Does Eating Eggs lead to Heart problems?

No, Eating Eggs in moderation is not associated with increased Heart problems.

Heart diseases are one of major killers in Men and Women. In the past, Cholesterol was exclusively blamed for most of the Heart problems. Nowadays, such a simplistic view has been abandoned. We now know that Heart diseases are due to a complex set of poor diet and life style.

Previously Eggs which have lot of dietary cholesterol have been subject to lot of bad press.

A recent pooled analysis of good quality data shows that ” moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations.”

So like everything else with regards to diet , moderation is the way to go !

Reference

Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m513 (Published 04 March 2020)

Cite this as: BMJ 2020;368:m513

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Is Chloroquine useful in treatment of Corona Virus?

Chloroquine and the related drug Hydroxy-Chloroquine are drugs commonly used to prevent and treat Malaria infections; and treat some Joint conditions.

During the initial stages of COVID-19 pandemic, there were some reports of Chloroquine being useful in treating Corona Virus.

A Chinese trial published in British Medical Journal BMJ now reports that ” Administration of hydroxychloroquine did not result in …. any meaningful antiviral benefits… compared to standard of care alone in patients admitted to hospital with mainly persistent mild to moderate covid-19

Chloroquine was not only useless but it had significant side effects in a minority. So Chloroquine or Hydroxy-Chloroquine should not be used routinely outside a clinical trial setting.

References

1. Hydroxychloroquine (HCQ). Wiki. https://en.m.wikipedia.org/wiki/Hydroxychloroquine

2. BMJ. Chloroquine and hydroxychloroquine in covid-19. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1432 (Published 08 April 2020)

3. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1849 (Published 14 May 2020)

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Face Masks: Should Public wear face masks because of Corona Virus pandemic ?

Should Public wear face masks because of Corona Virus pandemic ?

Yes.

In some of the Asian Countries there has been universal acceptance of face masks even before Corona Virus pandemic. Hence, it is not surprising that there is wide spread use of face masks during this pandemic .

In USA, after initial hesitation, CDC now recommends use of cloth face masks by public.

In Germany, many states have made face masks compulsory.

In UK, there has been no official recommendation about widespread use of face masks.

With so many unknowns, it is prudent to follow the advice published in British Medical Journal : WEAR A MASK !!

References

1. USA CDC. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

2 Germany: BBC news. Coronavirus: Germany’s states make face masks compulsory. 22 April 2020. https://www.bbc.co.uk/news/world-europe-52382196

3. TIME Magazine. https://time.com/5815251/should-you-wear-a-mask-coronavirus/

4. BMJ paper. Analysis. Face masks for the public during the covid-19 crisis. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1435 (Published 09 April 2020). Cite this as: BMJ 2020;369:m1435

5. BMJ editorial. Editorial. Covid-19: should the public wear face masks?. Editorials. Covid-19: should the public wear face masks? BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1442 (Published 09 April 2020). Cite this as: BMJ 2020;369:m1442

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Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views expressed are not substitute for professional advice.

Does air pollution in cities make your jogging and walking less beneficial ?

Yes, air pollution is now being recognised as an important cause of death in major cities and towns.

So avoid major roads and very busy streets.

Any benefit you might accrue from exercise can be wiped out by heavy air pollution if you are jogging on a heavily congested road.

References

1. Telegraph: Pollution wipes out the benefits of exercise, study suggests

2. BMJ . Air pollution. Short term exposure to fine particulate matter and hospital admission risks and costs in the Medicare population: time stratified, case crossover study

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6258 (Published 27 November 2019)

3. Telegraph. Does exercising in pollution do you more harm than good?

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Blaming the tools

Tools

Any one from any trade would be expected to use the tools of the trade appropriately.

Tweaking the tools unnecessarily or blaming the tools if things do not pan out as planned is generally frowned upon .

Same with medical professionals !

Please contribute your thoughts at BMJ rapid response page.

Interpreting test results: dont blame the tools

Access the article at: http://bmj.com/cgi/content/full/bmj.m1162

Toll-free link:
http://bmj.com/cgi/content/full/bmj.m1162?ijkey=sZarWS4YlJf9NS0&keytype=ref

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Plain English Medical Letters to Patients

Writing letters to patients in plain English without medical jargon is a gift that only a few doctors possess.

