and hence contribute to the development of a cancer. Many dozens of oncogenes have now been discovered and it appears very likely that many of them are important in the cause of human cancer. This does not mean that the cancers in humans arise as a result of virus infection. Alterations in these genes can occur as a result of a number of processes and, once they are altered, they can contribute to the formation of the cancer. The virus link with cancer in animals allowed us to discover oncogenes. Overactivity and altered activity of an oncogene is commonly found in many human cancers although the same oncogene may not be altered in all cancers of one organ. Disorder of an oncogene is likely to be one or more of the steps in the creation of a fully fledged cancer and several powerful examples of this are now known for common cancers, including lung cancer and cancer of the bowel.
Each oncogene is now usually given a brief name derived from the virus in which it was first found or from some other feature of its description. The three-letter name is typical and important examples are ras, myc and sis.
We have referred to oncogenes as important elements controlling the behaviour of a cell and, in particular, its proliferation. How do they do this? The answers are still uncertain but many important clues are being revealed and this field of cancer research is one of those developing most rapidly. The functions of different oncogenes may be very different from each other but most of them seem to be involved in the process by which factors control the proliferation of cells.
Thus some oncogenes may provide the genetic information which leads to the manufacture of substances (receptors) on the surface of cells which receive signals instructing that cell to multiply. Some oncogenes may code for the substances within the cell that transmit signals from the surface into the nucleus of the cell where most of the genetic control is occurring. Other oncogenes code for factors which are attached to the nucleus or contained within it which presumably act as the final pathway by which the signals are transmitted into the important control centres. Yet others may actually code for the signalling substances themselves (usually called growth factors). Alterations at any one of these points can result in the wrong message being transferred into the cell telling it to continue proliferating when a normal cell would be switched off, resting and without potential to cause any harm. Alterations in the oncogenes which are responsible for each of these stages in the process of signalling into the cell can therefore contribute to the development of cancer.
*8\194\4*

Cancer of the breast still threatens the lives of one in twelve Australian women. Little publicity surrounds the factors causing the appearance of breast cancer. Perhaps those factors would attract more attention if breast cancer was a disease of men; but it is not. Only one in a hundred cases of breast cancer will occur amongst the male population.
Excluding gender, the single most important variable in the development of breast cancer appears to be diet. A fat rich, low fibre western diet increases the risk of breast cancer by a factor of six times. High cholesterol alone doubles the chances of a woman developing cancer of the breast. Other factors of importance are age at the onset of periods, early onset of child bearing years, the taking of oestrogen tablets, a family history of breast cancer and the prior appearance of benign changes in the breast.
Looking at some of these risks in more detail women who start their periods before the age of 12 have nearly three times the risk of breast cancer compared to women who started their periods at age 14. Overall there is approximately a three fold increase in risk among first degree relatives of women who have breast cancer. However, among first degree relatives who had breast cancer before menopause or who had cancer in both breasts there is a staggering nine fold increase in risk.

Home Remedies
There is a clear and overriding imperative for more women to adopt a low fat, high fibre diet. The use of oestrogen, as Hormone Replacement Therapy (H.R.T.) after the menopause is still controversial concerning the risk of breast cancer. Current balance of opinion favours balancing oestrogen supplementation with progesterone. In any event, if H.R.T. is to be adopted, the reduced incidence of heart disease and osteoporosis will save more lives than any increase in the number of deaths caused by breast cancer.

*1/131/5*

They will not develop if you change your position often, keep dry, put some sort of padding over these danger points and get someone to massage them briskly, often. All of that is easier said than done. It is not much fun to change your position often if you are in pain and especially if there is only one position that is really comfortable for you. It is hard to change position often if you are partly paralysed or so weak that you can’t do it without help. It is hard to keep dry if you are incontinent. It can be fiddly to try to arrange padding over your danger points. You might feel reluctant to ask busy nurses, friends, or relatives to spend time helping you to change position and rubbing any sore areas to help restore a brisk circulation. However, it is worth taking all of this seriously. Things are likely to be even more difficult for you if you do develop a pressure sore, because then you won’t be able to sit or lie in the position that produced your sore at all!

*219/40/1*

Painkillers

A local anesthetic may have been injected, as a nerve block or into the wound during your operation, to reduce the pain as you regain consciousness. Its effects should last for about 6 to 8 hours. After this, and while you are still in hospital, you will be able to have pain-killing tablets or injections if necessary. Do ask for these injections if you need them, although following lumpectomies at least, regular oral analgesic tablets such as aspirin, paracetamol or Nurofen will probably be enough. Make sure you have some of these tablets at home for the next few days. Painkillers should be taken regularly (every 4 to 6 hours, or as indicated on their container) so that their effect does not wear off before you take the next dose. A dose as you go to bed may help relieve any discomfort and allow you to get a good night’s sleep.

If you have had auxiliary lymph glands removed, your armpit may be sore for a few days, and possibly numb for several weeks or months.

Getting out of bed

Effective pain control enables you to get out of bed and to move around with ease soon after your operation. Movement and exercise are important to avoid deep vein thrombosis and to keep your bladder and lungs working properly.

You should be able to get up and walk about as soon as the anesthetic effects wear off. Once you are fully mobile, you will be able to remove your anti-embolism stockings if you have been wearing them.

Bra padding

Before you leave hospital, you will be fitted with,-a temporary pad to put in your bra if you have lost a part or the whole of your breast. The pad will give some shape to your affected breast, and will also help to protect your wound. It can be worn at night if desired. Once the wound has healed, a more permanent prosthesis will be fitted if you want one.

Shoulder movement

While in hospital, you will only have limited shoulder movement until any drains have been removed, after which your range of shoulder movements should gradually return to normal within 2 to 4 weeks with gentle exercising. You may be visited by a physiotherapist on the day after your operation so that your degree of shoulder movement can be assessed. You will also be advised about exercises to help you regain the normal range of movement of the arm and shoulder on your affected side, and may be given a leaflet explaining how to do them.

There are some very simple exercises you can do while still in hospital to help to relieve some of the stiffness in your arm and shoulder, for example using your good arm to assist your affected arm with upward and sideways movements, and trying to brush your hair with your elbow resting on a table. Once you are at home again, you should try to exercise your arm and shoulder while carrying out your normal daily routine, for example while dusting and doing light housework.

Although the muscles in the chest wall are now not usually removed during a mastectomy unless absolutely necessary, they can become weakened by under-use after this operation, and exercises to help regain muscle strength are also important.

Discomfort following a mastectomy may also cause you to change your posture, for example by leaning towards the side of discomfort or bending forward. You should try to be aware of this tendency and avoid it if possible as good posture is important so that back pain does not become a problem.

*42/39/5*