What are the latest findings concerning breast and ovarian cancer?

Improved treatment and early detection through routine mammography in women over 40 years of age and in younger women with family history of breast cancer have improved the survival rate of breast cancer patients by 2% per year over the last ten years. In addition to getting regular mammograms, any changes in the breast should be evaluated by a physician. A higher risk of developing breast or ovarian cancer can be determined by genetic testing for mutations in the BRCA1 and BRCA2 genes. Women with a family history or heightened genetic risk of developing breast cancer may consider hormone therapy (Tamoxifen is the most common treatment), which has been shown to decrease the incidence of breast cancer in women at high risk (www.breastcancer.org).

Unfortunately, ovarian cancer remains more difficult to detect at the early and most curable stages. The symptoms of ovarian cancer are fairly nonspecific and often go undiagnosed. Change in urine production, bowl movements, gas production, indigestion, or weight in addition to pelvic pain, painful intercourse, or feeling of fullness should be discussed with a physician and an exam should be scheduled. The CA125 blood test is fairly unreliable, so new markers of ovarian cancer detection are under evaluation (Cancer Consultants Oncology Resource Center). A novel blood test in development referred to as OvaCheck™ appears to be more accurate at detecting early stage ovarian cancer (Lab Test Online at www.labtestsonline.org/news/ovacheck040606.html). A new “ovarian pap test” under clinical evaluation employs laparoscopy to collect surface ovary cells which can be examined microscopically for cancer (National Ovarian Cancer Coalition). A blood test which measures hypermethylation (chemical modification) of the BRCA1 and RASSF1A genes is under evaluation. Visit the video library at Dr.Koop.com for videos on breast biopsy, MRI guided biopsy, and freezing breast tumors, along with other informative videos.

5 Management Must-Haves

There is a “must-have” list for nearly anything these days. Any fashion show will call out must-have colors, textures, accessories for the upcoming season. Wired Magazine has must-have gadgets, mobile applications and tech-tools. Shopping for a new car comes with a must-have list of things like satellite radio and great gas mileage.

As a manager and business owner, I have my own must-haves to keep me on top of my game and found a short, but powerful, list I think can help any professional. These are the tools that, no matter where you are, you could still manage your business and slip back into your well-run practice.

1. Blackberry, or other smartphone. A Blackberry, iPhone or other smartphone allows you to stay in touch with the business side of your practice while away from the office. If you’re traveling and you want to check your messages or check in with employees, having such a phone will allow you to keep your business on track.

2. E-mail guidelines. It’s hard to imagine management of a business without e-mail because communication is so critical to the success of any project. However, when it’s not managed effectively, e-mail can become a time drain. It’s important to create e-mail guidelines in your business. Depending on the culture of your practice, develop e-mail rules that ensure that the communication is saving time and not wasting it.

A great guideline to set in place is to put the action items in the beginning. This sets the tone of the e-mail and offers the most important information upfront. As they say in journalism, don’t bury the lead. Make sure that what’s most important is in the first paragraph. Also, your communication should be something short, sweet and to the point, or else your message will not be received.

3. A collaborative space.Good project management (especially if you manage employees) is about collaboration and communication. We use a wiki, which is an online collaborative workspace. There are many implementations of wiki software–and most are both open source and free. Our wiki is a central hub for our work, where we coordinate our projects and processes, providing a central place to remain in touch with one another’s duties and status.

There is also Twitter and other social media platforms that can be used well for work purposes.

4. Project agreement. A project agreement will always keep projects from running amuck and to keep things running flawlessly in anyone’s absence from the business. Without a project agreement, other people might not be on board or know what their objectives are, or their roles, responsibilities and timelines. Defining a project at the beginning is critical. It’s okay if things change, and they often do, but when you have a project agreement, you have a foundation to build on and work from.

5. Project management scorecard. We use an online project management scorecard that looks at three kinds of performance: business, project and project team. The scorecard gives you a comprehensive look at all three dimensions, so you know where and how to improve within your business. Accountability and the ability to measure ensure that you will know when you’ve arrived at the destination called success.

Other than yearly reviews, people often forget to take a moment to think about what did and did not work so that future business projects have a better chance of succeeding. It’s imperative for personal and professional growth and to continue succeeding.

Harvard Researchers Launch Healthy Eating Plate

Boston, MA — Nutrition experts at Harvard School of Public Health (HSPH) in conjunction with colleagues at Harvard Health Publications have unveiled the Healthy Eating Plate, a visual guide that provides a blueprint for eating a healthy meal. Like the U.S. government’s MyPlate, the Healthy Eating Plate is simple and easy to understand—and it addresses important deficiencies in the MyPlate icon.

