Preventive CT to find lung cancer at its early stages.

Lung Cancer Screening Using Helical CT vs. Chest X-ray Reduces Deaths among Current and Former Heavy Smokers

Credit: Teresa Winslow (artist), for NCI

NOVEMBER 4, 2010, 11:00AM

By Brooke Layne Hardison

POSTED IN: Lung cancer | screening | tobacco

TAGS: chest, CT, lung, Lung cancer, NLST, screening, smoking,spiral, spiral CT, technology, test, x-ray

People with a history of smoking have a high risk of lung cancer – a disease with a five-year relative survival rate (for smokers and non-smokers combined) of only 15.8 percent.  Previous attempts at developing a test to find lung cancer early, when it is easier to treat, have not been able to demonstrate a decrease in mortality rates. Now, a study sponsored by the National Cancer Institute (NCI) has determined that low-dose helical computed tomography (CT) scans can reduce lung cancer mortality for current and former heavy smokers.  In the nation-wide study, which included over 53,000 participants, researchers found 20 percent fewer lung cancer deaths among those who were screened with low-dose helical CT (also known as spiral CT) compared with those who were screened withchest X-rays. In addition, deaths from all-causes (including lung cancer) were seven percent lower in those who received the low-dose helical CT scans.

“This is the first time that we have seen clear evidence of a significant reduction in mortality with a lung screening test in a randomized controlled trial.  The fact that low-dose helical CT provides a decided benefit will be a result that will have implications for the screening and management of lung cancer for many years to come,” said Christine Berg, M.D., NLST project officer for the NCI, in a press release.

In September 2002, the NCI launched the largest lung cancer screening study ever conducted.  The National Lung Screening Trial, or NLST, compared the effects of two lung cancer screening procedures, low dose helical CT and chest X-ray, in reducing mortality in current and former heavy smokers aged 55 to 74. Unlike previous trials, the NLST was a randomized control trial, the gold standard in clinical trials. Participants were randomly assigned to one of two comparable groups – chest X-ray or helical CT – and received three annual screenings based on their assigned technology.  The groups were followed for at least five years beyond the final screening. (Read an article in this publication from the launch of the trial in 2002)

“The results of this trial provide objective evidence of the benefits of low-dose helical CT screening in an older, high-risk population and suggest that if low-dose helical CT screening is implemented responsibly, and individuals with abnormalities are judiciously followed, we have the potential to save thousands of lives,” said Denise Aberle, M.D., NLST national principal investigator for ACRIN, in an NCI press release. “However, given the high association between lung cancer and cigarette smoking, the trial investigators reemphasize that the single best way to prevent lung cancer deaths is to never start smoking, and if already smoking, to quit permanently.”

Low dose helical CT, which was introduced in the 1990’s, uses computer-controlled X-rays to scan the entire chest in about 7-15 seconds during a single, breath-hold. The CT scanner rotates around the person, who is lying still on a table as the table passes through the center of the scanner.

(Figure A:) Conventional CT scan. (Figure B:) Spiral CT scan. Credit: NCI Cancer Imaging Program

A computer creates images from the X-ray information coming from the scanner and assembles these images into a series of two-dimensional slices of the lung at very small intervals so that increased details within the organs of the chest can be identified.  Virtually all hospitals and free-standing radiology facilities in the United States now have a helical CT machine, which are routinely used for diagnostics. While some facilities do perform helical CT scans for the purpose of screening for lung cancer, such practice has not been previously supported by evidence and is not currently covered by most insurance providers.

Screening with CT scans comes with its own risks.  Radiation exposure from repeated CT scans can lead to illness, including cancer, and people who get false-positive results may be subjected to unnecessary surgical procedures.   It’s important to note that most abnormalities detected with CT screening are not cancer, even in people who are at high risk.

There are over 94 million current and former smokers in the United States who are at high risk for lung cancer.  In 2010, it is estimated that 222,520 people will be diagnosed with, and 157,300 will die from lung cancer, the leading cause of cancer death in the United States.

More information about the new results of the NLST is available in National Lung Screening Trial – Initial results: Questions and Answers and Fast Facts on NLST.  For more information on lung cancer and screening, please visit our Lung Cancer Homepage.

