Saturday, 7 July 2007

High Squamish Nation diabetes rates put brakes on ice cream truck

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In my neighborhood, the jingle of the ice cream truck is ever in the distance. For some lucky reason, the truck does not drive through my family's subdivision. I say 'lucky' because if the truck did roll through daily, I'd constantly be saying "no" and disappointing my kids. To me, ice cream is a treat. But somewhere along the way, junk food and so-called treats have become the anchor of many children's diets. Call me an ice cream truck grouch, but children are suffering from the highest rate of childhood obesity in our nation's history. It is well known childhood obesity is a contributing factor in the rising rates of type 2 diabetes among today's youth. What are we going to do about it?

Doris Paul from the Squamish Nation in Vancouver has one answer -- ban the ice cream truck. Her disdain for ice cream trucks has grown as she witnessed the soaring rates of obesity and type 2 diabetes in her nation's people and her own family. Ms. Paul's father was one of the biggest fans of the jingling bells, licking many an ice cream cone on hot summer days. A kid at heart, he generously bought ice cream for neighborhood children. But he died last year from diabetes complications, and Ms. Paul believes he never equated poor nutrition with his health problems. Ms. Paul's sister is also dealing with diabetes.

Ms. Paul's initiative to ban ice-cream trucks from three native communities on Vancouver's north shore was backed by the Nation's councillors. A mother of five, she also backed up her activism by eliminating junk food from her own pantry, replacing potato chips, soft drinks and ice cream with fruits and vegetables. Her family suffered for awhile, but now reports feeling healthier. A community garden is in the works.

Meeda Falou, manager of Rainbow Novelties, is not pleased. Falou reports banning smoking would have more of an impact on health, and parents have the choice to buy lower calorie treats such as sherbet or popsicles.

Perry Kendall, British Columbia's provincial health officer, fully supports the initiative. He did acknowledge ice cream is a revered tradition in the communities, but the native people have a higher incidence of type 2 diabetes (three to five times more common), and it is common sense to remove sources of junk food. Ms. Paul noted many of the nation's children were visiting the truck three or four times a day. Read the full story in Globe and Mail.

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Average blood glucose instead of HbA1c

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Change appears to be coming for diabetes care. The HbA1c test may not be the safest approach for diabetics to follow in preventing complications. Instead, experts are saying the average blood glucose level per individual will add clarity to diabetic patients looking to manage their disease.

A study supporting the change showed a close correlation between average glucose and HbA1c levels. So the myth, busted is: maintaining an average blood sugar is a safer approach for diabetes management -- NOT CHASING A UNIFORM HbA1c value. The fluctuation in blood sugar is what causes complications in the small vessels of the eyes, kidneys and peripheral nerve endings. For example - sustaining a blood sugar of 200 mg/dL is a lot safer than waking at 240 and ushering a boatload of sugar into your cells to drop your sugar to 80 mg/dL. It is the transfer of glucose into the cell that causes the injury to cell membranes and resulting complications.

Think of it like the movement of the ocean. High tide to low tide happens gradually, over the course of many hours throughout the day. When a storm hits - the waves become turbulent, crashing against the shore causing erosion. Is the human body any different? I'm not a doctor -- but I did stay at a Holiday Inn Express last week.

Does this look swollen?

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What is the purpose of body fat? We all have it, some of us a little more than others. As we grow older, some of our diets fall out of balance with our energy needs causing our white fat cells to become swollen.

White fat cells secrete leptin, adiponectin and resistin. Leptin and adiponectin work together in suppressing appetite. Resistin is the newest discovered - and has been found to participate in the inflammatory response and resistence to insulin. It also triggers an immune response to irritation, so it may be the fat cells attempt to shut your piehole because we're not gonna take it. As the white fat cells take on excessive calories they begin swelling, resulting in an inflammatory response.

Inflammation, by definition, is a protective attempt to remove the injurious stimuli (excess calories) and initiate the healing process. As the fat cells dispatch hormones signaling inflammation - one could hypothesize that Type 2 diabetes is a response to an imbalanced diet - calories in versus calories out. So what do our white fat cells do for us? They are designed to store energy for use in times of need. When your body is sending out DEFCON signals of inflammation - I'd say that is a time of need, indeed. Would inducing ketosis till the swelling goes down help?

If a heart attack happens are you prepared?

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Heart attacks are the #1 cause of death for Americans, and although we spend a lot of time and energy on trying to avoid them, some of us will inevitably still go through the experience -- are you prepared? Whether it's for yourself or someone close to you, do you know what to look for and are you ready to take action? All too often people take much too long to seek treatment, usually because they fail to recognize the symptoms or just don't want to believe it's happening. And heart attacks can't wait -- every second counts! Click here for a review of the basic symptoms to watch for (pressure in the chest, squeezing pain, shortness of breath, feeling of lightheadedness) and what to do if you at all suspect a heart attack (call 911!).

Heart disease begins earlier than you think

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Pop quiz: at what age do you need to start worrying about heart disease? This is a question that is especially interesting to me, because, at nearly 27, I often think that health problems are a long way off and I can live my life how I please without suffering the consequences.

But I'm wayyyyyy off. Heart disease gets it's start in childhood! Yet because the effects don't become apparent until middle age, people thing that's when it begins. Wrong. Middle age is merely when your bad habits start to show themselves in the form of heart attacks.

So although you feel fine now, watch it. Your bad habits today will affect you in a few years. Count on it.

Diet pills. What would you endure to lose weight?

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We all know it by now. Eating healthy, exercising and maintaining a reasonable body weight makes for healthier living which means a lesser chance of heart disease and other such maladies. However, that is much easier said than done. Life is busy and there is not always time to hit the gym or take a walk. It is sometimes easier to take home fast food than prepare a balanced meal. These facts often lead to weighty issues that many of us find so difficult to correct. This is where the diet pills come into the picture. How much easier would it be to simply swallow a pill and forget about the exercise?

