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Published on Leave a comment on Chemicals Remain On New Clothes

Research for a doctoral thesis found that thousands of chemicals (from manufacturing the textiles and clothes) remain on finished clothes, and many of these remain after washing. Bottom line: wash new clothes before wearing! From Science Daily:

Toxins remain in your clothes

Thousands of chemicals are used in clothes manufacturing. Researchers at Stockholm University have examined if there are chemicals in the clothes we buy as well. Several substances related to health risks were identified and not even organic cotton was a guarantee for non-toxic textiles. In a new thesis 60 garments from Swedish and international clothing chains have been tested. An initial analysis found thousands of chemicals in the clothes and around a hundred chemicals were preliminary identified. Several of the substances were not on the producers' lists and are suspected to be by-products, residues or chemicals added during transport.

"Exposure to these chemicals increases the risk of allergic dermatitis, but more severe health effect for humans as well as the environment could possibly be related to these chemicals. Some of them are suspected or proved carcinogens and some have aquatic toxicity," says Giovanna Luongo, PhD in Analytical Chemistry at Stockholm University.

Depending on occurrence, quantity, toxicity and how easily they may penetrate the skin, four groups of substances were chosen for further analysis. The highest concentrations of two of these, quinolines and aromatic amines, were found in polyester. Cotton contained high concentrations of benzothiazoles, even clothes made from organic cotton.

The researchers washed the clothes and then measured the levels of chemicals. Some of the substances were washed off, with a risk of ending up in aquatic environments. Others remained to a high degree in the clothes, becoming a potential source of long-term dermal exposure. It is difficult to know if the levels of these harmful substances are hazardous, and what effects chemicals in our clothes can have in the long run.

Published on Leave a comment on Nanotubes Found in Lungs of Children

Scary study results showing what may scientists have long feared - that carbon nanotubes are being released into the environment and getting into our bodies with unknown health effects. The researchers point out that fine particulate matter (PMs) from air pollution penetrate lower airways and are associated with adverse health effects even with low concentrations and that carbon nanotubes are part of this fine particulate matter. Here they discussed how catalytic converters may convert carbon monoxide into carbon nanotubes during the process of converting carbon monoxide into safer emissions. The problem with carbon nanotubes is that they are so small - so small that we inhale them, but can't cough them out. Carbon nanotubes can be envisioned as one-atom thick sheets of carbon atoms that have been rolled into tubes with diameters as small as 1 nm and lengths up to several centimeters. And scientists are concerned that they may have inflammatory effects on the lungs (similar to what asbestos does). Of course the long-term studies have not yet been done....Because once again, technological advances have outpaced any safety sudies. The researchers studied the lung cells of children with asthma, but it is unclear whether the carbon nanotubes had any effect on or caused their asthma.

Two additional areas of serious concern regarding carbon nanotubes: (1) many tires now contain carbon nanotubes, and with abrasion (wear and tear) the nanotubes are released into the air (air pollution), and (2) the tire crumb fill used in synthetic turf fields. People, including athletes and developing children, are playing on these fields and whatever is in the tires (toxic chemicals, lead, etc. and carbon nanotubes) is being released into the air, and inhaled and ingested by those playing and exercising on the synthetic turf. From Futurity:

Nanotubes Found in Lungs of French Kids

Cells taken from the airways of Parisian children with asthma contained man-made carbon nanotubes—just like the kind found in the exhaust pipes of vehicles in Paris. The researchers report in the journal EBioMedicine that these samples align with what has been found elsewhere in US cities, in spider webs in India, and in ice cores. The research in no way ascribes the children’s conditions to the nanotubes, says Rice University chemist Lon Wilson, a corresponding author of a new paper describing the work. But the nanotubes’ apparent ubiquity should be the focus of further investigation, he adds.

“We know that carbon nanoparticles are found in nature,” Wilson says, noting that round fullerene molecules like those discovered at Rice are commonly produced by volcanoes, forest fires, and other combustion of carbon materials. “All you need is a little catalysis to make carbon nanotubes instead of fullerenes.”