Blood Sugar Control is Key to Prevent Diabetes and Chronic Disease

Humans did not evolve to metabolize the large amount of carbohydrate calories consumed by the most health conscious individuals today. High levels of blood glucose are a significant underlying factor that leads to the development and proliferation of many age-related diseases.

Diabetes, heart disease, stroke, cancer and dementia are all accelerated by slowly increasing fasting and post meal blood sugar levels that cause needless suffering and death for millions of unsuspecting people each year. Taking the necessary dietary and nutritional steps today can prevent the current explosion of new diabetes cases in the future and lengthen natural lifespan.

Redefining Healthy Blood Sugar Readings
Normal blood sugar levels have been continually revised downward over the past several decades as it`s determined that current levels cause cellular damage. Presently a fasting reading over 126 mg/dl repeated twice is considered cause for a diagnosis of diabetes.

A reading of 110 mg/dl or above is classified as impaired by the American Diabetes Association. Information published in the journal Diabetes Care indicates that a fasting blood glucose level above the range of 70 – 85 mg/dl dramatically increases the risk of developing heart disease and death from a heart attack. The researchers conclude “fasting blood glucose values in the upper normal range appears to be an important independent predictor of cardiovascular death in nondiabetic apparently healthy men.”

Excess Sugar Damages Vessel Walls, Leads to Insulin Resistance
Excess blood sugar triggers a cascade of potentially deadly processes that contribute to diabetes, hardening of the coronary arteries and neuropathic complications. High glucose levels from dietary sugar and excess carbohydrate consumption provokes the release of chemical cytokines that promote arterial wall inflammation, endothelial dysfunction and atherosclerosis. Eventually the pancreas is no longer able to secrete enough insulin, and the insulin that is produced is no longer able to efficiently escort sugar to the cells and muscles.

Naturally Lowering Blood Sugar with Diet
Nutrients such as cinnamon and vinegar taken before eating can help lower post meal blood sugar spikes and can compliment proper diet. The most dependable way to naturally cut blood sugar levels is to dramatically lower calories from carbohydrate sources at each meal. Totally eliminate all processed and refined carb foods including bread, pasta, corn and rice.

Depending on carbohydrate sensitivity, some individuals may also need to limit fruits and starchy vegetables as well. The results of a study published in the Journal of the American College of Nutrition shows that a diet rich in monounsaturated fats such as the Mediterranean diet improves post meal blood glucose levels and moderates healthy insulin response.

High Protein, Low Carbohydrate Breakfast Regulates Blood Sugar
The result of research published in the journal Diabetes Care demonstrates the importance of including protein as part of a low carbohydrate breakfast. Participants were given a high protein food shortly before eating a low carb breakfast. Post meal blood sugar readings were 40% lower than the same meal eaten without the protein source in advance. This underscores the importance of combining proteins and monounsaturated fat sources with each meal to slow down the release of potentially damaging sugar surges.

The best way to protect yourself from out of control blood sugar spikes is to monitor your blood glucose at 1 and 2 hour intervals after eating. Avoid any reading above 140 mg/dl as tissue damage has been observed with sustained levels above this threshold. Research provides extensive evidence that controlling fasting and post meal blood sugar results in lower disease risk and lengthened lifespan.

via Technorati

Aspirin: Pain Reliever, Heart Attack Preventer & Possible Cancer Preventer Rolled into One Tablet

If you take aspirin, you've got a pain reliever, heart attack preventer and possible cancer preventer rolled into one tablet. You might think that whoever invented aspirin is a genius, but the truth is humans have been using its natural equivalent for thousands of years.

"Aspirin is one of those things that, long before there were ever clinical trials or any kind of scientific knowledge, people figured out, 'Hey, I feel better when I take this substance,' " said Dr. Karol Watson, assistant professor of cardiology at University of California, Los Angeles.

The drug has been making headlines because a study in the Lancet recently found that a daily aspirin appeared to lower the risk of cancer by at least 20% during a 20-year period. That's based on data from more than 25,000 patients and builds on earlier findings that aspirin may lower the risk of colorectal cancer. The research has limitations and is not definitive proof, but it does add another benefit to an ancient remedy that has been called a miracle drug.

"There are no countries in which it is unknown, unappreciated, or unavailable," the late medical writer Berton Roueché wrote in 1955, in an article later published in the anthology "The Medical Detectives."

