An Active and Long Life Springs from Your Vascular Health (Part 2)

Continued on Strategies to control risk factors for stroke –

Fundamentally, atherosclerosis (particularly in carotid artery) is the primary cause of a significant portion of ischemic strokes. Cardiovascular risk factors can facilitate the progression of atherosclerotic plaque.

Atherosclerotic disease can be asymptomatic initially because it develops over time. When a plaque grows larger enough to reduce blood flow supplying to vital organs (usually >70% stenosis or narrowed vessel), ischemic symptoms may occur. However, it doesn’t mean that smaller plaques (30-40% stenosis) are stable without rupturing to cause a blockage.

How do you prevent or slow down atherosclerosis and stroke by reducing risk factors?

First, before I lay out key preventive strategies, let me quickly draw your attention to some risk factors for stroke, especially those modifiable and those beyond conventional cardiovascular risks. They include:

3 Highs (high blood pressure, high blood lipids, and high blood sugar)
Atherosclerotic disease and/or other cardiovascular disease
Obesity
Smoking and alcohol abuse
Unhealthy lifestyle such as poor diet and physical inactivity
Atrial fibrillation
Sleep apnea and other sleep problems
Chronic kidney disease
Sickle cell disease
Illicit drug use (marijuana, cocaine or heroin)

Illicit drug use can increase the risk of all types of strokes. Cannabis or marijuana use has been linked to vasospasm, ischemia, and increased hemorrhagic incidence in the brain, likely due to the vasoactive properties of delta-9-tetrahydrocannabinol (THC), a key component of these plants.

COVID-19 infection

Acute ischemic stroke and intracerebral hemorrhage are known neurological complications in patients with COVID-19, frequently in individuals 50 years or younger with asymptomatic COVID infection. The possible mechanisms include that blatant inflammatory response and “cytokine storm” associated with COVID cause endothelial injury; that the disease causes arterial and venous clots, thus resulting in poor outcomes.

Socioeconomic factors (e.g., lower income with inequality in health care, etc.)

Certainly, there are risk factors out of your control, such as age, gender, family history, a history of stroke, transient ischemic attack (TIA) or heart attack, and race. Note that black people have twice the risk as white, particularly young black population.

Here are 8 Key preventive strategies to put into actions:

I’d also like to stress that the point is not just knowing to have a healthy diet or exercise more, but to know important reasons behind and why these strategies work on targets to avert stroke.

1. Lower your blood pressure (BP).

As stroke doesn’t discriminate (by) age, neither does high blood pressure. High blood pressure is a leading cause of stroke. Young people should never disregard their elevated blood pressure, especially those with a family history of stroke or hypertension and black women.

High blood pressure is also the most significant controllable risk factor. Better BP control works, because evidence shows that tight BP control (systolic <130 mm Hg) was associated with a 42% lower incidence of stroke compared with standard control (130–139 mm Hg).

I’ve notified the danger of high BP, including to watch BP in young people. If you haven’t done so yet, please check out this article – Hypertension can be asymptomatic but potentially fatal.

If you have hypertension but with difficulty to manage it, try to figure out where you can target; for example, whether medication not working or side effect issues, whether your diet is healthy, you exercise enough or you have adequate support.

2. Lower your blood cholesterol. Critically, lower your bad cholesterol (LDL).

LDL increases plaque formation or growth in the arterial wall, and high cholesterol can also cause blood clots due to fatty deposits’ suddenly breaking off; if the blood supply to the heart or brain is significantly blocked, heart attack or stroke occurs. Avoiding or limiting diet high in saturated fat and trans fats, along with physical activity, can minimize the risk for stroke.

3. Lower your blood sugar, control your weight, and prevent diabetes.

Diabetes is an independent risk factor for stroke, and with combined overweight, its damaging impact on health piles up over time. Again, diabetes is controllable. Obesity and excess bodyweight pose an increased risk for diabetes, hypertension, heart disease and stroke.

4. Lower your stress level.

Cumulative psychological or mental stress is associated with increased inflammation in the body, and more significantly, with mortality, cardiovascular disease, and stroke.

Depression has a direct or indirect link to a number of illnesses including Alzheimer’s disease, and cardiovascular events. Studies also showed that stroke survivors who experienced high and persistent levels of stress negatively affected the brain repair process and recovery outcome.

5. Quit smoking. Non-smokers should encourage people around you to do so.

This sounds repetitive or nothing new, but this is one of the most valuable things you can do to save lives of people for whom you love and care.

Smoking increases inflammation in the body and plaque buildup in the blood vessels, and makes the blood thicker to facilitate clot formation, leading to heart attack and stroke. Needless to say, toxicities from smoking (e.g., nicotine and carbon monoxide, etc.) ravage your cardiovascular system, thus paving the road to stroke.

Don’t overlook second hand smoking and e-cigarette smoking either.

6. Practice a healthy lifestyle.

Poor diet and physical inactivity contribute to several cardiovascular risk factors and metabolic disorders, thereby presenting an increased risk for stroke. So, get more active, get a nutrients-rich diet, get bodyweight controlled, and get social. Equally important, have a well-balanced life including relationship, financial, and psychological wellbeing.

