Prevention

Robert Shmerling, M.D.

Studies reinforce life-saving benefits of colon cancer screening

Checking seemingly healthy people for cancer—what doctors call screening—seems like a simple process: Perform a test and either find cancer early and cure it or don’t find it and breathe easy. It works for colon, breast, and cervical cancers, but not for others. For colon cancer, there are several effective screening tests: colonoscopy, sigmoidoscopy, and stool testing. Two new studies in yesterday’s New England Journal of Medicine help further quantify their benefits. In the studies, all three types of test reduced the risk of developing or dying from colon cancer. Colonoscopy worked best, followed by sigmoidoscopy and then stool testing. The biggest challenge for colon cancer screening is getting people to have the available tests. About 50,000 Americans die of colon cancer each year—many of these can be prevented with early screening.

Lori Wiviott Tishler, M.D.

Drug-resistant bacteria a growing health problem

Antibiotic-resistant bacteria sicken more than two million Americans each year and account for at least 23,000 deaths. The main cause? Overuse of antibiotics. A new report from the Centers for Disease Control and Prevention, Antibiotic Resistance Threats in the United States, 2013, details the health and financial costs of antibiotic resistance in the United States. In terms of health, antibiotic resistance should be in the CDC’s top 15 causes of death. It also adds as much as $20 billion in direct health-care costs. And the problem could get worse before it gets better. Antibiotic resistance is a problem because commonly used antibiotics will become less able to treat common infections. The CDC identified three types of bacteria as urgent hazards: Clostridium difficile, Enterobacteriaceae, and Neisseria gonorrhoeae. Decreasing the use of antibiotics and preventing infection in the first place are two key steps to halting the problem.

Howard LeWine, M.D.

Want to live to age 120? Most Americans say no

As medical research and healthy living continues to extend life, the Pew Research Center asked more than 2,000 Americans if they would take advantage of medical treatments to slow the aging process and let them live to age 120. More than half (56%) said they would not, but 65% thought that other people would want it. The Pew survey did not ask why most adults would not want life extending treatment. Previous work has identified what people fear about getting too old. These include loss of independence, running out of money, not being able to live at home, pain, and more. But there are ways to minimize the problems that come with age. The strategies, like exercising and not smoking aren’t sexy, nor do they rely on medical breakthroughs. But they can maximize one’s “healthspan” as well as lifespan.

Patrick J. Skerrett

Falling TVs injure 17,000 kids a year

More than 17,000 American youths end up in emergency departments each year with injuries from a falling television set. Two-thirds of them are under age 5, according to a report published online today in the journal Pediatrics. From 1996 to 2011, nearly 400,000 children under 18 years old were treated in emergency departments for TV-related injuries. In 1996, most of the injuries occurred when kids ran into television sets. By 2011, injuries from falling TVs dominated. The rate of TVs falling from dressers, bureaus, chests of drawers, and armoires nearly quadrupled. The authors of the study suggest that adding TVs to the list of furniture types that come with anti-tip devices “would be an important step in decreasing the number of injuries resulting from falling TVs.”

Howard LeWine, M.D.

Taking aspirin linked to lower risk of colorectal cancer

Aspirin has many uses, from easing a headache or cooling a fever to preventing heart attacks and the most common kind of stroke. It may be time to add “preventing colorectal cancer” to the list. New results from the Women’s Health Study, a clinical trial that evaluated the benefits and risks of low-dose aspirin and vitamin E among nearly 40,000 women, show that aspirin reduces the risk of developing colorectal cancer by 20%. The effect isn’t immediate, but instead takes ten to 20 years to be seen. Aspirin isn’t without its drawbacks, including gastrointestinal bleeding and ulcer formation. Both occurred slightly more often among women taking aspirin. Although the Women’s Health Study results sound promising, don’t go reaching for the aspirin bottle just yet. Taking aspirin—and any other drug—is really a balancing act between benefits and risks.

Howard LeWine, M.D.

