Catching Breast Cancer
A mammogram detects about 80 to 85 percent of breast cancers. While it is one of the most important tools for breast cancer detection, the remaining 15 to 20 percent of cancers that are missed are a problem.
Frank Gilliland, M.D., USC associate professor of preventive medicine, and his colleagues found that cancers missed by mammograms tend to be more aggressive and grow faster than other breast cancers. "And these tend to happen in younger women," Gilliland adds.
Gilliland's team examined records from nearly 120,000 mammograms done in the early 1990s, looking for women diagnosed with a breast cancer tumor within 12 months after getting a clear mammogram. That type of tumor is known as an interval breast cancer.
A tumor can be missed if a radiologist makes an error, Gilliland says, but it also may be that a tumor was yet too small to be detected on the mammogram.
Researchers found that the missed cancer tumors tended to have more cells that reproduced quickly, and had fewer dying cells.
Though younger women are at lower risk for breast cancer than women age 50 and above-and mammograms in these women tend to show many false positives-those young women who do have tumors tend to have aggressive ones. It is critical to catch these tumors at an early stage for more successful treatment.
Gilliland says, "If you want to reduce mortality, it's important to increase the frequency of mammograms to once a year to catch these cancers before they have had a chance to spread."
According to the National Cancer Institute, a woman's chance of having breast cancer jumps from one out of 235 women at age 40, to one out of 54 women by age 50. Regular mammograms for women in their 40s may reduce their chance of dying from the disease by 10 to 18 percent.
Gilliland stresses the importance for women over 40 to get yearly mammograms: "If women let two to three years go between mammograms, that is when you run into trouble."
Kick Butts
Lung cancer isn't the only risk smokers take each time they light up a cigarette.
"Tobacco is the leading cause of head and neck cancers," says Dale Rice, M.D., chair of the Department of Otolaryngology/Head and Neck Surgery at the Keck School of Medicine. "Up to 90 percent of these cases are smoking-related."
More than 55,000 Americans develop cancer of the head and neck each year, and almost 13,000 die from it. Most cases are preventable.
The three most common head and neck cancers (or oral and oropharyngeal cancers) affect the tonsils, tongue and larynx. They tend to strike late in life, between age 40 and 60, but can be successfully treated if detected early.
Symptoms include a lump in the neck (especially if it is an inch or larger in diameter or grows quickly), pain in the throat or ears during swallowing, an eroded area or swelling in the mouth, a voice change, or growths on the skin of the face.
"If you smoke more than a pack a day or consume more than five alcoholic beverages a day, you're an A-list candidate for these types of cancers," says Rice.
Some people assume that chewing tobacco is a safe alternative to cigarettes. It is not. This product simply moves the cancer risk from the lungs to the mouth.
Luckily, survival rates for head and neck cancers are high (70 to 90 percent) if they are detected early. But Rice stresses these final words of advice: "Stop smoking. It's the single most important thing you can do for your health."
Itchy and Scratchy
Just hearing the word "chickenpox" can bring out a primal urge to scratch that awful itch.
But chickenpox-and its bumps, blisters and rashes-is not just a childhood disease. Adults who never had it as kids can still catch it, explains USC internist John L. Brodhead Jr., M.D. And when it hits adults, it can be a formidable foe.
Among other complications, chickenpox in adults can bring on interstitial pneumonia. As a result, patients may end up with a dangerous condition known as adult respiratory distress syndrome, says Brodhead.
"Adults have also had strokes because of inflammation of the blood vessels," Brodhead says. Although adults make up only about 2 percent of those infected with chickenpox, they account for 50 percent of the deaths from the disease. Adults who never had chickenpox as children can easily catch it through airborne droplets from an infected child's sneezes or coughs.
A vaccine is available, though, Brodhead says. Offered since 1995, it uses a weakened virus to spur the body to create antibodies against chickenpox. Brodhead suggests that adults who have not had chickenpox consult their doctor before getting the vaccine. The doctor can review the patient's health history and suggest the best option.
Some people should avoid the vaccine, he says: those who are HIV positive, have cancer or are pregnant, or people on steroids or who recently took steroids.
Even having had chickenpox as a child does not necessarily leave you protected. The virus remains in the body for life and can come back in adulthood as shingles-a condition consisting of fever, pain, malaise and a sudden eruption of blisters following a path of nerves along the skin.
Unfortunately, once you have had chickenpox, Brodhead says, "the vaccine can't protect you from getting shingles."
Take Care of Your Bones
Drink milk at the dinner table? Some scoff at the habit-but our bones may be better for it.
Calcium is a principal building block of our skeleton, the mineral that keeps our bones from growing brittle and breaking.
"Bones are a living organism, just like the heart," says Edward McPherson, M.D., USC associate professor of orthopaedic surgery. "Bone is not an inert matter. Old bone is reabsorbed back into the body while new bone is made."
But this process reverses by age 35, when the resorption outpaces new bone generation. Bones lose density, a condition that can lead to osteoporosis, or porous bone disease.
"Over time, you'll have potholes here and there," McPherson explains. "Every time you lay down to sleep you develop micro-cracks in your bone."
The secret to healthy bones? Get enough calcium and regular exercise, he says.
An adult should consume 1,000 mg of calcium daily. The following foods are the richest in calcium: plain, low-fat yogurt (415 mg. per cup), collard greens (357 mg. per cup), skim milk (302 mg. per cup) and tofu (260 mg. per cup).
As for exercise, McPherson recommends 30 minutes of daily moderate activity. And exercise is not just high-impact activities such as contact sports or running. Walking, gardening, playing golf or even dancing are all exercise, especially if done vigorously.
He also recommends that those with a high risk of osteoporosis-thin, fair-skinned people and post-menopausal women-get a baseline measurement of bone density in their late 30s. The full-body scan takes no more than 20 minutes.
"I'm extremely religious on that," McPherson says. "Fractures can be prevented with early detection and management."
So next time your friends laugh at your drinking habits, raise your milk glass proudly and toast to the health of your 206 bones.