7. Take seriously alcohol and drug abuse.

Alcohol influences on stroke are not uniform. While low to moderate alcohol consumption (£2 drinks daily for men or £1 for women) may reduce stroke risk, even low alcohol consumption escalates the risk of hemorrhagic stroke.

As mentioned above, regular substance use (e.g., cocaine, heroin, phencyclidine (PCP), amphetamines, and cannabis/marijuana) sets an increased risk for stroke, which is a common predisposing factor for stroke among young individuals.

8. Recognize warning signs of acute cardiovascular events (heart attack and stroke).

Young folks (those under 50) may think this is too early for you. Not anymore! Learn those signs seemingly not related to heart. For instance, sudden poor vision in one or both eyes are reported in 66.1% of stroke patients, and pain or discomfort in the arm or shoulder, 53.8%.

Take-home message:

Stroke is dangerous and deadly. Greater awareness, better control of modifiable risk factors all help prevention and timely treatment.

To reduce atherosclerotic plaque development, know your critical numbers (blood pressure, cholesterols and sugar), monitor them, and keep them at healthy levels, while maintaining a healthy weight through diet and exercise routine. More importantly, take these measures as early in life as possible.

Image credit: heart.org

An Active and Long Life Springs from Your Vascular Health (Part 1)

By Hui Xie-Zukauskas

What jumps to your mind when hearing “stroke”?

Whether you say – it’s a primary cause of death and long-term disability worldwide, or FAST (i.e., the acronym of stroke signs: Face dropping, Arm numbness/weakness, Speech difficulty—Time to call 911), high-five to you!

Have you ever thought of stroke as older people’s disease? If so, you need to know beyond that.

I’m going to provide you with the most recent and significant evidence on changing trends of stroke, based on American Heart Association’s statistics on heart disease and stroke 2022 update and wealth of research publications.

I’ve read some touching stories of stroke survivors from American Heart Association News. A common thread emerging in these stories: The survivors are young, age 20-40s, carrying out a typical routine on an ordinary workday, then stroke hit each of them, followed by a long, courageous journey of rehabilitation and recovery.

So, what’s happening here?

First, let me give you a snapshot of the big picture:

Each year, about 795,000 people experience a new or recurrent stroke.
Of all stroke types, – 87% are ischemic stroke (a blockage of the brain artery caused by a blood clot), and – 13% intracerebral hemorrhage (a bleed into the brain caused by burst of a weak vessel or ruptured aneurysm), including 3-5% subarachnoid hemorrhage.
Approximately 10% of all strokes occur in adults under 50 years of age.
On average, every 3.5 minutes, someone died of a stroke.

Although stroke rates declined slowly over decades in old adults, a concerning trend is that stroke incidence increased in young adults, and noticeably, young women (18-45 years) had a higher risk and incidence of ischemic stroke than men of the same age. Specifically, women at ages 35 or younger are 44% more likely to suffer from ischemic strokes than their male peers, but no gender difference in young adults age 35 to 45 years. Furthermore, women do worse after stroke.

But about 80% of strokes are preventable, and the key is to control risk factors.

What is sex difference in stroke? Why do women do worse?

Beside those modifiable and non-modifiable risk factors that increase the risk of ischemic stroke regardless of gender (I’ll address later), women have unique risk factors such as:

Pregnancy: Pregnant women have a 3 times higher risk than young, non-pregnant ones. Hypertension related disorders in pregnancy (e.g., preeclampsia, eclampsia) are known as a stroke risk factor, and the risk of stroke can be 5.2 times higher in these women.
Oral contraceptives (Birth control pills): The overall risk is low, but the risk increases in women with other risk factors (e.g., smoking, obesity, and higher cholesterols).
Migraine: It’s more common in women than in men, the risk increases with its frequency, and with additional risk factors (e.g., oral contraceptives, smoking, etc.)
Atrial fibrillation: Despite its high prevalence in men, atrial fibrillation triggered stroke risk increases in post-menopausal women.
Menopause: Higher risk and mortality of stroke occurred in women reaching menopause at age younger than 45 years.
Hormone replacement therapy (HRT): Current users of oral HRT had a higher risk of ischemic stroke than non-users, irrespective of low or high dose(s).

Other documented factors include preterm delivery, social or economic determinants, etc.

Women often fare worse in stroke, because age plays a large role as a nonmodifiable risk factor. Women tend to be older at the time of stroke, experience more severe stroke than men; they are also in poorer health prior to stroke, and more likely live alone and develop depression afterward. Strikingly, young women have a worse functional outcome too.

In addition, initial signs or symptoms of stroke in women may differ from those traditionally recognized ones, leading to certain misdiagnosis and delayed treatment in the clinical setting.

Strategies to control risk factors and prevent (or reduce) stroke – Stay tuned.

For now, remember: no one is too young for stroke, no time is set for stroke. In other words, stroke can hit anybody at any age and at any time!

So, recognize F.A.S.T.

Image credit: heart.org and vitalscan.com

Facing Challenges with Change or Chance

By Hui Xie-Zukauskas

In a nutshell, cancer has no cure-all or magic bullet. There are still many unanswered questions. We—not just oncologists and cancer researchers—everyone and the society, have a lot of challenges on the road ahead, despite remarkable progresses in cancer breakthroughs and medical technologies.

