World Cancer Day

The Union for International Cancer Control (UICC) is the largest and oldest international cancer organization dedicated to reducing the global cancer burden.  For the past 20 years, February 4th has been World Cancer Day.  It is a day to bring the world's attention to cancer and its impact around the world, the need for investment in research and innovation in the field of cancer treatment and helping people to understand cancer.  Access to information and knowledge about cancer can empower us all.  

What is the most common type of cancer?

Breast cancer has recently overtaken lung cancer as the most common type of cancer.  Breast cancer accounted for nearly 12% of new cancer cases this past year worldwide, with an estimated 2.3 million new cases, according to the World Health Organization (WHO).  This is the first time that breast cancer has been the most commonly occurring cancer globally.  

Lung cancer was the most common type of cancer for the last 20 years but is now in second place.  Colorectal cancer is the third most common cancer globally.

What are the risk factors for cancer?

Of course, different types of cancer have different risk factors, but many of the risk factors are the same for different cancers.  According to the WHO, around one third of deaths from cancer are due to the following risk factors:

• Tobacco use
• Obesity or high body mass index
• Low fruit and vegetable intake
• Lack of physical activity
• Alcohol use

What are the impacts of cancer in the world?

Each year, 10 million people die from cancer worldwide.  Almost 20 million new cases of cancer were diagnosed last year.  As the global population grows and life expectancy increases, cancer is expected to become more common.  Experts expect cancer deaths to rise to 13 million per year by 2030, and the total number of new cancer cases diagnosed to rise to 30 million by 2040.

How has the pandemic affected cancer?

Due to the change in the use of healthcare resources and the temporary hold on elective procedures in many hospitals, as well as people's fears about going to the doctor during the pandemic, cancer diagnosis has decreased.  Those cancers are surely still out there, but we just haven't found them yet.  The pandemic has also disrupted cancer treatment in many countries.  Delays in testing to complete diagnosis and delays in surgery or chemotherapy have had a big impact on cancer treatment.

Cancer research has also been slowed, or even stopped in some cases, due to the pandemic.  We need ongoing research to help find new treatments.

What can we do about it?

More than one third of cancer cases are preventable!  Another third can be cured if detected early and treated promptly and properly.  If we can implement the appropriate strategies for prevention, early detection, and treatment, we could save up to 3.7 million lives every year.

When we educate ourselves about cancer, we can make a difference.  

• Find out when you should start cancer screening and follow through with those screenings.  
• Remind your family members to get their mammogram and their colon cancer screening when it is due.  
• Be more physically active on a regular basis.
• Eat a healthy diet with plenty of fresh fruits and vegetables.
• Avoid tobacco use.
• Try to maintain a body mass index below 30, preferably below 26.
• Limit alcohol use.

Follow the links below for more information:

 World Cancer Day

American Cancer Society | Information and Resources about for Cancer: Breast, Colon, Lung, Prostate, Skin

If you have any questions about cancer, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

New Year’s Resolutions

Did you skip making a New Year's resolution for 2021? Did you make a resolution and have trouble sticking with it? Read on…

New Year's resolutions may have started with the ancient Babylonians about 4,000 years ago. One has to wonder if they were any more successful than we are in setting and keeping New Year's resolutions. Approximately 45% of adults set goals for the new year. However, research shows that only 8% keep those resolutions. 

You can do better by following a few straightforward tips. Enter the SMARTER goal. The SMART goal is not a new concept, it was first published by George Doran in 1981 and later expanded to include the Evaluated and Reviewed portion. Here is an overview:

• Specific: Target a specific area that you want to improve.
• Measurable: What is your indicator of progress? Put a number on it.
• Achievable: Can you do it?
• Realistic: What result can you realistically achieve with available resources?
• Time-related: When will you reach your intended result?
• Evaluate: Assess how well you achieved your goal.
• Review: Reflect on achievements. If necessary, adjust your approach or behavior to reach your goal.

Another strategy is to make a goal a habit, as proposed by James Clear in his best-selling book Atomic Habits. Think of your goal as a "habit loop" with three easy processes in mind.

• CUE. First set up a CUE (signal, prompt, or reminder) for your desired habit. For example, let's say your goal is to begin a habit of daily meditation. After you have established the SMARTER goal, select a cue that reminds you to follow through with your goal. This may be placing your favorite book in your favorite chair in which you will meditate. 
• CRAVING. The CUE sets up the second step in your habit loop - the CRAVING for the new habit. Make your new habit of meditation attractive and appealing so that you will feel that something is missing if you skip this part of your day. 
• REWARD. The final step in the habit loop is to REWARD yourself with something simple and meaningful for sticking with your meditation practice. 

After you set your goal, sticking with it is the more challenging part. Make your new habit obvious. Don't let your habit fade into the background of your daily routine. Sometimes life requires you to skip a day of your new habit. But try to avoid missing two days in a row. Set one goal at a time, keeping it easy and satisfying. Few people stick with difficult goals or goals that are not personally satisfying.

