Articles of Interest This Week

ON health study

My weekly list of articles of interest.

Cancer

From the UK, more data showing that the Cancer risk is much greater among men. Lifestyle factors (drinking and eating habits) are the likely the cause. And New Study Shows How Stress Feeds Cancer Cells provides confirmation of the contribution that stress can make to accelerating cancer growth rates.

To further deepen our understanding, at the genetic and molecular level, a Mass cancer mapping centre opens in the UK. Over time, this should provide more insight why drugs fail and lead to more personalized treatment. And RNA Fragments May Yield Rapid, Accurate Cancer Diagnosis provides hope that non-invasive early testing will become possible, rather than current biopsy techniques.

Drawing on the work of Freud and Rank (The Denial of Death), James Salwitz talks about how the ‘culture of cure’ in medicine prevents treating the non-animal or non-medical nature of people in Man: the demi-god dies. This hampers end-of-life discussion, where the spiritual and emotional have to come to the fore.

A reminder of the care that cancer (and other) organizations have to take in choosing celebrities to headline fundraises in Great cause, poor choice, criticizing the Ottawa Regional Cancer Foundation for selecting Jenny McCarthy, known anti-vaccine activist, to lead an exercise workshop. Personally, never understand the need for such celebrities to attract support for a worthwhile cause. Couldn’t they find someone more inspirational than a ‘television personality’ without this anti-vaccine and anti-health baggage? In the end, the Foundation bowed to public pressure and cancelled McCarthy’s visit (their ‘Komen moment’?).

And a lovely post by The Franco-American Flophouse about post-cancer treatment recovery, and the mixed emotions and feelings that go along with this in On Parole. Some good tips on how to get back to ‘normal’ – or more accurately, find a ‘new normal’ (e.g., writing, music, friends, reading and, in her case, discovering a new church and congregation).

Health and Wellness

An interesting discussion of the evolutionary roots of some of today’s conditions and diseases in Patients and Evolutionary History, suggesting alternative, behavioural changes to address some of these (e.g., the obvious ones like reducing sugar intake, more exercise, and some less so, e.g., more time outside and less screen or reading time to reduce near-sightedness).

I haven’t posted much on eHealth and mHealth recently but this recent piece What Does the Ideal Hospital mHealth Strategy Look like? struck me as one of the better ones, from both the perspective of health care workers and patients (I particularly like the idea of a ‘formulary’ of approved apps to guide patients).

Earlier, I posted the wonderful 23 and 1/2 hours: What is the single best thing we can do for our … video on the benefits of walking.

A doctor, a filmmaker and their video cure for health care tells the story of Dr. Mike Evans and the other people behind that and other health related videos.

As always, André Picard cuts through the posturing and politics on mandatory  flu shots and health workers in Health workers should make flu shot a point of pride.

Largely common sense, 6 ways to avoid illness when travelling provides some good tips, particularly important the more ‘exotic’ the travel destination.

A good interview with Lyle Palmer, the Executive Scientific Director, of the large-scale Ontario Health Study, outlining the success to date and next steps (about 230,000 Ontarians, broadly representative of Ontario’s population in socio-economic terms (less so in terms of diversity), have signed up, including yours truly. A good public health long-term study that integrates questionnaires and health records from provincial medicare from all participants, complemented by blood work and assessments from some. About 13 minutes here.

Other

One day we’re up, one day we’re down. The poignant tale of the current Canadian Finance Minister, coming to terms with health issues and the need for openness, is yet another illustration. Given the obvious change in his appearance and performance, due to his treatment with Prednisone (steroids) for a rare skin condition, bullous pemphigoid, remaining in the denial stage was no longer an option.

While initial reporting was discrete on the psychological side-effects of  Prednisone (e.g., depression, irritability, confusion), recent reporting (e.g., Side effects of Flaherty’s treatment don’t affect his performance, spokesman says) has openly discussed these. All of us who have taken Prednisone are familiar with these, and how it is not easy for us and those close to us. I cannot help asking, who was the ‘idiot’ on his staff that allowed him to red-eye to Europe for a full day of Davos meetings and interviews in his condition? Hopefully, despite the demands of his position, he will be cut some slack to help his recovery.

Yet another in a series of studies showing how bad we are at multitasking (Are Those Who Multitask Most the Worst at It?). My personal sense is, like most skills or talents, some people are better or worse than others (e.g., some politicians and senior policy makers), what is more important is for each of us to have a better read on our ability, and adjust accordingly.

A nice post from Blessings in Disguise on just how hard it is to change one’s behaviour, with a number of tips (start, baby steps, reward, be accountable, and replace) in Monday Motivation: Change.

And a good short video (2 minutes) on the writing process and creativity by Ira Glass, that applies to so many other areas of life:

Lastly, some of you may have read of Amy Webb’s data driven data approach. I loved this comment from her paediatrician when she applied her obsession with data (can’t describe it any other way) to raising her child:

[My husband and I] were tracking all possible data. It went way beyond poop. We were trying to figure out when she was most attentive so that we could occupy her – flash cards, me playing piano with her. By her six month visit, we asked her doctor to give her a grade, so that we knew whether or not we were making good progress. He gave her an A, and he gave us a C-. He told us to put the binder away and to stop making scatter plots of her … well, of her everything.

