Harvard Health Blog

Thanks in part to advertising, many men with prostate cancer believe that they’ll get better results with robot-assisted prostate surgery than with more traditional open surgery. The latest study doesn’t bear that out.

One year ago today, the detonation of two improvised bombs near the finish line of the Boston Marathon killed three people, injured more than 260 others, and shattered a day traditionally filled with joy and camaraderie. Although the bombing immediately extinguished the celebration, it sparked an outpouring of extraordinary work and compassion that continues to this day. Residents of Boston, the Commonwealth of Massachusetts, and beyond rallied to help those injured by the bombs. It is a testament to the extraordinary care and preparation by first responders and staff members at all Boston-area hospitals that only three people died. Many of the wounded were taken to teaching hospitals affiliated with Harvard Medical School. The medical school and its institutions take time today to mourn this senseless tragedy, pray for those who lost a loved one or who themselves still bear physical and emotional scars from the bombing, and acknowledge the work of first responders, emergency department staff, and others who have been part of the healing effort.

A new report from the Alzheimer’s Association says that as many as 5 million Americans have Alzheimer’s disease or some other form of dementia. Every 67 seconds someone in the United States develops Alzheimer’s disease or dementia. That’s 470,000 Americans this year alone. Given that these thieves of memory and personality are so common and so feared, should all older Americans be tested for them? In proposed guidelines released yesterday, the U.S. Preventive Services Task Force said “no.” Why not? Even after conducting a thorough review of the evidence, the panel said that there isn’t enough solid evidence to recommend screening, especially since not enough is known about the benefits and the harms. In part, the recommendation is based on the sad fact that so far there aren’t any truly effective approaches to stop the forward progress of dementia.

Severe headaches are a misery, whether they cause a dull ache or a steady, stabbing, or blinding pain. Such pain rarely comes from something catastrophic, like a tumor or a bleeding in the brain. Yet an estimated 12% of people with headaches get brain scans. A new study shows that these unnecessary scans add several billion dollars a year to health care costs for very little benefit. Excessive brain scanning costs more than just dollars. Repeated CT scans deliver enough radiation to increase the odds of developing cancer. Scans also tend to lead to more scanning if the test turns up something strange. Many people who see a doctor because of severe and recurrent migraine headaches don’t need brain scans. They need the right therapy to stop their pain.

An estimated 43.5 million Americans provide in-home, long-term care for older adult family members with a chronic illness. In a new JAMA survey, caregivers are typically women who spend about 20 to 40 hours a week providing care. Most caregivers feel abandoned and unrecognized by the health care system. Spousal caregivers face greater challenges than caregivers helping a parent for a variety of reasons, one of which is that they tend to be older. Many caregivers don’t know about, or take advantage of, services and support systems such as respite care, help with non-medical services such as housekeeping and cooking, counseling, and more. The Caregiver’s Handbook, a Special Health Report from Harvard Medical School, includes detailed information that can help women and men provide better care for their loved ones and take care of themselves.

The next time you have your blood pressure checked, ask your health care to check it in both arms, rather than just in one. Why? A big difference between the two readings can give you an early warning about increased risk of cardiovascular disease, a new study suggests. Harvard researchers found that people who have a 10-point difference in blood pressure from one arm to the other are 38% more likely to have a heart attack, stroke, or a related problem than those with arm-to arm differences less than 10 points. Small differences in blood pressure readings between the right and left arm are normal. But large ones suggest the presence of artery-clogging plaque in the vessel that supplies blood to the arm with higher blood pressure. Clogging there means there’s a good chance the arteries in the heart and brain are also clogged, boosting the odds of having a heart attack or stroke.

The grief of losing a spouse or partner affects not just emotional and mental health, but physical health as well. The surviving spouse or partner often develops health problems in the weeks and months that follow. A study published this week in JAMA Internal Medicine found that individuals who had lost a spouse or partner were more likely to have a heart attack or stroke within the next 30 days. Grief activates the sympathetic nervous system, which is responsible for revving up the body’s fight-or-flight response. That can lead to stress-induced changes in blood pressure, heart rate, and blood clotting. There is also a tendency after such a profound loss for the surviving spouse or partner to disregard his or her own health. It can take several months to a year to work through grief and grieving. If it lasts much longer, and is interfering with daily life—seeing friends, doing once-pleasurable activities—it’s possible that grief has morphed into something more serious, like depression.

Even after intensive rehabilitation therapy, many people who break a hip still can’t do things they used to do with ease, like dressing, rising from a chair, or climbing stairs, after . A report in this week’s Journal of the American Medical Association shows that simple exercises done at home can make a big difference in recovering from a broken hip. A set of “functional exercises” that mimic the kinds of things people normally do in their daily lives improved function and mobility among people who had broken a hip. It’s important :just do it.” At-home rehab is of no use if you don’t stick with it. These kinds of exercises can also help ward off post-fracture complications like blood clots, pneumonia, wound infections, and more. Extended bed rest after a major injury or surgery can feed a downward spiral of physical deconditioning and additional health problems.

The first-ever guidelines for preventing stroke in women don’t fool around. They offer ways to prevent this disabling and potentially deadly event from adolescence to old age. More than half of the 800,000 Americans who have strokes each year are women. Nearly 4 million American women are living with the aftermath of a stroke. And because women live longer than men, their lifetime risk of having a stroke is higher. Those numbers are why stroke prevention is especially important for women. The guidelines cover the use of oral contraceptives, high blood pressure during pregnancy, the use of hormones after menopause, and migraine with aura. They also cover the fundamentals of stroke prevention, like controlling blood pressure, exercising more, eating a healthy diet, and not smoking.

Cigarettes, cigars, and the like are the most deadly product that consumers can legally buy. It’s sadly ironic that they are sold in pharmacies, which are meant to dispense medications and other things designed to heal or promote health. The American Pharmacists Association, the American Medical Association, and other groups have urged pharmacies to stop selling cigarettes. Several major pharmacy chains have been mulling whether or not to take this advice. Today, one of them has acted. The CVS chain has decided to stop selling tobacco products, and will phase out their sales over the next year. The news came in a press release from CVS and an opinion piece published today in JAMA, the journal of the American Medical Association. Pharmacists will likely cheer the decision—one survey of pharmacists showed that only 2% of them favor the sale of tobacco products in their stores.