Alli, the over the counter form of diet pill wonder Xenical, is luring many customers to pharmacies everywhere in hopes of a thin future. Unfortunately, Alli has some none too pleasant side effects when taken improperly. Many customers, in their haste to pop a pill and lose some weight, overlook the side effects and end up in some pretty humiliating situations. It turns out that when taken incorrectly Alli induces bountiful and impromptu bowel movements. Customers are advised to begin taking the pills when not at work or to wear dark clothing when trying out the medication.

I am all for living a heart healthy lifestyle, but I would not go so far as to take a pill like this one. Working out and eating a more balanced diet would be better than a public display of ickiness.

Three heart transplant programs might lose funding

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Heart transplant programs in Texas, Minneapolis and Indiana have 30 days to drastically improve their transplant programs, or they'll lose precious federal funding, this article reports. Considering how important it is that a heart transplant be done right, it's a little frightening to know that there are transplant programs out there that are not up to par. And yet, it's reassuring to know that these programs are being monitored.

These transplant programs can retain their funding by submitting proposals of changes they intend to make in order to get their program up-to-snuff.

Thought for the Day: The power of being positive

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I recently had the fortune of watching a friend battle cancer successfully. She was diagnosed about one year ago with ovarian cancer and from the onset, she never wavered in her enthusiasm that she would beat it.

Always one to exercise, she never stopped engaging in her favorite pastime while undergoing treatment and having bouts of nausea (and worse) and was incredibly chipper *all the time*. In fact, I never saw her complain; not once.

Think about this:

Although some discount the mind-body connection, sometimes it is too hard to pass this by. In Melanie's case, her unwavering enthusiasm and positivity for an entire year of having cancer, I believe, helped lead her through it to the other side where the cancer seemed obliterated from her system. That's the power of positivity.


Now, I know "proof purists" may not count in anything that can't be scientifically proven and measured as stating that cancer was affecting my a mental state, and that's fine. For me, I feel differently.
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Survivor Spotlight: Melissa is still sorting it all out

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I met Melissa on the Young Survival Coalition website. She agreed to give her time to write about her breast cancer journey and offer advice that can help others going down the same road.

Melissa was only 29 when she was diagnosed with breast cancer. She blogs at To Keep You, A Breast that chronicles her journey.

How did you find out you had breast cancer?

I received my diagnosis while sitting in Friday evening rush hour traffic. Fortunately, it was gridlock so I had a few minutes to collect myself before I actually had to drive. About six weeks prior, I had found a lump in my right breast while in the shower. I originally thought it was just a knot in the muscle because I had been working out a lot and my muscle was sore. When the muscle pain went away and the lump was still there, I made an appointment with my primary care physician. She examined me and sent me for a mammogram and ultrasound. The day of the mammogram was the first time I was actually concerned that it might be something serious because they kept wanting to take more images and everyone was being extremely nice. I could tell during the ultrasound that the radiologist was really concerned. She told me to expect a call from my PCP that afternoon and that I needed a biopsy. They were able to make an appointment for the biopsy while I was there, but the date was almost two whole weeks away.

By the time of the biopsy, I was again sure there was nothing to worry about. While the radiologist did an ultrasound of the lump before the procedure, he told me he thought I should have an MRI because he suspected there might be a couple of lumps clustered together. That was when I hit full panic mode. During the procedure, which was on a Tuesday, he told me I would have the results by Thursday or Friday. By Friday at 3:00 pm, I was starting to get very anxious and called my PCP's office to see if they had the results. One of the nurses, who had been by me throughout the process told me they didn't have them yet but she would call and try to get them. She knew I was a nervous wreck and couldn't wait all weekend to find out. It was about 5:30 by the time she called back with the news that no one wants to hear. "Melissa, I'm sorry, but you have breast cancer."

What types of breast cancer treatments were recommended?

I consulted with two surgeons before making the decision to have a lumpectomy followed by radiation. Based on the size of my breasts, both felt that a good cosmetic result could be achieved while safely removing all of tumor. Because my tumor was 2.4 cm, and because I'm 29 years old, my oncologist also recommended four courses of Adriamycin and Cytoxan. My tumor was hormone sensitive, so I'll be taking Tamoxifen for five years after I complete chemo and radiation.

How did you research breast cancer and breast cancer treatments?

I spent a lot of time online reading articles about different types of cancer treatments and their outcomes and side effects. Because the average age of a breast cancer patient is 64, there were, and still are, a lot of questions about how this will impact my 29 year old body. There is not a lot of research on breast cancer and younger women. I read books, journals, anything I could get my hands on. I went to every doctor's appointment with a list of questions; my oncologist is now prepared for my arrival with copies of articles she wants me to read. How did you tell your family?

I told my parents while I was still sitting in gridlock. My family had been with me throughout the diagnosis and I knew they were awaiting the results as anxiously as I was. I called my sister once I was parked in front of my house. As a single woman, I didn't have a husband to share the news with, but my friends are like my family and I called a few of them over the course of the weekend to tell them the news. I let my parents handle telling the extended family. On Monday, I sent out a mass email to all of my friends, sharing my diagnosis with them and directing them to a blog I had set up for the purpose of keeping everyone informed. The blog has been a lifesaver- it allows me to keep everyone updated with the latest news from the doctors, word on how I'm feeling and any new developments, like losing my hair, and keeps me from repeating myself. Everyone feels like they have access to the latest news. It has also been therapeutic for me to have a place to chronicle this journey

If you'd like to read more from my blog, "To Keep You, A Breast" it can be found at http://melnorth.blogspot.com

Are you involved with any breast cancer support groups, fundraisers or breast cancer organizations?

My family and I have a team in the Susan G. Komen National Race for the Cure on June 2, 2007 in Washington, DC. My friends, family and I will be walking to raise money for the Komen Foundation's programs. I'll be in the midst of chemo, and my sister will be eight months pregnant, but we're determined to help make a difference.