Carbon nanotubes (the long rods) and nanoparticles (the black clumps) appear in vehicle exhaust from tailpipes of cars in Paris.

 

 

 

 

 

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Carbon inside a lung cell vacuole takes the form of nanotubes (rods) and nanoparticles (black clumps). Credit: Both photos Fathi Moussa, Paris-Saclay Univ.

 

A car’s catalytic converter, which turns toxic carbon monoxide into safer emissions, bears at least a passing resemblance to the high-pressure carbon monoxide, or HiPco, process to make carbon nanotubes, he says. “So it is not a big surprise, when you think about it,” Wilson adds.

The team—led by Wilson, Fathi Moussa of Paris-Saclay University, and lead author Jelena Kolosnjaj-Tabi, a graduate student at Paris-Saclay—analyzed particulate matter found in the alveolar macrophage cells (also known as dust cells) that help stop foreign materials like particles and bacteria from entering the lungs. 

The cells were taken from 69 randomly selected asthma patients aged 2 to 17 who underwent routine fiber-optic bronchoscopies as part of their treatment. For ethical reasons, no cells from healthy patients were analyzed, but because nanotubes were found in all of the samples, the study led the researchers to conclude that carbon nanotubes are likely to be found in everybody.

The study notes but does not make definitive conclusions about the controversial proposition that carbon nanotube fibers may act like asbestos, a proven carcinogen. But the authors reminded that “long carbon nanotubes and large aggregates of short ones can induce a granulomatous (inflammation) reaction.”

The study partially answers the question of what makes up the black material inside alveolar macrophages, the original focus of the study. The researchers found single-walled and multiwalled carbon nanotubes and amorphous carbon among the cells, as well as in samples swabbed from the tailpipes of cars in Paris and dust from various buildings in and around the city. “The concentrations of nanotubes are so low in these samples that it’s hard to believe they would cause asthma, but you never know,” Wilson says. “What surprised me the most was that carbon nanotubes were the major component of the carbonaceous pollution we found in the samples.”

The nanotube aggregates in the cells ranged in size from 10 to 60 nanometers in diameter and up to several hundred nanometers in length, small enough that optical microscopes would not have been able to identify them in samples from former patients. The new study used more sophisticated tools, including high-resolution transmission electron microscopy, X-ray spectroscopy, Raman spectroscopy, and near-infrared fluorescence microscopy to definitively identify them in the cells and in the environmental samples.

“We collected samples from the exhaust pipes of cars in Paris as well as from busy and non-busy intersections there and found the same type of structures as in the human samples,” Wilson says. “It’s kind of ironic. In our laboratory, working with carbon nanotubes, we wear facemasks to prevent exactly what we’re seeing in these samples, yet everyone walking around out there in the world probably has at least a small concentration of carbon nanotubes in their lungs,” he says. The researchers also suggest that the large surface areas of nanotubes and their ability to adhere to substances may make them effective carriers for other pollutants.

Published on Leave a comment on Chemicals Migrate From Containers to Food

 More and more studies are finding negative health effects from hormone disrupting chemicals (which we are exposed to every single day, and subsequently which are in all of us), such as parabens, phthalates, Bisphenol-A (BPA), and chemical substitutes for BPA such as Bisphenol-S (BPS) and BPF.  The last post had some recent studies that looked at health effects of hormone disrupting chemicals. The following article points out some of the many difficulties in developing packaging that is safe and doesn't leach endocrine disrupting chemicals or even other chemicals.

We generally focus on hormone disrupting chemicals in plastic bottles or metal cans (which their epoxy liners), but other parts of packaging may (or may not) also leach chemicals. Some leaching may occur with the adhesives used to seal foil pouches, and the polypropylene inner layers also may leach stabilizers. Glass jars are OK, but jar lids may be equipped with BPA-based epoxy liners and/or gaskets that leach plasticizers. Greaseproof wrappers may leach poly- and perfluorinated compounds used to make some packaging greaseproof (may occur if packaging is from India and China - because it is legal to import into USA and use).  Some ceramic kitchenware - the glazes used in artisanal pottery and older mass produced ceramics may leach toxic metals, especially lead. There can even be "offset migration" which occurs when the printed outer surface of food packaging transfers chemicals to the inner food-contact surface.  Whew...