Personalising complex medical terminology in a letter dictated over a few minutes is NOT an inherent skill possessed by many doctors including those who are native English speakers.

Dictating Plain English medical letters would take considerable time and effort – particularly if letters are going to succinctly summarise everything from a medical consultation.

In UK, with regards to Cancer, we are lucky to have cancer charities who do a good job of providing information in plain English ( E.g Cancer Research UK, Macmillan Cancer Support, Prostate Cancer UK).

Cancer Patients in UK also have the support of Cancer Nurse Specialists ( CNS ) who do a fantastic job of guiding patients through their cancer journey and clarify all medical jargon to patients.

Other specialities might not have the resources that are available to cancer patients. But, on the whole, Clinic Time slots are precious. Many UK specialists have long waiting lists.

So if further time and effort is to be expended in busy clinics for dictating plain English Letters – in addition to the usual Medical letters to GP – good clinical evidence is needed to demonstrate that separate plain English letters do benefit patients in a meaningful way.

Please do read the BMJ article and put forward your views in the rapid response section.

Access the article at: http://bmj.com/cgi/content/full/bmj.m949

Toll-free link:
http://bmj.com/cgi/content/full/bmj.m949?ijkey=nxJ9CdIVHKZW1Jd&keytype=ref

Disclaimer:

The views expressed here are my personal views and do not represent the views of any other professional organisation I am associated with…

Do omega 3 supplements provide protection from Stroke and Heart diseases?

It is a common belief that omega 3 fatty acids provide protection from strokes and heart attacks, and improve overall health.

A review from the esteemed Cochrane collaboration pours cold water on this belief.

The review concludes that omega 3 provides ” little or no meaningful effect on the risk of death from any cause”.

They conclude that “omega 3 supplements probably makes little or no difference to risk of cardiovascular events, coronary heart deaths, coronary heart disease events, stroke or heart irregularities”.

The review did find “moderate evidence that ALA, found in plant oils (such as rapeseed or canola oil) and nuts (particularly walnuts) may be slightly protective of some diseases of the heart and circulation”.

However, the effect was very small. They estimated that “143 people would need to increase their ALA intake to prevent one person developing arrhythmia”.

They also estimated that “One thousand people would need to increase their ALA intake to prevent one person dying of coronary heart disease or experiencing a cardiovascular event”.

Overall the review finds that overall “omega 3 provides little if any benefit at all”.

References

New Cochrane health evidence challenges belief that omega 3 supplements reduce risk of heart disease, stroke or death.

Cochrane Database of Systematic Reviews 2018, Issue 7. Art. No.: CD003177. https://www.cochrane.org/CD003177/VASC_omega-3-intake-cardiovascular-disease

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Walking is good exercise

New year. January. First month of a New year – it’s the time of year many people take a look at their lifestyle and vow to eat better, exercise better and live better.

Many people consider Gym or Health Club membership.

But Exercise doesn’t need to cost a lot. Being active, doesn’t need to be regimented.

Simply walking anywhere is good compared to no exercise at all. Walking in the Park or Quiet streets has lot of benefits.

Good article in BBC on the benefits of walking.

A word of caution though !

Avoid Walking or Jogging near busy roads so that the benefits of walking are not negated by pollution.

Reference

1. BBC. 8 reasons why we should all walk more. BBC.

2. Guardian. Traffic fumes in city streets ‘largely wipe out exercise benefits for over-60s’.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Is whole milk harmful ?

In years gone by , many viewed milk as a wholesome healthy food. Government encouraged consumption of milk by providing free milk.

But in recent years, milk is viewed with suspicion.

Vegans shun milk and diary products.

Perhaps the Vegans got it right all along at least as far as whole milk is concerned.

A very large study involving 168 153 women and 49 602 men was published recently in British Medical Journal. The study found that whole milk intake is associated with increased risk of death from heart problems and from some cancers such as lung cancer, ovarian cancer, and prostate cancer.

Interestingly “Cheese and yogurt intake was NOT associated with increased risk of death”.

The risk was also less with “skimmed or low fat milk”.

