Can governments afford to give up their addiction to cigarette taxes? That is the issue this New York Times article raises.
Duncan
....the government has become a financial stakeholder in smoking, some would argue, even as public health officials warn people about its deadly consequences. Smoking declines as cigarette taxes increase, but a core group of smokers hang on to the habit.
The reliance of government coffers on the taxes smokers pay, and on the tobacco settlement money, essentially provides a financial cushion for state governments and could be viewed as a government guarantee for the survival of the tobacco industry. Would politicians shut down an industry that supplies so much money?
http://snipurl.com/3r6e2
Wednesday, September 17, 2008
Sunday, September 14, 2008
Mammography Dangers To Be Aware Of
While mammograpy has its' uses and benefits, it is not completely benign especially for younger women. Samuel Epstein, author of Politics of Cancer, who has been analyzing cancer for decades, provides information all women should be aware of.
Duncan
Dangers and Unreliability of Mammography: Part 1
by Samuel Epstein, MD
Contrary to popular belief and misleadingly assurances by the media, the National Cancer Institute (NCI), and American Cancer Society (ACS), mammography is not a technique for early diagnosis. In fact, a breast cancer has usually been present for about eight years before it is usually detected.
Mammography poses major risks of which women still remain uninformed. Radiation from routine mammography poses cumulative risks of breast cancer. Contrary to misleading assurances that radiation exposure from mammography is trivial and similar to that from a chest X ray, about 1/1,000 of a rad (radiation-absorbed dose), the routine practice of taking four films for each breast results in some 1,000-fold greater exposure, 1 rad, focused on each breast rather than the entire chest. Thus, premenopausal women screened annually over ten years are exposed to about 10 rads for each breast.
The premenopausal breast is also highly sensitive to radiation with each rad exposure increasing breast cancer risk by 1 percent, resulting in a cumulative 10 percent increased risk over ten years of screening; risks are still greater for "baseline" screening at younger ages, for which there is no evidence of future relevance. Furthermore, cancer risks are up to fourfold greater for the 2 percent of women who are unknowing carriers of the A-T gene, and thus highly sensitive to radiation; estimatedly, this accounts for 20 percent of breast cancers annually.
Click link for more:
http://www.newliving.com/issues/apr_2005/articles/mammography.html
Here is a link to a much more complete though more difficult essay by Epstein on mammography dangers:
http://www.preventcancer.com/patients/mammography/ijhs_mammography.htm
Duncan
Dangers and Unreliability of Mammography: Part 1
by Samuel Epstein, MD
Contrary to popular belief and misleadingly assurances by the media, the National Cancer Institute (NCI), and American Cancer Society (ACS), mammography is not a technique for early diagnosis. In fact, a breast cancer has usually been present for about eight years before it is usually detected.
Mammography poses major risks of which women still remain uninformed. Radiation from routine mammography poses cumulative risks of breast cancer. Contrary to misleading assurances that radiation exposure from mammography is trivial and similar to that from a chest X ray, about 1/1,000 of a rad (radiation-absorbed dose), the routine practice of taking four films for each breast results in some 1,000-fold greater exposure, 1 rad, focused on each breast rather than the entire chest. Thus, premenopausal women screened annually over ten years are exposed to about 10 rads for each breast.
The premenopausal breast is also highly sensitive to radiation with each rad exposure increasing breast cancer risk by 1 percent, resulting in a cumulative 10 percent increased risk over ten years of screening; risks are still greater for "baseline" screening at younger ages, for which there is no evidence of future relevance. Furthermore, cancer risks are up to fourfold greater for the 2 percent of women who are unknowing carriers of the A-T gene, and thus highly sensitive to radiation; estimatedly, this accounts for 20 percent of breast cancers annually.
Click link for more:
http://www.newliving.com/issues/apr_2005/articles/mammography.html
Here is a link to a much more complete though more difficult essay by Epstein on mammography dangers:
http://www.preventcancer.com/patients/mammography/ijhs_mammography.htm
Saturday, September 13, 2008
Wonderful Essay on (Cancer) Statistics
I highly recommend this essay by Stephen Gould for anyone dealing with cancer, or supporting someone with cancer..
Duncan
The Median Isn't the Message by Stephen Jay Gould
My life has recently intersected, in a most personal way, two of Mark Twain's famous quips. One I shall defer to the end of this essay. The other (sometimes attributed to Disraeli), identifies three species of mendacity, each worse than the one before - lies, damned lies, and statistics.
Consider the standard example of stretching the truth with numbers - a case quite relevant to my story. Statistics recognizes different measures of an "average," or central tendency. The mean is our usual concept of an overall average - add up the items and divide them by the number of sharers (100 candy bars collected for five kids next Halloween will yield 20 for each in a just world). The median, a different measure of central tendency, is the half-way point. If I line up five kids by height, the median child is shorter than two and taller than the other two (who might have trouble getting their mean share of the candy). A politician in power might say with pride, "The mean income of our citizens is $15,000 per year." The leader of the opposition might retort, "But half our citizens make less than $10,000 per year." Both are right, but neither cites a statistic with impassive objectivity. The first invokes a mean, the second a median. (Means are higher than medians in such cases because one millionaire may outweigh hundreds of poor people in setting a mean; but he can balance only one mendicant in calculating a median).
