Category Archives: Cancer Risk Factors

Beyond Colon Cancer: The Hidden Cancers Threatening Young Lives

By Hui Xie-Zukauskas

Lower Cancer Risk_Sm_for LIIn recent years, there has been a concerning rise in cancer incidence and mortality among individuals aged 15–39. Notably, colorectal cancer (CRC) has shown an uptick in cases among those under 50, both in the US and globally. This underscores the urgent need for preventive measures to mitigate cancer risks and elevate awareness.

While it might be perplexing to see the unexpected rise in cancer among the younger population, considering that traditionally cancer primarily affects older adults, the reasons behind this trend are complex and fascinating. Let’s delve into this in simpler terms.

Cancer is caused by mutation, i.e., a permanent change in the DNA sequence of an organism. Mutations can result from damage to DNA and errors in DNA repair.

Imagine DNA as a blueprint for building a magnificent LEGO castle. Each LEGO brick represents a specific unit of DNA called a “base pair”. DNA damage is like the LEGO bricks get chipped or break due to various factors, DNA repair by enzymes works as repair crews identify damaged bricks and replace them with new ones. When the damage is too severe or the repair crew is overwhelmed, the building plan (DNA) can be disrupted and structural crises in the castle (cell malfunctions) take place.

We know that most of cancer risk in aging adults can be attributed to randomly acquired mutations in proliferating tissues or susceptible cell types. In contrast, cancers in younger individuals result from the presence of genetic predisposition or the exposure to carcinogens (cancer-causing agents) or both, which all impact DNA damage and repair, genomic integrity, and then accelerate cancer growth in a young body.

To illustrate further, its origins have three key elements: inherited genetic predisposition, environmental carcinogens (including cancer-causing viruses), and developmental mutations—the latter can vary greatly depending on mutational rates in various cell types. Importantly, the interplay between each element and among these factors can also contribute to the variation in cancer risk among different cells, tissues and age groups.

Colon cancer is not the only type of cancer with a high prevalence in young people. Other cancers include:

  • oropharyngeal cancers (more in adolescent and young cancer survivors),
  • breast cancer,
  • cervical cancer,
  • skin cancer, melanoma and
  • pancreatic cancer – its genomic feature distinctly involves the well-known tumor genes (including breast cancer’s BRCA1 and BRCA2).

I’d like to highlight some harmful environmental factors more relevant to young people, and mostly also apply to a broader population.

  • Traumatic brain injury (resulting from car accidents, sports, falls, bast injuries but leading to long-term chronic neuro-inflammation in the brain and link to CNS tumors)
  • Oncogenic pathogens or carcinogenic viruses – such as Infections by the human papilloma virus (HPV), causing cervical and oropharynx cancers; Infections by the Epstein-Barr virus (EBV), causing lymphomas and nasopharyngeal cancer; Merkel cell polyomavirus, causing Merkel cell carcinomas; Human T-cell lymphotropic virus, causing leukemias; and Fusobacterium, associated with colorectal cancer.
  • Hazard environmental exposures – Sunlight/UV damage, causing skin cancer; air-borne radon or tobacco smoke, or air-borne asbestos, causing lung cancer.
  • E-cigarettes – potential risk for oral cancer
  • Food-borne pre-carcinogens and/or carcinogens: generated by chemical or physical food processing, including N-nitroso compounds (NOCs), polycyclic aromatic hydrocarbons (PAHs), heterocyclic aromatic amines (HCAs), and acrylamide. Moreover, some fungi- and plant-derived substances pose a cancerous potential. Their mechanisms of action and relevance to human biology can be classified as either genotoxic (DNA-reactive) or epigenetic (effects other than DNA reactivity).

It’s essential to remember that adolescents and young adults diagnosed with cancer face a risk for early death. This risk, influenced by factors such as age at diagnosis, race, ethnicity, lower socioeconomic status and cancer type, is multifaced and requires adequate healthcare with careful monitoring.

Next, let’s move to colon cancer, especially early-onset CRC, with an emphasis on risk factors.

Modifiable risk factors

These include obesity, type-2 diabetes, heavy sugar and red meat diet, physical inactivity, smoking, high alcohol consumption, inflammatory bowel disease (IBD), and frequent antibiotic use.