Are you ready? Massive Ontario Health Study begins second phase – The Globe and Mail

ontario-health-studyI referred to this study in one of my weekly updates about 8-9 months ago (Week 28: Staying the Course) and found this update on the next phase interesting. Quote:

More than 225,000 Ontario residents, or 2.4 per cent of the province’s population, have signed up to participate in the Ontario Health Study. It is a massive research effort that hopes to gain a better understanding of the environmental, lifestyle and other factors that cause disease in order to develop better prevention and treatment strategies.

“No study in history has collected this much data on this many people this quickly,” said Lyle Palmer, executive scientific director of the Ontario Health Study. “It’s succeeded beyond our wildest dreams.”

…. But a new phase in the study is now beginning that will involve taking blood and doing a physical assessment. Select participants will be asked to go to a lab, where they will provide a blood sample as well as have their grip strength, blood pressure and heart and lung function measured. Collecting blood is an important part of the project because it will give researchers information about hormones, nutrients, vitamins and chemicals and how those may play a role in disease risk.

In addition, all the participants will be asked to answer questions about their mental health.

Palmer said the study’s participants closely mirror Ontario’s population, including a diversity of ethnic backgrounds and a fairly even split among men and women. The study also has an overrepresentation of aboriginal people, which is notable because they often face a higher risk for many chronic illnesses and other health problems. Many previous studies failed to focus on aboriginal groups, so the study will help to provide a unique, much-needed window into that population, Palmer said.

Look forward to seeing some of the findings and then the hard part, turning some of these into policy and program changes.

Are you ready? Massive Ontario Health Study begins second phase – The Globe and Mail.

Week 28: Staying the Course

Another good week.

I also had my regular bi-weekly clinic visit. All good. I can continue to taper down my Prednisone (4 tablets this week, and then a reduction of one tablet each week, so it is a gradual process). As my stomach problems seem to be over, no need for a colonoscopy, a procedure I was dreading somewhat (but if you don’t ask why and is this still necessary, it just happens!) Ironic, really, the same week a study comes out on the effectiveness of the procedure (Report Affirms Lifesaving Role of Colonoscopy); but as my CT scan was clear and the symptoms have gone away, no need for the additional worry of an additional test.

The only remaining noticeable side effect remains some irritability, usually over small things, which I continue to try to manage (biting my tongue!).

I also asked whether or not I should take Vitamin D, given that I have to avoid sun through clothing and sunscreen. Good question apparently, but the advice of 2000 units applies to all, not just someone in my situation. So I have started and readers can consider this for themselves.

Another sign of the 6 month mark and expected progress, my long-term disability insurance company wrote to my doctor asking for an update on my condition. I respected the process, not discussing what will be in the medical report prior to it being sent in (will ask next clinic visit) but given earlier discussions with my medical team, this is likely to be more of an issue at the one-year mark (August or so).

I filled out the large-scale comprehensive Ontario Health Study which is looking how lifestyle, environment and family history may influence our health. I expect some interesting data will emerge. If interested in completing the study (it is a bit clunky particularly the sign-up procedure), check it out at the following link.

For my reading this week, I have been going through an old diary and travel book, from different branches of the family, dating from the 1800s (5 generations ago). The diary is interesting in that some of the subjects are familiar and contemporary (extreme weather, raising children, money worries) while others are particular to the period (infant mortality).

The travel book, the old form of a blog, reflects the biases of the English of the time with respect to Turkey and the Middle East, particularly with respect to Islam, although the account of travelling and travellers of the period has its moments. This particular ancestor was a bit of a dilettante, it would appear, neglecting his family and inventing, at least in his self-promotion, a steam engine that in the end was neither built nor worked. The things one discovers.

For movies, we saw Pink Ribbons, Inc., a bit overly polemical but raising legitimate issues regarding corporate sponsorship of breast cancer charities and that the ‘false cheeriness’ can be counterproductive. As one person interviewed says, cancer is not cute and cuddly! Perhaps the most powerful part of the film are some of the interviews with Stage 4 breast cancer patients, and how they react to some of the messages.

I find the film, while respectful of people getting together to raise funds and be part of the cancer community, undervalues the human aspect of people wanting to feel that they are doing something to help. And just I find it annoying that Congressional hearings on birth control and related issues only had male witnesses, I found the lack of men being interviewed in Pink Ribbons, Inc. also irritating, given their perspective as husbands, family members, and caregivers.

More TV watching than other movies. The season closing to Downton Abbey, where the largely predictable happened but still fun, the Clinton documentary on PBS, reliving those years (while no excuse for his behaviour, there is something particular about sex scandals, and the hypocrisy of Gingrich et al), and watching the Republican Primary ‘Survivor’ debate. To put this all in perspective, some  watching again of Yes, Prime Minister.

Overall, a good week, lots of walking, time with our son back for reading week, and my wife had a good break skiing with a long-time friend out West, a necessary break for what we have all been going through.

No medical appointments this week, always a good thing, and will continue to see how the Prednisone phase-down continues. Highlights will be seeing our daughter’s school musical and one of my brothers coming next weekend to catch up and do his 3 month review of how I am doing!