Bottom line: Even BPA alternatives (labeled BPA-free) should be viewed as the same as BPA (as endocrine disruptors) - in other words, currently there are no good BPA substitutes. Read labels and try to minimize plastics in personal care products (e.g., lotion, fragrances) and your food if possible (e.g., choose glass, stainless steel, wax paper, aluminum foil). This is especially important during pregnancy.  Don't microwave food in a plastic dish or container, or covered with plastic wrap. Eat fresh foods and try to avoid soda cans and other packaged, processed foods, especially in plastic containers or metal cans. From Environmental Health Perspectives: A Hard Nut to Crack: Reducing Chemical Migration in Food-Contact Materials

When we buy food, we’re often buying packaging, too. From cherries to Cheez-It® crackers, modern foods are processed, transported, stored, and sold in specialized materials that account, on average, for half the cost of the item, according to Joseph Hotchkiss, a professor in Michigan State University’s School of Packaging. Consumer-level food packaging serves a wide range of functions, such as providing product information, preventing spoilage, and protecting food during the journey from production to retail to pantry, fridge, or freezer. That’s why food producers lavish so much time and money on it.

But what happens when these valuable and painstakingly engineered containers leach chemicals and other compounds into the food and drink they’re designed to protect? Such contamination is nearly ubiquitous; it happens every day, everywhere packaged food is found, with all common types of packaging, including glass, metal, paper, and plastic. Even as awareness of the issue grows, large-scale solutions that are scientifically and financially viable remain out of reach. The challenges in reaching them are many.  ...continue reading "Chemicals Migrate From Containers to Food"

Published on Leave a comment on Forget the Pills, Eat the Vegetables Instead

An article that discusses why supplements containing large doses of antioxidants, or beta-carotene, or even vitamin megadoses  doesn't work, and can even cause harm, while eating actual foods such as fruits and vegetables has many health benefits. This is what a number of the studies I've been posting also found (especially with health benefits from eating fish and not from fish oil). go ahead and throw out the megadose supplements, and instead eat lots of fruits and vegetables. Remember fruits and vegetables contain a complex mix of nutrients and feed our microbial communities, as well as having microbes on them. From Medical Xpress:

Forget the antioxidant pills; just stick with veggies

Why just stick to eating fruits and veggies when you can get an extra boost from supplements that put good things like antioxidants into a handy pill? And that seems like it should be a good idea. If the antioxidants that occur naturally in our food, like broccoli and carrots, are good for us, a supplement with the same thing must also be good. But that's not quite true.

Antioxidants are touted as protectors of our health because they eliminate free-radicals that damage molecules in cells and tissues by grabbing electrons from them, making those molecules, in turn, unstable....On this basis, a group of scientists proposed in 1981 the creation of a nutritional supplement to fight free-radicals. They reasoned that since many observational epidemiological studies had shown that people who eat lots of vegetables are at lower risk of colon cancer, heart disease and many other bad conditions, then the "active" ingredient should be identified and put into a pill. They thought that it must be beta-carotene, which helps make carrots orange, because it's an antioxidant.

But in the late 1980s, two intervention trials, one in Seattle and the other in Finland, started....For the Seattle trial, approximately 18,000 men and women were randomized in 1988 to receive either a tablet containing beta-carotene or a tablet containing no active ingredient, which is the famous placebo. The plan was to follow the men and women for 10 years; the researchers hypothesized they would observe a lower lung cancer risk in the beta-carotene tablet group, hopefully much lower. But the opposite happened and the trial had to be stopped early because the beta-carotene group suffered significantly more cases of lung cancer than the placebo group. The same thing was seen in the Finland trial. Importantly, the amount of beta-carotene in the tablet was much higher than occurs naturally in the body in both trials.   ...continue reading "Forget the Pills, Eat the Vegetables Instead"