References

1. Government Cheap Milk Scheme. Br Med J 1940; 2 doi: https://doi.org/10.1136/bmj.2.4170.806-b (Published 07 December 1940)

2. Vegetarian diets. BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b2507 (Published 08 July 2009)

3. Associations of dairy intake with risk of mortality in women and men: three prospective cohort studies. BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6204 (Published 27 November 2019). Cite this as: BMJ 2019;367:l6204

Futile antibiotic treatments

Infections are normally highly treatable with antibiotics.

But when someone is dying , the body’s immune system gets weaker. Hence infections quite often occur as part of the dying process.

Treating these infections are often futile. But human nature is inclined to “fight and survive” by all means. So quite often powerful antibiotics are used to treat these infections in dying patients.

There is an ethical argument against futile treatments.

There is also the risk of antibiotic resistance in general population if antibiotics are used inappropriately.

Submit your views at BMJ journal website (rapid response section).

References

Access the article at: http://bmj.com/cgi/content/full/bmj.l6706

Toll-free link:

http://bmj.com/cgi/content/full/bmj.l6706?ijkey=ZXN1zz6QXpPz8np&keytype=ref

Can long working hours kill you?

Yes, it can.

It has been well established by systemic review that working long hours can lead to excessive heart attacks. ( ref 1).

A recent French study indicates that working long hours can lead to increased risk of stroke ( Long hours defined as more than 10 hours on at least 50 days per year in this study) (ref 2).

So look after yourself and don’t push yourself too hard !

References

1. Long Working Hours and Coronary Heart Disease: A Systematic Review and Meta-Analysis .

2. Long working hours ‘linked to stroke risk’ BBC News.

Can weather affect joint pain?

Yes, weather can affect joint pain.

A study involving 2500 people conducted by University of Manchester study showed that “people with arthritis feel more pain on humid days”

The study reports that “Damp and windy days with low pressure can increase risk of experiencing more pain than normal”

Cold, damp days also made pain worse but interestingly pain was not made by temperature alone”.

Other studies in the past have also found a “significant correlation between humidity and pain“.

References

BBC News. People ‘more likely to feel pain on humid days’.

Does rheumatoid arthritis disease activity correlate with weather conditions?

The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis.

“Think Positive “ and live longer !

People with sunny disposition seems to live longer.

Having a positive outlook on life seems to protect heart.

Is it a case of “chicken vs egg” in that what came first. Do healthy people have a optimistic outlook and pessimistic people have lot of social, personal and health problems. Do life problems make people pessimistic or being optimistic makes one do better?

Researchers have adjusted the data for confounding factors. Evidence so far is very intriguing.

And the next question is – can one learn to be optimistic, change personality and have beneficial health effects. We don’t know at present.

References

1. Guardian. Optimists have lower risk of heart problems and early death.

2. Guardian. Optimism may hold secret to longer life, study suggests.

3. The association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA)

4. JAMA. Association of Optimism With Cardiovascular Events and All-Cause Mortality

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Crowdfunding expensive stem cell therapies

Crowd fund metaphor

If you have come across a desperate request to crowdfund an expensive stem cell therapy, read this well researched BBC article before you contribute.

Hope is a powerful driver particularly when someone is facing immense difficulties in life. Human beings have a natural inclination to fight against all odds and it seems to be inbuilt in our DNA and psyche.

But not all promising treatments do help desperate people searching for a cure.

Reference.

BBC news. The unwarranted hype of stem cell therapies. By Jules Montague. 21 August 2019

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Dietary advice: take it with a pinch of salt

Official dietary advice as well as various “Diets” promoted by various celebrities tend to be very prescriptive. They often give the impression that the evidence behind everything they promote is very clear cut.

But truth is far more murkier ( I might say more “mish mash “).

A new study analysis of old data comes to a different conclusion about “red meat”. This is in fact not surprising as the evidence for various Dietary guidelines and “Diets” are not usually robust and watertight and involves lot of assumptions.

What is the take home message:

Eat “everything you like” in moderation and try to make it as balanced as possible with substitutes for things you avoid !!

Avoid processed food as much as possible and eat fresh.

Don’t be surprised if the next two studies on this topic reach three different conclusions.