The larger issue that creates a common distrust or contempt for statistics is more troubling. Many people make an unfortunate and invalid separation between heart and mind, or feeling and intellect. In some contemporary traditions, abetted by attitudes stereotypically centered on Southern California, feelings are exalted as more "real" and the only proper basis for action - if it feels good, do it - while intellect gets short shrift as a hang-up of outmoded elitism. Statistics, in this absurd dichotomy, often become the symbol of the enemy. As Hilaire Belloc wrote, "Statistics are the triumph of the quantitative method, and the quantitative method is the victory of sterility and death."
This is a personal story of statistics, properly interpreted, as profoundly nurturant and life-giving. It declares holy war on the downgrading of intellect by telling a small story about the utility of dry, academic knowledge about science. Heart and head are focal points of one body, one personality.
In July 1982, I learned that I was suffering from abdominal mesothelioma, a rare and serious cancer usually associated with exposure to asbestos. When I revived after surgery, I asked my first question of my doctor and chemotherapist: "What is the best technical literature about mesothelioma?" She replied, with a touch of diplomacy (the only departure she has ever made from direct frankness), that the medical literature contained nothing really worth reading.
Of course, trying to keep an intellectual away from literature works about as well as recommending chastity to Homo sapiens, the sexiest primate of all. As soon as I could walk, I made a beeline for Harvard's Countway medical library and punched mesothelioma into the computer's bibliographic search program. An hour later, surrounded by the latest literature on abdominal mesothelioma, I realized with a gulp why my doctor had offered that humane advice. The literature couldn't have been more brutally clear: mesothelioma is incurable, with a median mortality of only eight months after discovery. I sat stunned for about fifteen minutes, then smiled and said to myself: so that's why they didn't give me anything to read. Then my mind started to work again, thank goodness.
If a little learning could ever be a dangerous thing, I had encountered a classic example. Attitude clearly matters in fighting cancer. We don't know why (from my old-style materialistic perspective, I suspect that mental states feed back upon the immune system). But match people with the same cancer for age, class, health, socioeconomic status, and, in general, those with positive attitudes, with a strong will and purpose for living, with commitment to struggle, with an active response to aiding their own treatment and not just a passive acceptance of anything doctors say, tend to live longer. A few months later I asked Sir Peter Medawar, my personal scientific guru and a Nobelist in immunology, what the best prescription for success against cancer might be. "A sanguine personality," he replied. Fortunately (since one can't reconstruct oneself at short notice and for a definite purpose), I am, if anything, even-tempered and confident in just this manner.
Hence the dilemma for humane doctors: since attitude matters so critically, should such a sombre conclusion be advertised, especially since few people have sufficient understanding of statistics to evaluate what the statements really mean? From years of experience with the small-scale evolution of Bahamian land snails treated quantitatively, I have developed this technical knowledge - and I am convinced that it played a major role in saving my life. Knowledge is indeed power, in Bacon's proverb.
The problem may be briefly stated: What does "median mortality of eight months" signify in our vernacular? I suspect that most people, without training in statistics, would read such a statement as "I will probably be dead in eight months" - the very conclusion that must be avoided, since it isn't so, and since attitude matters so much.
I was not, of course, overjoyed, but I didn't read the statement in this vernacular way either. My technical training enjoined a different perspective on "eight months median mortality." The point is a subtle one, but profound - for it embodies the distinctive way of thinking in my own field of evolutionary biology and natural history.
We still carry the historical baggage of a Platonic heritage that seeks sharp essences and definite boundaries. (Thus we hope to find an unambiguous "beginning of life" or "definition of death," although nature often comes to us as irreducible continua.) This Platonic heritage, with its emphasis in clear distinctions and separated immutable entities, leads us to view statistical measures of central tendency wrongly, indeed opposite to the appropriate interpretation in our actual world of variation, shadings, and continua. In short, we view means and medians as the hard "realities," and the variation that permits their calculation as a set of transient and imperfect measurements of this hidden essence. If the median is the reality and variation around the median just a device for its calculation, the "I will probably be dead in eight months" may pass as a reasonable interpretation.
But all evolutionary biologists know that variation itself is nature's only irreducible essence. Variation is the hard reality, not a set of imperfect measures for a central tendency. Means and medians are the abstractions. Therefore, I looked at the mesothelioma statistics quite differently - and not only because I am an optimist who tends to see the doughnut instead of the hole, but primarily because I know that variation itself is the reality. I had to place myself amidst the variation.
When I learned about the eight-month median, my first intellectual reaction was: fine, half the people will live longer; now what are my chances of being in that half. I read for a furious and nervous hour and concluded, with relief: damned good. I possessed every one of the characteristics conferring a probability of longer life: I was young; my disease had been recognized in a relatively early stage; I would receive the nation's best medical treatment; I had the world to live for; I knew how to read the data properly and not despair.