I've also gotten involved with the Young Survival Coalition through their website. They provide a great source of information for younger women with breast cancer. Their message boards have also been a tremendous source of support for me; I have found a group of women at the same stage of treatment that I can share my thoughts and questions with and find out if they are experiencing similar symptoms or emotions.

What advice would you give to someone newly diagnosed with breast cancer?

For me, the hardest part was waiting; waiting for more information, waiting for answers, waiting for surgery or treatment to begin. But I came to realize that this time was a good thing. It gave me the time I needed to research all of the possible treatment options and come to terms with what was happening. Also, even if you love the first surgeon, oncologist, specialist you meet with, get a second opinion. I'm sure the first surgeon I met with would have done a fine job, but after meeting with my second opinion, I knew she was the right choice for me. Take the time to gather all of the information that you need to make the best choice for you. Waiting a couple of extra days isn't going to impact your outcome and you'll feel much more comfortable with what is happening. Also, don't be afraid to speak up when something doesn't feel right or you have questions.

What advice would your give the family members and friends of someone diagnosed with breast cancer?

Be patient. Try to gauge from them how much they want to talk about it and be there if they need someone to listen, but don't constantly bring it up if they don't. Also, instead of saying "let me know if there's anything I can do," do something. Show up and clean their bathroom or drop off a meal. It makes it so much easier on the patient when they don't have to think of ways they need help and ask for it. Try to anticipate what you might want in such a situation and do that for your friend. She's probably never going to ask you to clean her toilet, but when she spends all weekend hugging it after chemo, she'll really appreciate the fact that it's clean!

As a breast cancer survivor, what thoughts do you have on surviving breast cancer and being a breast cancer survivor?

I'm still sorting out what this means to me. It means that I take the extra second to tell the people I love that I love them so that should something bad happen, they will know. It means that I try to concern myself less with the trivial day-to-day things like drama at work, a cracked windshield on my car or people that say stupid, thoughtless things because in the grand scheme, these things aren't as important. It means I spend more time taking care of myself, by going to the gym or preparing a healthier meal, so that my body is as strong as it can be while I fight this disease and beyond. It means I will do everything in my power- raise funds, raise awareness, lobby legislators and participate in studies- to help find a cure for this disease so that my mother, sister, friends, and hopefully a daughter of my own one day, won't have to fight the same battle

Name three breast cancer book you would recommend:

Dr. Susan Love's Breast Book was a huge help for me when I was first diagnosed. It does a great job of explaining everything, including the basics of how this disease forms and grows.

Nordie's at Noon and Why I Wore Lipstick to My Mastectomy were great inspirations. It was wonderful to know that there are other young women out there who face the same tough choices I am up against. Hearing other's personal stories let me know that I wasn't alone in this.

Name other breast cancer related resources that you recommend:

The Young Survival Coalition (">www.youngsurvival.org) is a great resource and support for young women facing breast cancer.

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Woman gives up fight for compensation against national energy laboratory

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A Californian woman has given up her fight against the Department of Labor to receive compensation for stomach cancer that she believes was caused by her years of working at the Lawrence Livermore Laboratory, according to the Contra Costa Times.

Francine Moran, 61, had filed a claim in 2003 under the under the Energy Employees Occupational Illness Compensation Program Act. In 2005, she received a response that she was being denied compensation as there was "only a 43.9 percent chance her cancer was caused by her job."

The calculation of her exposure, based on the readings of a radiation-monitoring badge she wore at the lab, had fallen short of the 50 percent needed to qualify for compensation. She appealed the decision because she was not told to wear a badge for the first five years of her employment at the laboratory.

"It's like they were saying, 'Yes, we caused your cancer, but not by enough,'" she said. "And I think that's very insulting."

Moran recently suffered a heart attack in 2006,which she believes was caused by the stress of the whole process. The heart attack was her turning point, according to Moran. She decided to drop the case and live the rest of her life to the fullest.

Penn State football players tackle kidney cancer

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More than 90 Penn State football players will compete on July 13 in an event where they plan to tackle kidney cancer. Well, maybe they won't literally tackle kidney cancer -- wouldn't that be nice -- but by raising awareness and funding, they'll surely make a difference.

The strength and conditioning event, called Lift For Life, will benefit the Kidney Cancer Association for the fifth year in a row. In past years, it's generated more than $148,000. In the 2005-06 year alone, $60,000 was raised for this rare disease.

Lift For Life
challenges the mental and physical endurance of student-athletes and consists of 11 exercises. Think traditional bench and leg presses and the less conventional giant tire flip and iron cross and you've got an idea of what will take place in just one week.

Complete with a public meet and greet and an autograph signing, this event is sure to please -- and educate. If you'll be in the area on this glorious summer day, stop by Holuba Hall on the Penn State University campus with a $10 donation. Doors will open at 1:30 PM and the event will run from 2:00 to 7:00 PM.

Environmental factors and genetics role in breast cancer

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The Sister Study is a clinical trial that is now enrolling patients to determine what environmental factors and genes play a part in developing breast cancer.

Researchers want to find what causes breast cancer, and through understanding this they can work to prevent the disease altogether. There are some known factors to contribute and or prevent the development of breast cancer -- diet, exercise, hormone therapy, breast-feeding and smoking. However, the prevalence of the disease suggest there are other factors at play that we are not aware of at this time.

Women who fit the following criteria are urged to enroll in the Sister Study and join the fight against this disease:

  • A sister related by blood, alive or deceased, diagnosed with breast cancer.
  • Ages 35 -74 years.
  • Living in the United States or Puerto Rico.

The Sister Study is being conducted by the National Institute of Environmental Health Sciences and will be evaluating women from all backgrounds, occupations, races and ethnicities to attempt to identify environmental and genetic factors that may be associated with affecting the risk of breast cancer.