Starting off 2022, I’d like to emphasize a couple of challenging areas where we all can contribute to saving lives.

Cancer landscape is changing. Cancer cases in age are getting young (such as colon cancer), rare or malignant cancers show upticks (such as pancreatic cancer). Cancer itself is a disease of changing; the changes taking place inside the body dynamically. Our human practices are connected to our health outcomes.

One of the key attentions in fighting cancer is the influence of one’s daily habits or culture and the environment (both physical and social). So, can we all relate to this? Based on multiple cancer risk factors in our daily life that I previously described, how about starting with just one unhealthy behavior to change for this New Year’s Resolution and doing it consistently? As for environment in our home, workplace and community, get rid of as many cancer-causing substances or toxins as you possibly can.

Then look at a bigger picture: climate change can significantly impact public health, specifically one area is through affecting food security, which involves our dietary behavior. A smart approach is to increase consumption of plant-based foods—that in turn, not only to reduce the human impact on the environment but also to reduce the incidents of chronic diseases from cardiovascular conditions to cancers.

Furthermore, let’s provide more support for cancer patients. Recent studies in breast cancer survivors revealed that social environment contributes to a huge difference in an individual’s prognosis. This is because social environment can alter basic physiological processes that may modulate cancer growth, and social isolation enables this physical setting to promote cancer.

One current twist is the challenge of COVID pandemic. Many people skipped early screening or testing, and healthcare systems were overwhelmed by care for severely sick patients with COVID. Fundamentally, the concern is that delayed detection or diagnosis will lead to promoting cancer growth, bringing about a poor projection in years or a decade later, as cancer is not formed overnight. With advanced medicine and technology nowadays, the earlier you detect a cancer or precancerous cells, the sooner you can get effective treatment, and the better outcome or prognosis you will achieve.

So, if you have reservation to a hospital visit or preventive screen, you can always take advantage of virtual appointment/visit or available home-testing kit. Those genetically vulnerable individuals need to take more stringent risk-reducing measures.

One immediate action is HPV vaccination. Why?
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Human papilloma virus (HPV) is a family of more than 150 related viruses. According to CDC, “HPV is so common that nearly all sexually active men and women get the virus at some point of their lives.” To help you understand more, I’m highlighting some new research updates:

HPV does not just cause female cancers, though being responsible for 99% of cervical cancer and 65% of vaginal cancer. Evidence shows HPV to be the cause of estimated 90% anal cancer, ~60% penile cancer, and 50% or higher of mouth and throat cancers.
Although sexual transmission is a well-known route to get infected by HPV, the route of HPV transmission is beyond penetrative sex, can occur through skin-to-mucosa or skin-to-skin contact.
Routine screening test may not detect all types of HPV viruses. HPV can also survive well outside its host, thereby potentially being transmitted through non-sexual modes. For instance, the high-risk type HPV16 is highly resistant to disinfection.

Therefore, HPV vaccination is crucial; it’s safe and effective, with proven efficacy in preventing cervical cancer. Youths and young adults should follow the recommended guidelines to get vaccinated, and parents should support and protect the children.

Last but not the least, believe the power and facts/evidence of science, go to your trusted doctors for advice. Disregard those spreading vaccine disinformation that continue the reckless indifference to both science and human lives.

At the end –

Each new day is a gift and/or opportunity, and each new year opens a new chapter.

We can do more and add more, don’t let your desire for life and for your health wane!

Image credit: Pixabay and CPD

How to Relieve Stress during the Holidays and in Daily Life

By Hui Xie-Zukauskas

Have you ever asked yourself this question: How did you manage your stress levels this year? Whether you realize or not, this is a question about your health, especially your long-term wellness.

Stress comes in all sizes and kinds. Paradoxically, it often occurs during the holiday season too. Thankfully, there are various tools for managing stress. Here, I will emphasize eight simple but powerful stress-management tips.

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Key Vitamins for Holiday Meals at Home and during Travel

By Hui Xie-Zukauskas

Eating what you like (not what you really need) cheerfully at the Holiday table and/or eating poorly on the road are hazardous for your physical and immune health.

In this holiday season, I’d like to emphasize the importance of dietary vitamin A and vitamin D. Why?

First, it serves an update on some new knowledge of their role in gut health and immunity. Second, it is critical at this time, with ongoing COVID-19 pandemic, yet emerging a new variant “Omicron”. Finally, it is also significant for public health because micronutrient deficiency in children is a serious concern around the world.

Let’s start with the immune health.

Essentially, our immune responses to harmful invasion comprise two types of protection: one is from B cells, they generate antibodies to neutralize a virus or bacteria; and the other is from T cells, they kill virus-infected cells.

Consider this—if T cells can eliminate the human cells infected by the coronavirus, then they help prevent or stop the progression of COVID-19. That’s why your immune function is vital at this time for indulging the holiday season and fending the new variant in COVID transmission.

Now, we move to the gastrointestinal (GI) system.