Published on Leave a comment on New Report About Harms of Endocrine Disruptors

A report released this week by the Endocrine Society states that the list of health problems that scientists can confidently link to exposure to hormone-disrupting chemicals has grown to include: diabetes, cardiovascular disease, obesity, reproductive and developmental problems, thyroid impairment, certain reproductive cancers, and neurodevelopmental problems such as decreased IQ. This statement (report) is based on the summaries of 1300 studies on endocrine disrupting chemicals (EDCs), and it also adds support to the idea that even minute doses of these chemicals can interfere with the activity of natural hormones, which play a major role in regulating physiology and behavior. The statement also stated that most industrial chemicals released into the environment—numbering in the tens of thousands—have never been tested for endocrine-disrupting potential. EDCs include such common chemicals as bisphenol A (BPA), phthalates, parabens, some pesticides (e.g., atrazine), flame retardants, some persistent organic pollutants, and dioxins.

Where are endocrine disruptors found? People are exposed to chemicals with estrogenic effects in their everyday life, because endocrine disrupting chemicals are found in low doses in thousands of products. Many plastic products, including those advertised as "BPA free", have been found to leach endocrine-disrupting chemicals (the substitute chemicals are no better than BPA, and may be worse). Examples: plastic food containers which then leach into foods, linings of metal beverage, formula, and food cans, soft plastic toys, dental sealants, consumer goods, receipts, personal care products that contain parabens or phthalates (e.g., found in lotions,sunscreens, fragrances), household products (such as cleaning products, vinyl shower curtains) , cars (that new car smell in car interiors), etc. Americans love plastics, but there is a serious human health cost.

NOTE: To minimize EDC exposure - try to avoid plastic food and beverage containers. Instead try to use glass, stainless steel, or ceramics. Eat as many unprocessed and fresh foods as possible. Use cloth shower curtains. Read labels and avoid BPA, phthalates, parabens. Avoid fragrances. Don't use or buy non-stick pans, stain and water-resistant coatings on clothing, furniture and carpets. When buying new furniture, check that it doesn't have added fire retardants.

Of course any public discussion of the harms from endocrine disrupting chemicals, as well as the newly released Endocrine Society report, is drawing sharp criticisms from the chemical industry (especially the American Chemistry Council, the largest trade group for the chemicals industry). Of course. We all know that the lobbying efforts by the chemical industry to suppress and deny the evidence of harm to humans from EDCs has been and will continue to be massive. Sadly, but at this point EDCs are found in almost everyone on earth. More about the report, from Science Daily:

Chemical exposure linked to rising diabetes, obesity risk

Emerging evidence ties endocrine-disrupting chemical (EDC) exposure to two of the biggest public health threats facing society -- diabetes and obesity. EDCs contribute to health problems by mimicking, blocking or otherwise interfering with the body's natural hormones. By hijacking the body's chemical messengers, EDCs can alter the way cells develop and grow. Known EDCs include bisphenol A (BPA) found in food can linings and cash register receipts, phthalates found in plastics and cosmetics, flame retardants and pesticides. The chemicals are so common that nearly every person on Earth has been exposed to one or more.  ...continue reading "New Report About Harms of Endocrine Disruptors"

Published on Leave a comment on Shrink Your Brain With An Unhealthy Diet

Over and over studies find that a person's diet is linked to health and diseases, and now a study finds that an unhealthy diet is linked to shrinkage of the brain, specifically the volume of the left hippocampus. The biggest effects on the hippocampus are found with both greater consumption of an unhealthy diet and lower consumption of a healthy diet.  The hippocampus is a brain structure associated with both learning and memory, as well as mood regulation, and is specifically implicated in depression. In dementia and Alzheimer's disease, the hippocampus is one of the first regions of the brain to suffer damage.