References

1. BBC news. Is red meat back on the menu?

2. New York Times. Eat Less Red Meat, Scientists Said. Now Some Believe That Was Bad Advice.

3. The original study article from Annals of Internal Medicine. Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium.

4. Daily Mail. You DON’T need to cut out red meat: Scientists say official advice on eating less beef, pork and lamb is based on bad evidence and having it four times a week poses ‘NO cancer risk’ 

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Veliparib : Another new drug for treatment of Ovarian Cancer

Veliparib trial data has certainly brought more options to the table in treatment of advanced Ovarian cancer.

Trial data presented at ESMO congress at Barcelona shows that first line therapy with Veliparib is beneficial.

Acknowledgement: Copyright of Slides: Authors and ESMO

References

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

New drug combination for Ovarian Cancer (Olaparib and Bevacizumab)

New trial data presented at the ESMO cancer Congress 2019 in Barcelona, Spain, show excellent results for the combination of Olaparib and Bevacizumab. The combination looks likely to become standard of care in at-least a subgroup of patients.

The expert discussing the trial data did raise the possibility that most benefit seems to come from Olaparib in patients with BRCA mutations and whether Olaparib alone instead combination is enough for this group. More data is awaited.

References

1. ESMO 2019 congress press release. Ovarian Cancer: More Women Benefit from Maintenance Combined Targeted Therapy [ESMO 2019 Press Release]

Acknowledgement: Copyright of Slides: Authors and ESMO

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Melanoma Skin cancers: significant improvement in life expectancy with immunotherapy

Advanced melanoma skin cancers used to carry a dismal prognosis.

Data presented at Barcelona European Cancer Congress ( ESMO) shows the prognosis has improved remarkably in the recent years.

Fifty percent of patients are now alive for at-least five years. It is quite a remarkable achievement for immunotherapy.

References

1. ESMO press release. One in Two Patients with Metastatic Melanoma Alive after Five Years with Combination Immunotherapy [ESMO 2019 Press Release].

2.BBC News. Skin cancer: Half of people surviving advanced melanoma. By James Gallagher. Health and science correspondent, BBC News

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Exercise: Anything is better than nothing

Many people put off exercise thinking it needs to be a planned activity with time allocated for it.

A paper published in British Medical Journal ( BMJ) reports that any exercise is good and contributes to good health compared to no exercise

The recent UK guidelines also advises to “clock up few minutes at a time” whenever and wherever you can. (UK Chief Medical Officer).

You don’t need to run a marathon or join a running group. Just taking the stairs rather the lift would be good.

References

1. Guardian. Even a few minutes’ exercise is good for you, new guidelines state.

2. BMJ. British Medical Journal. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4570 (Published 21 August 2019)

Cite this as: BMJ 2019;366:l4570

3. Daily Telegraph. No such thing as too little exercise, says Chief Medical Officer, as ten minute minimum is scrapped.

4. BBC news. Strengthen muscles as well as heart to stay fit and healthy, say top doctors

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Celery Juice: Super Juice ?

Why Celery Juice is popular now?

Every year some type of food or fruit trends on the social media after being hyped by celebrities and Influencers.

Unfortunately, it seems Celery Juice is trending now.

Just because something is endorsed with good intentions by well meaning people doesn’t mean you have to blindly believe them.

Read the BBC news article for a balanced account .

Reference

1. Celery Juice: The big problem with a viral Instagram ‘cure. BBC news.

Is Vegan diet the most healthy ? Are there any risks from Vegetarian diet?

Life would be very simple if we can have clear cut answers with regards to the best diet for everyone’s health.

A recent study published in BMJ indicates that while Vegan diet reduces risk of heart problems it can increase the risk of strokes.

The results might seem confusing and scientists would be certainly seeking more answers. But don’t be surprised if another study from some other research group comes up with a contradictory result. That’s normal in science.

What’s most important is to realise that there are no easy scientific answers to most scientific questions. Research quite often shows unexpected results. What is a logical scientific question quite often throws up unexpected answers.

Overall, the message is “have a well balanced diet” without omitting essential nutrients.