Fertility drug gives cancer patients hope

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For young women diagnosed with cancer, the disease is more than life-altering, it also sometimes dashes all hopes and dreams they might have had for the perfect marriage, the perfect career and the perfect foray into motherhood. It might seem impossible to have children after cancer, since treatment often seriously compromises a woman's chance at conceiving, but all hope's not lost. For instance, Hodgkin's survivors can get pregnant, according to a study, and women who've undergone chemo can freeze their eggs for fertilization.

And now it's being shown that a drug developed in Australia can give new hope to wannabe mothers. It works by shielding the ovaries from harmful cancer treatments by temporarily shutting them down, so to speak. The drug's been impressing doctors around the world, and honestly, I can't wait to see it hit the market and offer some salvation for young women from the horror that is cancer.

Protein found more in men linked to higher liver cancer rate

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A reason more men end up developing liver cancer than women may have been discovered, as new findings have pointed to a protein that's produced more by males than females.

The protein (interleukin-6) results in adding liver inflammation to an existing chronic liver condition that can lead liver cancer. It was found that women produce less of the protein due to estrogen keeping the level in check.

With men three to five times as likely to develop liver cancer than women, avoiding large amounts of alcohol and -- if possible -- avoiding hepatitis infections (B and C types) are key for men in not developing conditions that could lead to liver cancer.

Surgeons say minimally invasive lung surgery should be standard of care

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According to University of Cincinnati thoracic surgeons, many academic medical centers can integrate minimally invasive lung surgery into their training programs. Currently, only about 10 percent of lung cancer operations are done with these minimally invasive techniques, but over half of the patients who need the surgery would qualify for this less invasive procedure. Minimally invasive surgery can result in a faster recovery and less pain for the patient.

Minimally invasive lung surgery (thoracoscopic lobectomy) is performed through a series of small incisions rather than a major chest incision.

"Thoracoscopic lobectomy should be considered the standard of care for patients with early-stage lung cancers," says Michael Reed, MD, assistant professor of surgery at UC. "But few surgeons offer the procedure because it's difficult and requires a lot of additional training."

Prior to the implementation of this training program at UC, only 18 percent of lobectomies were performed with minimally invasive techniques; now Reed estimates that 75 percent at the hospital are done using this approach.

Cigarette taxes proving effective

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What does it take to prevent a person from buying a pack of smokes? It doesn't seem that banning cigarette commercials from television has done the job. Nor does it appear that ending the reign of ads like Joe the Camel has deterred younger people from taking up the habit. Could it be that slapping higher taxes on cigarettes makes a difference?

Currently 43 states have implemented a higher cigarette tax since 2002. The average amount of taxes went from just $0.43 per pack to $1.07. With every increase states have seen a decrease in younger people buying smokes. The higher taxes are giving the participating states more revenue to channel into health care a smoking prevention programs.

Just think if cigarette taxes were raised a bit more. What then? Fewer kids buying smokes and more revenue for health care? Sounds like a good thought to me.

Worthy Wisdom: A confession in health and healing

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In this Worthy Wisdom series, I have been spouting off all sorts of grand ideas about health and healing, diet and nutrition, exercise and fitness. What I share all comes from Canyon Ranch in Tucson, Arizona. I spent four days there. I plan to spend a lifetime practicing what their experts preach.

Canyon Ranch worked for me. I bought into every one of their healthy living approaches and for the two months since I've departed this desert destination, I've done just about everything right -- the eating, the exercising, the de-stressing. And as I sit here eating a bowl of red raspberries instead of a bag of chips and handfuls of M&Ms, I think it's only fair I make a confession.

I've made many attempts at changing my lifestyle. I've gone without sweets several times in my life, only to later reintroduce them into my daily routine and inevitably go way overboard on my consumption. The same goes for soda. There have been times when I've obsessed about exercise. And times when I've let it go altogether. My stress levels have been up and down and all around. I've searched long and hard for the motivation to change, to do better, be better, feel better. It took cancer to push me over the edge, toward positive and long-lasting change.

I don't want you to think I just simply went to Canyon Ranch, gathered a bunch of terrific techniques, and quickly and successfully set them in motion. Canyon Ranch came after a long line of defeats. It took cancer and two years of solid soul searching for me to get my butt in gear. Canyon Ranch came at the perfect time. I was primed and ready. And finally, I feel good about how I'm conducting my life in a post-cancer world.

I confess: I'm not a quick study. I'm 37 years old and have just now found my way. For those of you finding your ways, good for you. Stick with it. For those who are still wavering or find it hard to hang on to a good and healthy plan, don't give up. The time will come. And when it comes, you'll know. It will just seem right, and effortless. It won't seem like a chore, an obligation, or deprivation. It may take something profound in your life before you make a commitment. It may not. Either way, you'll see what I mean when the time arrives. Until then, be patient. It worked for me.

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Pavarotti continues to live and work with pancreatic cancer

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Luciano Pavarotti, famed tenor, continues to live with pancreatic cancer and is currently recording a new collection of classical religious music. He also continues to teach a select group of students every day according to an article from the AP.

Pavarotti underwent surgery in 2006 to remove a cancerous mass.

Recently, an Italian magazine quoted one of Pavarotti's daughters, Guiliana, as saying her father "knows he will die soon." She insists that her words were taken out of context. Pavarotti apparently took the mixup in stride and laughed about it.

According to Corriere della Sera newspaper, Pavarotti responded further, "You want to hear from me -- whether I'm dead? I'm getting better, I'm on the mend."

Best wishes to Pavarotti and his family as he continues to live and to create, in spite of pancreatic cancer.






Genetically modified skin cells might fight cancer

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The process of genetically modifying something is widely believed to be bad (hence the organic movement) but what if genetic modifacation cured cancer? Don't worry, I'm not talking about your food here -- genetic modification of skin cells has been shown to fight a deadly form of childhood cancer.

In tests involving mice performed at the University College London's Institute of Child Health, results a promising when genetically modified skin cells are pitted against neuroblastoma. Although rare, the condition is potentially fatal and accounts for 10% of childhood cancer.