So....you want to protect your hippocampus from shrinkage. The researchers themselves  suggest that the effects may be reversible, and suggest "dietary interventions to promote hippocampal health". Once again, a healthy diet means lots of plant-based foods (for example, a Mediterranean based diet with lots of fruits, vegetables, legumes, nuts, berries, seeds), and decreasing a Western-style diet with highly processed foods, low fiber, lots of meat, fat,  and refined sugars. From Medscape:

Unhealthy Diet May Shrink the Brain

Consumption of an unhealthy Western diet characterized by meat, hamburgers, chips, and soft drinks, may reduce the volume of the left hippocampus, whereas a healthy diet of fresh vegetables and fish may increase hippocampal volume. In a study of more than 250 individuals, investigators found that during a period of 4 years, there was a difference of more than 200 cubic millimeters in hippocampal volume between individuals who ate a healthy diet and those who consumed an unhealthy diet.  ...continue reading "Shrink Your Brain With An Unhealthy Diet"

Published on Leave a comment on Millions of Deaths Annually Due to Air Pollution?

A recent post (Air Pollution Can Kill You) discussed recent research that found that air pollution is linked to an overall increase in death rates, especially cardiovascular disease. But how many deaths each year are linked to air pollution? Recent research suggests that outdoor air pollution, mostly by fine particulate matter with a diameter smaller than 2.5 micrometers (PM2.5), leads to 3.3 million premature deaths per year worldwide, predominantly in Asia. The number one cause  worldwide is residential energy use such as heating and cooking, (India ,China, and the developing world).

But surprisingly agriculture or farming is number 2 worldwide. How can that be? Well, farms produce ammonia from fertilizer and animal waste. That ammonia then combines with sulfates from coal-fired power plants and nitrates from vehicle exhaust to form the soot particles that are the big air pollution killers. The United States had about 54,905 deaths in 2010 from soot and smog. Power plants and traffic (vehicle emissions) are big sources of the air pollution linked to deaths in the USA. From Medical Xpress:

Millions of premature deaths tied to air pollution

Outdoor air pollution leads to more than 3 million premature deaths per year, primarily in Asia, according to a letter published online Sept. 16 in Nature.

Johannes Lelieveld, Ph.D., from the Max Planck Institute for Chemistry in Germany, and colleagues used a global atmospheric chemistry model to investigate the link between premature mortality and seven emission source categories in urban and rural environments. The researchers found that outdoor air pollution, mostly by fine particulate matter with a diameter smaller than 2.5 micrometers (PM2.5), leads to 3.3 million premature deaths per year worldwide, predominantly in Asia. The largest impact on premature mortality globally comes from residential energy use such as heating and cooking, prevalent in India and China. In the United States, emissions from traffic and power generation are important. Agricultural emissions make the largest relative contribution to PM2.5 in the eastern United States, Europe, Russia, and East Asia, with the estimate of overall health impact depending on assumptions regarding particle toxicity. 

...continue reading "Millions of Deaths Annually Due to Air Pollution?"

Published on Leave a comment on Air Pollution Can Kill You

Another study finding negative health effects from air pollution. This year I've posted several studies that found negative effects on the brain (and even cognition) from air pollution for people of all ages. Now this latest study found that in areas with air pollution, long-term exposure to outdoor fine particulate matter (PM2.5),which are fine particles in the air, are linked to an overall increase in risk of death, especially due to cardiovascular disease. The fine particles in the air contribute to the development of potentially fatal heart and lung diseases because they slip past the body's defenses and can be absorbed deep into the lungs and bloodstream. They are not sneezed or coughed out the way larger natural particles, like airborne soil and sand, are removed from the body's airways. From Science Daily:

Link between air pollution, increased deaths and increased deaths from heart disease affirmed

In what is believed to be the largest, most detailed study of its kind in the United States, scientists at NYU Langone Medical Center and elsewhere have confirmed that tiny chemical particles in the air we breathe are linked to an overall increase in risk of death. The researchers say this kind of air pollution involves particles so small they are invisible to the human eye (at less than one ten-thousandth of an inch in diameter, or no more than 2.5 micrometers across).

In a report on the findings, published in the journal Environmental Health Perspectives online Sept. 15, the scientists conclude that even minuscule increases in the amount of these particles (by 10 micrograms per cubic meter of air, for example) lead to an overall increased risk of death from all causes by 3 percent -- and roughly a 10 percent increase in risk of death due to heart disease. For nonsmokers, the risk increase rises to 27 percent in cases of death due to respiratory disease.