“Unfortunately, like the earlier U.S. Department of Agriculture Pyramids, MyPlate mixes science with the influence of powerful agricultural interests, which is not the recipe for healthy eating,” said Walter Willett, rofessor of epidemiology and nutrition and chair of the Department of Nutrition at HSPH. “The Healthy Eating Plate is based on the best available scientific evidence and provides consumers with the information they need to make choices that can profoundly affect our health and well-being.”

Comparing the Harvard Healthy Eating Plate to the USDA’s MyPlate shows the shortcomings in the government’s guide. MyPlate does not tell consumers that whole grains are better for health than refined grains; its protein section offers no indication that some high-protein foods—fish, poultry, beans, nuts—are healthier than red meats and processed meats; it is silent on beneficial fats; it does not distinguish between potatoes and other vegetables; it recommends dairy at every meal, even though there is little evidence that high dairy intake protects against osteoporosis but substantial evidence that high intake can be harmful; and it says nothing about sugary drinks. Finally, the Healthy Eating Plate reminds people to stay active, an important factor in weight control, while MyPlate does not mention the importance of activity.

The Healthy Eating Plate is based on the latest and best scientific evidence which shows that a plant-based diet rich in vegetables, whole grains, healthy fats, and healthy proteins lowers the risk of weight gain and chronic disease. Helping Americans get the best possible nutrition advice is of critical importance as the U.S. and the world faces a burgeoning obesity epidemic. Currently, two in three adults and one in three children are overweight or obese in the U.S.

“We want people to use this as a model for their own healthy plate or that of their children every time they sit down to a meal—either at home or at a restaurant,” said Eric Rimm, associate professor of epidemiology and nutrition at HSPH and a member of the 2010 U.S. Dietary

Guidelines Advisory Committee.

The sections of the Healthy Eating Plate include:

• Vegetables: Eat an abundant variety, the more the better. Limited consumption of potatoes is recommended, however, as they are full of rapidly digested starch, which has the same roller-coaster effect on blood sugar as refined grains and sweets. In the short-term, these surges in blood sugar and insulin lead to hunger and overeating, and in the long term, to weight gain, type 2 diabetes, heart disease and other chronic disorders.
• Fruits: Choose a rainbow of fruits every day.
• Whole Grains: Choose whole grains, such as oatmeal, whole wheat bread and brown rice. Refined grains, such as white bread and white rice, act like sugar in the body. Eating too many refined grains can raise the risk of heart disease and type 2 diabetes.
• Healthy Proteins: Choose fish, poultry, beans or nuts, which contain healthful nutrients. Limit red meat and avoid processed meats, since eating even small quantities of these on a regular basis raises the risk of heart disease, type 2 diabetes, colon cancer and weight gain.
• Healthy Oils: Use olive, canola, and other plant oils in cooking, on salads, and at the table, since these healthy fats reduce harmful cholesterol and are good for the heart. Limit butter and avoid trans fat.
• Water: Drink water, tea or coffee (with little or no sugar). Limit milk and dairy (one to two servings per day) and juice (one small glass a day) and avoid sugary drinks.

The sizes of the sections suggest approximate relative proportions of each of the food groups to include on a healthy plate. They are not based on specific calorie amounts, and they are not meant to prescribe a certain number of calories or servings per day, since these numbers vary from person to person. The aim of the Healthy Eating Plate is to illustrate one way to put together a healthy meal that fits within the guidelines of the Healthy Eating Pyramid, which was created by nutrition experts at HSPH in 2001 and updated in 2008. (Read about the Healthy Eating Pyramid on the HSPH Nutrition Source website.)

“One of the most important fields of medical science over the past 50 years is the research that shows just how powerfully our health is affected by what we eat. Knowing what foods to eat and in what proportions is crucial for health. The evidence-based Healthy Eating Plate shows this in a way that is very simple to understand,” said Anthony Komaroff, professor of medicine at Harvard Medical School and editor in chief of Harvard Health Publications.

Utilizing Online Education in Massage School

Online education utilized in the massage profession can add great value to any massage school and instructor. There are now some excellent software programs available to study anatomy and physiology, featuring graphics that more than likely exceed the artistic talents of a massage instructor.

Hands-on massage education will—and should—remain exactly that: hands-on, face-to-face massage class training. However, the rest of massage online education is negotiable. Imagine a massage student who has viewed the information prior to coming to class. This would give students an opportunity to hear new terminology before they come to class. The instructor would then validate this new terminology, which would be the second time the massage students are exposed to new terminology. By the end of class, the massage students now have heard the new terminology more often than if the massage student had learned it for the first time in class that day or night. (Teaching models say students must hear subject matter at least three times to make a connection.)

My favorite example of massage online education is how greatly it may improve a body ergonomics class. There is so much to teach in the subject of body ergonomics. There is first the terminology and then there are the correct poses to be positioned in to distribute proper body weight to perform specific massage techniques. What if the massage instructor could concentrate more on direct body ergonomics when the massage student was in class?