Thursday, 5 July 2007

Even a sun worshiper may have low vitamin D levels

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My mom mentioned to me a few weeks ago her vitamin D levels were low. A type 1 diabetic, she visits her internist around three times a year. This round of blood work showed a deficiency. She felt it odd, considering she religiously takes 400 I.U. of vitamin D daily and participates in sunny outdoor activities year-round. On the advice of her internist, she doubled her dose.

A new study released in the June issue of The Journal of Clinical Endocrinology & Metabolism reveals vitamin D levels can remain low in many individuals soaking up abundant sunshine. This is contrary to the current clinical recommendation which calls for sun exposure on hands and face for 15 minutes for sufficient vitamin D.

Researchers measured vitamin D levels in 93 Hawaiians with high amounts of self-reported sun exposure. Participants had at least three or more hours of sun exposure per day on five or more days per week over the past three months. After measuring for vitamin D, 51 percent of the subjects had serum 25-hydroxyvitamin D concentrations below 30 ng/mL, considered low vitamin D status.

Low vitamin D levels contribute to osteoporosis and osteomalacia/rickets, and may also play a role in cancers, multiple sclerosis, infection, hypertensions and even diabetes. Never knew indequate vitamin D levels and diabetes were even remotely connected. A 2001 Finnish study showed a relationship between low vitamin D in children and development of type 1 diabetes.

An aside, hope the sun is shining on your Fourth of July festivities!

Consumers Union comic cartoon urges FDA reform

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Celebrate the 4th of July! Be informed - it's patriotic. Check out an awesomely funny video from Prescription for Change. The colorful cartoon comes complete with singing and dancing prescription drug capsules, accompanied by the seriously screwed-up patients who popped pills with abandon and are now suffering the horrible consequences. (Male lactation, anyone?)

Prescription for Change is a public awareness-raising project funded by the powerful nonprofit Consumers Union. The vid's purpose: to raise awareness about inadequate prescription drug regulation in the US and to recruit public support in pushing for change. Specifically, it's about rallying support for the drug safety bill (HR2900) now before the US House of Representatives. It's not too much to ask, surely, that prescription medications be safe and affordable, and that information about drug side effects be fully explained to patients.

Diabetics be aware: a major case in point, illustrating Prescription for Change's critique of the status quo, is the Avandia scandal. The US Food and Drug Administration (FDA) failed to alert the public that Avandia, the Type 2 diabetes drug, manufactured by GlaxoSmithKline, increases the risk of heart attack. Oops.

View the cartoon by visiting YouTube. Or click here to visit the Prescription for Change website, which also features additional information about why reform is needed. You can also send an email to your Representative in support of the changes. Can Prescription for Change make a difference? Stay tuned.

Review of inhaled insulin research reveals a mixed bag for type 2s

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Inhaled insulin was approved by the Food and Drug Administration in 2006. A new review of the body of published research on inhaled insulin reveals positive and negative results. Keep in mind, this body of research is lean and only covers a six month window of follow-up.

Researchers examined eight studies involving 1,881 patients with type 2 diabetes to compare inhaled insulin, injected insulin and oral medications.

On the positive side, inhaled insulin worked as well as short-acting injected insulin to control blood sugar over three months. Inhaled insulin can also improve blood glucose control for type 2s who have not had good results with short-acting insulin taken on top of baseline insulin. But inhaled insulin users had more difficulty controlling low blood glucose (hypoglycemia).

For patients who had never taken any form of insulin, inhaled insulin alone was better than oral medications to control blood glucose levels at a three-month follow-up. But again, higher rates of hypoglycemia occured for patients taking oral medications plus inhaled insulin.

Researchers point out existing evidence on inhaled insulin for type 2 patients is unable to answer important clinical questions regarding patient satisfaction, inhaled insulin's effect on other diabetes complications, weight gain and one of the most important issues, long-term impact on lung function. Additionally, inhaled insulin dosing is not as precise as injected insulin, but companies are working on the problem.

Lead researcher, Dr. Jonathan Treadwell, stated the resistance of doctors and patients to inhaled insulin focuses on the concern for possible long-term lung damage. The question remains whether inhaled insulin could exacerbate existing lung problems suspected in many people with diabetes. Treadwell says it is too early know if inhaled insulin could be used as extensively as injected insulin. Here is an AP story from last March on doctor resistance to Pfizer's inhaled insulin product Exubera.

Inhaled insulin is not recommended for patients who have smoked within the past six months, have lung disease, anyone younger than 18 or experiencing an episode of hypoglycemia. Read this Newswise story in dLife.

Diabetes epidemic brings prosthetic industry boom

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Diabetes-related health complications can cause severe nerve and tissue damage to the lower limbs. In the worst cases (and, unfortunately, this happens all too often), this necessitates amputation. The medical research field is working on ways to prevent or heal such damage before such drastic action is required. But what of those who do lose feet or legs? The next step is learning to use prosthetics. And, as the LA Times reports today, the prosthetic industry is experiencing a boom as diabetes rates soar.

Let's look at some numbers to illustrate just how much demand has grown: there are now 1.9 million amputees in the US, reports the Times article, and approximately sixty percent of those are diabetes-related. Compare this, says reporter Daniel Costello, with the 630 veterans of Iraq and Afghanistan who have undergone amputation. A shocker, isn't it? It's also estimated that around five of every one thousand diabetics eventually require amputation of damaged feet and/or legs.

These days, "there's no such thing as a slow day," remarks William Yule, prosthetist and manager of Hanger Prosthetics & Orthotics in Downey. "It can be hard because you can't help thinking a lot of these people don't need to be here," says Yule, alluding to the fact that so many of his clients are overweight Type 2 diabetics. Times reporter Costello spoke with Yule and others in the prosthetic industry and found that the upswing in business is an across-the-board phenomenon that some say is unrivaled since the Civil War, when maimed soldiers returning from battle brought about an unprecedented demand for prosthetics.