"Our data add to a growing body of evidence that particulate matter is really harmful to health, increasing overall mortality, mostly deaths from cardiovascular disease, as well as deaths from respiratory disease in nonsmokers," says lead study investigator and health epidemiologist George Thurston, ScD, a professor of population health and environmental medicine at NYU Langone. "Our study is particularly notable because all the data used in our analysis comes from government- and independently held sources."

According to Thurston, fine particles can contribute to the development of potentially fatal heart and lung diseases because they slip past the body's defenses and can be absorbed deep into the lungs and bloodstream. They are not sneezed or coughed out the way larger natural particles, like airborne soil and sand, are removed from the body's airways. Moreover, Thurston says, fine particles are usually made of harmful chemicals such as arsenic, selenium, and mercury, and can also transport gaseous pollutants, including sulfur and nitrogen oxides, with them into the lungs.

For their research, Thurston and his colleagues evaluated data from a detailed health and diet survey conducted by the National Institutes of Health (NIH) and the American Association of Retired Persons (AARP). The NIH-AARP study involved 566,000 male and female volunteers, ages 50 to 71, from California, Florida, Louisiana, New Jersey, North Carolina, Pennsylvania, and the metropolitan areas of Atlanta and Detroit. Analyzing information gathered about the participants between 2000 and 2009,....

Indeed, the team did not find any significant difference in the effect of particulate matter exposure between different sexes or age groups or by level of education. The researchers also noted that limiting the analysis to only the state of California, which has the most rigorous controls on air pollution, did not produce a different overall level of risk; instead, they found the same association between particulate matter exposure and increase in risk of death from all nonaccidental causes and from cardiovascular disease.

Published on Leave a comment on How Many Healthy Years Do You Have Left?

The following article posted average life expectancies for both men and women in countries throughout the world. But what was interesting is that it also gave the average years that a person would be healthy and also unhealthy (which is typically the last years of life). And no matter which country one looks at and the average life expectancy of men and women, it turns out that on average people spend about one eighth of their life in a disabled or unhealthy state. Or between 10 to 20% of their life disabled or unhealthy.

So looking at the United States, it is expected that the average women will live 81 years, but about 13 of those years will be in poor health. Men in the USA will live on average 76 years, but of that about 11 years will be unhealthy. Which means, don't wait until retirement to travel and do all those things you want to do, because you may have health issues preventing you from doing those things - so get out there NOW and DO IT ALL. The "bucket list" should be started now. (Note: I only copied information for 5 countries, but the actual chart has 188 countries. Do go check it out.) From NPR News:

Check Out Life Spans Around The World — And Likely Years Of Ill Health

How Long Will You Live — And How Many Of Those Years Will Be Healthy?

Here are the life expectancies in 188 countries — and the number of unhealthy years a person faces. No matter where you live, the range for years of healthy life is 80 to 90 percent.

Life expectancy compared with global average:

COUNTRY       MALE    UNHEALTHY YEARS       FEMALE       UNHEALTHY YEARS

GLOBAL            68                  8                                     74                       10

CANADA           79                 10                                     83                       12

CHINA               73                   8                                     79                         9

MEXICO             72                  9                                      78                       11

RUSSIA               65                 7                                       76                       10

USA                    76                 11                                      81                       13


Credit: Christopher Groskopf and Alyson Hurt/NPR     Notes: — Life expectancies are estimated for individuals born in 2013.  

Source: Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition

It's one of those good news/bad news stories. A study in the medical journal The Lancet found that people around the world — in countries rich, poor and in the middle — are living longer. But here's the rub. You can't count on living those extra years in good health.

In the first of what will be an annual look at health along with life span around the world called the Global Burden of Disease Study, researchers found that between 1990 and 2013, life expectancy rose by 6.2 years. The average life span at birth across the globe is now 71.5 years, though rates vary tremendously by region. People live the longest, according to the Lancet study, in Andorra, in southwestern Europe, or an average of 83.9 years. People die the youngest, an average of 48.3 years, in Lesotho, in Africa.