Non-modifiable risk factors

Particularly for early-onset CRC, being male, black or Asian, having IBD, or a family history of CRC are among non-modifiable risks.

Based on recent scientific evidence, early-onset CRC is associated with a genetic predisposition, mainly attributed to sporadic mutations in some genes (e.g., APC, KRAS, BRAF, TP53) that trigger uncontrolled cell growth and subsequent tumor formation.

However, one overlooked group is individuals younger than 50 years (<50 years) who do not usually undergo screening if they are at average-risk (defined as those without a personal or family history of CRC, without a personal history of IBD). Currently, there are little data regarding risk factors for CRC at average-risk young adults who are also asymptomatic.

Act to lower cancer risk

Armed with a comprehensive awareness and an inner-warrior mindset, act swiftly in the specific domains to impede or prevent cancer development within your young body.

  1. Live a healthy lifestyle. Eat a plant-based diet, stay active, avoid smoking, limit alcohol, and practice sun-safety.
  2. Maintain a healthy weight.
  3. Get screened for early detection.
  4. Get cancer risk assessment and genetic counseling. (for high-risk individuals)
  5. Get the HPV vaccination. Protect yourself from sexually transmitted infections.

Finally, cancer in young people disrupt crucial life stages such as education, career development and family planning. Early diagnoses can have long-term consequences in every aspect of individual’s well-being. Furthermore, the rising cancer burden in young people poses a significant public health challenge. Thus, the unexpected vulnerability in young people demands our attention and dedication to this troubling shift.

 

Image credit: Matt Cole, Mis wanto at Vecteezy

Artificial Sweeteners: What Helps and What Hurts

By Hui Xie-Zukauskas

Past-Present-Future on AS & CancerWhen it comes to artificial sweeteners, do you have mixed feelings? Are you confused about its link to cancer risk or not? Well, you’re not alone.

All over scientific literature, this topic remains intensely controversial. I summarized where we are on an association between consumption of artificial sweeteners and risk of cancer in a flowchart illustration here.

Briefly, little or no evidence from past decades shows common artificial sweeteners have a cancer-causing (i.e., carcinogenic) potential, except a link to bladder cancer in animals but inconsistent results in humans. The US FDA also approved the safety of several artificial sweeteners as food additives.

However, this view has shifted in recent publications. Especially, a large epidemiological study (102,865 adults, follow-up nearly 8 years) found that participants who heavily consumed artificial sweeteners—aspartame and acesulfame-K—showed a 13-15% higher risk of cancer (e.g., breast, obesity-related cancer), compared with non-consumers (Debras et al. PLoS Med. 2022). Keep in mind that obesity is linked to more than ten types of cancer. Meanwhile, the International Agency of Research on Cancer (IARC) would place a high priority in the near future to evaluate the possible carcinogenic effect of aspartame on humans, as recommended by its advisory group.

So, what do you do? How the renewed awareness influences your choice on a healthy and palatable diet?

Artificial sweeteners exist in a wide variety of food (especially those packaged or processed), drinks, drugs, and hygiene products. Therefore, virtually everybody uses or ingests artificial sweeteners, knowingly or not.

An immediate concern is about unanticipated or undesirable consequences from its regular consumption, along with confusion, or worse, disinformation.

But this is more complex than what one may think.

To help clarify it, let’s examine what helps and what hurts in critical areas, so that you can strike a balance between benefits and risks, and make wise choices.

What helps –

Artificial Sweeteners packs_SmWe all have a sweet tooth, and often add a little amount of sugar to enhance our food’s flavors and pleasure.

Artificial sweeteners—as sugar substitutes—are calorie-free and nutrient-free. With their sweet taste or perception, these food additives may affect certain health outcomes. For instance, they are used as a strategy to reduce calorie intake in weight loss programs, though controversies exist. Furthermore, as for whether these sweet alternatives are advantageous, there is little evidence based on long-term studies to demonstrate that.

What hurts – 

Aspartame Structure_SmAfter all, artificial sweeteners are synthetic chemicals hidden in packaged foods and soft drinks, which are different from natural sugar contained in fruits and vegetables.