An important consideration in being successful is the behavioral process underlying such goals. For example, two people set a goal of meditating for five minutes daily. One person is successful; the other is not. The underlying processes are what differentiates the success or non-success. As Clear noted, we do not rise to the level of our successes, we fall to the level of our processes. We do better when we focus more on our underlying processes, not getting stuck on setting our goals. 

This can be the best of previous years. Ask yourself what and who is really important in your life? It is OK to be surprised, when you take a few moments to dig deep in your personal values and hear what rises to the top.  We often set goals without thoughtful and reflective consideration of what is most important in our lives. Think carefully about changes you want to make in this new year. 

Wishing you a healthy, happy, and wholesome 2021!

If you have any questions about New Year resolutions, please log into your account and send us your question. We are here to help.

Dr. Joe Banken PhD

Performance-Enhancing Substances: Should we be worried?

Performance-Enhancing Substances (PES) are used by children, teens, and adults to improve their athletic performance and for appearance changes. These can be dietary supplements, legal and illegal drugs, such as anabolic steroids, human growth hormone, creatinine, and stimulants.

Which are common PES? What do they do and how do they harm our children or us?

1. Anabolic steroids
   Used to increase muscle mass and strength.
   The main anabolic from our body is Testosterone.  Many athletes take a synthetic modification of testosterone. 
   A particularly dangerous class of anabolic steroids are the so-called designer drugs. These are synthetic steroids that have been illicitly created to be undetectable by current drug tests.
   Risks:
   -Male: prominent breasts, shrunken testicles, infertility and prostate enlargement.
   -Female: baldness (could be irreversible), deeper voice, enlarged clitoris, increased body hair, irregular periods.
   -Male and female: severe acne, high blood pressure, aggressive behavior, liver abnormalities and tumors, changes in cholesterol, psychiatric disorder (depression), drug dependence.
   -Taking anabolic steroids is prohibited by must sports organizations and it is illegal. 
2. Human Growth Hormone (HGH)
   Human growth hormone has an anabolic effect. Athletes take it to improve their muscle mass and performance. It is available with a prescription and administered by injection.
   Adverse effects: muscle weakness, fluid retention, joint pain, diabetes, vision changes, carpal tunnel syndrome, enlargement in heart and high blood pressure.
3. Creatine
   Creatine is a naturally occurring compound produced by your body that helps your muscles release energy. Creatine appears to help muscles make more adenosine triphosphate (ATP), which stores and transports energy in cells, and is used for quick bursts of activity, such as weightlifting or sprinting. It is available over-the-counter as a supplement.
   Adverse effects: abdominal pain, muscle cramps, weight gain.
   It appears safe if used at the recommended dose, but there are no long-term studies.
4. Stimulants
   Common stimulants include caffeine and amphetamines. Cold remedies often contain the stimulants ephedrine or pseudoephedrine hydrochloride. Energy drinks contain high doses of caffeine and other stimulants. The street drugs cocaine and methamphetamine are also stimulants.
   Stimulants can improve endurance, reduce fatigue, decrease appetite, and increase concentration.
   Adverse effects: irritability, insomnia, dehydration, heatstroke, dependence or addiction, palpitations, heart rhythm abnormalities, weight loss, high blood pressure, stroke, hallucinations, and heart attack.

What can we do as parents?

The American Academy of Pediatrics recommends the following to parents:

Guidance for Parents with Concerns About PES Use: 

1. Get involved...
   •  Be aware of new pressures as athletes progress through different levels of  participation and competition
   •  Emphasize the basics of hard work, pushing limits, teamwork, respect for competitors 
   •  Give options for alternative ways to achieve peak performance
   •  Monitor any use of supplements or shakes
   •  Do not hesitate to ask directly about supplement use
   •  Provide a counterpoint for prodrug and prosupplement messages
   •  Become knowledgeable about PES
   •  Be persistent 
2. Stay connected and create a strong partnership with your child's coach...
   • Get to know the team rules
   • Keep coach informed of any pertinent issues that may be occurring in    athlete's life
   • Respect role of coach
   • Talk to coach before or after practice, avoid sensitive discussions on game days
3. Keep lines of communication open with the athlete...
   • a. Emphasize the importance of good health
   • b. Use the news as a starting point for discussions on PES use 
   • c. Emphasize that there are no shortcuts to peak performance 
4. Engage health care providers if you are concerned about PES use...
   • Call provider before check-up and request that possibility of PES use be addressed during examination.
5. Know the warning signs of PES use, which include the following:
• Rapid changes in body shape
• Aggressive behavior or atypical mood swings 
• Extreme hair growth or acne
• Excessive time in weight room
• Voice changes (especially for girls) 
6. If you discover that your child is using PES...
   • Keep lines of communication open
   • Seek outside help

Should our children use PES?

Some athletes may appear to improve their performance with certain supplements or drugs, but at what cost? The list of side effects is very extensive, and some are irreversible. The short-term benefits are evident in some cases, but with a risk that outweighs the benefit. Doping is prohibited by most sports organizations. Taking performance-enhancing substances is very risky.

If you have any questions about performance-enhancing substances, please log into your account and send us your question. We are here to help.

Valerie C. Hines, MD, FAAP