Another technical point then added even more solace. I immediately recognized that the distribution of variation about the eight-month median would almost surely be what statisticians call "right skewed." (In a symmetrical distribution, the profile of variation to the left of the central tendency is a mirror image of variation to the right. In skewed distributions, variation to one side of the central tendency is more stretched out - left skewed if extended to the left, right skewed if stretched out to the right.) The distribution of variation had to be right skewed, I reasoned. After all, the left of the distribution contains an irrevocable lower boundary of zero (since mesothelioma can only be identified at death or before). Thus, there isn't much room for the distribution's lower (or left) half - it must be scrunched up between zero and eight months. But the upper (or right) half can extend out for years and years, even if nobody ultimately survives. The distribution must be right skewed, and I needed to know how long the extended tail ran - for I had already concluded that my favorable profile made me a good candidate for that part of the curve.
The distribution was indeed, strongly right skewed, with a long tail (however small) that extended for several years above the eight month median. I saw no reason why I shouldn't be in that small tail, and I breathed a very long sigh of relief. My technical knowledge had helped. I had read the graph correctly. I had asked the right question and found the answers. I had obtained, in all probability, the most precious of all possible gifts in the circumstances - substantial time. I didn't have to stop and immediately follow Isaiah's injunction to Hezekiah - set thine house in order for thou shalt die, and not live. I would have time to think, to plan, and to fight.
One final point about statistical distributions. They apply only to a prescribed set of circumstances - in this case to survival with mesothelioma under conventional modes of treatment. If circumstances change, the distribution may alter. I was placed on an experimental protocol of treatment and, if fortune holds, will be in the first cohort of a new distribution with high median and a right tail extending to death by natural causes at advanced old age.
It has become, in my view, a bit too trendy to regard the acceptance of death as something tantamount to intrinsic dignity. Of course I agree with the preacher of Ecclesiastes that there is a time to love and a time to die - and when my skein runs out I hope to face the end calmly and in my own way. For most situations, however, I prefer the more martial view that death is the ultimate enemy - and I find nothing reproachable in those who rage mightily against the dying of the light.
The swords of battle are numerous, and none more effective than humor. My death was announced at a meeting of my colleagues in Scotland, and I almost experienced the delicious pleasure of reading my obituary penned by one of my best friends (the so-and-so got suspicious and checked; he too is a statistician, and didn't expect to find me so far out on the right tail). Still, the incident provided my first good laugh after the diagnosis. Just think, I almost got to repeat Mark Twain's most famous line of all: the reports of my death are greatly exaggerated.
Postscript By Steve Dunn
Many people have written me to ask what became of Stephen Jay Gould. Sadly, Dr. Gould died in May of 2002 at the age of 60. Dr. Gould lived for 20 very productive years after his diagnosis, thus exceeding his 8 month median survival by a factor of thirty! Although he did die of cancer, it apparently wasn't mesothelioma, but a second and unrelated cancer.
In March 2002, Dr. Gould published his 1342 page "Magnum Opus", The Structure of Evolutionary Theory. It is fitting that Gould, one of the world's most prolific scientists and writers, was able to complete the definitive statement of his scientific work and philosophy just in time. That text is far too long and dense for almost any layman - but the works of Stephen Jay Gould will live on. Especially I hope, The Median Isn't The Message .
Duncan
The Median Isn't the Message by Stephen Jay Gould
My life has recently intersected, in a most personal way, two of Mark Twain's famous quips. One I shall defer to the end of this essay. The other (sometimes attributed to Disraeli), identifies three species of mendacity, each worse than the one before - lies, damned lies, and statistics.
Consider the standard example of stretching the truth with numbers - a case quite relevant to my story. Statistics recognizes different measures of an "average," or central tendency. The mean is our usual concept of an overall average - add up the items and divide them by the number of sharers (100 candy bars collected for five kids next Halloween will yield 20 for each in a just world). The median, a different measure of central tendency, is the half-way point. If I line up five kids by height, the median child is shorter than two and taller than the other two (who might have trouble getting their mean share of the candy). A politician in power might say with pride, "The mean income of our citizens is $15,000 per year." The leader of the opposition might retort, "But half our citizens make less than $10,000 per year." Both are right, but neither cites a statistic with impassive objectivity. The first invokes a mean, the second a median. (Means are higher than medians in such cases because one millionaire may outweigh hundreds of poor people in setting a mean; but he can balance only one mendicant in calculating a median).
The larger issue that creates a common distrust or contempt for statistics is more troubling. Many people make an unfortunate and invalid separation between heart and mind, or feeling and intellect. In some contemporary traditions, abetted by attitudes stereotypically centered on Southern California, feelings are exalted as more "real" and the only proper basis for action - if it feels good, do it - while intellect gets short shrift as a hang-up of outmoded elitism. Statistics, in this absurd dichotomy, often become the symbol of the enemy. As Hilaire Belloc wrote, "Statistics are the triumph of the quantitative method, and the quantitative method is the victory of sterility and death."
This is a personal story of statistics, properly interpreted, as profoundly nurturant and life-giving. It declares holy war on the downgrading of intellect by telling a small story about the utility of dry, academic knowledge about science. Heart and head are focal points of one body, one personality.
In July 1982, I learned that I was suffering from abdominal mesothelioma, a rare and serious cancer usually associated with exposure to asbestos. When I revived after surgery, I asked my first question of my doctor and chemotherapist: "What is the best technical literature about mesothelioma?" She replied, with a touch of diplomacy (the only departure she has ever made from direct frankness), that the medical literature contained nothing really worth reading.