The massage student could potentially study the lesson in advance of the body ergonomics class. This way, massage students would be exposed to the new terminology and definitions, such as archers’ stance, etc. When they then arrive for class, the massage instructor could immediately begin to position the massage student in the proper stances because the student was already aware of the terms and definitions.

By utilizing online education, responsible students can walk into class relatively on the same level to begin implementation of their newly learned terminology. This then allows massage instructors to immediately begin a clinic to give a 3-D lesson of what was learned in the massage online education portion of the class. It really is a win-win for massage students and teachers.

 

Better Chronic Pain Management

Pain-care management needs to be improved, with health care professionals committing to improve care as well as a retooling of the health-care system to help people who are suffering, states an editorial in CMAJ (Canadian Medical Association Journal).

According to a recent analysis, chronic pain affects people of all ages, with an estimated 500,000 Canadians aged 12 to 44 years, 38 percent of seniors in long-term care institutions and 27 percent of seniors living at home experiencing regular pain.

“Experts agree that much can be done now with newer analgesics, nonpharmacologic techniques such as nerve blocks and physical therapies, as well as spiritual and supportive care,” write Drs. Noni MacDonald, Ken Flegel, Paul Hébert and Matthew Stanbrook. “Availability of quality care for pain is the major problem. Health professionals have not mounted a response commensurate with the magnitude of the problem.”

The authors argue for a broad strategy to help increase pain-management expertise, including education, technology and supported self-care and lay coaching.

Healthy Lifestyle Habits Lower Heart Failure Risk

If you don’t smoke, aren’t overweight, get regular physical activity and eat vegetables, you can significantly reduce your risk for heart failure, according to research reported in Circulation: Heart Failure, an American Heart Association journal.

In a new study, people who had one healthy lifestyle behavior decreased their heart failure risk, and each additional healthy behavior further decreased their risk.

Heart failure affects about 5.7 million Americans. At age 40, a person’s lifetime risk of developing heart failure is one in five.

“Any steps you take to stay healthy can reduce your risk of heart failure,” said Gang Hu, M.D., Ph.D., lead author of the study and director of the Chronic Disease Epidemiology Laboratory at the Pennington Biomedical Research Center in Baton Rouge, Louisiana. “Hypothetically, about half of new heart failure cases occurring in this population could have been prevented if everyone engaged in at least three healthy lifestyle behaviors.”

Previous research has shown an association between healthy lifestyle behaviors and lower risk of heart failure in men. The new study is the first to find a similar connection in women.

Researchers followed 18,346 men and 19,729 women from Finland who were 25 to 74 years old. During a median follow-up of 14.1 years, 638 men and 445 women developed heart failure. Participants were classified by BMI: normal weight (less than 25 kg/m2); overweight (25-29.9 kg/m2); and obese (greater than 30 kg/m2).

After adjusting for heart failure risk factors, such as high blood pressure, diabetes and a past heart attack,

researchers found:

• Male smokers had an 86 percent higher risk for heart failure compared to never-smokers. Women smokers’ risk increased to 109 percent.
  Being overweight increased heart failure risk by 15 percent in men and 21 percent in women compared to normal-weight people. The risk increased to 75 percent for obese men and 106 percent for obese women.
• Moderate physical activity reduced the risk of heart failure by 21 percent in men and 13 percent in women compared to a light physical activity level. High levels of physical activity lowered the risk even further: 33 percent in men and 36 percent in women.
• Eating vegetables three to six times per week decreased heart failure risk by 26 percent in men and 27 percent in women compared to those who ate vegetables less than once per week.
• Furthermore, the more healthy lifestyle behaviors a person engaged in, the greater the decline in risk.

Engaging in all four healthy lifestyle behaviors decreased the risk for heart failure by 70 percent in men and 81 percent in women, compared to 32 percent in men and 47 percent in women who engaged in only one healthy behavior.

Many people remain unaware of the link between unhealthy lifestyle behaviors and heart failure risk, researchers said. Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through the heart to meet the body’s needs for blood and oxygen. Basically, the heart can’t keep up with its workload.

“Healthcare workers should discuss healthy lifestyle habits with their patients and stress that they can do more,” Hu said.

Lavender Aromatherapy Reduces Stress and Pain

Aromatherapy is an effective complement to a massage therapy session. New research indicates lavender aromatherapy provides a significant decrease both stress and pain.

Investigators at the Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University , Daegu, Korea, set out to measure the effects of lavender aromatherapy on 30 healthy volunteers, according to an abstract published on www.pubmed.gov.

The subjects were randomly allocated to two groups: the experimental group received oxygen with a face mask coated with lavender oil for five minutes, and the control group received oxygen through a face mask with no lavender oil for five minutes, the abstract noted.

Stress level, and pain intensity of needle insertion before aromatherapy were similar between the two groups; however, the stress values and pain intensity of needle insertion were significantly reduced compared with the control.

The research was published in the Journal of Alternative and Complementary Medicine.