Excessive sugar intake can negatively impact human metabolism and health. Likewise, excessive consumption of artificial sweeteners is undoubtedly risky.

Of potentially grave concern is those pregnant women and young children who consume aspartame-containing foods and beverages in a large quantity, because research reveals that offspring of rodents exhibit increased incidence of leukemia and lymphoma after fetal or prenatal exposure to aspartame. And there is a clear dose-response correlation between aspartame exposure and occurrence of blood or lymphatic malignancies. Obviously, aspartame is a carcinogen in rodents.

Paradoxically in dietary intervention to counter weight gain, artificial sweeteners might not be as efficient as expected, or at least need to be considered cautiously.

First, we know that sugar is a driver of inflammation and weight gain, and artificial sweeteners are also inflammatory foods. After reviewing more than 100 studies that investigated aspartame in both higher (>40 mg/kg/d) and safe (<40 mg/kg/d) dosages, and ascertaining its harmful effects on various cells, tissues and organs, the authors concluded “aspartame use could not only exacerbate existing systemic inflammation but also cause inflammation if healthy individuals ingest it on a regular basis” (Choudhary & Pretorius. Nutr Rev. 2017).

Chronic, low-grade inflammation is a significant risk factor for the development of many diseases including cardiovascular diseases, diabetes, cancer, neurological disorders (e.g., Alzheimer’s), and arthritis, right? So is malnutrition (or micronutrient deficiency). Malnutrition is associated with not only lower body weight but also obesity.

Taken together, it’s important to understand adverse effects of artificial sweeteners and their metabolites. For individuals with or susceptible to inflammatory bowel disease, it’s critical to avoid or at least limit artificial sweeteners, processed foods, and sugar-sweetened beverages.

Again, lifestyle with a healthy diet is an integrative, effective solution. If you eat more veggies, fruits and less processed foods, you easily curb added sugar or artificial sweeteners without loss of nutrients. For example, you may sprinkle fresh fruits (such as pineapples, oranges, or watermelon, etc.) or dried fruits (such as raisins or dates) onto your salad (or other dish) as a sweet addition—not only making it palatable but also supplying antioxidants (i.e., a bonus). Alternatively, use a tiny amount of honey or maple syrup, when necessary, which is relatively healthier than artificial sweeteners.

So, take-home points:

Enjoy nutrients-dense foods and reduce sugar intake overall. Specifically, eat plenty of fruits and veggies for natural sweetness, and engage in more physical activity to prevent inflammation.

 

Image Credits: CancerPreventionDaily, Pixabay

Key References: click here

4 Takeaways for Colon Cancer Smart plus Prevention Tips

By Hui Xie-Zukauskas

Colon Cancer Prevention_Cleveland Clinic HealthImagine your colon functions fairly well for years. Unaware was that healthy cells in the inner lining of your colon developed changes in their DNA (i.e., mutation), and formed polyps that may start cancer, a couple of which reside on the left side of your colon. You are either asymptomatic or unchecked by mistaking cautionary signs as normal. Fortunately, one day these polyps (varying 0.4 to 10 mm in size) showed up on your colonoscopy and the surgeon successfully removed them, thus stopping the cancerous growth.

Unfortunately, millions of people had their polyps growing in size from tiny (about a match head) to giant (≥25 mm or almost 1 inch), from benign lumps progressed to malignant tumors that invade adjacent tissues or distant organs. Then we all know the sad ending.

How should you be aware that you need a colon cancer screening (when or based on what)? What’s new about colon cancer pertinent to you and your loved ones?

I summarized 4 takeaways from updated research findings here. In addition, I’m highlighting proven preventive measures in a memorable poetry style.

So, let’s dive in the takeaways.

1.      Risk factor you might have overlooked

Primary risk factors for colorectal cancer can be categorized as:

-          non-modifiable ones that you can’t control, such as age, taller height, family history, personal history of inflammatory bowel diseases or polyps (pre-cancerous growth), etc., and

-          modifiable ones that are more lifestyle or diet behaviors related, including tobacco smoke, heavy intake of alcoholic beverages, obesity/overweight, high consumption of red or processed meats and dairy fats, and physical inactivity.