Of course, trying to keep an intellectual away from literature works about as well as recommending chastity to Homo sapiens, the sexiest primate of all. As soon as I could walk, I made a beeline for Harvard's Countway medical library and punched mesothelioma into the computer's bibliographic search program. An hour later, surrounded by the latest literature on abdominal mesothelioma, I realized with a gulp why my doctor had offered that humane advice. The literature couldn't have been more brutally clear: mesothelioma is incurable, with a median mortality of only eight months after discovery. I sat stunned for about fifteen minutes, then smiled and said to myself: so that's why they didn't give me anything to read. Then my mind started to work again, thank goodness.
If a little learning could ever be a dangerous thing, I had encountered a classic example. Attitude clearly matters in fighting cancer. We don't know why (from my old-style materialistic perspective, I suspect that mental states feed back upon the immune system). But match people with the same cancer for age, class, health, socioeconomic status, and, in general, those with positive attitudes, with a strong will and purpose for living, with commitment to struggle, with an active response to aiding their own treatment and not just a passive acceptance of anything doctors say, tend to live longer. A few months later I asked Sir Peter Medawar, my personal scientific guru and a Nobelist in immunology, what the best prescription for success against cancer might be. "A sanguine personality," he replied. Fortunately (since one can't reconstruct oneself at short notice and for a definite purpose), I am, if anything, even-tempered and confident in just this manner.
Hence the dilemma for humane doctors: since attitude matters so critically, should such a sombre conclusion be advertised, especially since few people have sufficient understanding of statistics to evaluate what the statements really mean? From years of experience with the small-scale evolution of Bahamian land snails treated quantitatively, I have developed this technical knowledge - and I am convinced that it played a major role in saving my life. Knowledge is indeed power, in Bacon's proverb.
The problem may be briefly stated: What does "median mortality of eight months" signify in our vernacular? I suspect that most people, without training in statistics, would read such a statement as "I will probably be dead in eight months" - the very conclusion that must be avoided, since it isn't so, and since attitude matters so much.
I was not, of course, overjoyed, but I didn't read the statement in this vernacular way either. My technical training enjoined a different perspective on "eight months median mortality." The point is a subtle one, but profound - for it embodies the distinctive way of thinking in my own field of evolutionary biology and natural history.
We still carry the historical baggage of a Platonic heritage that seeks sharp essences and definite boundaries. (Thus we hope to find an unambiguous "beginning of life" or "definition of death," although nature often comes to us as irreducible continua.) This Platonic heritage, with its emphasis in clear distinctions and separated immutable entities, leads us to view statistical measures of central tendency wrongly, indeed opposite to the appropriate interpretation in our actual world of variation, shadings, and continua. In short, we view means and medians as the hard "realities," and the variation that permits their calculation as a set of transient and imperfect measurements of this hidden essence. If the median is the reality and variation around the median just a device for its calculation, the "I will probably be dead in eight months" may pass as a reasonable interpretation.
But all evolutionary biologists know that variation itself is nature's only irreducible essence. Variation is the hard reality, not a set of imperfect measures for a central tendency. Means and medians are the abstractions. Therefore, I looked at the mesothelioma statistics quite differently - and not only because I am an optimist who tends to see the doughnut instead of the hole, but primarily because I know that variation itself is the reality. I had to place myself amidst the variation.
When I learned about the eight-month median, my first intellectual reaction was: fine, half the people will live longer; now what are my chances of being in that half. I read for a furious and nervous hour and concluded, with relief: damned good. I possessed every one of the characteristics conferring a probability of longer life: I was young; my disease had been recognized in a relatively early stage; I would receive the nation's best medical treatment; I had the world to live for; I knew how to read the data properly and not despair.
Another technical point then added even more solace. I immediately recognized that the distribution of variation about the eight-month median would almost surely be what statisticians call "right skewed." (In a symmetrical distribution, the profile of variation to the left of the central tendency is a mirror image of variation to the right. In skewed distributions, variation to one side of the central tendency is more stretched out - left skewed if extended to the left, right skewed if stretched out to the right.) The distribution of variation had to be right skewed, I reasoned. After all, the left of the distribution contains an irrevocable lower boundary of zero (since mesothelioma can only be identified at death or before). Thus, there isn't much room for the distribution's lower (or left) half - it must be scrunched up between zero and eight months. But the upper (or right) half can extend out for years and years, even if nobody ultimately survives. The distribution must be right skewed, and I needed to know how long the extended tail ran - for I had already concluded that my favorable profile made me a good candidate for that part of the curve.
The distribution was indeed, strongly right skewed, with a long tail (however small) that extended for several years above the eight month median. I saw no reason why I shouldn't be in that small tail, and I breathed a very long sigh of relief. My technical knowledge had helped. I had read the graph correctly. I had asked the right question and found the answers. I had obtained, in all probability, the most precious of all possible gifts in the circumstances - substantial time. I didn't have to stop and immediately follow Isaiah's injunction to Hezekiah - set thine house in order for thou shalt die, and not live. I would have time to think, to plan, and to fight.