The Times article also includes a photo gallery that's worth checking out.

Homeopathy and diabetes

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I was excited to see my friend, Lissa Coffey, appearing on The Today Show this morning. Lissa is a PhD, a relationship expert and sociologist. Lissa shares her ancient wisdom and modern style through her site, Coffey Talk, and her newsletters. A recent newsletter addressed homeopathic medicine and I share with you how this applies to the treatment of diabetes.

Homeopathic medicine is a natural pharmaceutical science developed in the early 1800s. It uses small doses of natural substances (animal, vegetable, and mineral) to stimulate the body's own defenses. Homeopathy is a word derived from the Greek words for similar and disease. It is medicine based on the law of similars that says a substance will help to heal symptoms similar to those that it is known to cause. This is the same principle behind immunization.

When I received Lissa's newsletter on homeopathic medicine immediately I thought of how this applies to diabetes - a disease of insulin antibodies attacking the naturally produced insulin in the body. Why would you treat a disease with the exact hormone that caused it? Novo, Lilly, Aventis - you are all making a grave mistake in forcing American's to use GM human insulin, both Type 1 and Type 2. The extinction of porcine and bovine insulin has consequently proven to be detrimental to diabetics over the last 25 years. Studies show tighter control - yet complications on the rise. How do you explain this? I'm not excited for what the future holds, unless we see a return of these similar but not exact insulin forms.

SickKids partners to speed cure research for diabetes

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In December 2006, The Hospital for Sick Children in Toronto, Canada (SickKids) researchers found that mice injected with capsaicin -- the chemical that makes chili peppers hot -- were rapidly cured of Type 1 diabetes. Now with widespread credence following their discovery, SickKids has partnered with Approach Therapeutics to accelerate the human clinical trials for this cure.

Researchers discovered that Type 1 diabetes is caused by malfunctioning pain nerves surrounding islets. These nerves mistakenly tell the brain that the islets are inflamed and the body creates insulin autoantibodies to destroy them. The researchers injected capsaicin, also known as "substance P", to kill the pancreatic pain nerves. Researchers observed that the injected mice's islet cells began producing insulin normally almost immediately. The nerve cells secrete neuropeptides that tell the islets to release insulin. The nerves weren't secreting enough neuropeptides, causing inflammation resulting in insulin autoantibodies that caused Type 1 diabetes. The researchers also found that the treatments helped curb the insulin resistance that causes Type 2 diabetes.

Thanks to SickKids and Approach Therapeutics for the promising news. Looks like the cure for diabetes could come from a land where universal healthcare lives.

Wednesday, 4 July 2007

"Balance and Stretch" kit for kids gets thumbs up

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It's thumbs up for the AT-A-GLANCE Balance & Stretch Day Planner. The kit, which is designed for use by kids with Type 1 diabetes, was evaluated by researchers from none other than the Joslin Diabetes Center, that leading institute for diabetes study (and Harvard affiliate, to boot). The conclusion: the day planner is an effective way for Type 1 youngsters to get in the habit of managing their diabetes. The results of the study were announced at the recent American Diabetes Association's Scientific Sessions conference in Chicago.

The AT-A-GLANCE day planner allows kids to keep track of their daily eating, sleeping and activity patterns, logging everything in a specially designed calendar notebook. Other handy info, such as insulin and other medications taken can also be recorded, along with reminders of health checkup appointments and so on.

Here's how Joslin tested the kits' efficacy: kits were distributed to children attending diabetes camp. The kids used them for the two-week duration of the camp, and Joslin conducted follow-up checks three months after that. Bottom line: kids who used the planner were more knowledgeable about diabetes and diabetes management and - critically - demonstrated fewer negative feelings about having and managing the condition. They also showed a tendency toward improved glycemic control.

Click here to visit the AT-A-GLANCE website and view images of the day planner's page layout. AT-A-GLANCE products are manufactured by MeadWestvaco. The Balance & Stretch planner was developed by the company with input from Joslin and also The Barton Center for Diabetes Education, and is designed to be suitable for and appealing to both children and teenagers. Hmm. They might want to work on that last bit... Anything designed to be appealing to kids is surely going to make your typical teen feel like a dork and, therefore, something they are not going to want to tote around! Having said that, I like the design a lot.

HealthCentral announces 2007 Top Diabetes Sites

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The HealthCentral Network, Inc. (THCN) has announced their First Annual 2007 Top Site Awards for small Web sites and individual blogs focusing on diabetes. Winners were picked for their dedication and support for diabetes education and individuals living with diabetes, as well as fostering a web-based diabetes community.

THCN gathered an in-house team of experts to choose this year's top diabetes sites. Recipients of the award share THCN's mission to highlight patient voices in health information.

Now for the drumroll ... here are the First Annual 2007 HealthCentral.com Top Diabetes Sites:

Diabetes Mine, Six Until Me, Diabetes Monitor, Daily Diabetic, David Mendosa, Diabetes Update, Close Concerns, Diabetes Self-Management, Diabetes Notes and Scott's Web Log.

In the short time I've been blogging on diabetes, I have learned immense amounts of information, and felt the care and concern these talented writers share with the on-line diabetes community. Through the back and forth dialogue capability of blogging, readers and writers share supportive and opposing viewpoints, and continue to learn from each other with a raw honesty peppered with compassion, personal experience and intelligent insights.

To the winners, hats off to you! Kick back and enjoy the accolades. So many are grateful for your mentorship. But please, do get back to work soon -- we need you.

Novo asks you to aboutface

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Meet the Face of Change is a photo exhibit owned by Novo Nordisk featuring YOU -- the face of change. Change for what, I asked? Well, it seems Novo would like to change your opinion of the barriers to insulin treatment for Type 2 diabetics. The common belief of insulin treatment for Type 2 diabetes is that it is the point of no return. Why? First instincts are usually correct.

