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.

Articles of Interest this Week

quadruple DNA helix

Here are some of the articles I found interesting this week.

Cancer

What kind of patient are we? Does it make any difference? Susan Gubar on the advantages or not of being a good, polite and cooperative patient in Living With Cancer: The Good Patient Syndrome. She is more cynical than me; my experience is that being polite, courteous and expressing thanks builds the relationship that allows one to flag, professionally, when things do not appear to be going right or potential mistakes are being made.

The ongoing discussion of Lance and Livestrong continues, with some interesting takes on celebrity cancer struggles, starting with Ilana Horn’s Lance Armstrong, Susan Komen, cancer and me, a great piece that reminds us that life provides plenty of adversity to remind us what counts, without cancer, and celebrity tales of success just place more pressure on us ordinary folk. Sunrise Rounds reminds us that cancer ‘heroes’ are all around us, no need to resort to the celebrities in Replacing Lance; Cancer heroes.

We tend to focus on certain aspects of our cancer treatment and recovery. While on one level, this is an example of  a superficial concern (First came my cancer diagnosis, then came my bad hair year), we all find different ways of dealing with our cancer and its after effects, and whether this is anchored more deeply or a more superficial ‘proxy’, matters less than whether it provides a helpful coping mechanism.

Australia is often at the leading edge on sun protection, given their hot and sunny summers, and this piece provides a good overview of good sunscreen and other sun protection techniques (Sunscreen, skin cancer and the Australian summer). Bit strange to be referring to this article during the extreme cold snap this week!

Encouraging news from the front line of cancer research on using synthetic HDL (high density lipoprotein) nanoparticles, by starving B-cell lymphoma cells of one of their key nutrients, natural HDL in New way to kill lymphoma without chemotherapy: Golden nanoparticle starves cancer cell to death. A number of years away, to say the least.

More on the research front as curiouser and curiouser, cancer genetics become more complicated in Quadruple DNA helix discovered in human cells, leading to possible treatment that would only target quadruple DNA helix cancer cells, with less toxicity to normal cells. But also a long way off and much more research required.

And on the more practical level, for those of you with peripheral neuropathy (numbness in feet or hands), this short 5 minute video from Memorial Sloan-Kettering may be of interest (Diagnosing Chemotherapy-Induced Peripheral Neuropathy).

Health and Wellness

Contributing to the ongoing debate on cancer screening, Overdiagnosis: An epidemic or minor concern? takes an interesting approach, comparing screening to preventing snipers, arguing for better and more informed discussion with patients on the potential risks and benefits.

Building on this, another good piece on how patients and doctors need to understand each other, how probabilities work (and don’t work), and what the risks and tradeoffs are with any proposed treatment, always taking into account the patient’s priorities and wishes in When the Patient Knows Best. Part of the challenge that most of us have, particularly at the beginning, is that we are still too much in shock and starting the learning curve to be very effective. I was more effective the second time round than the first, given I was more knowledgeable, more confident in my discussions with my medical team, who were by then well-known to me.

On the general health policy front, while I agree with the assumption that patients need financial incentives to improve lifestyle choices in Patients need pay for performance too, this is not terribly well articulated and without examples. A better example of an integrated approach is an earlier post on the approach of the Cleveland Clinic (Smokers Penalized With Health Insurance Premiums).

We are what we eat and reflect our environment. The links between endocrine disruptors in household chemicals and obesity are explored in Warnings From a Flabby Mouse, yet another possible factor contributing to obesity in addition to poor lifestyle choices (lack of exercise, nutrition). See also earlier article How Chemicals Change Us.

Mark Bittman on the cleverness and cynicism of the Coke obesity ad Coke Blinks – I don’t recall Coke supporting the Bloomberg Big Gulp ban. The parody video is quite well done in calling Coke (and the soft drink industry) out on this. And this shameful position, given the obesity epidemic among their communities – money talks in Minority rights groups NAACP and Hispanic Federation join lawsuit against NYC big soda ban.

Good summary on recent findings on smoking death rates and the importance of stopping smoking early to avoid early death in New Report On Smoking In Women Confirms That “Women Who Smoke Like Men Die Like Men”.  While no hard evidence, and no link to some of the more graphic anti-smoking images on cigarette packages in countries like Canada,  Experts believe plain packaging of tobacco products would cut smoking. My own take is that is has been the range of anti-smoking initiatives, including labelling, that have contributed to declining rates.

Other

A somewhat tongue-in-cheek piece on courtesy and politeness in The Courtesy Control Malfunctions, a bit similar to Susan Gubar’s piece but in a more general context. As always, context matters, sometimes being more direct is appropriate, sometimes not, although better to err on the politeness side.

On the more serious side, a discussion of how we are able to hold contradictory beliefs, and some of the biases that are reinforced by our worldview in The Mind’s Compartments Create Conflicting Beliefs. At the individual level, being aware of this phenomenon, and consciously reading and exposing oneself to different viewpoints, is one tactic; when trying to convince others, being aware of their worldview can be helpful in how one approaches a discussion. Useful in any number of personal and professional situations.

Lucy Kellaway on the importance and challenge of plain language. The test examples are funny but pointed in Bosses fail the 10-year-old test, and a reminder to us all.

If you apply the 10-year-old test to business in general, it quickly becomes clear which practices should be kept and which eliminated. Why do the bosses of big US companies earn almost 400 times more than the average worker? Try answering that in a way that a child would accept. It can’t be done.

Many of the things that most of us spend our days at work doing fail the test, too. Sifting through the emails that have arrived in my inbox in the past hour or so, I’ve found one from a management consultant telling me that “the next evolutionary change in business requires a paradigm shift in thinking, involving a grassroots revamp”.

A 10-year-old could never see the sense in that, so it deserves to be eradicated. As, perhaps, does the entire management consultancy industry.