GI tract is a large, important organ/system of immunity. T cells, in fact, represent one of the most abundant immune cell population in the gut. In addition, the gut microbiota may be regarded as crucial troupes or team players of the human defense because fundamentally they regulate our GI immune system.

Gut microbiome play an important role in both health and many illnesses such as infection, cancer, Alzheimer’s disease, and etc., just to name a few.

Another example is functional dyspepsia (upset stomach), which is a common gastrointestinal disorder characterized by recurring symptoms of indigestion without obvious cause; it can be long-lasting, and hard to treat. And disturbance of the gut microbiota has been implicated in this problem, so has the immune cells.

Next, what these matters have to do with vitamin A and vitamin D?

A great deal. Diet is a principal regulator of the gut microbiota. Vitamin A and D play an indispensable role in this function and far beyond.

Vitamin D can be obtained from exposure to sunlight through outdoor activity and then followed by biological reaction and conversion in the body, whereas vitamin A is only acquired through diet. They have immunomodulatory effects on controlling acute and chronic inflammations.

Both vitamin A and vitamin D normalize the gut epithelial and mucosal immune functions by regulating gut microbiota, and consequently maintain homeostasis of the body. Deficiency in either one brings about less diverse, more imbalanced microbial communities, weakened defense by mucosal barrier, and increased susceptibility to injury or infection of the GI tract. In other words, the condition alters the microbiome and integrity of the GI epithelial barrier. It’s like the dam—once the gate is broken, the flood can rush in.

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Diet and Deficiency of the vitamins influence changes in your body.

Vitamin A deficiency, especially in childhood, may result in increased mortality related to GI and respiratory infection, cause anemia and blindness, and impair GI immune and/or vaccine responses.

People with autoimmune diseases share a tendency of vitamin D deficiency. A recent finding showed that over 80% of COVID-19 patients (out of 216) had a status of vitamin D deficiency. Evidently, vitamin D deficiency, old age, and obesity—though as independent risk factors, the combination contributed to COVID-19’s severity and unfortunate outcome.

How to turn this knowledge into health benefits for you and yours

Practical advice:

Have fun with colors and immune boosters, along with creativity for flavor or taste in the holiday meals, whether as side dishes, desserts or smoothie. If you and yours are on the road, make sure to integrate carrots, mushrooms, green veggies, colorful fruits, and salmon or tuna into your food.
Pay attention to your daily diet, esp. whether vitamin A and D are insufficient in your food. A healthy and balanced diet should provide you the adequate amount you need.
It’s important that if vitamin A and/or D from foods are insufficient, ensure your infants or kids (6 months to 5 years) have adequate intake of dietary supplements, based on WHO’s recommendation. Keep in mind that liver (e.g., beef liver) is a rich source of both vitamin A and D.
People with some diseases (e.g., those of digestive tract) or with very poor diets may need to take a vitamin A supplement, but it’s wise to consult with your doctor.
If you need to take a supplement for vitamin A or D, make sure to take it with food, because vitamin A and D are fat-soluble.
Don’t take these supplements to prevent or treat cancer. There is no clear evidence; in fact, some evidence suggests harmful effects.

In summation

When you and your family celebrate the holiday time, enjoy the “life-essential vitamin” (=vitamin A) and “sunshine vitamin” (=vitamin D) too!

Additionally, tampering down or subduing your appetite for certain food (i.e., high fat, high sodium, and high sugar) and holding back for another plate or portion, all can go a long way to protect your health and immunity. After all, your immune strength depends on more than antibodies or food alone.

Have a happy, healthy, and safe Holiday season!

Image credit: Pixabay and CPD

Unique and Reflective Angles to Breast Cancer

By Hui Xie-Zukauskas

Are you scared or terrified when hearing a breast cancer diagnosis (whether it happens to yourself or your loved ones)? I can fully understand it. Many lives lost to breast cancer (young, old, ordinary folks or celebrities) are so sad and alarming!

What I’ll share with you here is my hope that you may think and approach breast cancer differently.

Have you thought about how the liver and liveliness (or vigor) related to breast cancer? If you have an open mind, read on for different perspectives.

First, let me briefly underscore the genetics of this disease (as I’ve addressed it previously), but many folks still believe or blame the genes. That’s understandable too.

But the genes do not tell the full story.

We all have BRCA1 and BRCA2 genes, both women and men, because BRCA is not a sex-linked gene. The gene mutation can be inherited from either parent. For women with a BRCA mutation, the lifetime risk of breast cancer is approximately 80 percent, and the chance of ovarian cancer is 54 percent. Men may carry the BRCA mutation, but they have a lower risk.

The fact is—Of more than 200,000 breast cancer cases newly diagnosed each year, BRCA gene mutation accounts for about 10 percent of them. Furthermore, about 85 percent of women diagnosed with breast cancer have no family history of the disease. So, there are more promising areas for treatment and prevention.

Next, let me dive a little deeper into an alternative therapy, without replacing any proven successful treatments by surgery, chemotherapy and advanced immunotherapy.