Studies have shown that Type 2 diabetics injecting insulin create insulin antibodies (IAA). Type 1 diabetics have these antibodies upon diagnosis. Type 1 diabetes was also formerly referred to as insulin-dependent diabetes. Insulin antibodies (IAA) develop and attack the natural insulin produced, resulting in insulin dependence. Type 2 diabetics do not have the same level of IAA. Once they begin injecting insulin that looks like human insulin (the kind Novo makes) - you run the risk of developing IAA. The use of animal-insulins did not cause the development of IAA to the same extent. If you plan to start injecting insulin - ask your doctor if he will check you for IAA. As a Type 2 diabetic, you DO NOT have to become an insulin-dependent diabetic.

I asked Novo to explain what Meet the Face of Change is about. What are they trying to change? The response I received from Nov explains their wishes to strengthen the drive of their business, among other core values. Now I ask you - how do you drive a business that sells insulin? Sell more insulin. For the 16 million Type 2s not yet in this lineup- please consider if insulin-dependent diabetes is the face you want to meet. Don't add insulin to injury. It may not be the path of least resistance, but cut back on simple sugars, increase fiber consumption, and take a walk after dinner. Meet the face of change by putting your best foot forward, not your face on a campaign for vulture capitalism.

Unexplained high insulin levels possibly lead to fatality and coma in Chicago hospital

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Between May 7 and June 5, three elderly female patients within the same wing at the University of Chicago Hospitals in Hyde Park showed signs of insulin overdose. None of them were prescribed insulin and only one, Ruthie Holloway, was identified as a 'dietary diabetic'. Two have died and one remains in a coma.

Two of the patients had extremely high insulin readings over 2,600 micro international units per microliter. 82-year-old Ruthie Holloway died. An unnamed 68-year-old woman is in a coma. Both women were admitted to the hospital for urinary tract infections. A third patient admitted for complications of Alzheimer's disease, 89-year-old Jessie Sherrod, was not tested for insulin levels, but was hypoglycemic at the time of death. A blood sample from Sherrod has since been taken. Two additional cases of hypoglycemia are also being investigated involving a non-diabetic 89-year-old man who is alive, and a 30-year-old female cancer patient who died June 21. Hospital officials state they do not think the female cancer patient could be connected to insulin as she was not admitted within the same wing nor was she a diabetic.

A 2,600 insulin level is hundreds of units over a normal level which ranges from 10 to 50 micro international units per microliter. Dr. Irl Hisch, medical director of the Diabetes Care Center at the University of Washington in Seattle, stated the only way insulin levels could be that high is to inject it from a bottle.

Hospital officials notified the Chicago Police Department on June 22 after internal investigations could not determine cause of death. They are also examining a range of possible explanations including medication error, laboratory error related to serum insulin levels and product integrity of medications.

If the dangerously high insulin levels were an intentional act, what a heinous crime. Here are the latest and original stories published in the Chicago Tribune.

When did the FDA learn about Avandia?

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The way that the US Food and Drug Administration (FDA) dropped the ball on Type 2 diabetes drug Avandia has fueled calls from both in and outside of government for FDA reform. We should all be afraid, very afraid, that a government body charged with protecting the public good on such a basic level is toothless. And that's putting it kindly.

The public radio show Marketplace just ran a two part feature on this issue. Its reporter asks the question: when did the FDA first learn about the health risks posed by Avandia (namely, increased risk for heart attack)? Also, what did the FDA know before the story broke in the media? Shockingly, Avandia manufacturer GlaxoSmithKline (GSK) informed the FDA back in 2005 that the drug raised the risk of heart attack. GSK even supplied the FDA with a copy of its internal analysis on the subject in 2006, which the FDA then confirmed with its own analysis. The FDA's explanation for its silence was that it was trying to assemble a comprehensive picture of the situation before acting. Sure. But how much longer would the FDA have sat on the Avandia issue if the story hadn't broken following the criticisms of cardiologist Steven Nissen?

Because the FDA is supposed to be our public health watchdog, these questions will ultimately prove far more significant than questions about what GSK knew and when. Big Pharma - like all business enterprises, large and small - is focused on the bottom line. It's up to the FDA to look out for the rest of us. Yet many in our government believe in letting market forces prevail; that in a healthy economy, little government oversight is necessary. Fact is, this just doesn't work. Are you scared yet?

Happy July 4th!

The link between heart and kidney disease

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If you've cared for someone with heart disease, you may already know about the heart and kidney connection. Because the same two common conditions damage the heart and the kidneys -- high blood pressure and diabetes -- diseases of both organs commonly go hand in hand.

Though health experts have long known of the connection, a recent study of 37,000 adults -- average age 53 -- found that the effect of chronic kidney disease (CKD) on the heart is much more alarming than first thought. During the study, experts looked for three markers that indicated CKD:
  1. the rate the kidneys filtered blood
  2. the level of the protein albumin in the urine
  3. anemia



What they found was that as these markers rose, so did the risk of heart disease, and that those with CKD and heart problems had triple the risk of dying from heart related problems in a 2.5 year period. And the effect is visible in reverse -- those with heart disease were twice as likely to develop kidney problems.

What this means to you, the patient, is this:
  • Cardiac patients should have their kidney functioning closely monitored.
  • High-risk patients should know their GFR, or the rate their kidneys filter blood. Some experts believe ALL adults should know this number. A normal GFR is 120.
  • Kidney disease should be treated aggressively with drugs like ACE inhibitors.
  • CKD patients should have cardiac risk factors -- like high blood pressure -- tightly controlled.

4 habits to fight heart disease at any age

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In a long-term strictly observational study that covered the lives and lifestyle habits of over 15,000 adults since the 1980s, 4 specific habits were shown to have a significant impact on heart disease and risk of death:
  • Eating at least 5 servings of fruits and vegetables daily
  • Exercising (i.e. walking) for at least 2.5 hours weekly
  • Maintain a healthy BMI outside of the obese range
  • Not smoking
The study didn't actually look at any other habits, but the people who adopted these 4 (even in mid-life) were 40% less likely to die and 35% less likely to get heart disease. Those are some big numbers -- how many of these habits can you honestly say you have? How many are you working on?