A recent, large study (based on 47 observational studies involving 280,644 colorectal cancer and 14,139 colorectal adenoma cases) indicated that taller individuals had a 14% higher risk of colon cancer and 6% higher odds of adenomas (a type of benign tumor). Note that taller stature has been linked to an increased risk of several other cancers.

The findings are intriguing and supported from other perspectives. For example, Laron syndrome (LS) is a rare genetic condition, characterized with congenital deficiency of insulin-like growth factor-1 and dwarfism. Patients with LS do not develop cancer.

This is significant yet overlooked because current cancer screening guidelines do not define height as a risk factor or relevant specifics that one should get screened. So, it’s up to doctors’ recommendations or an individual’s choice.

2.      Age for colon cancer trending younger (under age 50)

In contrast to falling or steady rates of colorectal cancer incidence in older adults, a concerning trend is the rising occurrence of young people (< 50 years old) with colorectal cancer. Simply blaming obesity and diabetes in this population might be too early, because new studies shed a light from various angles. Gut microbiome may play a role in carcinogenesis as bacteria alter inflammatory and immune environment. High consumption of sugar-sweetened beverages in adolescence and young adulthood may also contribute to an increased risk of early-onset colorectal cancer.

In addition to reinforcing awareness, an immediate outcome improvement can be done by early screening. Multiple societies and the United States Preventive Services Task Force have updated their recommendation—individuals should initiate screening for colorectal cancer at age 45, instead of age 50.

3.      Obesity as a strong and sustained risk

Obesity and/or being overweight is a well-known, independent risk factor for more than ten cancers, and with obesity comes a worse prognosis. We also know that gut microbiota imbalance can influence cancer, and there are identified colon cancer-promoting bacteria. Recent studies showed that changes in gut microbiota composition occur in patients with colon cancer, particularly among those having a BMI >25 kg/m2.

Cumulative history or effects of excess weight is another issue, as an investigation newly published on JAMA Oncology (online March 17, 2022) emphasized a greater role of cumulative lifetime excess weight in colon cancer risk. The researchers defined “cumulative lifetime exposure” as the subjective numbers of years lived with an overweight condition or obesity, and found that excess weight effect at all ages (between 20 and 70 years) studied is clearly associated with an increased colon cancer risk. In other words, the longer one is carrying excess body weight, the more likely he/she will develop colon cancer.

4.      Polyps’ vulnerability and risk critical to screening methods

Although not all polyps will become cancer, many cancers, especially in colon, start from polyps. Vulnerability and/or risk of polyps turning to cancer depend on their size, shape, number, and microscopic characteristics or pathology.  The larger in size and the more in number the polyps, the greater likelihood they are on the road to cancer. The good news is that polyps can be safely and successfully removed during the colonoscopy.

That’s why colon cancer screening is critical. There are several screening tests with variable specificity and sensitivity—from at-home, stool-based kits (e.g., fecal immunochemical test or FIT, Cologuard DNA test), a new blood-based biomarker test to sigmoidoscopy and colonoscopy. Of all, colonoscopy is still the gold standard, and a preferred test strategy.

However, consider as an early intervention, even starting with at-home kits, is better than doing nothing. Understandably, the cost associated with different preferences may be involved in the decision-making, that’s why your voice to ensure life-saving screening should be raised loudly.

At the end, colon cancer is a most common but preventable cancer!

I draw your attention to the effective, preventative strategies below in a poetry style.

Title: Reminder of Colon Cancer Prevention

Imagine your colon cool and smooth,

With a regular bowel move;

To steer away from cancer growth,

Your brain and action are your tools.

 

Rainbow dish stands a golden rule,

More water, veggies and fruits,

Less red and processed meats,

No smoke, alcohol, and junk foods;

Stay lean and burn fat,

Walk, run, or yoga, whatever you choose.

 

Let your motion get annoying pounds removed,

Let your screening discard any malign root;

Enlighten your disease prevention and a long life,

Keep a good, positive mood!