But regardless of socioeconomics, geography or total number of years lived, the study shows what appears to be a universal part of the human condition: people live an average of one-eighth of their lives in a disabled or unhealthy state.

"What's interesting is that wherever you go around the world, about seven-eighths of life expectancy is healthy," says Peter Byass, professor of global health at UmeaUniversity in Sweden. "I'm not sure we totally understand why.We probably can't do a lot about decreasing this part of life that's not healthy," he adds. "That pretty much appears to be a part of being human."

Healthy life — the measure researchers used, called HALE, or healthy life expectancy years — ranged from a high of 73.4 years in Japan to a low, again in Lesotho, of 42 years. Not much is known about when those years of ill health occur. "A lot of the unhealthy stuff is around end of life," says Byass.

Spending more money on health care doesn't seem to reduce the proportion of life spent in ill health. The study was based on regional data and showed that in high-income North America, men live an average of 76.64 years, but only 66.17 of those years are healthy; women live an average of 81.62 years, but experience good health in only 68.85 of those years. The United States, which spends more on health care than any other country, is part of that high-income region. "This is seen even in places where there's a high investment in health care," says Byass, who wrote a commentary accompanying the Lancet study.

Countries where people die the youngest have the highest rates of communicable diseases like AIDS, malaria and tuberculosis as well as high rates of maternal and childhood mortality and malnutrition. "If we want to have a healthier global population, more equal health, the world has got to invest in getting rid of those avoidable problems in poorer countries, mainly in Africa," says Byass.

Published on Leave a comment on Nearly 70% of Prostate Cancers Can Just Be Watched?

The issue of overdiagnosis and overtreatment has recently been in the news, especially when discussing breast cancer, prostate cancer, and thyroid cancer. Meaning too much unnecessary treatment with harms, when the best approach would have been to do nothing, as studies have suggested or actually shown. Now here is an article in Medscape suggesting that rather than be quick to operate or treat, the best approach for nearly 70% of prostate cancers may be just "watching".

The U.S. Preventive Task Force, which analyzes the value of screening tests, in May 2012 recommended AGAINST routine prostate-specific antigen (PSA)-based screening for prostate cancer for all age groups. According to them, studies do not show that benefits of routine screening of asymptomatic prostate cancer and the resulting treatment outweigh the harms of treatment (e.g., surgical complications including death from surgery, erectile dysfunction, urinary incontinence, bowel dysfunction, and bladder dysfunction), or that prostate cancer treatment even reduces mortality (deaths).

They point out that: "There is convincing evidence that PSA-based screening programs result in the detection of many cases of asymptomatic prostate cancer. There is also convincing evidence that a substantial percentage of men who have asymptomatic cancer detected by PSA screening have a tumor that either will not progress or will progress so slowly that it would have remained asymptomatic for the man's lifetime. The terms "overdiagnosis" or "pseudo-disease" are used to describe both situations." (NOTE: others have argued against this recommendation)

When reading the full Medscape article, it was pointed out that in the study being discussed, one person who was offered active surveillance but declined and was treated with an immediate radical prostatectomy, still died of metastatic prostate cancer. This was an example of a case where when the disease is truly aggressive, it may have spread "like a bird" throughout the body (in Dr. H. Gilbert Welch's terms in his books Overdiagnosed and Less Medicine, More Health) from the very beginning, and may be unstoppable no matter what is done.

I have also noticed reading other prostate cancer studies that a certain percentage of prostate cancers regress from the point of diagnosis (the PSA test and biopsy). In other words, researchers are finding that cancer can have different paths: regresses, stays the same, grows slowly (and can be treated when symptoms appear), or grows very quickly and is so aggressive and unstoppable that it goes through the body "like a bird". And we don't know which will be the aggressive ones when we first find them, thus the controversies over what to do: screen or not?, and treat or not?  ...continue reading "Nearly 70% of Prostate Cancers Can Just Be Watched?"