Medical crises don’t take vacations

The sudden hospitalization yesterday of Teresa Heinz Kerry, wife of U.S. Secretary of State John Kerry, while vacationing on Nantucket Island is high-profile testimony that illness can happen at any time—even during a vacation. Heinz Kerry was taken by ambulance on Sunday afternoon to Nantucket Cottage Hospital. She was accompanied by her husband. After being stabilized, she and the Secretary of State were flown to Massachusetts General Hospital in Boston. Neither the hospital nor Heinz Kerry’s family has commented on the nature of her illness. News reports say she is in critical but stable condition. Heinz Kerry’s situation highlights the value of electronic medical records, and the hazards of not having, or being able to access, medical information when you are travelling or on vacation.

Patrick J. Skerrett

Fluids, cool air key to avoiding heat stroke

Summer’s heat is as predictable as winter’s chill. Heat-related illnesses—and even deaths—are also predictable. But they aren’t inevitable. In fact, most are preventable. Most healthy people tolerate the heat without missing a beat. It’s not so easy for people with damaged or weakened hearts, or for older people whose bodies don’t respond as readily to stress as they once did. There are three different levels of heart-related illness: heat cramps, heat exhaustion, and heat stroke. Some simple choices can help you weather the weather. Drinking water and other hydrating fluids is essential. Putting off exercise or other physical activity until things cool down also helps. Chilled air is the best way to beat the heat. Sticking with smaller meals that don’t overload the stomach can also help.

Stephanie Watson

Volunteering may be good for body and mind

There’s something gratifying about volunteering. Whenever I work a charity event—which I try to do with some regularity—I often get more out of it than I give. A new study suggests that volunteering has positive implications that go beyond mental health, and may include better physical health. They study, from Carnegie Mellon University, found that adults over age 50 who volunteered on a regular basis were less likely to develop high blood pressure than non-volunteers. High blood pressure is an important indicator of health because it contributes to heart disease, stroke, and premature death. It’s impossible for this study to prove that volunteering was directly responsible for the lower blood pressure readings, but the results are in line with other findings on the topic. Aristotle once surmised that the essence of life is “To serve others and do good.” If this line of research is any indication, serving others might also be the essence of good health.

Patrick J. Skerrett

Matchless strategy for tick removal; 6 steps to avoid tick bites

What’s the best way to remove a tick burrowed into your skin? Don’t use one of the folk remedies, like touching it with a hot match, covering it with petroleum jelly or nail polish, or freezing it. These are all supposed to make the tick “back out” of the skin on its own. But they often have the opposite effect, forcing the tick to hold tight, burrow deeper, and possibly deposit more of its disease-carrying secretions into the wound, which increases the risk of infection. Instead, do what the Centers for Disease Control and Prevention recommend: Use a pair of fine-tipped tweezers to grasp the tick as close to the skin as possible. Then pull it out with a steady motion. Once the tick has been removed, clean the skin with soap and water. Dispose of the tick, which is probably still alive, by placing it in alcohol or flushing it down the toilet. For most people who are bitten by a tick, removal ends the saga. For others, though, it is just beginning, since the bite of a tick can transmit Lyme or other tick-borne disease

Howard LeWine, M.D.

HPV transmission during oral sex a growing cause of mouth and throat cancer

Actress Angelina Jolie recently went public with her double mastectomy to prevent breast cancer. Governor Chris Christie told us his reasons for gastric bypass surgery. And now actor Michael Douglas is shining the spotlight on the human papilloma virus (HPV)—the number one cause of mouth and throat cancer. In an interview published in The Guardian newspaper in London, Douglas mentioned that his own throat cancer could have been brought on by oral sex, a common way to become infected with HPV. HPV transmitted by sexual contact often doesn’t become active enough to cause symptoms. When it does become active, it tends to invade mucous membranes, such as those covering the lining of the vagina, cervix, anus, mouth, tongue, and throat. An HPV infection can cause warts in and around these tissues. Most people sexually exposed to HPV never develop symptoms or health problems, and most HPV infections go away by themselves within two years. But the infection can persist and cause long-term problems. These include cervical cancer in women, penis cancer in men, and in both sexes some cancers of the anus and oropharyngeal cancer (cancer in the back of throat, including the base of the tongue and tonsils).