 

Image Credit: Cleveland Clinic Health Essentials

Facing Challenges with Change or Chance

By Hui Xie-Zukauskas

New opportunity with Change 2022_PixabayIn 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:

  1. 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.
  2. 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.
  3. 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

Invisible But Critical Players: Focus on Cancer

By Hui Xie-Zukauskas

Microbiota & Cancer in Puzzle_PixabayOut 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:

  1. Healthy diet. Healthy eating—particularly plentiful fiber intake—promotes a right balance of microbiota, which is also safter and more effective than supplements.
  2. 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.
  3. 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.

———————————————–

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

The Power of Preventing Cancer: Vigilance at Your Control

By Hui Xie-Zukauskas

Vigilant and Cancer Risk_PixabayWhen a doctor delivers a cancer diagnosis to you or your loved one, it’s like a punch coming from nowhere that hits you really hard. The big C word brings more “c”s with it, chaos in life, crisis in health and finance, and crying in physical or emotional pains. That’s why we all try to avoid that devastation.

There are ways you can protect yourself and your loved ones from cancer damage. This is not a myth or far-reaching statement; in fact, there are evidence-based numbers revealing that 40 to 50% of cancers can be prevented simply through lifestyle changes.

To begin with, you need to be vigilant. Take a few examples:

Food is medicine until food and drink that are unhealthy or mixed with carcinogens creep through the entrance to your body, assisted by misinformation or a false sense of your body’ needs or naively directing a blind eye on what’s in it.

Breath brings life, and so we take daily breathing as a blessing or for granted. That’s until environmental pollutants or toxins flowing in the air that we breathe are found in the blood or body fluid samples.

Consider work. Are you flooded with deadlines, pressures, and/or abuse of any kind? Those are stress builders, as well as obstacles for your getting a good night’s sleep.

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Cancer arises from a complex process involving genetic, environmental and lifestyle factors, and their interactions. Cancer-caused changes are not immediate or visible, but rather gradual or subtle while we cruise along on what may seem to be a comfortable and convenient voyage. Yet, cancer may silently and slowly become a part of our body and our life.

Whether cancer has a loud or a quiet voice or no voice at all, it merits attention. We should give cancer our gift of curiosity and sensitivity, as well as focused and committed shields against its arrival.

There is a blueprint for cancer prevention. The first step is to assimilate that blueprint. The next step is taking action to follow it, one stride at a time.

The bottom line is: You can prevent cancer. It is within your own power.

 

Image credit: Pixabay

Holidays with Cholesterol- and COVID-Conscience

By Hui Xie-Zukauskas

Veggie plate w-Fruits heartThis holiday season is unique in the unprecedented way that our health, life and family are affected while the COVID-19 pandemic has spiked out of control across the US. That’s why I’m bringing the role of cholesterol into the picture.

Here are what we know about cholesterol:

  1. Almost everybody has the knowledge that cholesterol is bad for your heart (especially those low-density lipoproteins or LDL), because when “bad cholesterol” is excessively high in the blood and produces buildup or plaque in your arteries, it can slow or stop blood flow to vital organs, leading to heart attack or stroke.
  2. The accumulation of cholesterol is a common feature of cancer or malignant tissues. Moreover, cholesterol synthesis is tightly regulated in normal cells for physiological functions but dysregulated in various cancer cell types. Then, cholesterol dynamics in adherence and migration of cancer cells plays a critical role in cancer progression.
  3. Recent studies have shown that hypercholesterolemia (i.e., a high blood cholesterol level) is one of risk factors for hospitalization and severity of COVID-19 in diverse populations of patients infected with coronavirus.

Let me elaborate a little more on how bad cholesterol impacts severity and fatality of COVID-19.

This is possible given several high-risk patient populations associated with coronavirus infection including those with diabetes, hypertension, heart disease, stroke and cancer. After all, a high cholesterol level is a risk factor in all of these chronic conditions.

Following key points further support the possibility –

a) Alterations in cholesterol level actually occur during other viral infections such as HIV and hepatitis.

b) Membrane cholesterol is an important component to facilitate viral entry into host cells. Because a virus cannot replicate or reproduce itself until it enters your cells, higher membrane cholesterol levels can enhance the virus entering your cells, and enable serious infection.

c) Recent studies have also found that patients with severe COVID-19 have significantly lower HDL cholesterol (i.e., high density lipoproteins or “good cholesterol).