References

1. BBC news. Plant-based diets ‘linked to higher stroke risk‘ Vegan and vegetarian diets ‘link to higher stroke risk’ Sept 2019.

2. BMJ. British Medical Journal.

Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4897 (Published 04 September 2019)

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Low Carb Diet

High carbohydrate diet can make a person put on weight.

The extra weight can put a strain on the knees and logic dictates that over time this can cause knee problems due to excessive “wear and tear”.

So would a Low-Carbohydrate and Low-Fat Diet help to relieve Pain in Individuals with Knee Osteoarthritis.

Yes, low carb diet can indeed have positive effect on Knee pain.

A study testing the efficacy of two dietary interventions found that low carb diet can reduce pain intensity .

Reference

Pain Med. 2019 Mar 13. pii: pnz022. doi: 10.1093/pm/pnz022.

The Effect of Low-Carbohydrate and Low-Fat Diets on Pain in Individuals with Knee Osteoarthritis.

Strath LJ1, Jones CD1, Philip George A1, Lukens SL1, Morrison SA2, Soleymani T3, Locher JL4, Gower BA5, Sorge RE1.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Surprising Number of Americans Believe Alternative Therapies Can Cure Cancer

woman holding white laptop between women

Photo by rawpixel.com on Pexels.com

A recent National Cancer Opinion Survey found that a significant Number of Americans Believe Alternative Therapies Can Cure Cancer.

Nearly four in 10 Americans (39%) believe cancer can be cured solely through alternative therapies such as enzyme and oxygen therapy, diet, vitamins, and minerals.

Even many of the respondents with direct cancer experience—people who have or had cancer and family caregivers—believe cancer can be cured solely through alternative medicine.(22% and 38%, respectively).

The American survey also found that younger people are the group most likely to hold these views: 47% of people ages 18 to 37 and 44% of people ages 38 to 53.

It is counterintuitive that the generation with access to vast online information at the swipe of a finger holds such unscientific views. One wonders whether the social media is inadvertently promoting misinformation.

References

1.American Society of Clinical Oncology : Second National Cancer Opinion Survey.

 

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Can Turmeric control cancer ?

Turmeric powder

 

Turmeric is an orange coloured spice widely used in Indian dishes.

Turmeric has been used in Indian traditional medicine (Siddha and Ayurveda).

Turmeric has anti-inflammatory and anti-Cancer properties when tested in laboratories.

Remember – a potential to be beneficial (based on lab studies) is not the same as being proven to work in humans. Lot of substances which are promising in the laboratory eventually turn out to be useless in humans.

If you search PUBMED database- which is an online database of scientific papers- you will find hundreds of papers pertaining to medicinal use of turmeric and its key ingredients such as curcumin. But unfortunately among the many hundreds of published papers, there are very few human trials which have explored turmeric as a anti-cancer treatment.

Inspite of the positive anectodal reports on various internet sites, the available scientific evidence for use of turmeric as an anti-cancer treatment is very spare. ( references below).

Hence it is not worthwhile using turmeric as a cancer treatment.

If you do like Indian dishes, use turmeric as a spice in your normal diet.

But do stay away from the supplements which are sold with health claims.

 

ginger and turmeric powder

Photo by Pixabay on Pexels.com

References

The EssentialMedicinal Chemistry of Curcumin.Nelson KM, Dahlin JL, Bisson J, Graham J, Pauli GF, Walters MA. J Med Chem. 2017 Mar 9;60(5):1620-1637.

Phase I clinical trial of oralcurcumin: biomarkers of systemic activity and compliance.Sharma RA, Euden SA, Platton SL, Cooke DN, Shafayat A, Hewitt HR, Marczylo TH, Morgan B, Hemingway D, Plummer SM, Pirmohamed M, Gescher AJ, Steward WP. Clin Cancer Res. 2004 Oct 15;10(20):6847-54.

A Placebo-Controlled Double-Blinded Randomized Pilot Study of Combination Phytotherapy in Biochemically Recurrent Prostate Cancer.van Die MD, Williams SG, Emery J, Bone KM, Taylor JM, Lusk E, Pirotta MV. Prostate. 2017 May;77(7):765-775.

