Angelina Jolie revealed yesterday in a New York Times op-ed article that she underwent a double mastectomy even though she doesn’t have breast cancer. She did that because she carries a gene (BRCA1) that substantially increases her chances of developing the disease. Her mother’s 10-year losing battle with ovarian cancer helped guide her decision. Women who carry BRCA1, BRCA2, or who have at least two close relatives—a mother, sister, or daughter—who have had breast or ovarian cancer are candidates for prophylactic mastectomy. Some women who develop cancer in one breast often have both breasts removed to avoid a recurrence of the disease. Taking time to make the decision, and talking it over with a trusted and knowledgeable expert, is an important part of the decision-making process. Having as much information as possible before choosing prophylactic mastectomy is as empowering as making the decision itself.
Posts by Stephanie Watson
As wait times to see a doctor for simple problems like sinusitis and urinary tract infection lengthen, more and more Americans are turning to retail health clinics—walk-in medical facilities located in pharmacies, grocery stores, and retailers such as Wal-Mart and Target. The number of visits to such clinics quadrupled from 1.48 million in 2007 to 5.97 million in 2009, according to a study published in the journal Health Affairs, and topped 10 million last year. Convenience is driving this migration to retail health clinics, since you can walk into a retail health clinic without an appointment, and many are open nights and weekends. Although most retail clinics focus on immunizations and common ailments such as strep throat and sinus infections, some are beginning to manage chronic conditions such as high blood pressure, diabetes, high cholesterol, and asthma.
Chest pain brought on by exercise or stress, a condition known as angina, holds back millions of Americans from living life to the fullest. There’s long been a perception that angina symptoms in women are different than they are in men. Doctors often use the term “typical angina” to describe the angina symptoms that men relate. Symptoms more commonly described by women have been dubbed “atypical angina”—suggesting that women are somehow experiencing an unusual manifestation of heart trouble. A new Harvard study shows that women and men probably experience the same symptoms, but describe them differently. By any name or description, chest discomfort is crucial for women—and their doctors—to pay attention to. And that means acknowledging the possibility of angina no matter how a women describes suspicious chest-related symptoms.
Chelation therapy removes metals that have built up in the body. It is an FDA-approved way to treat mercury, lead, and other types of heavy-metal poisoning, as well as for iron overload (hemochromatosis) and some types of anemia. It has also been touted as an alternative therapy that can cure heart disease. Results from the 10-year, $31 million Trial to Assess Chelation Therapy (TACT) show that it slightly reduced the risk of heart problems in heart attack survivors. Proponents of chelation therapy will say this proves what they’ve been preaching. But the editors of JAMA, which published the trial results say that the findings “should serve to dissuade responsible practitioners from providing or recommending chelation therapy for patients with coronary disease and should discourage patients with previous MI [heart attack] from seeking this therapy with the hope of preventing subsequent cardiovascular events.”
People tend to think that the telltale sign of depression is sadness—a pervasive down, dragging feeling that won’t let up, day after day. But depression often manifests itself as something else entirely—like aches and pains or memory lapses. These “unusual” symptoms are actually quite common. They can mask depression—and delay an important diagnosis—especially in older people, who often display their depression in ways other than sadness. These include trouble sleeping, lack of energy, fatigue, trouble concentrating or remembering, loss of appetite, and aches and pains that don’t go away. If you have one or more of these symptoms that can’t be traced to an illness or ailment, a frank talk with a trusted doctor about the possibility of depression might be a good step forward.
At least once a week throughout my childhood, a migraine would force my mother to retreat into her bedroom. She’d shut the blinds and burrow under the covers, overwhelmed by a pain so severe it turned the faintest sound into an agonizing roar and launched waves of nausea with the slightest movement. Though my family and I tried to be sympathetic, it was hard for us to fully comprehend my mother’s migraines or understand why she had to miss so many events because of them. When you’re on the outside looking in, you can’t begin to appreciate how severely disabling—and life disrupting—chronic migraine can be. A study from Thomas Jefferson University in Philadelphia, released last week in PLoS One, found that chronic migraine sufferers experience as much social stigma as people with epilepsy—a disease that produces far more obvious and dramatic symptoms. Some of that stigma is external—for example, getting treated differently by friends or colleagues, and some is internal.
Living through the physical and emotional toll of breast cancer is so traumatic that some women can’t bear the thought of doing it again. That’s why a growing number of women who have already been diagnosed with cancer in one breast are taking the drastic measure of having both breasts removed (a procedure called prophylactic mastectomy). Yet a University of Michigan study presented last week at the American Society of Clinical Oncology’s Quality Care Symposium showed that nearly three-quarters of women who had this procedure were actually at very low risk of developing cancer in the healthy breast. In other words, many women are unnecessarily exposing themselves to the potential risks of a double mastectomy—including pain, infection, and scarring. The new study suggests that more and better information about breast cancer recurrence—and the risks and benefits of prophylactic mastectomy—are needed as women consider this procedure.
It’s Halloween—a time when we’re preoccupied with witches, ghouls, and other frightful creatures. But this year, no creature is generating as much buzz as the zombie. Zombies have inspired movies and TV shows, video games—even a bloody Pride and Prejudice takeoff. Could all this talk of the undead be foreshadowing a real-life zombie apocalypse? In fiction, yes. But not in real life. A Harvard ethnobotanist once found that a neurotoxin was the cause of several cases of zombie-like living deaths in Haiti. Oddly shaped proteins called prions have also been linked to brain diseases that vaguely resemble zombieism. In his novel The Zombie Autopsies, Dr. Steven Schlozman, a zombie enthusiast and professor of psychiatry at Harvard Medical School, imagined an infection scenario that turns normal human beings into flesh-craving monsters. Although a pandemic that creates zombie-like symptoms is theoretically possible, a real-life zombie apocalypse shouldn’t be high up on our list of worries.
Depression can strike at any age. Children can develop it, as can octogenarians. No matter when it starts, depression can drain the joy and pleasure from life. The first appearance of depression later in life may also be a signal of memory loss or dementia down the road. According to a study in the Archives of General Psychiatry, dementia is more common among people who become depressed in middle age or later in life than among those who aren’t depressed. Depression is often overlooked in older adults, so it’s important to be on the lookout for warning signs, like feelings of hopelessness, loss of interest in activities, trouble sleeping, and more. It’s important to treat depression in individuals with the beginning of dementia, and older individuals who are depressed should be evaluated for dementia.
Researchers at Kansas State University have developed a blood test that rapidly detects breast cancer (as well as non-small cell lung cancer) in very early stages, long before symptoms appear or the cancer can be seen by other methods. The experimental test identifies enzyme patterns that differ from one type of cancer to another. According to the researchers, the test can detect very early breast cancers (stages 0 and 1), as well as early lung cancers (stages 1 and 2), within an hour, with 95% accuracy. However, they tested only 32 participants with various stages of breast or lung cancer, as well as 12 people without cancer. Whether finding cancer that early makes a difference for treatment and survival remains to be seen.