Surely, this virus or the disease is new, so is scientific research at this stage. Nevertheless, careful consideration of these findings can only help you.

So, how do these new findings translate to your benefits?

1)      If you’re on medication such as Statin for your cardiovascular disease, medication adherence is important.

2)      For holiday meals, pay attention to food intake, avoid fatty foods, use other alternative ways to eat less fat, sugar, and refined wheat to lower cholesterol and prevent chronic inflammation.

3)      Focus on lifestyle modification and immune strengthening. (e.g., add more exercise, refrain from tobacco and alcohol, ensure stress relief and enough sleep, in addition to healthy diet.)

As I’ve always emphasized, it’s very important to know your numbers when it comes to cholesterol.

If your awareness and effort are insufficient in this regard, you can start with modifying holiday foods to avoid or minimize cholesterol bump after holiday. Never too late to stay healthy. For instance:

  • Make cranberry sauce yourself to reduce sugar amount in processed can products.
  • Make mashed potatoes with less milk and less/none butter. Then mix with gravy from roast chicken oil or other flavorful item/ingredient to adjust the taste.
  • Replace dinner rolls with whole grain version, because refined wheat would be converted to blood sugar.

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You get the idea.

At this point, you may also be wondering if you should take cholesterol-lowering drugs or supplements? This is a valid thought. However, remember that diet and exercise are proven ways to reduce cholesterol. Unless absolutely necessary, you may get a prescription after consulting with your physician, which needless to say it’s a complex issue. As for cholesterol-lowering supplements, data are not conclusive and formulations are not regulated. So, the best resort advisable is nutrient- and antioxidant-rich foods instead.

Cancer remains a major public health concern too. Controlling dietary fatty components as well as intake can prevent cancer and fight coronavirus infection.

Collectively, it is worth reflecting on your lifestyle and strategizing your plan to optimize your wellness while enjoying Thanksgiving and the coming holiday season.

May abundant love to you and your loved ones, along with cholesterol- and COVID-awareness, bring you safe and joyful holidays!

 

Image credit: pixabay

From Dilemma to Deadly Disease: How Do You Deal with It

By Hui Xie-Zukauskas

Balance Covid and CancerDo you have a loved one or friend suffering from cancer? How are they doing, particularly regarding wellbeing and cancer treatment aspect during the COVID-19 pandemic?

Also, are you one of the folks whose cancer screening is due or who may experience something uncomfortable, concerned yet reluctant to schedule a hospital visit?

I’m asking these questions because if the answer is yes, you are not alone. This is the reality and challenge we face now.

A dilemma is confronting us. Staying away from the hospitals may delay a critical treatment or a timely diagnosis, which could worsen cancer progression and prognosis; yet visiting the hospital may increase a risk for the coronavirus infection, which can lead to a potentially dangerous or destructive outcome.

So, I’m going to address this struggle and solutions to help you make a better decision about your health.

Balance current situation with long-term gain

Let’s face it. Oncologists have warned that delayed cancer screening and diagnosis during COVID-19 will result in thousands and more avoidable deaths in the coming decade.

The experts’ insight is clear. Although fearing of COVID-19 risk is understandable, there is also unintended consequence in cancer. I cannot emphasize enough that cancer develops through a multistep process over years. Regardless of what’s going on around the world and how many things we put on hold, malignant growth does not stop.

That is why detecting and treating early lesion(s) are critical. Cancelled or delayed cancer screenings suggest some undetected cancers because screening benefits are undeniable. Then undetected cancer that actually exist translate to the delay or loss of interventions, consequently allowing the cancer to grow or metastasize.

So, weigh in benefits and risks, or pros and cons, make cancer care or screening a priority and take COVID-19 precautions at the same time. Fortunately, it can be done safely.

The best example that early detection and treatment save lives is late Justice Ruth Bader Ginsburg’s cancer journey, during which she went through successful treatments with colon, lung and pancreatic cancer since 1999. We can take a brief note on what she taught us.

Learn from Justice Ginsburg’s cancer battle

First, we see hope and inspiration from advanced medical therapies, from her personal battles and survivorship. It’s truly extraordinary that Ginsburg fought five bouts of cancer last two decades and lived well to 87 years old.