Efficacy and Safety of Curcumin in Treatment of Intestinal Adenomas in Patients With Familial Adenomatous Polyposis.Cruz-Correa M, Hylind LM, Marrero JH, Zahurak ML, Murray-Stewart T, Casero RA Jr, Montgomery EA, Iacobuzio-Donahue C, Brosens LA, Offerhaus GJ, Umar A, Rodriguez LM, Giardiello FM. Gastroenterology. 2018 Sep;155(3):668-673.

Effect on prostatic specific antigen by a short time treatment with a Curcuma extract: A real life experience and implications for prostate biopsy.Fabiani A, Morosetti C, Filosa A, Principi E, Lepri L, Maurelli V, Fioretti F, Servi L. Arch Ital Urol Androl. 2018 Jun 30;90(2):107-111.

Pharmacodynamic and pharmacokinetic study of oral Curcuma extract in patients with colorectal cancer.Sharma RA, McLelland HR, Hill KA, Ireson CR, Euden SA, Manson MM, Pirmohamed M, Marnett LJ, Gescher AJ, Steward WP. Clin Cancer Res. 2001 Jul;7(7):1894.

Consumption of the putative chemopreventive agent curcumin by cancer patients: assessment of curcumin levels in the colorectum and their pharmacodynamic consequences.Garcea G, Berry DP, Jones DJ, Singh R, Dennison AR, Farmer PB, Sharma RA, Steward WP, Gescher AJ. Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):120-5.

A double-blind, placebo-controlled randomised trial evaluating the effect of a polyphenol-rich whole food supplement on PSA progression in men with prostate cancer–the U.K. NCRN Pomi-T study.Thomas R, Williams M, Sharma H, Chaudry A, Bellamy P. Prostate Cancer Prostatic Dis. 2014 Jun;17(2):180-6

Consumption of the putative chemopreventive agent curcumin by cancer patients: assessment of curcumin levels in the colorectum and their pharmacodynamic consequences.Garcea G, Berry DP, Jones DJ, Singh R, Dennison AR, Farmer PB, Sharma RA, Steward WP, Gescher AJ. Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):120-5.

A phase I/II study of gemcitabine-based chemotherapy plus curcumin for patients with gemcitabine-resistant pancreatic cancer.Kanai M, Yoshimura K, Asada M, Imaizumi A, Suzuki C, Matsumoto S, Nishimura T, Mori Y, Masui T, Kawaguchi Y, Yanagihara K, Yazumi S, Chiba T, Guha S, Aggarwal BB. Cancer Chemother Pharmacol. 2011 Jul;68(1):157.

Phytosome complex of curcumin as complementary therapy of advanced pancreatic cancer improves safety and efficacy of gemcitabine: Results of a prospective phase II trial.Pastorelli D, Fabricio ASC, Giovanis P, D’Ippolito S, Fiduccia P, Soldà C, Buda A, Sperti C, Bardini R, Da Dalt G, Rainato G, Gion M, Ursini F. Pharmacol Res. 2018 Jun;132:72-79.

Monoclonal gammopathy of undetermined significance, smoldering multiple myeloma, and curcumin: a randomized, double-blind placebo-controlled cross-over 4g study and an open-label 8g extension study.Golombick T, Diamond TH, Manoharan A, Ramakrishna R. Am J Hematol. 2012 May;87(5):455-60.

 

Image credit: Simon A. Eugster. Turmeric (Curcuma longa):fresh rhizome and powder.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Does Cranberry juice relieve bladder symptoms due to radiation cystitis?

bowl of red round fruits

Many people do look for natural remedies to help with their symptoms.

Anectodally, many patients undergoing radiotherapy have reported that Cranberry Juice has eased their radiation cystitis symptoms.

What is the scientific evidence behind it ?

Should all patients having cystitis symptoms during radiotherapy take cranberry juice?

There is certainly scientific basis to expect benefit from Cranberry Juice.(1).

A lab study and a volunteer study (with volunteers from Japan, Hungary, Spain and France) has shown that certain chemicals in Cranberry can make bacteria ‘less sticky‘ to urinary tract walls and hence potentially reduces virulence of the bacteria.(1). But subsequent large studies have NOT confirmed any large benefit from Cranberry in terms of treating or preventing urinary tract infections. (2)(3).