One final point about statistical distributions. They apply only to a prescribed set of circumstances - in this case to survival with mesothelioma under conventional modes of treatment. If circumstances change, the distribution may alter. I was placed on an experimental protocol of treatment and, if fortune holds, will be in the first cohort of a new distribution with high median and a right tail extending to death by natural causes at advanced old age.
It has become, in my view, a bit too trendy to regard the acceptance of death as something tantamount to intrinsic dignity. Of course I agree with the preacher of Ecclesiastes that there is a time to love and a time to die - and when my skein runs out I hope to face the end calmly and in my own way. For most situations, however, I prefer the more martial view that death is the ultimate enemy - and I find nothing reproachable in those who rage mightily against the dying of the light.
The swords of battle are numerous, and none more effective than humor. My death was announced at a meeting of my colleagues in Scotland, and I almost experienced the delicious pleasure of reading my obituary penned by one of my best friends (the so-and-so got suspicious and checked; he too is a statistician, and didn't expect to find me so far out on the right tail). Still, the incident provided my first good laugh after the diagnosis. Just think, I almost got to repeat Mark Twain's most famous line of all: the reports of my death are greatly exaggerated.
Postscript By Steve Dunn
Many people have written me to ask what became of Stephen Jay Gould. Sadly, Dr. Gould died in May of 2002 at the age of 60. Dr. Gould lived for 20 very productive years after his diagnosis, thus exceeding his 8 month median survival by a factor of thirty! Although he did die of cancer, it apparently wasn't mesothelioma, but a second and unrelated cancer.
In March 2002, Dr. Gould published his 1342 page "Magnum Opus", The Structure of Evolutionary Theory. It is fitting that Gould, one of the world's most prolific scientists and writers, was able to complete the definitive statement of his scientific work and philosophy just in time. That text is far too long and dense for almost any layman - but the works of Stephen Jay Gould will live on. Especially I hope, The Median Isn't The Message .
Thursday, September 11, 2008
Arthoscopic Knee Surgery Fails the Test
Here is an item on knee surgery from the Wall Street Journal Health Blog. It was also mentioned on NPR today.
Duncan
September 11, 2008, 8:29 am
Knee Surgery No Help for Arthritis
Posted by Jacob Goldstein
Surgeons take it as an article of faith that a chance to cut is a chance to cure. So it's a pretty big deal when a study clearly shows that a common surgery doesn't actually help certain patients. Even more so if the study is confirming similar results from a previous study.
That's what happened this week, when the New England Journal of Medicine published a study that showed arthroscopic surgery doesn't provide any benefit for moderate to severe arthritis of the knee.
Researchers randomly assigned nearly 200 patients to receive either surgery, drugs and physical therapy, or drugs and physical therapy alone. Three months later, patients who had surgery had slightly less pain than those who did not. But there was no significant difference between the two groups at six months, one year or two years. The difference at two years was the main measure the researchers looked at.
A 2002 study had similar results.
http://snipurl.com/3pdn9
Duncan
September 11, 2008, 8:29 am
Knee Surgery No Help for Arthritis
Posted by Jacob Goldstein
Surgeons take it as an article of faith that a chance to cut is a chance to cure. So it's a pretty big deal when a study clearly shows that a common surgery doesn't actually help certain patients. Even more so if the study is confirming similar results from a previous study.
That's what happened this week, when the New England Journal of Medicine published a study that showed arthroscopic surgery doesn't provide any benefit for moderate to severe arthritis of the knee.
Researchers randomly assigned nearly 200 patients to receive either surgery, drugs and physical therapy, or drugs and physical therapy alone. Three months later, patients who had surgery had slightly less pain than those who did not. But there was no significant difference between the two groups at six months, one year or two years. The difference at two years was the main measure the researchers looked at.
A 2002 study had similar results.
http://snipurl.com/3pdn9
Wednesday, August 20, 2008
Fruit Juices that Interact with Pharmaceuticals
You have probably figured out that I am not a fan of pharmaceuticals especially for extended periods of time (like the rest of your life.) Nevertheless if you feel you need them, it is best if you have information on how. Duncan
More Juices Found to Affect Drugs'
Effectiveness: Study
Orange and apple join grapefruit on list of drinks that may pose problems
Posted August 19, 2008
By Kathleen Doheny
HealthDay Reporter
TUESDAY, Aug. 19 (HealthDay News) -- Grapefruit juice, long known to boost the absorption of certain medications, isn't the only juice that doesn't mix well with drugs, according to the Canadian researcher who first identified the ill effects of grapefruit juice.
Other common juices, including orange and apple, may limit the body's absorption of drugs, compromising their effectiveness, said David Bailey, a professor of medicine and pharmacology at the University of Western Ontario, in London, Ontario, Canada.
Bailey was expected to present his research Tuesday at the American Chemical Society's national meeting, in Philadelphia.
"The original finding is that [grapefruit juice] markedly boosts the amount of drug that gets into the bloodstream," Bailey said. He first reported that nearly 20 years ago when he discovered that grapefruit juice increased the body's blood levels of the drop felodipine (Plendil), used to treat high blood pressure.
Since the original finding, other researchers have identified dozens of other medications that could interact adversely with grapefruit juice, Bailey said.