History of aspirin

The word "aspirin" wasn't a coincidence. It comes from Spiraea, a biological genus of shrubs that includes natural sources of the drug's key ingredient: salicylic acid. This acid, resembling what's in modern-day aspirin, can be found in jasmine, beans, peas, clover and certain grasses and trees.

The ancient Egyptians used willow bark as a remedy for aches and pains, said Diarmuid Jeffreys, author of "Aspirin: The Remarkable Story of a Wonder Drug." They didn't know that what was reducing body temperature and inflammation was the salicylic acid.

It wasn't until thousands of years later that people began to isolate the key ingredients of aspirin. An 18th-century clergyman, Edward Stone, rediscovered aspirin, in effect, when he wrote a report about how a preparation of powdered willow bark seemed to benefit 50 patients with ague and other maladies, Roueché wrote.

Aspirin's uses for heart patients came to light in 1948 when California physician Dr. Lawrence Craven recommended an aspirin a day to reduce heart attack risk, based on what he had observed in patients.

The Nobel Prize in medicine in 1982 was awarded to researchers who demonstrated the reason -- it inhibits production of hormones called prostoglandins. Prostoglandins are responsible for the formation of clots that leads to heart attacks and strokes, and aspirin prevents that clotting from happening.

Toward better preventative medicine

Today, aspirin is universally recognized as heart-attack prevention in men who have had prior heart attacks, and it has also shown to have benefits against stroke in women.

More than 1/3 of all adults, and 4 out of 5 people with heart disease, use aspirin regularly, according to data from the Centers for Disease Control and Prevention presented in a 2006 study. And the number of regular aspirin users rose 20% from 1999 to 2003.

Still, it's not necessarily the go-to for over-the-counter painkillers. In 2007, pain relievers such as Advil, Tylenol and Aleve were among the top five analgesics sold; aspirin did not make the cut.

"If you're hurting, you're going to reach for a stronger pain reliever," Watson said. "In most cases, a baby aspirin a day is not going to make you feel any better or worse."

The U.S. Preventive Services Task Force recommends that men 49 to 79 take aspirin to prevent heart attack, and that women 55 to 79 take it to guard against ischemic strokes, when the potential benefits outweigh the potential harms from an increase in gastrointestinal hemorrhage. In other words, aspirin can increase bleeding because of decreased clotting, so if you have bleeding problems, it's not a good idea.

Aspirin's potential cancer benefits have come on the scene more recently, and there aren't standard guidelines in that regard. The agency discourages taking aspirin to prevent colorectal cancer in people with average risk for that disease. Also, the mechanism isn't entirely understood, although the thought is that aspirin helps the body cut off blood supply to cancer growths, Jeffreys said..

Patients should not just take it without consulting their physicians, Fishman said. Certain conditions such as bleeding disorders make taking aspirin dangerous. Some supplements, such as fish oil and garlic, can also cause bleeding problems in combination with aspirin, he said. Aspirin is not approved for children younger than 2 and should be used with caution in very young people because of apossible link to Reye's syndrome.

Still, it's likely that aspirin has even more benefits that just haven't been discovered yet, Jeffreys said. In his view, the drug is taken for granted, and not enough emphasis is placed on it.

"If I'm stranded on a desert island, and I can take one drug with me, that's the one I'm taking," Watson said.

via CNN Health 

Ever wondered how hormones work?

 

What the hormone system is

The hormone system is a network of glands and organs in the body that produce hormones. It is also called the endocrine system. The main parts of the hormone system are shown in the diagram below.

Back to top

 

 

Hormones and how they work

Hormones are natural substances made by the glands and organs of the hormone system. Our bloodstream carries the hormones around the body. Each gland makes a different hormone and most make more than one.

There are many different hormones. Each only works on the particular cells that are able to receive and respond to that hormone’s message. So they act as chemical messengers between one part of the body and another.

Each hormone has a different purpose. Generally speaking, they control how we respond to changes in the environment around us, as well as

• Growth and development
• How the body works
• Our mood
• Sexual function
• Reproduction

After a hormone is released, it travels from the gland to its target cells through the bloodstream. It connects to a part of the target cell called a receptor. The connection triggers a response in the cell. The type of response depends on the type of hormone.

In the brain, the hypothalamus and the pituitary gland control the whole hormone system and levels of hormones in the body.

Back to top

 

 

The hypothalamus and hormone level control

The hypothalamus is part of the brain and not actually part of the endocrine system.