Second, we learn her resilience and commitment to life, health and work. Ginsburg’s rigorous exercise routine, her dedication to the job she loved, exceptionally she rarely missed work while undergoing cancer treatments, her time with family and friends, all helped her combat cancers.

Finally, we can ascertain that early diagnosis and treatment matter, as they can steer cancer course towards cancer-free direction. In Ginsburg’s case, every time doctors found a new cancer by accident came as a result of her routine checkups or treatments for other conditions. Then immediate surgeries and therapies restored her health. You can view it as luck or timely discovery or both.

Because she recently died from complications of pancreatic cancer, let’s extend to the next point.

Zero in preventing pancreatic cancer
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Pancreatic cancer is one of the most malignant and lethal diseases. It is highly invasive and can widely metastasize to various organs of the body. It’s also resistant to most treatments, with a poor prognosis (up to now a five-year survival rate is lower than 9%).

But when it comes to pancreatic cancer, it’s easy to permit a blind spot. This is because the disease rarely displays specific early signs and there is no acceptable screening test available at this time.

Even though one may experience some symptoms such as abdominal pain, stomach ache or lower back pain, jaundice, or bloating and weight loss, these indications can easily be brushed off in the hustle and bustle of everyday life. And worse, when these sufferings or concerns are presented, individuals already have an advanced pancreatic cancer that’s untreatable or unresectable.

More alarming is that incidence of pancreatic cancer has been increasing in recent years. Based on scientific projection, by 2030 it will end up second deadliest cancer in the U.S. next to lung cancer.

All the above-mentioned aspects, therefore, make the urgent need to understand causes and risk factors of pancreatic cancer. More important, the key is prevention and early detection.

After all, genetic factor is about 10%. Be watchful and eliminate the blind spot. Focus more on modifiable risk factors. Here are actions you can take:

  1. Trust your instinct and science. Don’t put off cancer diagnosis or cancer-related visits. You can always consult via Telemedicine first if any need or troubling concern arises.
  2. Open to necessary hospital/clinic visits. Don’t let fear and anxiety overwhelm you. Hospitals have made stringent protocols to ensure the safety of both patients and staff. I personally witnessed it at different hospitals from recent experience with my family member’s illnesses.
  3. Go for genetic testing if you are a high-risk individual, such as having a family history of pancreatic cancer, other cancers or certain familial syndromes, and hereditary pancreatitis. It can detect a cancer-causing mutation that drives pancreatic tumor growth. Moreover, BRCA1 and BRCA2 mutations trigger not only breast and ovarian cancer but also pancreatic cancer.
  4. Beware changes in your body (including subtle ones). Don’t ignore symptoms that may indicate something is wrong.
  5. Pay attention to elderly people. The risk goes up with aging, because ~80% diagnosed are 60 years old and up.
  6. Control diabetes, chronic pancreatitis, and obesity, especially childhood obesity—all are well established risk factors.
  7. Live a healthy lifestyle. No smoking, no heavy alcohol drinking, no high fat and high sugar food, and minimize red or processed meat consumption. Be physically active.
  8. Maintain a good oral health. Emerging evidence has linked poor oral hygiene or poor periodontal health to a higher risk for pancreatic cancer. This relation between a chronic oral infection and carcinogenesis should be no surprise, given that chronic inflammation and bacterial/viral infection are underlying mechanisms for cancer development.
  9. Build a powerful immune system. Make it your strong defense and preserve from diet, exercise to mentality and sleep.
  10. Protect yourself, your family and your community whether it’s fighting against carcinogens or the coronavirus. This is a personal responsibility. Before having an effective and safe vaccine to prevent COVID-19, wear a mask when out in public, watch your space at least 6-feet apart from others, wash your hands frequently, and avoid close contact with people who are sick.

Conclusion

The fear of COVID-19 has influenced some people’s decision to cancel or act on cancer screening or treatment. However, one should make effort to prioritize cancer screening, diagnosis and care while taking precautions to minimize COVID-19 risk. And become vigilant about pancreatic cancer.