Doctors traditionally warn against drinking grapefruit juice if you're taking certain medications for high cholesterol, high blood pressure and heart rhythm problems, according to the American Academy of Family Physicians.
In his latest research, Bailey found that grapefruit juice, as well as orange and apple juice, can lower the body's absorption of some medications. Those drugs include the anti-cancer drugs etoposide (Etopophos, Vepesid); certain beta blockers like tenormin (Atenolol) and talinolol (Cordanum), used to treat high blood pressure and prevent heart attacks; cyclosporine, which is used to prevent organ transplant rejection; and some antibiotics, including ciprofloxacin (Cipro), levofloxacin (Levaquin), and itraconazole (Sporanox).
Bailey also found that healthy volunteers who took the allergy drug fexofenadine (Allegra) with grapefruit juice absorbed only half the amount of the drug, compared with volunteers who took the medicine with water.
In each case, substances in the juices affected the absorption of the drugs. Some chemicals block a drug uptake transporter, reducing drug absorption; other chemicals block a drug metabolizing enzyme that normally breaks down the drugs, he said.
"We don't [yet] know all the drugs affected," Bailey said.
Michael Gaunt is a medication safety analyst at the Institute for Safe Medication Practices in Horsham, Pa. He said, "If this study holds true [in future research], you are going to have to warn people in a similar fashion" about other juices.
Gaunt's advice for now: "In general, it's safest to take medication with water."
Bailey agreed. If you opt for water, he said, "a glass is better than a sip. It helps dissolve the tablet." And cool water is better than hot, he added, because your stomach empties cool water faster, sending the medication on its way to the small intestine and finally the blood stream.
More information
To learn more about juice and medication interactions, visit the American Academy of Family Physicians.
Monday, August 18, 2008
Practical Ways to Reduce Your Cancer Risk
Below I have posted one of the fact sheets from the Center for Enviornmental Oncology which is at the University of Pittsburg. I learned of the center from a book I am currently reading titled: The Secret History of the War on Cancer by Devra Davis who works at the Center.
There is no way to completely insure yourself against developing cancer but there are ways to significantly decrease the probability.
Duncan
Fact Sheets - Cancer Prevention: 12 Things You Can Do To Reduce Cancer Risk
Until very recently, cancer prevention has largely focused on early diagnosis and treatment, also known as secondary prevention. By the time secondary prevention becomes necessary, the disease in question has already taken hold within an individual, and doctors just want to lessen its impact by finding it and treating it early. Alternatively, primary prevention is the practice of avoiding the causes of a disease in order to prevent getting it in the first place. Not nearly enough attention has been paid to primary prevention of cancer, but we do know some things you can do to reduce the chance that you will develop cancer during your lifetime. Read on to find out about 12 things you can do to avoid cancer.
1. Avoid smoking, overeating, and overdrinking, and keep moving. Take the stairs instead of elevators; find a form of exercise you like and commit to doing it with a friend. Plan to walk instead of drive. When driving, stick with the speed limit to save lives, save energy and reduce cancer-causing pollution; speed kills, pollutes and fuels terror.
2. Use x-rays and other radiation sparingly and keep a record of all x-rays. The excessive use of x-rays in infants and children may be one of the reasons more young people (those under 40 years of age) are getting cancer and can also contribute to cancer in adults. Earlier this year, the American College of Radiology advised against unnecessary and excessive use of diagnostic radiation in children for this very reason. Before ordering x-rays doctors should carefully weigh the risks and benefits of using MRI, or ultrasound, technologies that do not involve radiation.
3. Unless someone in your immediate family has had breast cancer before menopause, hold off getting your first mammogram until at least age forty, or until your doctor advises you start having them—and then have them done sparingly. Mammography does not prevent breast cancer, but can reduce deaths from the disease in post-menopausal women. It is also important to have regular physical exam of breasts by a health professional.
4. Use hormones sparingly. Lifetime use of hormones affects cancer risk. Consider alternatives to chemical contraception such as IUDs and condoms (which also protect against sexually transmitted disease). Avoid long term use of medications that contain hormones, including hormone replacement therapy.
5. Test your basement for radon and if you live in an area with uncertain water quality, use a simple filter. An invisible gas, radon can seep into homes from the ground and increase the risk of lung cancer. It can easily and inexpensively be remedied.
6. Do not consume food and beverages that contain aspartame. Sweeten your food with good old-fashioned sugar or honey, or stevia instead. Despite having FDA approval, aspartame, the sugar substitute, was never given a green light by scientists—all were concerned about its potential to cause cancer. New independent studies raise further concerns about its long term safety.
7. Use cell phones with an earpiece and speakerphone so the phone itself is not held up against your head. Children should not use cell phones. Studies claiming that there is no link between cell phone use and brain cancer were not conducted on people who used cell phones as much as the average person today. Cell phones emit low doses of microwave radiation that destroy rat brain cells and memory and reach one inch into the human brain. While British authorities recommend that children not use cell phones at all, some American firms are pushing phones for five year olds.
8. Buy local foods in season from farmers who use fewer pesticides. Use omega-3-fatty acid supplements free of pollutants and eat a diverse diet, rich in vitamin D, calcium and fiber.