Foundation of traditional Chinese medicine (TCM) on breast cancer therapy

I’m going to elaborate this in the following ways:

First, TCM view on breast cancer

In TCM, breast cancer refers to “mild rock”. The condition belongs to syndromes related to anger from the liver and depression from the spleen, loss of qi and blood. In clinical practice, patients with liver sluggishness and qi stagnation often have breast lumps, characterized by hard texture, unclear boundary, and mostly the same skin color. It can also be accompanied by chest tightness, rib area swelling or dilation, and impatience.

Then a variety of therapies are available—in combination with internal treatment, external treatments, and other ways such as psychological counseling in order to restore a physical state harmony—overall individualized, comprehensive treatments for a patient. The key is the TCM holistic view and differentially diagnostic approach through indications of the tongue and pulse, ultimately determining a prescriptive formula with a mixture of several Chinese medicinal herbs.

Second, the role of Qi in cancer development

As I discussed before, qi is the vital energy that moves with blood throughout the body at all times. It is everywhere in the body and interconnected with the organs (TCM often refers to the visceral), which keeps our wholeness in balance. One famous belief is that flow of qi makes blood circulate; stagnation of qi causes blood stasis. Therefore, the stagnation of flowing qi and blood over time leads to mass, lump or tumor.

Now the next question should be addressed is – What can cause qi stagnation?

In TCM’s view, one of causes for qi stagnation is attributed to emotional imbalance. Specifically, when intensive, persistent emotions dominate (e.g., uncontrolled anger, depression, stress, or lasting grief), not only can they interrupt normal harmony of organ functions, but also they impair the immune system. So, one of diseases for which there is a great concern about the adverse effect of emotional distress or disturbance is cancer.

In essence, this notion is comparable with Western medicine on psychological or psychosocial factors played in some diseases. Research has revealed that psychological stress may impact breast cancer onset and progression. To be clear, emotions do not automatically modify the genes, but they do trigger a surge of cellular changes that affect the immunity and alter the genes associated with stress.
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Third, of guiding philosophies of TCM, it urges one to prevent diseases rather treat them.

A treasured remedy for cancer prevention is to safeguard against a holistic imbalance resulting from poor diet, unhealthy lifestyle, harmful stressors or environmental pollutions, and to strengthen your inner qi.

One extra point: TCM has its unique advantage in breast cancer therapy. Unlike adverse or toxic effects from chemo- or radiotherapy, TCM treatment does not cause further damage to physical body or strength in general, but may facilitate restoring qi.

How can we harness vital energy to prevent cancer? - Eight Tips:

1. Make your immune system strong. Our immune system is our powerhouse to fight cancer. That’s why scientific innovations tap into the body’s immune system to destroy cancer cells. So, cultivate healing energy and sustaining qi or vitality through strong immunity.

2. Control your emotions to keep qi flow. Maintaining a positive outlook on life helps boost your positive energy. Anger, fear, sadness, and anxiety can adversely affect your qi. Have you noticed that stress can drain your energy? Another key to flowing qi is to share your feeling, let it out and let it go.

3. Foster gratitude. Devote time daily to appreciate what you have, even the small things. Keep content, cheerful, and compassionate. Doing so will channel your enlightened spirit and vital energy!

4. Go for a nutrient-packed diet. Various factors influence qi, thus be aware of them. Nutrition supports both the level and the quality of your energy. A balanced, healthy diet can prevent qi deficiency.

5. Exercise regularly and purposely. Be physically active because it keeps qi moving and blood circulating! Intentionally practice the moves that you love, and practice deep breathing or meditation to elevate your inner awareness.

6. Maintain a healthy weight. Obesity is a state of energy imbalance and a noteworthy risk factor of breast cancer. It is partly related to sluggish qi and metabolic dysfunction.

7. Rest and relax well. Sufficient sleep can restore vibrant qi, cultivate healing qi, and maintain the holistic harmony.

8. Be vigilant about early detection! Get a genetic screening to identify the BRCA gene mutation, and start effective measures or therapy early. Treat any illness early. Doing so will help protect your vital qi.

Breast cancer prevention is for both women and men, especially based on our shared genetics. We cannot control our genes, gender, age, race, or family history. However, each of us can strengthen our qi and foster a healthy lifestyle, all is vital to keeping cancer at bay.

The bottom line is –

With TCM in mind, you can act with knowledge, self-care, vitality and prevention, rather than let fear cloud your thinking or paralyze your function.

Happy flowing Qi!

Image credit: Pixabay and CPD

Shining Clarity on Coffee and Cancer

By Hui Xie-Zukauskas

Steve and Karen, friends of mine, each has drunk more than five cups a day of black coffee—no sugar, no cream—for decades. I’m amazed always because I cannot drink coffee black.

Ari came in work every day with his morning coffee, whether it was Starbucks or a regular one to “stimulate his mind and brain”.

Sound familiar? Obviously, coffee drinking is a popular pleasure around the world.

On top of this, scientists have discovered numerous health effects of coffee. However, lingering confusions about coffee drinking seem to hardly disappear. Even market trends flow with controversies.

Here I’m going to provide renewed clarity on some controversies, misunderstandings or uncertainty and explain why, based on accumulated research, recent literature and knowledge.