 

Image credit: Scientists & CPD

 

 

Hypertension Can Be Asymptomatic but Potentially Fatal

By Hui Xie-Zukauskas

BP Measure & Heart_pixabayWhen is the last time you checked your blood pressure? How is your child or children’s blood pressure?

Hypertension (high blood pressure) is a multifaceted issue, and I’d like to address why it matters in several brief, yet key points.

In case you are not aware, high blood pressure is redefined at a reading of 130/80 rather than 140/90 mmHg, according to 2017 guidelines from the American Heart Association and the American College of Cardiology.

It’s important to pay attention to the new normal—i.e. the reading should be lower than 120/80 mmHg, because when systolic (top) number is 120-129 and diastolic (bottom) number is lower than 80 mmHg, your blood pressure is referred to “elevated status”. So, if your reading exceeds 130/80 mmHg, read further.

Hypertension a common risk factor for various cardiovascular and other chronic illnesses. It often remains overlooked in the absence of symptoms. However, hypertension is a silent killer.

Hypertension is a primary risk factor for cardiovascular mortality (heart attack and stroke), and can bring about end-organ damage including chronic kidney diseases and renal failure. Even if people survive a life-threatening emergency, many face challenges of disability and complications that reduce the quality of life.

Hypertension is positively associated with some types of cancer, specifically renal cell carcinoma and breast cancer.
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Hypertension is becoming more common in children and adolescents but is under-diagnosed among this population, including those with a normal weight without a family history of hypertension. This is not surprising given the obesity epidemic, which presents alarming statistics—more than 1/3 of youth are overweight or obese and nearly 20% of children/adolescents has obesity. The relationship between hypertension and obesity has been clearly established; both can cause severe long-term health consequences.

As we live at a moment of crises, the compounding effect of COVID-19 reached an out of control point. A recent research published on European Heart Journal (2020 June; 41:2058-2066) reveals that patients with hypertension have a two-fold increase in the risk of dying from COVID-19 compared to those without hypertension. Antihypertensive treatment has lowered the mortality risk significantly compared with those left untreated.

The good news is that high blood pressure is a modifiable risk factor, and many hypertension-associated problems are preventable! So, focus on prevention.

The top strategy for preventing hypertension is lifestyle modification starting from a young age. Treating primary hypertension in children is almost exclusively a matter of an improved dietary and behavior regimen, including a more nutritional diet with reduced sodium intake, increased physical activity, and healthy weight. Pharmacological intervention is secondary strategy if your physician indicates it is needed.

A take-home-message: Watch your blood pressure, control your blood pressure to prevent acute cardiovascular events and help reduce the COVID-19 burden.

 

Image credit: Pixabay

A New Hope to Keep Cancer at Bay

By Hui Xie-Zukauskas

Hui-s Book_12-2019(This is Part 1 of Miniseries.)

Cancer is a devastating disease and indiscriminate regarding age, sex, genetic, economic or social status.

Do you want to avoid cancer? Do you know what to do to prevent cancer?

My book titled “Key Strategies for Cancer Prevention” is recently released. It translates science into life-saving strategies and speaks in lay people’s term.

This book helps you discover how to prevent cancer. It addresses the driving forces behind cancer development, and provides a comprehensive, concrete guide for a daily, healthy lifestyle in an enjoyable way. Through prevention, you can optimize your overall well-being.

The book starts with dissecting how cancer risk factors exist and influence your daily life, then addresses potential contributors to cancer before it draws your attention to the most common and deadliest cancers. The book also offers extra advice or tips for a healthy and cancer preventive lifestyle.

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Yes, most cancers are preventable! A lifestyle of mindfulness and modification can take you a long way, and importantly, you can achieve proven results with joy and love through step by step, incremental progresses.

My goal is to have more people embrace the powerful knowledge and ultimately save more lives.

If you are among folks who are eager to learn and take actions for a healthier, happier, and longer life, the book is for you.

Now please join me and help me bring this life-saving book to light. The book is available at bookstores (e.g., iUniverse, Barnes & Noble), and Amazon in paperback and kindle/eBook formats. Other eBook venues include Apple, Google Play, etc. Once you get your copy, read it, tell people around you, and desirably post review on Amazon.

Sharing is caring. By helping me spread the words about it, you also make a big difference in saving lives!