9. Don't put anything on your baby's skin that you can't eat. The materials that create "no more tears" in baby shampoo are banned in several countries, because they cause cancer in animals. In some cases lotions used on the heads of African-American babies caused development of breasts and pubic hair. The FDA has no authority to regulate any of these harmful compounds in personal care products, unlike the European Union.
10. Look under your sink and read the labels on your cleaning products—in general, the fewer ingredients they have, the better for you they are. Baking soda, vinegar, lemon juice, and toothpaste can be used to clean most things around the home. Some room deodorizers and mothballs contain carcinogens.
11. Don't microwave anything in plastic, no matter what the directions say. Some plastic chemicals can leach into food.
12. Unlike nearly all industrial nations of the world, America and Canada have not banned asbestos. Before doing home renovations and repair of attics, roofing, ceiling and flooring tiles, find out if they contain asbestos and hire certified contractors if they do. Zonolite attic insulation and some forms of kitty litter contain asbestos-related materials. Half of all people with a rare form of cancer thought to be uniquely tied with asbestos called mesothelioma have no known workplace contact with asbestos.
Through leading a healthy life and avoiding certain known carcinogens, it is possible to reduce your lifetime risk of developing cancer. It is true that much remains to be learned about the environmental causes of cancer. While researchers continue to explore the causes, we can use what is already known to start practicing cancer prevention today.
http://www.environmentaloncology.org/12reducerisk
http://snipurl.com/3hjgh
There is no way to completely insure yourself against developing cancer but there are ways to significantly decrease the probability.
Duncan
Fact Sheets - Cancer Prevention: 12 Things You Can Do To Reduce Cancer Risk
Until very recently, cancer prevention has largely focused on early diagnosis and treatment, also known as secondary prevention. By the time secondary prevention becomes necessary, the disease in question has already taken hold within an individual, and doctors just want to lessen its impact by finding it and treating it early. Alternatively, primary prevention is the practice of avoiding the causes of a disease in order to prevent getting it in the first place. Not nearly enough attention has been paid to primary prevention of cancer, but we do know some things you can do to reduce the chance that you will develop cancer during your lifetime. Read on to find out about 12 things you can do to avoid cancer.
1. Avoid smoking, overeating, and overdrinking, and keep moving. Take the stairs instead of elevators; find a form of exercise you like and commit to doing it with a friend. Plan to walk instead of drive. When driving, stick with the speed limit to save lives, save energy and reduce cancer-causing pollution; speed kills, pollutes and fuels terror.
2. Use x-rays and other radiation sparingly and keep a record of all x-rays. The excessive use of x-rays in infants and children may be one of the reasons more young people (those under 40 years of age) are getting cancer and can also contribute to cancer in adults. Earlier this year, the American College of Radiology advised against unnecessary and excessive use of diagnostic radiation in children for this very reason. Before ordering x-rays doctors should carefully weigh the risks and benefits of using MRI, or ultrasound, technologies that do not involve radiation.
3. Unless someone in your immediate family has had breast cancer before menopause, hold off getting your first mammogram until at least age forty, or until your doctor advises you start having them—and then have them done sparingly. Mammography does not prevent breast cancer, but can reduce deaths from the disease in post-menopausal women. It is also important to have regular physical exam of breasts by a health professional.
4. Use hormones sparingly. Lifetime use of hormones affects cancer risk. Consider alternatives to chemical contraception such as IUDs and condoms (which also protect against sexually transmitted disease). Avoid long term use of medications that contain hormones, including hormone replacement therapy.
5. Test your basement for radon and if you live in an area with uncertain water quality, use a simple filter. An invisible gas, radon can seep into homes from the ground and increase the risk of lung cancer. It can easily and inexpensively be remedied.
6. Do not consume food and beverages that contain aspartame. Sweeten your food with good old-fashioned sugar or honey, or stevia instead. Despite having FDA approval, aspartame, the sugar substitute, was never given a green light by scientists—all were concerned about its potential to cause cancer. New independent studies raise further concerns about its long term safety.
7. Use cell phones with an earpiece and speakerphone so the phone itself is not held up against your head. Children should not use cell phones. Studies claiming that there is no link between cell phone use and brain cancer were not conducted on people who used cell phones as much as the average person today. Cell phones emit low doses of microwave radiation that destroy rat brain cells and memory and reach one inch into the human brain. While British authorities recommend that children not use cell phones at all, some American firms are pushing phones for five year olds.
8. Buy local foods in season from farmers who use fewer pesticides. Use omega-3-fatty acid supplements free of pollutants and eat a diverse diet, rich in vitamin D, calcium and fiber.
9. Don't put anything on your baby's skin that you can't eat. The materials that create "no more tears" in baby shampoo are banned in several countries, because they cause cancer in animals. In some cases lotions used on the heads of African-American babies caused development of breasts and pubic hair. The FDA has no authority to regulate any of these harmful compounds in personal care products, unlike the European Union.
10. Look under your sink and read the labels on your cleaning products—in general, the fewer ingredients they have, the better for you they are. Baking soda, vinegar, lemon juice, and toothpaste can be used to clean most things around the home. Some room deodorizers and mothballs contain carcinogens.