One persistent myth or confusion surrounds the link between coffee consumption and cancer risk. You can be comfortably assured that coffee itself doesn’t increase cancer risk. To be even more clear, no evidence up to date concludes that coffee consumption causes cancer.

So, how does this certainty come?

What might be confusing and problematic involves two factors. One is acrylamide—a byproduct derived when coffee beans are roasted; it is a “probable human carcinogen” (Group 2A) classified by the International Agency for Research on Cancer (IARC). However, its amount in coffee is insignificant, no cause for concern. Plus, acrylamide exposure via coffee is less than that from dietary source (French fries or fried foods) and tobacco (smoke or smokeless, a known carcinogen in Group 1).

The other factor is temperature (not the coffee itself), because IARC does classify drinking very hot beverages at or above 65^oC (149^oF) as “probably carcinogenic to humans” (Group 2A). Not just hot coffee. Drinking any hot liquids (tea, water or soup) have been linked to an increased esophageal cancer risk, which is conceivable as a result of the cell injury and recurring repair—leading to mutation and tumor growth over time. Put the two factors together, acrylamide becomes toxic only at high dose and at high temperature.

An additional fact came from the respected agency’s thorough evaluation. IARC actually took “coffee” out of their previous classification as a “probable human carcinogen” in 2016, owing to limited or inadequate evidence and inconsistent results in humans.

By contrast, strong evidence has revealed that coffee consumption may lower a risk of developing some types of cancer, but has no association with various cancers at all. Noticeably, coffee drinking reduced the liver and endometrial cancer cases, with support of a dose-dependent relationship. It also showed a decrease in the risk of postmenopausal breast cancer. As for cancer of many other organs such as lung, colon, pancreas, ovarian, prostate, mouth and pharyngeal, findings pointed to either a slight protective effect of coffee, or no association, or inconclusive results.

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Interestingly, most benefits of coffee are attributed to several key compounds, including caffeine, caffeic acid, chlorogenic acid, diterpenes (cafestol, kahweol), and polyphenols. Proposed mechanisms of their anti-cancer effects include a) help control cell growth and proliferation by blocking pro-carcinogenic proteins; b) defend against oxidative stress and DNA damage through antioxidant and anti-inflammatory properties; and c) stimulate enzymes or pathways leading to carcinogenic inactivation and cancer cell death.

It’s also worth mentioning, added calories from plentiful sugar, cream or whole milk with coffee consumption, just like drinking sugar-sweetened beverages excessively and frequently or ingesting unhealthy dietary fats, are potential health hazards—presenting a risk for chronic disorders such as cardiovascular diseases, diabetes and obesity.

Collectively, drinking coffee on a regular basis has a protective effect against some types of cancer, but no influence on other types, and no evidence of causing cancer. Because of its complex mixture of bioactive components, particularly containing a myriad of antioxidants, coffee acts not just as a mental stimulant but as a defensive agent for your health, which should come as no surprise.

Nevertheless, vegetables, fruits and whole grains are among the richest sources of antioxidants. And a healthy lifestyle goes well beyond coffee drinking.

Bonus ─ Wisdom for coffee delight:

Stay moderate: It’s beneficial and healthy to have coffee no more than 5 cups/day (or 400 mg/day).
Beware additions: Don’t drink coffee when it’s too hot, or with too much sugar and too much cream.
Take precautions: If you have health issues such as GERD, bladder control, osteoporosis, etc., do limit the amount. If coffee triggers your anxiety, don’t drink it on an empty stomach. Some medications interact with coffee too, so follow your doctor’s directions.

Having cleared up certain confusion or “dispersed the confusion on coffee” in this post, I hope you find an inspiration or refreshed perspective that can add to your wellness tool kit.

Happy coffee drinking!

Image credit: Pixabay

Implication of Bacterial Toxins in Targeted Cancer Therapy

By Hui Xie-Zukauskas

When hearing “anthrax”, most people immediately fear either a serious infectious disease or a biological weapon. Do you know that scientists are harnessing certain toxins (such as anthrax) as a novel tool to kill cancer cells? A recent study (published in International Journal of Cancer, 2020) has demonstrated the effectiveness and safety of this approach specifically in targeting bladder cancer, one of the top common cancers with a high recurrent rate (~70%) and frequent resistance to chemotherapies.

A poor cure rate of bladder cancer remains a major challenge mixed with an opportunity. Unlike the normal bladder cells with a protective layer, bladder cancer cells uniquely overexpress epidermal growth factor receptor (EGFR) while being exposed to the bladder lumen in contact with urine. EGFR is a protein on the cell membrane, functioning like a lock for its key— epidermal growth factor (EGF), a protein binding to EGFR to drive cell growth.

Taking advantage of this characterization, lead author Jack and colleagues developed a compound by combining EGF with anthrax toxin, and then incubated bladder cancer cells (from mice, dogs and the humans, respectively) with the EGF-toxin in the presence of saline and urine. Because of a strong chemical/structural bond between EGF and EGFR, these cancer cells took up this toxic agent (or “bait”) as expected. Therefore, the EGF-toxin stuck firmly to and struck quickly at bladder cancer cells—by binding and internalizing then exercising toxin enzymatic activity—and ultimately eliminated an average 85% of human cancer cell population at concentrations below 10 nanomolar (nM) within minutes.