Foods to avoid if you're looking for a heart healthy summer

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Summer brings to mind the crisp smell of a freshly mowed lawn, the excitement of a trip to the amusement park and the taste of some fabulous, rockin' foods. Unfortunately, some of the summer all time favorites are bad news for those of us looking to lead heart healthy lives. The fried chicken, macaroni salads and fudge cakes that frequent many an evening picnic table are laden with fat and calories. The hot dogs and ice cold beer that accompany a baseball game are also bearers of high fats contents and huge numbers of carbohydrates. And my all time favorite, the iced frappuccino topped with a glob of whip cream is brimming with calories and more fats.

With that unfortunate news in mind it might be time to restructure those mental connections with these fatty treats. A summer picnic could feature a fresh fruit salad, unsweetened sun tea and skinless, grilled chicken. That bi-weekly frappuccino, although one of my favorites, could be replaced with a glass of ice water garnished with a lemon slice. As for the beers and hot dogs? That truly is a hard one. For a more in depth list of the summer food offenders, click here.

This summer, take care of your heart

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Summer makes me feel alive. Everything's fresh, green and fragrant. People are happier, myself included because I love being outside. Since summer is a time of liveliness, we should all use the warm weather to prolong our lives by taking care of our hearts.

Healing Guru Mary Ann Copson has a number of healthy tips to follow this summer to create positive energy for your mind and body. It's a little long, but the main points I got from the article are these:
  • You should eat fresh, light meals
  • You should lower your cholesterol to help prevent blockages in your arteries
  • You should engage in moderate activity
  • You should form or maintain social relationships
  • You should work at understanding the energies in your body and accept the importance of your heart, which guides those energies
What healthy tips do you have this summer?

Thought for the day: Isaac Asimov

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"If my doctor told me I had only six minutes to live, I wouldn't brood. I'd type a little faster." - Isaac Asimov

Famous quotations can provoke powerful messages and thought. As individuals, we can read the same quotes but give to it totally unique meanings. This quote means to me -- that if I was to find out that my cancer recurred, I would still need to carry on, hold my head up and keep going. Live life to the fullest.

I started to think about what the author of this quote was saying about himself. I wondered what it meant in his own life. Issac was a science fiction writer who died in 1992. I think that maybe since he was a writer, upon learning of his death, would want to tell more stories, finish ones he already started or just get all of him that he could into this life as a legacy for him to leave behind. I couldn't know what was really in Issac's mind and I can't know whats in yours but many times we can read these messages and connect with them.

I do know that sometimes reading quotes -- is like poetry to me.

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Opera singer Beverly Sills dies from lung cancer

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I wrote on June 29 about the serious health condition of Opera singer Beverly Sills. At the time, Sills -- sick with cancer -- was in a Manhattan hospital, gravely ill, with her daughter by her side. I didn't name her cancer because I didn't know of her specific condition. Now, as I've just learned of her death, I know more about her illness.

Sills, described in this news story as "the Brooklyn-born opera diva who was a global icon of can-do American culture with her dazzling voice, bubbly personality and management moxie in the arts world," died on Monday of inoperable lung cancer at the age of 78. She died at her Manhattan home with her family and doctor by her side. She was a non-smoker.

Sills' illness was revealed just last month.

Marvel Comics writer on Captain America, cancer

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Writer Jeph Lobe has been working through the stages of grief in the most recent issues of Marvel Comics. You see, Captain America has been gunned down. And his buddies -- Wolverine, the Avengers, Iron Man, and Spider-Man -- are battling with denial, anger, bargaining, and depression. The whole story will be revealed when the latest issue, Fallen Son, hits newsstands July 5th, the day after Independence Day.

Loeb, also an executive producer for NBC's Heroes, chose his storyline to represent current politics.

"Part of it grew out of the fact that we are a country that's at war, we are being perceived differently in the world," he says. "He wears the flag and he is assassinated -- it's impossible not to have it at least be a metaphor for the complications of present day."

Loeb's storyline also stems from something much more personal -- the death of his 17-year-old son from cancer.

"So many people have lost their sons and daughters over the years, for the greater good or to cancer or other horrible things," said Loeb. "I wanted this to be something people would identify with."

So what will come of Captain America's death? Will he come back from the dead? That's not important right now, says Loeb.

"The question is, how does the world continue without this hero?" he says. "If that story of his return gets told further down the line, great. But everyone's still been dealing with his loss."

At Captain America's funeral, a eulogy is delivered and superheros everywhere are asked to stand up and honor their hero. Loeb did something similar at his son's funeral.

"It was this moment where I realized that we were all different, but this boy, my son, made us all connected," he said. "It was powerful."

Cancer doctors under stress

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In a study of 401 cancer specialists in the UK, 102 exhibited possible psychiatric morbidity and more than one in ten showed clinically important levels of depression. The study was published by Professor Chris Todd and his team at the University's School of Nursing, Midwifery and Social Work and Christie Hospital, Manchester in Clinical Medicine in June.

The team surveyed all palliative medicine, clinical oncology and medical oncology specialists in the country. 63% of the specialists responded to the study.

The main concerns for the respondents included being over-stretched, keeping up-to-date with knowledge, fear of making mistakes, talking to distressed relatives and long working hours. For the palliative care group, stress factors included making the right decision as a team and low prestige of specialty.

Todd adds, "Many doctors in various specialties experience high levels of stress during their working lives and are more at risk of depression, alcoholism and suicide than the general population. They also report that it can affect their performance. Cancer clinicians are exposed to high risk of poor mental health and other work has shown that their psychiatric morbidity has increased markedly over recent years."

As far as what can be done to alleviate this problem, Todd suggests tackling workload problems as well as changing the culture to allow these specialists to work through and talk about difficulties without a fear of affecting their career prospects.