11. Don't microwave anything in plastic, no matter what the directions say. Some plastic chemicals can leach into food.
12. Unlike nearly all industrial nations of the world, America and Canada have not banned asbestos. Before doing home renovations and repair of attics, roofing, ceiling and flooring tiles, find out if they contain asbestos and hire certified contractors if they do. Zonolite attic insulation and some forms of kitty litter contain asbestos-related materials. Half of all people with a rare form of cancer thought to be uniquely tied with asbestos called mesothelioma have no known workplace contact with asbestos.
Through leading a healthy life and avoiding certain known carcinogens, it is possible to reduce your lifetime risk of developing cancer. It is true that much remains to be learned about the environmental causes of cancer. While researchers continue to explore the causes, we can use what is already known to start practicing cancer prevention today.
http://www.environmentaloncology.org/12reducerisk
http://snipurl.com/3hjgh
Sunday, July 20, 2008
Know Your Food- Not all meat is created equal
What kind of food you eat is very important and how the food was raised is very important. Read the article below. After you do, I'll bet that every time you go to eat pork, you'll want to know how the pigs were raised. What is true here is equally true for beef and poultry- the details will vary somewhat but the general processes will be parallel. -Duncan
SWINE OF THE TIMES
The making of the modern pig
by Nathanael Johnson
This article was originally published in Harpers Magazine, May 2006 and is also available here as a PDF (108 KB).
My interest in pig sex began over drinks at a bar in Burley, Idaho. My friend Becky was telling me that she couldn't stand her job at a big hog farm outside of town. Each day she faced an unending line of sows, filing into the room where she worked. Occasionally one of the over 200–pound pigs broke ranks, knocking Becky down.
"Sometimes they get nervous when you stimulate them," she said.
I set down my beer.
"Stimulate?"
"Yeah, for artificial insemination. Usually if you bring a boar around they'll get in the mood. But if not you just have to get in there and start rubbing away."
At my urging, my friend obligingly laid out the intricacies of coaxing sows to conceive, along with equally piquant methods of harvesting boar semen. It all seemed like an awful lot of trouble for something creatures normally do without encouragement.
I love my prosciutto, my bacon in the morning, and although I'm not usually squeamish about the realities of agriculture, I'm not sure I had ever thought of my food as something that depended upon artificial insemination. It began to make perfect sense, of course, when I started to gather the facts. The science of pork production has made major strides in the last twenty years, and one wouldn't expect to find pigs mating the old–fashioned way at state–of–the–art hog facilities. But, as I was to find, artificial insemination ("AI," in the industry) is more than a sign of modernization. It has served as the enabling technology for a process that has transformed pigs from affable, potbellied forest dwellers to panicky, torpedo–shaped clones that cannot survive outdoors but nonetheless produce monstrous, lean hams.
Previously, any concerns I might have had about hog farming always vanished right about lunchtime. But when I discovered the ubiquity of this breeding technique I became curious: If it takes human–aided swine masturbation to bring the Christmas ham to the family feast, what else is involved in producing America's pork? Although artificial insemination is by no means the worst indignity inflicted on the modern pig in the course of this transformation, it is a fair symbol for all the other indignities we have visited on it.
http://www.porkopolis.org/columns/modernpig.htm
http://snipurl.com/3271s
SWINE OF THE TIMES
The making of the modern pig
by Nathanael Johnson
This article was originally published in Harpers Magazine, May 2006 and is also available here as a PDF (108 KB).
My interest in pig sex began over drinks at a bar in Burley, Idaho. My friend Becky was telling me that she couldn't stand her job at a big hog farm outside of town. Each day she faced an unending line of sows, filing into the room where she worked. Occasionally one of the over 200–pound pigs broke ranks, knocking Becky down.
"Sometimes they get nervous when you stimulate them," she said.
I set down my beer.
"Stimulate?"
"Yeah, for artificial insemination. Usually if you bring a boar around they'll get in the mood. But if not you just have to get in there and start rubbing away."
At my urging, my friend obligingly laid out the intricacies of coaxing sows to conceive, along with equally piquant methods of harvesting boar semen. It all seemed like an awful lot of trouble for something creatures normally do without encouragement.
I love my prosciutto, my bacon in the morning, and although I'm not usually squeamish about the realities of agriculture, I'm not sure I had ever thought of my food as something that depended upon artificial insemination. It began to make perfect sense, of course, when I started to gather the facts. The science of pork production has made major strides in the last twenty years, and one wouldn't expect to find pigs mating the old–fashioned way at state–of–the–art hog facilities. But, as I was to find, artificial insemination ("AI," in the industry) is more than a sign of modernization. It has served as the enabling technology for a process that has transformed pigs from affable, potbellied forest dwellers to panicky, torpedo–shaped clones that cannot survive outdoors but nonetheless produce monstrous, lean hams.
Previously, any concerns I might have had about hog farming always vanished right about lunchtime. But when I discovered the ubiquity of this breeding technique I became curious: If it takes human–aided swine masturbation to bring the Christmas ham to the family feast, what else is involved in producing America's pork? Although artificial insemination is by no means the worst indignity inflicted on the modern pig in the course of this transformation, it is a fair symbol for all the other indignities we have visited on it.
http://www.porkopolis.org/columns/modernpig.htm
http://snipurl.com/3271s
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