The hypothalamus works with the pituitary gland to control the activity of most of the other glands of the endocrine system. It reacts to changes in the amount of hormones in the body. When the level of a particular hormone drops below what it should be, the hypothalamus signals to the pituitary gland. The pituitary then produces hormones that tell other organs to produce the hormone that the body needs.

For example, the thyroid gland makes thyroid hormones. It only does this when the hypothalamus detects that the level of thyroid hormones is low. The hypothalamus signals to the pituitary gland to produce thyroid stimulating hormone (TSH). TSH stimulates the thyroid to produce thyroid hormones. When the thyroid hormones are at the right level, the hypothalamus signals to the pituitary gland to stop producing TSH. The thyroid gland then stops making thyroid hormones. This system is called a negative feedback mechanism and is how the body controls hormone levels.

Back to top

 

 

The pituitary gland

This is a small gland on the under surface of the brain. It makes a number of hormones and controls many different body functions. Many of the pituitary gland hormones signal to other parts of the hormone system to make, or stop making, other hormones.

Pituitary hormones control

• Growth, by producing growth hormone
• The speed of body processes (metabolism) - thyroid stimulating hormone (TSH) tells the thyroid gland to make thyroid hormones
• Steroid levels - adrenocorticotropic hormone (ACTH) tells the adrenal glands to make steroids
• Breast milk production after birth - prolactin makes the breasts produce milk
• Periods and egg production in women
• Sperm and testosterone production in men

Egg and sperm production are controlled by two pituitary hormones, follicle stimulating hormone (FSH) and luteinising hormone (LH). These control oestrogen and progesterone levels in women and testosterone levels in men. FSH and LH levels are in turn controlled by the hypothalamus.

Back to top

 

 

The pineal gland

The pineal gland is a very small gland deep in the brain. It makes the hormone melatonin, which controls sleep patterns. You can see the position of the pineal gland in the diagram above.

Back to top

 

 

The thyroid and parathyroid glands

The thyroid gland is at the base of the neck. You can see the position of the thyroid and parathyroid glands in the diagram above. The thyroid makes these hormones

• T3 - also called tri iodothyronine
• T4 - also called thyroxine
• Calcitonin

The hormones T3 and T4 help to control how fast your body works – your metabolic rate. If your thyroid gland doesn’t make enough of these hormones, you put on weight and feel very tired and lacking in energy.

If your thyroid gland makes too much of the T3 and T4 hormones, you lose weight and have an increased appetite. With an overactive thyroid you may also feel anxious and find it difficult to relax.

Calcitonin helps to control the amount of calcium in the body.

There are 4 parathyroid glands. They are very small glands at the base of your neck very close to the thyroid gland. They make parathyroid hormone (PTH). Along with calcitonin and vitamin D, PTH controls the level of calcium in the body.

Back to top

 

 

The adrenal glands

You have two adrenal glands - one above each kidney. They make several hormones. Cortisol is a natural steroid hormone that affects the level of sugar in the blood. Aldosterone helps to regulate the body’s water and salt balance, and the blood pressure.

The adrenal glands also produce small amounts of the male and female sex hormones (oestrogen and testosterone).

Probably the best known hormone made in the adrenal gland is adrenalin (epinephrine), which helps us to respond quickly when under stress. Another similar hormone, noradrenalin (norepinephrine), also helps us to respond quickly under stressful conditions.

Back to top

 

 

The pancreas

The pancreas is quite high up in your abdomen. It lies across the body, where your ribs meet at the bottom of your breastbone, just behind your stomach. You can see the position of the pancreas in the diagram above. It is about 6 inches long and shaped like a leaf. The pancreas makes insulin, which controls the amount of sugar in our blood. It also makes other hormones that help with digestion, including glucagon, somatostatin and pancreatic polypeptide.

Back to top

 

 

The ovaries

The ovaries produce 2 sex hormones, oestrogen and progesterone. Together they control the menstrual cycle (periods).

During puberty oestrogen helps the development of female sexual characteristics, including breast growth and the maturing of the womb (uterus) and vagina.

Progesterone plays a part in maintaining pregnancy.

Back to top

 

 

The testes

The testicles or testes produce the hormone testosterone. Testosterone gives male qualities such as a deep voice and beard growth. It also controls sex drive (libido), the ability to have an erection.

via Cancer Research UK