But Radiation Cystitis is not due to bacterial infections although infections can co-exist sometimes. Hence the use of Cranberry has been studied separately in patients undergoing radiation therapy.

A New Zealand study involved 41 men undergoing radiotherapy for prostate cancer. Taking Cranberry (one capsule a day at breakfast) was found to reduce symptoms of pain and burning. (4).

On the other hand, in a study from Canada involving 112 patients , consumption of Cranberry juice compared with apple juice had no effect on radiation cystitis symptoms. (5).

Another study from United Kingdom was inconclusive because of poor patient recruitment and poor compliance. (6).

So the scientific evidence is inconclusive at present.(7).

Practically, if someone is keen to try it – the best course of action – ( for someone not intolerant of cranberry juice) – is to try it and see whether it offers any symptomatic benefit .

Disclaimer: Please note- This is NOT medical advice. This blog is purely for information only. See your own doctor to discuss options.

There are prescription medications available to help with radiation cystitis symptoms.

References:

1.Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study. BMC Infect Dis. 2010 Apr 14;10:94.

2. BBC News. Does Cranberry juice stop cystitis. By Claudia Hammond. (Accessed 1st Jan 2019).

3. BBC News. Ditch cranberry juice for urine infection . (Accessed 1st Jan 2019).

4.Standardized cranberry capsules for radiation cystitis in prostate cancer patients in New Zealand: a randomized double blinded, placebo controlled pilot study. Support Care Cancer (2015) 23: 95.

5. A Randomised Trial of Cranberry Versus Apple Juice in the Management of Urinary Symptoms During External Beam Radiation Therapy for Prostate Cancer. G.Campbell et al. Clin Oncol (R Coll Radiol). 2003 Sep;15(6):322-8.

6. A Randomised Double-blind Placebo-controlled Trial to Determine the Effect of Cranberry Juice on Decreasing the Incidence of Urinary Symptoms and Urinary Tract Infections in Patients Undergoing Radiotherapy for Cancer of the Bladder or Cervix. Cowan CC, et al. Clin Oncol (R Coll Radiol). 2012.

7.Chemical- and radiation-induced haemorrhagic cystitis: current treatments and challenges. BJU Int. 2013 Nov;112(7):885-97.

Image credit: Photo by Jessica Lewis on Pexels.com

Low carbohydrate diet

The advocates of low-carb diet received a scientific boost recently.

An American trial, published recently in the British Medical Journal, compared the effects of low-carb-high-fat diet with high-carb-low-fat while keeping total calories and protein intake constant.

This elegantly done trial shows that carbohydrates are bad for weight loss. A diet with a combination of low-carb-high-fat content was the winner in this trial and it promoted energy loss and helped maintain weight loss.

Reference:

Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial.

Can alcohol cause cancer?

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Can alcohol cause cancer?

Yes,  worldwide, 1 in 20 cancers are attributed to alcohol .

How much drinking causes cancer?

“Even modest use of alcohol may increase cancer risk, but the greatest risks are observed with heavy, long-term use”

“The more that a person drinks, and the longer the period of time, the greater their risk of development of cancer, especially head and neck cancers”

Are light drinkers at risk ?

Risk of cancer is present at  even at low levels of consumption.  Hence, the World Cancer Research Fund/AICR makes the following recommendation: “If alcoholic drinks are consumed, limit consumption to two drinks a day for men and one drink a day for women.” They also recommend that, “for cancer prevention, it’s best not to drink alcohol.”

Is wine less risky than spirits?

No,  the risk is present “regardless of the specific type of alcoholic beverage (ie, beer, wine, or spirits/liquor)”

Which cancers can arise due to alcohol?

Alcohol is causally associated with Mouth, Throat, Gullet, Liver, Breast and Bowel cancers.

Links:

  1. Alcohol and Cancer: A Statement of the American Society of Clinical Oncology. http://ascopubs.org/doi/full/10.1200/JCO.2017.76.1155
  2. Alcohol is a direct cause of seven ​​forms of cancer, finds study . https://www.theguardian.com/society/2016/jul/22/alcohol-direct-cause-seven-forms-of-cancer-study

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