The high efficiency in toxin-triggered cancer cell death from in vitro studies encouraged the researchers to conduct in vivo analyses. First, in order to test potential adverse effects of the EGF-toxin, they injected this agent into the bladder of tumor-free animals (six mice and four dogs), and detected no toxicity after monitoring physical, urinary, blood, and biochemical measures over a month. Next, they proceeded to treat six tumor-bearing dogs, in which bladder cancer was massive, resistant to conventional therapy and verified with EGFR overexpression. The results showed that all dogs treated had an average of ~30% reduction in tumor size after a single cycle of 5-day therapy, and the treatment was well-tolerated. Adverse effects included mild bladder irritation, and slightly increased blood in urine or frequency of urination by day 5 treatment, but they were self-resolved without any intervention.

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Although their success limited in combating surface (i.e., non-invasive) bladder cancer from preclinical studies, the researchers speculated the bright potential of this therapeutic strategy for invasive bladder cancer. Overall, in searching for a “magic bullet” to fight “war on cancer”, using bacterial toxins for targeted cancer therapy should be cheered as a smart tactic to destroy some cancer cells.

Source / Reference:

Jack S, Madhivanan K, Ramadesikan S, Subramanian S, Edwards DF 2nd, Elzey BD, Dhawan D, McCluskey A, Kischuk EM, Loftis AR, Truex N, Santos M, Lu M, Rabideau A, Pentelute B, Collier J, Kaimakliotis H, Koch M, Ratliff TL, Knapp DW, Aguilar RC. A novel, safe, fast and efficient treatment for Her2-positive and negative bladder cancer utilizing an EGF-anthrax toxin chimera. Int J Cancer. 2020;146(2):449-460.

Image credit: Pixabay; CancerPreventionDaily

Invisible But Critical Players: Focus on Cancer

By Hui Xie-Zukauskas

Out of sight, out of mind is a familiar saying. What I’m going to share is something that is out of sight, but that we should always keep it in mind.

It’s about microbiota—the community of microorganisms (including bacteria, fungi, lower and higher eukaryotes, and viruses) that live within human beings.

They are fascinating creatures, so small that they are invisible, numbering in trillions, diverse in makeup, and importantly, exerting both local and distant effects on human health and diseases.

The microbiota exist as a part of the normal flora in our gastrointestinal tract, oral cavity and urinary-genital tissues. They can cause or promote various diseases, including wound infection, life-threatening conditions, and chronic diseases such as diabetes and cancer, by disrupting the human microenvironment and the immune system.

The interactions among microbiota affect human health too. For example, a respiratory virus infection may cause a perturbation in gut microbiota; conversely, gut microbiota may contribute to respiratory diseases. That’s why scientists have investigated the link between gut microbiota and COVID-19. We know that the composition of gut microbiota decreases as one ages, and we know that COVID-19 in elderly patients has been more severe and fatal, so gut microbiota may play a role in this disease.

Microbiota also have diverse activities with different consequences in your body. Take one bacterial species as an example. Bacteroides spp. are your friends that usually contribute to your nutritional status as well as mucosal and systemic immunity. In contrast, when the colon integrity is disrupted, they can be your foes (or at least acting as opportunistic pathogens) for causing potential infection.

Now we move to their impact on cancer, as microbial pathogens account for 15-20% of all cancers.

Growing evidence has linked the gut microbiota to gastrointestinal cancers (e.g., colon, pancreatic cancer), and vaginal microbiota to cervical cancer. As I’ve discussed previously, an imbalance of gut microbiota can influence breast cancer development.

Here, I want to emphasize microbiota’s impact on prostate cancer risk and development. So, what’s the connection?

First, the microbiota of men with prostate cancer can differ from those of healthy men. Various bacteria (species) are prevalent in prostate tissues from prostate cancer patients but not from healthy control subjects.

For example, of 14 studies, more than a dozen of bacterial species are most common in the prostate tissues and the adjacent tissues from men with prostate cancer, and these abundant species are significantly associated with prostate cancer. (Note: Their odd, multi-letter names are excluded here but attached at the end).

What’s intriguing is that one of these tiny creatures you may have heard of. Propionibacterium acnes (P. acnes) is the most abundant bacterial species on the human skin. But researchers found that it is one of predominant types in the prostate tissue samples, along with considerable tissue inflammation. This suggests that P. acnes infection is a contributing factor in prostate cancer development.

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Finally, although pathogenesis of prostate cancer is multifactorial, the microbiota can influence the risk and progression of prostate cancer by altering immune system, mediating inflammation, impacting tumor microenvironment, and damaging DNA (through increased pro-cancer agents or their metabolites).

Summary

The overall message here is that when it comes to your health, it’s worth caring about critical issues that may be out of sight.

The bottom line is that the microbiota—good or bad tiny creatures—are important players in our health and diseases, particularly in cancer development. We need to live with these microorganisms harmoniously.

So, what we do to achieve this goal? There are three areas for focused, fundamental strategies:

Healthy diet. Healthy eating—particularly plentiful fiber intake—promotes a right balance of microbiota, which is also safter and more effective than supplements.
Hygiene practice. Bacterial or viral infection-indued inflammation increases a risk for cancer, and hygiene is one of major factors affecting the makeup and functions of microbiota.
Higher awareness of stressors. Smoking, poor diet, age, environmental pollutants or factors, and diseased conditions can cause microbial dysbiosis; because these stressors upset the balanced state of microbiota.

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P. S. Types of microbiota in the studied prostate tissue samples that linked to prostate cancer: (alphabetical order)

Acinetobacter, Actinobacteria, Alphaproteobacteria, Bacteroidetes, Bacteroides spp, Enterobacteriaceae, (commonly, Escherichia coli.), Firmicutes, Lachnospiraceae, Propionibacterium acnes (P. acnes), Propionicimonas, Proteobacteria, Pseudomonas, Staphylococcus spp, Sphingomonas spp, Veillonella

Image credit: Pixabay

Amazing Five Breakthroughs on Cancer Treatment

By Hui Xie-Zukauskas

Cancer is a leading cause of death globally according to the World Health Organization. In 2020, it accounts for nearly 10 million deaths worldwide. The sad reality is that some malignant cancers remain incurable despite remarkable progress achieved in cancer diagnosis and treatment.

The good news is that novel therapeutic breakthroughs are continuously being made to fight cancer!

I’m going to highlight a few of numerous advances, especially those tackling common malignant cancers.

1. Precision oncology

Cancer differs from one individual to another. Precision oncology equips doctors to tailor cancer treatment specifically to a person’s cancer. Genes, proteins, or even blood vessels that promote cancer cells to grow and metastasize are targeted in these therapies. Leveraging biomarkers (genes, proteins, and different types of molecule) plays an essential role in personalized medicine and in fighting cancer. The validated biomarkers can improve risk stratification, cancer screening and differential diagnosis, evaluate cancer prognosis, and predict response to treatment. Along with the patient’s data, optimal therapy decision can be made. In other words, biomarkers facilitate the effort that can match the right patient with the right treatment at the right time. For instance, the innovation has been applied in diagnostic test for lung cancer and target treatment for metastatic breast cancer.

2. Immunotherapy

Immunotherapy harnesses your own immune system to beat cancer. It uses the immune cells from a patient or a transplant donor to attack blood cancer cells (e.g., in leukemia, lymphoma, or myeloma), especially cancers that are resistant to chemotherapy or remain after chemotherapy. Immunotherapy with immune checkpoint inhibitors has been approved for the first-line therapy of advanced non-small-cell lung cancer (NSCLC). Immunotherapy through novel approaches used alone or in combination has substantially improved clinical outcomes of oncology and hematology, including in metastatic melanoma. Certainly, immunotherapy is intriguing and full of complexity, especially when some cancers don’t respond to it well.

3. Controlled Nitric Oxide (NO) delivery

NO is a small, very reactive signaling molecule with a half-life less than 10 seconds. It regulates various key physiological functions, including blood vessel dilation, bronchial dilation, neuronal communication, and wound healing, etc. Underproduction of endogenous NO contributes to several chronic conditions from cardiovascular and lung diseases to cancer. Inhaled NO has been a valuable therapy for neonatal pulmonary hypertension, pulmonary inflammation control, and some heart and lung surgeries.

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4. Virus-based treatment or engineered oncolytic viruses

Multidrug resistance is a big problem in cancer therapy, especially chemotherapy. Now oncolytic viruses are used to kill cancer cells by exploiting cancer cell-specific vulnerabilities and infecting them while sparing normal cells. Unlike vaccine-strain viruses failing to meet some critical safety and efficacy criteria, these genetically engineered viruses (such as oncolytic measles virus or adenovirus) enhance cancer therapy in clinical efficiency. Virus-based treatment has been used in glioblastoma, a malignant brain tumor; also, in breast cancer and lung cancer.

5. Proton beam therapy (PBT) as advanced radiation therapy

Radiation therapy has been advancing rapidly in various ways. One way is proton therapy. Protons are positively charged particles of energy, a form of radiation that can send an intense burst of energy to a highly focused area, which means it kills cancer cells without damaging healthy tissues nearby. PBT therapy has been used for several common cancers including the lung, breast and prostate cancer as well as brain cancer.

Although many challenges remain to reach the full therapeutic potentials of these advanced biomedical technologies, future treatments for patients with cancer are very promising!

These exciting breakthroughs inspire us to prevent cancer by strengthening our body’s natural defense, so that the immune system can watch for and attack cancer cells effectively. We can also take advantage of new technologies for protection from common cancers (e.g., colon, breast, cervical, and prostate cancer), because they can be controlled if detected early and treated adequately.

Image credit: Pixabay, Clipart-Library, CancerPreventionDaily

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Key Vitamins for Holiday Meals at Home and during Travel

Unique and Reflective Angles to Breast Cancer

Shining Clarity on Coffee and Cancer

Implication of Bacterial Toxins in Targeted Cancer Therapy

Invisible But Critical Players: Focus on Cancer

Amazing Five Breakthroughs on Cancer Treatment